Abdominal Aortic Aneurysm

Advanced Vascular Surgery is committed to providing exceptional, comprehensive care for abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) patients in the Western Michigan area. Working from state-of-the-art hybrid operating suites located in Kalamazoo-area hospitals, our goal is to provide access to compassionate and thorough treatment options. We are the founders of the Regional Aortic Center of Excellence, which has established a multidisciplinary approach and coordinated patient-centered care for best outcomes.

What is abdominal aortic aneurysm?

The aorta is the largest artery in the body. It starts in the heart, travels through the chest (thoracic aorta) and through the abdomen (abdominal aorta). At the level of the umbilicus (belly button), this artery divides.

An aneurysm is a bulging or ballooning of an artery. It can form at any level in the aorta. This results in weakened walls that can rupture without warning. If rupture occurs, massive bleeding results and, if untreated, death follows. AAA’s are the tenth leading cause of death in men over 50 in the US, with ruptures accounting for approximately 20,000 deaths each year. Repair of an aneurysm is done by replacing the aorta with a bypass graft or by inserting a ‘stent graft’ within the vessel.

Symptoms

Abnormal Forceful Pulse

AAA often causes an abnormal forceful pulse that is felt just above the umbilicus. A trained professional can feel and measure the approximate diameter of this artery.

Back Pain

Occasionally, a person will experience a new onset of back pain, which can be moderate to severe, and is not explained by back injury.

No Symptoms

Most often, there are no symptoms and the aneurysm is discovered during a routine physical examination, or when CAT Scan or MRI are done for a different ailment. AAA runs in families and occurs more often in older patients.

Diagnosis

Examination

A complete physical examination.

Ultrasound Testing

An ultrasound is a painless test that allows the physician to view the aorta and measure its diameter. This test is routinely performed in the office.

CAT Scan of the Aorta

CAT Scans are usually performed in a hospital setting and may require IV dye infusion.

Treatments

Medical management consists of monitoring a small aneurysm using ultrasound every 6-12 months. If an increase in the diameter occurs, then an operation may be required. We will emphasize smoking cessation, healthy living, blood pressure control, and lipid management.

There are two surgical options for the treatment of AAA: open surgical repair and minimally invasive endovascular aneurysm repair (EVAR). Generally, surgical repair is recommended for aneurysms based on size, growth, and other associated factors.

Open surgical repair of the AAA involves an abdominal incision to gain access to aneurysm. The aneurysm is opened and a graft is sutured into the proximal and distal ends of the aorta or aortic branches. The dilated portion of the aorta is then closed over the graft.

Endovascular Aneurysm Repair (EVAR) is a minimally invasive alternative to open surgical repair. This procedure involves small incisions in the groin to allow for insertion and positioning of an endovascular stent graft at the location of the aneurysm.

Benefits of EVAR include significantly shorter hospital stays and lower risk for peri-operative death. At Advanced Vascular Surgery we are leaders in endovascular innovation and are able to offer minimally invasive endovascular repair of all segments of the aorta.

Risks of Operation

Risks of open surgical repair of the aorta include – but are not limited to – bleeding, infection, prolonged hospitalization, bowel dysfunction, bowel injury, renal failure, myocardial infection, stroke, and death. Risks of endovascular stent graft repair include bleeding, infection, renal failure, arterial occlusion, and risks of conversion to open aneurysm repair.