Repair of the abdominal aortic aneurysm is a surgical procedure that is usually carried out when it is felt that there is an unacceptably high risk of the abdominal aorta rupturing (splitting). This is a life-threatening emergency.
The abdominal aorta
The abdominal aorta runs down the centre of the abdomen, and it is one of the largest arteries in the body. The role of the abdominal aorta is to take blood from the heart and distribute it, via a network of branching blood vessels, to all of the body’s organs.
What is an aneurysm?
An aneurysm is a bulge in a blood vessel that is caused by a weakness in the blood vessel wall. As the blood runs through the weakened blood vessel, the pressure of the blood causes the blood vessel to bulge outwards like a balloon.
In many cases, the exact cause of an aneurysm is often unclear, but known risk factors include:
- smoking,
- high blood pressure (hypertension), and
- having a family history of aneurysms.
A healthy abdominal aorta has a diameter of 2-3cm (one inch). If an aneurysm develops, the diameter of the aorta may increase. The increase in diameter weakens the walls of the aorta, increasing the risk of the aorta rupturing (splitting).
A ruptured aortic aneurysm can cause massive internal bleeding and requires prompt emergency treatment to prevent death. It is estimated that 80% of people with a ruptured aneurysm will die, and that many of these will die before being able to reach a hospital. Even with emergency treatment, the outlook is poor and 50% of people will die despite the best efforts of surgeons.
Ruptured aneurysms are a small, but significant, cause of death in the UK. In the UK, each year an estimated 8,000 people die as a result of a ruptured aortic aneurysm and an estimated 1,400 people die due to an intracranial aneurysm.
When should surgery be carried out?
Due to the risk, it is usually recommended that surgery should be used to repair the aneurysm:
- if the aneurysm grows to (or beyond) a diameter of 5.5cm (2.1 inches),
- if the aneurysm grows by more than 0.6-0.8cm (0.25-0.3 inches) a year, and/or
- if you have a family history of ruptured aneurysm.
An abdominal aortic aneurysm is usually repaired using a technique called grafting. This involves removing the section of the aorta that contains the aneurysm and replacing it with a piece of synthetic tubing which is known as a graft.
