Aortic Aneurysm VASK

1. What is Aortic Aneurysm? Everything you need to know Aorta is the largest artery in our body. It carries blood from the heart to all the major organs. The weakening of the aortic wall results in the ‘ballooning’ of blood vessels. This potentially life-threatening condition is called Aortic Aneurysm. The widening of blood vessels often ends up bursting, causing severe bleeding and pain. An aneurysm can arise anywhere along the aorta, but it most normally occurs below the kidney level (infrarenal abdominal aortic aneurysm). Abdominal Aortic Aneurysms (AAA) An Abdominal Aortic Aneurysm is the enlargement of at least 3 cm of the abdominal aorta. The majority of Abdominal Aortic Aneurysms begin below the renal arteries and end above the iliac arteries. The rise in the number of smokers, population aging, improved diagnostic tools, and the introduction of screening programs have increased the incidence of abdominal aortic aneurysms during the last two decades. The disorder is present more common in males than in females. Aortic aneurysms are not uncommon, but most of them are asymptomatic. The most common cause of an aortic aneurysmis ‘atherosclerosis’ (degenerative aneurysm), which results in the deposition of the fatty materials, causing weakening of the vessel wall. Major risk factors of Aortic Aneurysm •Gender, age, unhealthy lifestyles, and family history can increase the probability of developing aortic aneurysms. •Men are more vulnerable than women •Most often in older people with an age of 60 and more •Hypertension especially if uncontrolled •Smoking (carries a high risk for aneurysm rupture) and tobacco use in any form. Approximately 75% of all abdominal aortic aneurysms have a history of smoking.

2. •High Cholesterol •Unhealthy lifestyles •Obesity •Family history of aneurysm •Marfan's syndrome and Ehlers-Danlos syndrome are two genetic illnesses. Symptoms of abdominal aortic aneurysm Many times, the patients are asymptomatic. •Vague or constant abdominal pain •Back pain •Sometime patients can easily palpate a pulsatile lump in the abdomen •When the aneurysms bursts (ruptures), the patient may have severe intolerable abdominal pain. Sometimes the patient may experience a collapse/ fall in blood pressure Diagnosis of Abdominal Aortic Aneurysm Mostly by various imaging studies, starting with Ultra sonogram followed by Contrast CT abdomen or MRI abdomen if the kidney function test is normal. What happens when you leave it untreated? The fatal complication is the rupture of an aneurysm, where blood leaks outside the aorta and spreads to the abdomen require immediate medical treatment. Rarely a patient may also develop blood clots getting pushed from the aneurysm into lower limb blood vessels which cause a sudden decrease in blood circulation to the affected leg. Treatment of Aortic Aneurysms •The main treatments for aortic aneurysms are medicines, surgery, and EVAR.

3. •Medicines- Drugs are given to control the risk factors like blood pressure, cholesterol, and control of blood sugars. Blood thinners (antiplatelet) are also given to the patients since the risk factors are the same as coronary artery disease. •Surgery- Traditional surgery is a time-tested modality where the aneurysm bearing segment of the aorta is replaced by an artificial blood vessel (prosthetic graft). •EVAR- Endo Vascular Aneurysm Repair is less invasive, where stent-graft is placed via thigh blood vessel into the aneurysm. The stent covers the aneurysm and prevents it from enlarging in size or rupture. Can Aortic Aneurysm be cured with medicines alone? Yes and No! Yes, if detected early and small in diameter. In these circumstances, the aneurysm can be kept under control with proper management of risk factors by quitting smoking and through adequate blood pressure control. No, if the aneurysm is already has reached the critical diameter or causing symptoms. In these circumstances, no medicines are available to shrink the size of the aneurysm and there is always a possibility of rupture if not treated. Which is the best method of treating aortic aneurysms? Surgery or Stents? Each procedure has its pros and cons. In surgery, though the post-procedure recovery period takes more time, it bears a good long term outcome. In stents, the post- procedure recovery is very smooth, can return to work within days, but needs strict follow-up with the treating doctor, which can extend even lifetime since delayed complications can occur. Aortic aneurysms treatment: Whom to consult? Vascular Surgeons are the right choice in treating abdominal aortic aneurysms since they are well trained in both surgeries and endovascular stent techniques. They can give

4. patients holistic care and choose the best modality tailored to the individual patient after assessing the risk and benefits.