An aortic aneurysm is a permanent bulge in the wall of the body's main artery, most often in the abdomen, and it usually causes no symptoms until it grows. Aortic aneurysm treatment depends on its size and growth: from regular monitoring with scans to repair with a covered stent-graft through a catheter or with open surgery. Dr. Walid Naser assesses these cases in Amman.
Note: Sudden severe pain in the belly or back, especially with dizziness, fainting or sweating, may mean the aneurysm has burst. This is a life-threatening emergency: call an ambulance or go to the emergency department straight away.
Symptoms
Most aneurysms cause no symptoms and are found by chance during a scan for something else. Sometimes there may be:
- A pulsing feeling in the belly near the navel.
- Ongoing pain in the belly or lower back.
- Chest or back pain with an aneurysm in the chest.
- Sudden severe pain with dizziness or fainting, which is an emergency sign.
Causes
It happens when the artery wall weakens over time. Risk factors include:
- Smoking, one of the most important factors.
- Older age, especially in men.
- High blood pressure.
- Atherosclerosis.
- A family history of aortic aneurysm.
- Some inherited connective tissue conditions.
Diagnosis
Aneurysms are usually found on scans. Once found, your doctor requests tests to measure the size and see its shape and location.
- Abdominal ultrasound.
- CT angiography to plan treatment.
- Assessment of the heart, lungs and kidneys before any repair.
Treatment options
The choice depends on the size, growth and shape of the aneurysm and your general health:
Your doctor will explain when repair becomes appropriate and how the two methods differ in what the procedure involves and the follow-up needed afterwards.
- Regular monitoring with scans for a small aneurysm, with stopping smoking and blood pressure control.
- Medicines prescribed by your doctor to control risk factors.
- Endovascular repair (EVAR): a covered stent-graft passed through a puncture or small cut in the groin to line the artery from inside.
- Open surgery to replace the bulging section with a synthetic tube through a cut in the abdomen.
What to expect on the day and after
Repair is done in hospital. The hospital stay and recovery vary with the type of procedure and your health, and your surgeon will explain what to expect in your case.
- Monitoring in hospital after the procedure.
- Care of the wound or puncture site.
- A gradual return to activity as instructed.
- Regular follow-up scans are essential after endovascular repair.
- Staying smoke-free and keeping blood pressure under control.
When to book an appointment
Book an appointment if:
- A doctor has told you that you have an aortic aneurysm.
- A parent, brother or sister has had an aortic aneurysm.
- You are an older man who smokes or used to smoke and would like an assessment.
- You feel a pulsing or ongoing pain in your belly.