An aortic aneurysm is a pathological enlargement of the abdominal aorta with a diameter of more than 3 cm. It is by far the most common aortic aneurysm and occurs more frequently in families. The main cause of aortic aneurysms is arteriosclerosis. Men over the age of 65 are most frequently affected by this arterial dilatation.
An aneurysm is a pathological enlargement of a blood vessel. If the abdominal aorta (body artery) is affected , doctors speak of an aortic aneurysm.
Most abdominal aortic aneurysms are asymptomatic, i.e. the patient may have no symptoms for years or even for life.
A dreaded complication is the bursting of the aneurysm, which results in severe internal bleeding and is often fatal.
Symptomatic abdominal aortic aneurysms are accompanied by back or flank pain. If the aneurysms displace other organs, the symptoms may be misinterpreted.
Doctors usually discover aortic aneurysms by chance during routine examinations or when a patient consults a doctor because of other complaints.
Sketch of an abdominal aortic aneurysm @ Henrie /AdobeStock
An abdominal aortic aneurysm operation is often a preventive measure. In some cases, however, it is also a very urgent emergency procedure.
In addition to open surgery, minimally invasive treatment is also possible today under certain circumstances. The following video shows how an aneurysm of the aorta develops:
The risk of rupture increases exponentially with increasing vessel diameter:
Therefore, surgery should be performed on an aneurysm with a transverse diameter of 5 cm or more (4.5 cm for women).
For an abdominal aortic aneurysm with a diameter of between 4 and 5 cm, surgery may also be advisable.
The decision as to whether surgery should be performed also depends on other factors.
If it is not an emergency procedure, the risk of rupture must be weighed up against the possible complications of surgery.
Doctors are more likely to consider surgery for younger patients and patients with few comorbidities.
In older patients with concomitant diseases, doctors often suggest close monitoring.
Open aortic aneurysm surgery is associated with a higher complication rate in this patient group.
Endovascular aneurysm removal may be an alternative here. Surgery for an abdominal aortic aneurysm is never without risk.
Surgery is indicated if the aortic aneurysm increases rapidly in size (> 4 mm per year) and there are signs of rupture. If a rupture is present, surgery must be performed immediately.
An aneurysm rupture often presents with the following symptoms:
Blood loss leads to circulatory failure
A specialist in vascular surgery is responsible for open surgery on an abdominal aortic aneurysm. The operation should be performed in a maximum-care hospital that has been approved by the Medical Service of the health insurance funds.
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