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Abdominal Aortic Aneurysms: A Silent Threat

Summary & Participants

Abdominal aortic aneurysms usually grow silently for years until they rupture and become deadly. Learn if you are at risk and who definitely needs to be screened.

Medically Reviewed On: July 06, 2008

Webcast Transcript

ANNOUNCER: An aneurysm is an abnormal enlargement or bulging of an artery, caused by damage or weakness in a blood vessel wall. If left untreated, the vessel can burst and become deadly.

THOMAS RILES, MD: Aneurysms can occur in almost any part of the body. They can occur in the aorta, in the abdomen, in the chest, in the brain. They can occur to an artery in a kidney, a liver. Virtually any vessel in the body can create an aneurysm. The most common aneurysms that we see in our population are in the aorta of the abdomen.

ANNOUNCER: Abdominal aortic aneurysms are responsible for 1 to 2 percent of all deaths in men over the age of 65 and account for 15,000 deaths annually in the United States.

THOMAS RILES, MD: The aorta is the largest blood vessel in the body. It starts at the heart, makes an arch in the chest like a candy cane, coming down through the chest and into the abdomen. It stops right at the level of the belly button, where it splits into branch arteries going on to the legs.

The normal size of an aorta is about the size of a quarter or a half -dollar, which would be 2 centimeters to 2.5 centimeters. Anything larger than 3, we use the term "aneurysm."

ANNOUNCER: The natural progression of any aneurysm is that it slowly grows and the "bulge" becomes larger over time.

THOMAS RILES, MD: After they reach a certain size, the walls become so weak that they can rupture and bleed.

Only about 25 percent of individuals survive a ruptured aneurysm. Usually the bleeding is internal; it's so rapid that most individuals can't survive.

ANNOUNCER: Aortic aneurysms are more common in men than in women and are usually seen in people over the age of fifty. Additional risk factors include a family history of aneurysms, high blood pressure, hardening of the arteries and smoking.

One of the main reasons that aortic aneurysms have such a high mortality rate is that in most cases there are no recognizable symptoms. In fact, most aneurysms are found by accident through a physical exam, such as an annual physical, or by an ultrasound or CAT scan being performed for some other reason. Once an aneurysm is detected the choice of treatment depends on its size.

THOMAS RILES, MD: Generally, aneurysms that are less than 5 centimeters, the chance of rupture is very, very small, perhaps maybe 1 in 500.

Most of us will not recommend surgery, but will recommend that the patient have serial measurements over the next year or two. The rationale here is that most of the treatments are probably at a higher risk than the risk of the rupture. Once the aneurysm is larger than 5 centimeters, then we start talking about treatment options, which is usually some sort of a surgical procedure to replace the weakened blood vessel with a new synthetic graft that will act as their new aorta.

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