CONDITIONS

Aneurysms

OVERVIEW

An aneurysm is the enlargement, dilatation or bulging of an artery, caused by weakness in the arterial wall. Aneurysms most commonly affect the aorta (the major artery carrying blood from the heart), but can also affect the peripheral arteries in the legs. The most common type seen by Dr Moydien is an abdominal aortic aneurysm (AAA), which occurs in the part of the aorta that runs through the abdomen. The naturally history of aneurysm is for it to enlarge and eventually rupture.

While most aneurysms do not show symptoms until they are large, aneurysms can cause problems even when small as a result of clot formed within the aneurysm or due to compression of surrounding structures. As aneurysms enlarge the risk of it bursting increases. A ruptured aneurysm is life-threatening.

WHAT ARE THE SYMPTOMS OF AN ABDOMINAL AORTIC ANEURYSM?

Most aneurysms are silent, showing little to no symptoms until they enlarge or rupture. Some people with abdominal aortic aneurysms experience symptoms such as:

  • Abdominal pain
  • Lower back pain
  • Pulsating sensation near the belly button

Male patients who smoke, have high blood pressure, high cholesterol, and are over the age of 60 years are more at risk of developing an abdominal aortic aneurysm. It is essential to be screened for an abdominal aortic aneurysms if you are at high risk. Screening can simply be done with an abdominal ultrasound. Left untreated, an abdominal aortic aneurysm is life-threatening.

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WHAT DOES TREATMENT INVOLVE?

The treatment of an abdominal aortic aneurysm is highly individualised, and treatment may vary depending on the particular case. For any aneurysm, there is a risk of rupture and thus treatment is indicated.

Medical treatment involves managing all your cardiovascular and aneurysm risk factors and closely monitoring your aneurysm. Treatment decisions are based on the size of your aneurysm and the presence of symptoms. For small aneurysms, this may involve 6 monthly follow-up and monitoring with ultrasound scan to monitor the growth of your aneurysm. As aneurysms enlarge or become symptomatic, urgent repair is indicated.

The options for repair include open surgery and less invasive endovascular repair. Open surgical repair involves replacing the aneurysmal diseased segment of the aorta with an artificial tube graft (prosthesis). Endovascular aneurysm repair (EVAR) is minimally invasive and is performed in the CathLab via a small incision in the groin. The aneurysm is repaired from within by relining and excluding the aneurysm with a stentgraft (prosthesis). It’s relatively pain free, offers a shorter hospital stay and faster recovery and is the preferred treatment approach.

Dr Moydien is experienced in treating abdominal aortic aneurysms (AAA), and it is advised that you seek urgent treatment for your aneurysm if diagnosed. He also offers screening for those at higher risk of developing this condition as well as the monitoring and surveillance of smaller aneurysms.

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