Abdominal Aortic Aneurysm (AAA)

What Is an Abdominal Aortic Aneurysm?

An Abdominal Aortic Aneurysm (AAA) is a localised enlargement or bulging of the aorta, the main blood vessel that carries blood from the heart through the chest and abdomen.

Over time, the weakened section of the aortic wall can expand. If the aneurysm continues to grow, there is a risk of rupture, which is a life-threatening medical emergency.

Causes, Symptoms & TreatmentWhat Causes AAA?

AAAs develop due to weakening of the aortic wall. Contributing factors include:

• Smoking

• High blood pressure (hypertension)

• Atherosclerosis (build-up of plaque in the arteries)

• Genetic predisposition or family history

Symptoms

In many cases, AAAs do not cause symptoms in their early stages and are often detected incidentally.

When symptoms do occur, they may include:

• A deep, persistent, or pulsating pain in the abdomen

• Lower back pain

A ruptured aneurysm is a medical emergency and may present with:

• Suddenly, severe abdominal or back pain

• Dizziness or collapse

• Nausea and sweating

Treatment Options

Management depends on the size of the aneurysm and the risk of rupture. When an aneurysm reaches a size where the risk becomes significant, intervention is recommended.

Endovascular Aneurysm Repair (EVAR)

EVAR is a minimally invasive procedure used to treat AAAs and is often preferred over traditional open surgery where appropriate.

Benefits of EVAR include:

• Smaller incisions (typically in the groin)

• Shorter hospital stay and faster recovery

• Reduced postoperative pain

• Lower overall procedural risk in suitable patients

Overview of the EVAR Procedure

• Access: Small incisions are made in the groin, and thin tubes (catheters) are inserted into the arteries.

• Deployment: A stent-graft (a fabric-covered metal mesh tube) is guided through the blood vessels to the site of the aneurysm.

• Positioning: The stent-graft is carefully positioned and expanded within the aorta, sealing off the weakened area and redirecting blood flow through the graft.

• Closure: The catheters are removed, and the small incisions are closed.

Recovery & Follow-Up

Recovery following EVAR is typically faster than with open surgery. Many patients are discharged within 24–48 hours, depending on their overall health.

Regular follow-up imaging is essential to:

• Monitor the position of the stent-graft

• Ensure the aneurysm remains sealed

• Detect any potential complications early