This is the most common form of aneurysm and occurs below the renal arteries in the abdominal portion of the aorta.
Key Points:
- Typically seen in males over 60, especially smokers or hypertensives
- Remains asymptomatic until large
- May cause abdominal pain, back pain, or pulsating sensation in the belly
- Detected incidentally during scans for other issues
Why Size Matters:
- Aneurysms <4.5 cm are usually monitored.
- When size reaches 5–5.5 cm, the risk of rupture increases substantially.
- 40% of aneurysms >5.5 cm may rupture within 5 years if untreated.
- Average growth rate is 0.3–0.4 cm per year.
Complications of AAA:
- Rupture – Sudden, catastrophic bleeding
- Thromboembolism – Clots forming in the aneurysm may block leg arteries
- Compression – Pressing on nearby organs causing pain or dysfunction
Occurs in the chest portion of the aorta. Less common than AAA but equally serious.
Key Features:
- Can involve ascending aorta, aortic arch, or descending thoracic aorta
- Risk factors include genetic disorders (like Marfan’s or Ehlers-Danlos), trauma and high blood pressure
- Symptoms may include chest or back pain, difficulty swallowing or hoarseness if compressing nearby structures
Thoracic aneurysms are typically diagnosed by CT scan or echocardiography and require careful follow-up. Surgery is advised when:
- Ascending aorta >5.5 cm
- Descending thoracic aorta >6 cm
- Faster growth rate >0.5 cm/year
These occur in the arteries branching off from the abdominal aorta and going toward the pelvis and legs.
Important Notes:
- Often associated with abdominal aortic aneurysms
- Can cause pelvic pressure, urinary symptoms, or leg pain
- Risk of rupture increases when size crosses 3 cm
- May be discovered during scans for leg pain or urinary issues
- Performed alongside endovenous procedures.
- Tiny incisions are made to hook out bulging veins.
- Helps reduce symptoms and improves cosmetic appearance.
- Removal of the entire saphenous vein via open surgery.
- Rarely done today due to the success of endovenous techniques.
- Reserved only for select cases where endovenous access isn’t possible.