Non-Surgical Treatment of Abdominal Aneurysm
Aneurysm of the Aorta in the Abdomen or Chest Cavity and Its Treatment
The main artery (aorta) extends downward from the heart and splits into two branches as it reaches the legs. The section of the aorta that runs through the chest or abdomen can abnormally widen or balloon out. This condition, commonly seen in men who smoke, have high cholesterol, and suffer from atherosclerosis, is known as an “aneurysm.” The normal diameter of this artery is about 2–2.5 cm; the condition is considered to have started when the diameter exceeds 3 cm. When it reaches 5–5.5 cm, treatment becomes necessary.
What Symptoms Can an Abdominal Aortic Aneurysm Cause?
An abdominal aortic aneurysm may not cause any symptoms at all. However, it can sometimes lead to complaints such as a pulsing sensation in the abdomen (feeling like the heart is beating in the belly), abdominal pain, or leg pain when walking. In rare cases, it may also cause indigestion, a persistent feeling of fullness, and abdominal bloating.
What Are the Risks of an Abdominal Aortic Aneurysm?
If an abdominal aortic aneurysm continues to enlarge, the greatest risk is rupture. In such cases, some patients may die immediately at the moment of rupture. Those who reach the hospital require emergency surgery with very high risk. As the aneurysm grows in size, the risk of rupture increases.
Apart from rupture, clots may form inside the aneurysm and break off, traveling to the leg arteries, which can cause severe foot pain or even gangrene. The aneurysm may also become completely filled with clots, leading to blockages in the main artery or kidney arteries. If the renal artery becomes blocked, kidney failure may develop.
How Is It Diagnosed?
One of the easiest ways to detect an abdominal aortic aneurysm is abdominal ultrasonography. This method can provide information about the location, size, and presence of clot within the aneurysm. Another method is abdominal CT scan, which offers more detailed information than ultrasound. Additional diagnostic methods include angiography, CT angiography, or MR angiography. Individuals over 60 with atherosclerosis should be screened at least once by a cardiovascular surgeon for abdominal aneurysm, even if they have no symptoms.
Treatment Process
Abdominal aortic aneurysms can be treated with open surgery or a non-surgical method by placing a synthetic graft (stent-graft). In open surgery, the aneurysmal segment is removed and replaced with a synthetic vessel.
Because patients with abdominal aneurysms are usually elderly and may have heart, lung, or kidney disease, open surgery can carry high risks. Some patients may not be suitable candidates for surgery at all. In such cases, the minimally invasive, anesthesia-free stent-graft method is considered.
This method involves placing a synthetic graft into the aneurysmal section of the aorta via the femoral artery (EndoVascular Aneurysm Repair – EVAR). When performed in the chest area, it is known as TEVAR.
Below is an angiographic image showing a patient with an abdominal aortic aneurysm before and after successful stent-graft placement.
Frequently Asked Questions
Yes. If left untreated, it can rupture and lead to life-threatening internal bleeding. The risk increases as the aneurysm enlarges. Prompt diagnosis and treatment are crucial to prevent serious complications.
No. If the aneurysm is small and not growing rapidly, regular monitoring is usually sufficient. However, if it is larger than 5.5 cm or expanding quickly, surgical or endovascular (EVAR) treatment is recommended.
Most aneurysms do not cause symptoms and are discovered incidentally. However, some patients may experience abdominal or lower back pain, a pulsating mass that feels like a heartbeat in the abdomen, or back pain.
No, not every patient’s vascular anatomy is suitable for EVAR. Proper vessel diameters and angles are required for safe and effective stent-graft placement. Suitability is evaluated through imaging methods such as CT angiography.
Yes, generally. Ultrasound is a practical and risk-free method for detecting an aneurysm. However, for detailed measurements and surgical planning, a CT scan provides clearer and more precise information.