Aneurysms

This refers to a swelling of the artery in the body. This commonly affects the artery in the abdomen(tummy) thus called an Abdominal Aortic Aneurysm (AAA). It can also affect the artery in your chest (Thoracic aneurysm), behind the knee (Popliteal aneurysm) but can also affect any other vessel in your artery. The rest of the discussion will be on abdominal aortic aneurysms.

This is either diagnosed when patients have scan of their tummy for other reason such as unexplained pain. It may also be found because your G.P. has felt a swelling in your tummy and sent you of for a scan to look for an aneurysm. In some parts of the countries men aged 65 years are being screened for this condition.

Abdominal Aortic Aneurysm can cause the following symptoms:

• Rupture: presents with back or tummy pain and requires emergency treatment otherwise it is fatal.
• Back pain: some aneurysm can cause back pain even if they have not burst.
• Clots in leg: Some aneurysm can throw of clots down to your leg and these patient then present with a painful leg.
• Incidental: generally many aneurysms have no symptoms and are found by chance. The aneurysm is then treated to reduce the chance of rupture.

If you are found to have an aneurysm, your G.P. will refer you on to your local vascular sur-geon. The vascular consultant will discuss with you about your aneurysm, whether it needs to be treated or just needs follow up. The consultant will also look at improving your general health in terms of advice regarding smoking, making sure your blood pressure is controlled, starting you on a statin (cholesterol lowering drug) and also asking you to take a low dose aspirin or an alternative antiplatelet drug.

Generally abdominal aortic aneurysm are repaired when they are between 5-6cm. Women are likely to be offered repair when their aneurysm is 5cm and men when their aneurysm is more than 5.5cm.

Thoracic aneurysm are repaired when they reach 6cm but the timing and size of repair will depend on the patients and following discussion with their vascular or cardiothoracic consultant.

There are two main options for treating an abdominal aortic aneurysm:

Endovascular: this is also known as ‘minimally invasive surgery’ and involves a cut in the groin and passing a stent into the aneurysm. Before this can happen all the patients with the abdominal aortic aneurysm will have a special scan to look at whether the aneurysm is suitable for minimally invasive treatment. Patients usually stay in hospital between 1-3 days.

Open: This is the conventional form of treatment requiring a open operation on the tummy with a stay in the intensive care unit afterwards. Patients will stay in the hospital for 5-7 days.