“Aneurysm” is a diagnosis that stirs up fear and anxiety in our patients lives. An aneurysm is defined as a focal enlargement of an artery to more than 1.5 times its normal diameter. An aneurysm can occur in almost any area of the body, but the most common ones occur in the abdomen. An Abdominal Aortic Aneurysm (AAA) is the most common type. An AAA begins just below the renal arteries and extends down to the bifurcation of the aorta. AAA rupture risk increases with size, however when the aortic diameter is less than four centimeters the rupture risk is close to zero. When the diameter exceeds five centimeters, the rupture risk rises to three percent to 15 percent per year. Often these aneurysms are discovered on a routine evaluation such as an ultrasound performed as a ‘screening test’ at a local church or event center. They are also often discovered incidentally during an X-ray examination for something else or on a physical examination when a pulsating mass is felt in the abdomen.
Once an AAA is suspected, the most important test to be performed is a CTA (Computed Tomography Angiogram) of the abdomen and pelvis using a special thin slice protocol. This will allow the exact size and shape of the aneurysm to be determined, and will assist the surgeon in determining the best treatment options.
Treatment options for AAA have progressed dramatically over the past 20 years. Currently more than 85 percent of AAA patients can be treated with a minimally invasive procedure called an Endograft. This procedure is performed in the endovascular suite with light anesthesia. It takes about one hour to perform the procedure which is accomplished entirely through a quarter-inch incision in each groin. The endograft is passed up through the femoral artery and into the abdominal aorta replacing the aneurysm from the inside. Patients are kept in the hospital overnight for observation and can resume normal activities the following day.
In the 15 percent of patients who are not candidates for the minimally invasive approach, the aneurysm can be repaired in the operating room with a more traditional surgical approach. This approach requires 5-7 days in the hospital and 4-6 weeks before resuming normal activities.
At the INTEGRIS Heart and Vascular Institute at INTEGRIS Bass, we have performed more than a hundred AAA Endografts. If you would like more information or need to schedule an appointment for evaluation, please call my office at 580-616-7634.
David W. Vanhooser, M.D.
Chief, Cardiovascular Surgery
INTEGRIS Heart and Vascular Institute