Abdominal Aortic Aneurysm

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is done if an abdominal aortic aneurysm threatens to rupture?

Threatened rupture of abdominal aneurysms is a surgical emergency. Once an aneurysm ruptures, 50% of patients die before they reach the hospital. The longer it takes to get to the operating room, the higher the mortality.

What is the medical management (nonsurgical management) of abdominal aortic aneurysm?

Once an aneurysm is detected, the goal is to try to prevent it from enlarging. Life-long control of risk factors is a must and includes the following:

  • Stopping cigarette smoking.
  • Controlling high blood pressure: Beta blocker medications may be used to control both blood pressure and to decrease the pressure within the aneurysm.
  • Controlling blood cholesterol.
  • Keeping diabetes under control.
  • Routine monitoring of the size of the aneurysm:
    • A normal aorta measures up to 1.7 cm in a male and 1.5 cm in a female.
    • Aneurysms that are found incidentally or by accident that are less than 3.0 cm do not need to be re-evaluated or followed.
    • Aneurysms measuring 3.0 to 4.0 cm should be rechecked by ultrasound every year to monitor for potential enlargement and dilation.
    • Aneurysms measuring 4.0 to 4.5 cm should be monitored every 6 months by ultrasound.
    • Aneurysms measuring greater than 4.5 cm should be evaluated by a surgeon for potential repair.

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

Svensjö, S., et al. "Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease." Circulation 124.10 (2011): 1118-1123.

Previous contributing author: Dennis Lee, MD

Medically Reviewed by a Doctor on 10/30/2015

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