Screenings key to diagnosing abdominal aortic aneurysms

Vascular nursing week is June 9-15

Red water balloon

Screening is important in diagnosing an abdominal aortic aneurysm, a bulge or ballooning in the body’s main artery.

If a family member has been diagnosed with an abdominal aortic aneurysm, the chances of other family members having an aortic aneurysm are significant. Screening is important for these family members, especially after the age of 50.

An aortic aneurysm is a bulge or ballooning (enlargement) in part of the aorta, the body’s main artery. This bulge in the abdomen is called an abdominal aortic aneurysm, or AAA (“triple A”). (View an illustration of an abdominal aortic aneurysm.)

In general, aortic aneurysms occur more frequently in men and people over age 60. “We have found that people with high blood pressure and those who smoke may have a faster growth of the aneurysm,” says Becky Bertha´, RN and Clinical Care Coordinator at the University of Michigan Frankel Cardiovascular Center. “About 6 percent of women will develop an abdominal aortic aneurysm, and the condition often ruptures at a smaller size in females.” (Listen to a podcast about abdominal aortic aneurysm ruptures in women with U-M Frankel Cardiovascular vascular surgeon Katherine Gallagher.)

Many aortic aneurysms do not cause problems, especially if they are small and slow-growing, but if the bulge gets too big, it can burst and cause death. AAA’s are the tenth leading cause of death in men over age 50 in the U.S., with ruptures accounting for approximately 20,000 deaths each year

Ninety percent of aneurysms found through screening

Because anyone can develop an aneurysm and the symptoms are often silent, screening is critical, says Bertha´, “If the aneurysm increases in size, you may develop back or abdominal pain. A pulsating mass in the abdomen should be investigated.”

Ninety percent of aneurysms are found through screenings or incidentally during a medical evaluation for another problem. “Whether you go to a healthcare facility or visit a community location, it’s important to get screened, especially those over age 60 if there is no family history, If there is a family history, screening should occur at age 50,” she says. “Most people don’t realize they have an aneurysm, and most aneurysms are diagnosed through screening.”

Abdominal aortic aneurysm screening done with ultrasound

An AAA screening is done via ultrasound. The test involves the use of a wand, which is applied to the abdomen and uses high frequency sound waves to create an image of the abdominal aorta. An aneurysm or other abnormality can be seen on this image. When the ultrasound is complete, a vascular surgeon or radiologist examines the pictures for an aneurysm.

The screening is fast and painless and can be done in a doctor’s office, hospital or community location, such as a mall.

If you have an AAA

If an AAA is detected, your healthcare provider will regularly monitor its growth. If the aneurysm is found to be large, he or she may suggest that you have a CAT scan for further evaluation of its size.

Some aneurysms can be treated with medicine that lowers blood pressure. Smoking can contribute to an increase in the size of an aneurysm, so should be avoided. Surgery is usually recommended for large AAA’s or when the aneurysm is growing fast.

There are two types of surgery. One is traditional open surgery where an incision is made in the abdominal area and the aorta is repaired. The other type of surgery, called endovascular aneurysm repair, is a minimally invasive procedure that requires a small incision in the groin (to insert a catheter), followed by the placement of a stent graft inside the aneurysm to reinforce weak spots in the artery.

Your vascular surgeon will evaluate you for the best procedure for your type of aneurysm, also taking into consideration your overall health.

University of Michigan Frankel Cardiovascular Center Logo - blueThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit the Heart and Vascular page on UofMHealth.org.