Abdominal Aortic Aneurysm: Causes, Symptoms, Treatment and Cost

An aneurysm in the abdominal aorta, which is the biggest artery in the abdomen, is medically referred to as an abdominal aortic aneurysm (AAA). Arteriosclerosis is typically the root cause of this condition.

• Saccular Aneurysm: This type of aneurysm is the most common type, and occurs when the aorta bulges from one direction similar to a balloon.
• Fusiform Aneurysm: This type of aneurysm is a uniform dilation in both directions along the entire circumference of the aorta, similar to how an umbrella looks like.
• Dissecting Aneurysms: These types of aneurysms occur due to tears in the inner lining of the aorta, allowing blood to flow into that layer and separate it from other layers causing them to become weak.
• Uterine Artery Aneurysm: Uterine artery aneurysms occur when there is a bulge or weakening in one or both uterine arteries that supply blood to the uterus and surrounding reproductive organs.

• Abdominal aortic aneurysm (AAA) happens when the large blood artery (aorta) that provides blood to the abdomen, pelvis, and legs becomes excessively enlarged.
• AAA is often caused by atherosclerosis (hardening of the arteries).
• Risk factors include smoking, high cholesterol levels, high blood pressure, family history of AAA, and age (especially over 60).
• A vehicle accident or surgical complications are two more potential reasons.

Most of the time, there are no symptoms.

Legs, lower back, and abdomen discomfort may be experienced if the aneurysm grows or bursts.

If an aneurysm ruptures, internal bleeding in the abdomen and shock can result.

Other common signs and symptoms may include:

• Nausea and vomiting
• Clammy skin
• Rapid heart rate
• Lightheadedness or dizziness.

• Quit smoking: Smoking has been associated with a higher risk of AAA.
• Exercise regularly: Physical exercise may aid in the management of blood pressure, obesity, and other AAA risk factors.
• Maintain a healthy weight: Overweight people are more likely to have a AAA rupture or dissection.
• Consider preventive screening if indicated: Men over 65 who have smoked at any point in their lives should consider speaking with their doctor about abdominal aortic aneurysm screening tests including ultrasound or CT scan to detect aneurysms before they rupture or dissection occurs.

• Physical examination: During the physical exam, your doctor can feel for a pulsating mass in your belly which may indicate the AAA has leaked or ruptured.
• Ultrasound: This test uses sound waves to create images of the abdominal area; it is used to look specifically at the aorta to see if there are any bulges indicating an AAA present in the vessel wall.
• CT scan: This type of scanning creates cross-sectional images using X-rays and computer technology; it is often used together with contrast dyes in order to better visualise a possible AAA.
• MRIs: MRIs use magnetic fields and radio waves to construct detailed images of organs, soft tissues, and bones; they may be used to better determine if there is leakage from an AAA or detect any changes in its size or shape over time.
• Angiography: This test uses dye injected into blood vessels to create x-ray images of what's inside; this type of imaging can be useful for determining whether repair surgery would be beneficial for someone with an AAA that has not yet ruptured or been leaking fluid into surrounding tissue.
• Blood tests: In some cases, a C-reactive protein (CRP) test may be used to detect inflammation in the lining of the aorta. A complete blood count (CBC), liver and kidney function tests, and other blood tests may also be performed.

• Internal bleeding: Abdominal Aortic Aneurysms (AAA) can rupture, leading to internal bleeding or shock.
• Organ damage: In the event of a rupture, the blood may pool in nearby organs and cause severe injury or death.
• Hypertension: Uncontrolled hypertension raises the risk of rupture and may lead to additional AAA enlargement.
• Embolism: If a ruptured AAA sends clot fragments into blood vessels, it can hinder blood flow to organs and tissues causing ischemia or even stroke-like symptoms.
• Atherosclerosis: AAA is strongly associated with arterial plaque buildup, otherwise known as atherosclerosis, which leads to decreased vascular circulation and may cause organ damage or fatality if untreated.

• Herbal Remedies: Consume herbs like Tulsi, Amla, Turmeric, and Ginger to reduce inflammation caused by an aortic aneurysm.
• Coconut Oil: consuming coconut oil regularly can reduce the size of an aortic aneurysm.
• Garlic: Consumption of garlic helps to break down plaque build-up in the arteries and hence reduces the chances of bursting of the aortic aneurysm.
• Pomegranate: Regular consumption of pomegranate helps to keep your blood vessels strong and healthy thereby reducing chances of rupture or enlargement of the abdominal aortic aneurysm.
• Yoga: Practising regular yoga poses help to strengthen your core muscles thus providing improved support for your aorta and other tissues in your abdomen thereby reducing any further strain on it caused by abdominal aortic aneurysm.

• Consume a diet that is nutritious, balanced, and low in trans fat and saturated fats.
• Increase your consumption of fruits, veggies, and whole grains.
• Consume lean sources of protein such as skinless poultry, fish, eggs and legumes.
• Increase your intake of foods rich in omega-3 fatty acids, such as salmon, mackerel, and sardines, to combat inflammation.

• High saturated fats: Foods high in saturated fats, like red meat, processed meats, and full-fat dairy items, may elevate cholesterol levels and exacerbate heart disease.
• Trans Fats: Eating too much trans fat can raise bad (LDL) cholesterol levels in the blood and put you at an increased risk of developing heart disease or stroke.
• Refined Carbohydrates: Refined carbs—such as white breads, pastries, sugary cereals and soda—can cause rapid spikes in blood sugar levels that can lead to an increase in inflammation throughout the body and the development of abdominal aortic aneurysm (AAA).
• Fried Foods: Fried foods have been linked to an increased risk of AAA because they contain higher amounts of unhealthy fats and oils than other cooking methods.
• Sodium-rich foods: Excess sodium consumption increases your risk of developing high blood pressure, which puts strain on your arteries, leading to AAA formation/progression over time.

• Pharmacologic therapy: Pharmacologic therapy includes medications to reduce inflammation and lower blood pressure in order to manage symptoms.
• Open Abdominal Aortic Aneurysm (AAA) Repair: This procedure involves making an incision in the abdomen to expose the aorta and stitching a fabric patch over the aneurysm, allowing it to heal.
• Endovascular AAA Repair: This procedure involves using a catheter-based approach to insert a device, such as a stent graft, into the aneurysm in order to repair it without needing to open up the abdominal cavity.
• Thoracic Aortic Aneurysm (TAA) Repair: Involves making an incision near or on the chest to access and repair any tears that might be present in the thoracic arteries or veins due to an aneurysm.
• Hybrid Aortic Aneurysm Repair: When there is an overlap between TAA and AAA, a hybrid approach is sometimes used combining both open surgery with endovascular stenting in order to reduce surgical complexity and mortality risk.

The best doctor to consult for an Abdominal Aortic Aneurysm is a vascular surgeon. They specialise in diseases of the vascular system and have experience dealing with abdominal aortic aneurysms.

Other medical specialists such as cardiologists, interventional radiologists, and diagnostic radiologists may also be consulted for diagnosis and treatment options for an abdominal aortic aneurysm.

• Beta-blockers: These medications are often used to treat hypertension and other cardiac diseases, but they may also be used to address abdominal aortic aneurysms. Beta-blockers include propranolol, metoprolol, atenolol, and carvedilol, among others.
• Calcium channel blockers: These drugs are also effective at lowering blood pressure, but they can also help reduce the risk of an aneurysm forming or growing too large.
• ACE inhibitors: ACE inhibitors work to relax the arteries, reducing their diameter and making it more difficult for an aortic aneurysm to form or expand in size. Captopril and enalapril are two examples.
• Angiotensin receptor blockers (ARBs): ARBs block a hormone found in the body called angiotensin II from binding receptors on blood vessels that would cause constriction and increased pressure in the aorta artery walls; this keeps them from bursting or becoming enlarged as easily as with other medications. Drugs such as losartan and valsartan are examples of ARBs that may be prescribed for abdominal aortic aneurysms.
• Statins: These medications are primarily used to lower cholesterol levels in the body but have been linked with having beneficial effects on reducing inflammation which could possibly lower risks associated with having abdominal aortic aneurysms by increasing clotting factors around weakened areas of artery walls due to plaque buildup etcetera.

The recovery time following abdominal aortic aneurysm repair depends on the complexity and severity of the procedure.

Generally, patients can expect to be in hospital for 5-7 days. The healing process then typically takes between 6-12 weeks as the body adjusts and recovers from the surgery.

No, the effects of treatment for an abdominal aortic aneurysm (AAA) are not everlasting.

Treatments such as surgical repair and stent grafting can help reduce the size of an AAA and stabilise it, but this doesn't mean that they can permanently stop their growth.

Even with treatment, there is still a chance that the aneurysm will continue to expand over time or rupture.

• After treatment of an abdominal aortic aneurysm, it is important to follow all post-treatment instructions and adhere to a regular follow-up schedule with your doctor.
• Close observation should be maintained in order to detect any symptoms of infection or bleeding and potential complications such as recurrent aneurysm or organ damage from the surgery.
• You will likely be prescribed pain medications and anticoagulants for a period of time after the surgery, so it is important to follow your doctor’s directions regarding these medications.
• Post-surgery care may also include lifestyle modifications such as quitting smoking, maintaining healthy eating habits, engaging in regular exercise and limiting alcohol consumption or other activities that might raise your blood pressure or put strain on your abdominal area.
• Proper wound care should be taken in order to reduce the risk of infection including keeping the incision site clean and dry and changing dressing regularly if necessary.

Generally, costs range from Rs 15,000 to Rs 3 Lacs. This could include costs for tests, consultations with doctors and surgeons, hospital admission and stay charges, operative cost (surgical expenses) and post-operative care. The complexity of the surgery and the medical condition of the patient are also important factors that affect the overall cost.

• Nausea and vomiting.
• Difficulty passing urine.
• Pain or tenderness in the flank (area between the ribs and hip).
• Fever
• Infection of the surgical wound.
• Internal bleeding (haemorrhage).
• Perforation of surrounding organs.
• Kidney problems (from contrast dye used in imaging tests).

If you are experiencing abdominal aortic aneurysm-related issues, you should consult a nearby physician, as they can lead to complications such as 'internal bleeding, organ damage, and embolism,' for which the treatment course can vary from a few months to years, depending on the seriousness of the situation.