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Abdominal Aortic Aneurysms: A Silent Threat

Summary & Participants

Abdominal aortic aneurysms usually grow silently for years until they rupture and become deadly. Learn if you are at risk and who definitely needs to be screened.

Medically Reviewed On: July 06, 2008

Webcast Transcript

ANNOUNCER: If surgery is recommended, there are two types currently being performed.

THOMAS RILES, MD: The classical procedure that was developed in the 1950s requires an incision in the abdomen. The aorta has to be isolated; clamps are placed on the vessels to stop the blood flow, and then the graft is inserted as an interposition between the good artery above and the good artery below.

The second type of surgery has been developed only the past decade, and it's called an endograft. Essentially it's the same type of graft, but rather than opening the abdomen to sew it in, the graft is threaded up through the artery in the leg, and then opened up, deployed to make a bridge across the aneurysm.

ANNOUNCER: The risks associated with surgery on aortic aneurysms is primarily heart attack as the procedures can be stressful on the heart. Bleeding, clotting, and infection can also occur, however, the risk of death or severe complication from surgery is low: approximately 2 percent.

Because of the high mortality from undetected aneurysms, the issue of screening has become increasingly important. And in 2005, the US Preventative Task Force released new recommendations, specifically for people at high risk.

THOMAS RILES, MD: The US Preventative Task Force has recommended that men who are smokers who are between the ages of 65 and 75 have an ultrasound to detect abdominal aortic aneurysms.

ANNOUNCER: Unfortunately, this recommendation was not carried to women but it doesn't mean that this not also a woman's disease.

THOMAS RILES, MD: If a patient has a screening test, and the aorta is less than 3 centimeters, the recommendation is that that is enough. They don't need to be followed again for perhaps up to 10 years. If the aorta is between 3 and 4 centimeters in diameter, then they should be followed every year with another ultrasound. If it is between 4 and 4.5 centimeters, the frequency of testing should be every six months. Of course, if the aorta is larger than 5 centimeters, then the patient would be advised to have treatment right away.

ANNOUNCER: It is estimated that half of the individuals that currently die from aneurysms each year could be saved by this simple, painless test.

THOMAS RILES, MD: The tragedy about aneurysms is that most individuals who have a rupture and might die from an aneurysm never knew that they had the aneurysm before. What we really would like to do is to have a program so that individuals who are at risk can have screening, and they can be told whether or not they are at risk, and if they are, that they could be advised to have appropriate treatment.

Now that this recommendation has come out from the task force, I think it will be much more likely that hospitals will be opening up screening centers for abdominal aortic aneurysms.

ANNOUNCER: For a screening center near you log on to www.vascularweb.com.

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