Aortic aneurysm is a disease that results in a balloon-like dilatation of the aorta [main blood vessel supplying blood to entire body), and it keeps on expanding over time.
Aortic aneurysm and aortic dissection are serious health problems. Rupture of aortic aneurysm is one of the leading causes of death around the world, and 50% of the patients die even before reaching the hospital.
Abdominal Aortic Aneurysm [AAA]- Involving the part of aorta in the abdominal cavity
Thoracic Aortic Aneurysm (TAA]- Involving the part of aorta in the chest
Thoraco-Abdominal Aortic Aneurysm (TAAA]- Involving parts of aorta in the chest as well as abdomen
Risk Factors
Sudden, severe abdominal pain
Severe back pain
Feeling of swelling/heaviness in stomach
Decreased hunger sensation/appetite
The diagnosis may be confused with renal stone, gastritis, hernia or lumbar spine disease.
Consult a qualified vascular-endovascular surgeon immediately.
Investigations needed include abdominal ultrasonography/CT scan (as advised by the vascular surgeon)
If neglected, an aortic aneurysm can get ruptured in a process similar to an expanding balloon, leading to on-the-spot death of the patient.
The patient can even die before reaching the hospital.
Medical treatment: Patients with an aneurysm smaller than 5.5 cm in men and smaller than 5 cm in women are usually treated by medications and 6-monthly serial evaluation with CT scan. If the aneurysm is seen to be increasing in size, the patient is advised to undergo therapeutic intervention.
Who needs urgent intervention?
Procedure is performed at a dedicated vascular cath lab. It involves placement of an endovascular stent-graft through small incisions at the top of leg into the aorta. This graft covers the abnormal portion of aorta and prevents blood flow into the aneurysm. Consequently, the aneurysm gets closed and shrinks over a period of time.
As compared to open surgery, EVAR/TEVAR has a lower risk of complications and death in the short-term along with the advantage of a shorter hospital stay (3-4 days).
Performed in patients not suitable for endovascular repair. Open surgery starts with the exposure of the dilated portion of the aorta via an incision in the abdomen or abdomen and chest, followed by the insertion of a synthetic graft [tube] to replace the diseased aorta. The graft is sewn in by hand to the non-diseased portions of the aorta and, finally, the aneurysmal sac is closed around the graft.
Recent advancement in terms of minimal invasive surgery and robotic surgery is also available at selected centers in the country.
(Open + Endovascular combination] - This approach is used to treat complex aortic aneurysms.
Endovascular aortic repair is emerging as a standard of care for both simple and complex aneurysms.
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