What is an abdominal aortic aneurysm?
An Abdominal Aortic Aneurysm (AAA) consists in a dilation of the aorta, which is the body´s major blood vessel. It exits the heart, and its branches carry blood to all internal organs. Aneurysms can originate in any blood vessel in the body, the most frequent place being the abdominal aorta, which lies just under the renal arteries (blood vessels feeding the kidneys). An aneurysm can swell until, like a balloon, it bursts. The bigger the aneurysm, the more likely it is to swell. The consequences of a burst aneurysm can be fatal. The aim of all aneurysm surgery is to avoid the rupture.

 How frequently do they occur?
 Aneurysms are four times more common in men than in women, and generally occur after the age of 55-60 years. In the United States, between 5 and 7% of people aged over 60 have abdominal aortic aneurysms. The incidence of aortic aneurysms increases every 10 years, as the population ages.

Who runs the risk of having an AAA?
The people who have a greater risk of developing an AAA are:

•   Men the condition is four times more common in men than in women. 
•  Aged over 60 years. 
•  Smokers. 
•  Family history of abdominal aneurysm or elsewhere in the body. 
•  Arteriosclerosis (hardening of the arteries).
• Hypertension. 
•  Patients suffering from heart conditions. 
•  Family history of vascular illnesses.

What are the symptoms of AAA?
An abdominal aortic aneurysm bursts in the majority of cases without presenting any prior symptoms. This illness, which affects both men and women, generally never manifests itself. When it does exist, the main symptoms are:

•  Intense abdominal pain, which may or may not be constant. 
•  Lumbar pain which may be reflected in other places. 
•  Pulsing sensation in the abdomen. 
•  Weakness. 
•  Sometimes the swelling can be felt in the abdomen.

An aneurysm bursting is a more serious situation, and the main symptoms are:

•  Sudden, intense pain. 
•  Pallor. Quickened pulse. 
•  Dry mouth and thirst.
• Nausea and vomiting.
• Fainting. 
•  Sweats.
•  Shock.

If you suspect a burst aneurysm, you must see your doctor immediately.

How is an AAA diagnosed?
Apart from the clinical examination which leads to a diagnosis, imaging techniques may also be used: Ultrasound, computerised tomography, Magnetic Resonance, Arteriography.

 How can an AAA be treated?
If the aneurysm is small, it is examined using imaging techniques. If the aneurysm has reached a particular size, or is growing rapidly, surgery may be necessary. The aorta normally measures close to 2.3cm in diameter for men and 1.9cm for women. Aneurysms of 5 cm or more in diameter require surgery. There are two treatments available:

1. Open surgery. The surgeon makes an incision in the abdomen and positions a tube made of a special material.

2. Endovascular treatment (minimally-invasive technique). Prior to the procedure, the doctor examines the images captured beforehand (tomography, angiography). In this way, he/she is able to select the appropriate prosthesis for each patient. The doctor then makes small incisions on either side of the groin to get access to the femoral arteries (major blood vessels in the legs).
Guided by images from an X-ray device, the doctor introduces a catheter (tube) containing a prosthesis through the arteries located in the groin, moving it up to the aorta. The prosthesis is covered in a special synthetic material and the catheter contains a device for freeing the prosthesis. When it is in position, the prosthesis is released, expanding to an appropriate diameter and preventing blood from reaching the aneurysm; the catheter is then withdrawn. In the lower section, the prosthesis is divided into two at the connection, and in some cases has one or two extensions (smaller calibre of prosthesis than the principal prosthesis), depending on the model of prosthesis selected. Blood flow is thus restored to the aorta and the arteries in the pelvis and legs, without filling the aneurysm again (closure or exclusion of the aneurysm).