October 12, 2023 Author : Mário Marques Vieira An aortic aneurysm is an abnormal dilation of the largest artery in the body. It can happen in any area of the aorta but is more common in the abdominal portion. An aneurysm is considered to be present when the diameter of the artery is increased by 1.5 to 2 times its normal diameter. In men, an aortic aneurysm is considered when the diameter of the artery is greater than 30 mm. This silently evolving vascular disease affects many people around the world. Its incidence is estimated in 4-8 cases per 1000 people; It mainly affects men over 65 years of age; Although less frequently, women can also develop an aortic aneurysm. Causes of aortic aneurysm Abdominal aortic aneurysms occur when the wall of the aorta weakens and the artery dilates. The exact causes of an aneurysm formation are not fully understood, but it is known that there are risk factors such as: Age; Smoking; Hypertension; Family history of aneurysm. Screening recommendations Given that abdominal aortic aneurysms can progress without symptoms until they reach an advanced stage, it is crucial to consider carrying out screening tests in people at risk . Therefore, to identify the presence of aneurysms at an early stage, when treatment options are more effective, as a general rule, screening is recommended: Performing abdominal ultrasound with Doppler in male smokers over 65 years of age; The age decreases to 50 years when there are direct relatives with aortic aneurysm, whether treated or not; For women with similar risk factors, medical evaluation is also essential, as the presence of an aneurysm may have a worse prognosis. Aortic aneurysm treatment When diagnosed early, abdominal aortic aneurysm can be treated effectively. The main treatment options are: Conservative treatment and surveillance In cases of small aneurysms, regular surveillance of the aneurysm with tests to monitor its growth may be an option. This option usually occurs in fusiform aneurysms with a diameter of less than 55 mm in men and 50 mm in women. Open surgery For larger or rapidly growing aneurysms, open surgery is an option. In this procedure, access to the area to is made through a large incision in the abdominal area and the weakened portion of the aorta is replaced with a synthetic material. Endovascular repair (EVAR) A less invasive alternative is endovascular treatment, often with just a skin puncture. In this treatment, the aorta is accessed through small holes in the groin and a stent (tube) is placed that reinforces and excludes the weakened wall. Prognosis The prognosis of abdominal aortic aneurysm depends on the size and growth of the aneurysm and the patient general health. When treated in time, the prognosis is generally favorable, with low mortality rates associated with either endovascular repair or open surgery. However, if an abdominal aortic aneurysm is not diagnosed and treated timely, it can result in a rupture of the aneurysm (and of the artery) with fatal consequences. Abdominal aortic aneurysm is a serious condition that requires immediate medical attention. Anyone who meets the aforementioned risk factors - especially men over 65 and women with similar risk factors - should be evaluated by a specialized medical team. Early diagnosis and proper treatment of an aneurysm can save your life. Be sure to seek medical advice if you are at risk. Prevention and timely treatment are the best allies in the fight against abdominal aortic aneurysm. Meet the vascular surgery clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
