What is an Abdominal Aortic Aneurysm (AAA)?
An abdominal aortic aneurysm (AAA) is a balloon-like bulge in your body's main blood vessel (the aorta) that runs through your belly. 1
Understanding the Basics
The aorta is your body's largest artery - think of it as the main highway that carries oxygen-rich blood from your heart to the rest of your body. 1 It travels down through your chest and into your abdomen (belly area). 1
When the wall of this artery becomes weak, the pressure from blood flowing through can cause it to bulge out like a balloon. 1 This bulge is called an aneurysm. 1 Doctors diagnose AAA when the aorta in your belly measures 3.0 cm (about 1.2 inches) or larger in diameter. 2
Why AAA is Dangerous
The most serious danger is that the aneurysm can rupture (burst), causing life-threatening internal bleeding. 1 When this happens, 65-85% of patients die. 3
Most people with AAA have no symptoms at all until it ruptures - this is what makes it so dangerous. 1 You can't feel it or know it's there without special testing. 1 Some people may notice a pulsating feeling in their belly, but this is uncommon. 2
Who Gets AAA?
Older men who smoke or have ever smoked have the highest risk. 1 An "ever smoker" means someone who has smoked at least 100 cigarettes in their lifetime. 1
Other important risk factors include: 4, 5
- Being over 65 years old
- Being male
- Having high blood pressure
- Having a family history of AAA
- Having heart disease or other blood vessel problems
AAA is much less common in men who never smoked and in women who have ever smoked. 1 It's rare in women who have never smoked. 1
How AAA is Found and Monitored
Screening is done with an ultrasound - a safe, painless test that uses sound waves to create a picture of your aorta. 1, 6 The technician measures the width to see if there's a bulge. 1
If a small AAA is found (less than 2 inches wide), your doctor will monitor it with repeat ultrasounds over time. 1 Small aneurysms grow slowly, typically about 1-2 mm per year. 7
Treatment Options
Surgery is generally recommended only when the aneurysm reaches 5.5 cm (about 2.2 inches) or larger, or if it's growing very quickly. 1, 6
There are two surgical approaches: 1
- Open surgery: The surgeon removes the bulging section and replaces it with a man-made tube (graft)
- Endovascular surgery: The surgeon inserts a metal tube (stent graft) inside the aneurysm to strengthen it, without removing the aneurysm itself
Who Should Be Screened?
Men ages 65-75 who smoke or have ever smoked should get a one-time ultrasound screening. 1, 6 This screening can reduce the risk of dying from a ruptured AAA by about half. 1
Doctors may consider screening for men ages 65-75 who never smoked, especially if they have other risk factors like family history. 1, 6
Women who have never smoked should not get routine screening because the risks outweigh the benefits. 1, 8 For women who have smoked, the evidence is currently insufficient to make a firm recommendation. 8