Studying Abdominal Aortic Aneurysms

This is of particular interest to my family, having lost at least one to this condition.

Woodruff Health Sciences Center | Emory University | Atlanta, GA | NIH Bioengineering Grant Links Emory, Georgia Tech in Abdominal Aortic Aneurysm Research:
"Abdominal aortic aneurysms are a major cause of illness and death in the United States. A widening and bulging of the large artery that runs through the body from the heart into the abdomen, these aneurysms - which can go undetected until they suddenly rupture -- are the 10th leading cause of death in men over age 55. Approximately nine percent of men over age 65 have an abdominal aortic aneurysm.

Through a Bioengineering Research Partnership (BRP), a team of scientists at Emory University and the Georgia Institute of Technology will conduct in-depth studies of abdominal aortic aneurysms to discover exactly why and how they form and how they can be prevented. The partnership is supported by a new five-year, $6 million grant from the National Institutes of Health.

. . .

Abdominal aortic aneurysms often have no symptoms, but if the aneurysm ruptures, the patient often dies within minutes. Previous studies have documented the risk factors associated with the condition, but researchers do not understand exactly why and how it develops. The risk increases with age, so as people live longer the magnitude of the problem continues to increase.

. . .

Predicting the likelihood of aneurysm rupture is extremely difficult and patients often don't notice them until they already are leaking or ruptured, Taylor points out. Even small aneurysms often expand rapidly and progress to rupture. And although traditional cardiovascular risk factors are related to the formation of abdominal aortic aneurysms, the risk factors are different from those for coronary artery disease or peripheral vascular disease."

Other links:

USC Center for Vascular Care:
"Smoking is the most influential of all the risk factors. Although the mechanism by which smoking causes or worsens aneurysms is not known, it is known that the number of cigarettes and years smoked, increasing depth of inhalation, and the presence of COPD significantly impacts AAA prevalence, size, rate of expansion and risk of rupture.

Signs and Symptoms

Most AAA's are asymptomatic (lack symptoms), which leads to difficulty in detection. Occasionally, aneurysms may be felt as a “mass” or "lump" in the abdomen that pulsates with each heartbeat. Some aneurysms are found during evaluation of pain in the back or side that can occur as the aneurysm grows and presses on the spinal column and nearby nerves. Today, AAA's are most frequently found on X-rays that are done for other reasons, such as an ultrasound of the gallbladder or an MRI or CT scan of the back. When AAA's become symptomatic it is usually because of a rupture of the aneurysm. When rupture occurs, the person experiences severe pain in the back and/or abdomen and may feel faint or become unconscious due to internal bleeding and a sudden fall in blood pressure. Unless the leaking aneurysm is surgically repaired immediately, death results.

Treatment
Most experts agree that almost all AAA's larger than 5.0 cm in diameter should be repaired. In some instances, smaller aneurysms may be considered for treatment. If surgical repair is deferred because the AAA is smaller than 5.0 cm, then periodic ultrasound examinations (i.e. every six months) of the aneurysm must be done to monitor the AAA for an increase in size. If during monitoring the AAA expands to larger than 5.0 cm, repair should be done."

Imaging of Abdominal Aortic Aneurysms - April 15, 2002 - American Family Physician:
"Given the high rate of morbidity and mortality associated with abdominal aortic aneurysms (AAAs), accurate diagnosis and preoperative evaluation are essential for improved patient outcomes. Ultrasonography is the standard method of screening and monitoring AAAs that have not ruptured. In the past, aortography was commonly used for preoperative planning in the repair of AAAs. More recently, computed tomography (CT) has largely replaced older, more invasive methods. Recent advances in CT imaging technology, such as helical CT and CT angiography, offer significant advantages over traditional CT."

Early Detection of Abdominal Aortic Aneurysm Prevents Emergency Situation:
"Abdominal aortic aneurysms can develop over time. Patients with this type of condition sometimes will have back or pelvic pain or cold, numb or tingling sensation in the feet due to blocked blood flow to the legs. But most patients have no symptoms at all, which is cause for concern because if the aneurysm ruptures, the result is a life-threatening situation. Sometimes, AAA is detected incidentally when patients undergo an X-ray, ultrasound or a CT scan for some other abdominal complaint. A mass may also be detected through a hands-on abdominal exam.

An ultrasound screening is suggested for people who are considered high risk. Patients at the greatest risk for AAA are usually older than 65 and have atherosclerosis (hardening of the arteries) or a connective tissue disorder. It tends to be more common in males. Smokers have a higher risk of occurrence. You should also be screened if anyone in your family has had an aneurysm.

With early detection, we can catch an abdominal aortic aneurysm before it becomes an emergency situation. If we detect an aneurysm that is smaller than 5.5 cm in diameter, we can monitor it with regular ultrasounds. If it’s over 5.5 cm in diameter, the risk of rupture increases and surgery may be necessary.

Symptoms of a ruptured AAA can be severe pain in the lower abdomen and back; nausea and vomiting; clammy, sweaty skin; lightheadedness and rapid heart rate. The internal bleeding from the rupture can cause shock, which is a life-threatening condition. "