An Aortic Abdominal Aneurysm (AAA) is pretty common, about 4 in 100 men and about 1 in 100 women over the age of 65 have an AAA. It becomes more common with increasing age. However, most people with an AAA are not aware that they have one.
Professor Ian Loftus, consultant vascular surgeon at Spire St Anthony’s Hospital explains:
“When treating an aneurysm to a certain extent you are up against time. The national recommendation is eight weeks from time of diagnosis to treatment because there is a risk of the aneurysm rupturing; most areas fail to meet that target. In effect, the sooner the aneurysm is treated the better, both for peace of mind of the patient and to remove the risk of interim rupture.
“There are several treatment options for aneurysms including open surgery and EVAR. EVAR is the safer of the two types of surgery, the complications are lower and the length of stay in hospital time taken to recover can be dramatically shorter. The requirements for ITU are also much less. EVAR is a very established technique now, but requires specialist equipment which is now available and helping patients at Spire St Anthony’s.”
Endovascular surgery (EVAR) is a type of "keyhole" surgery where incisions are made in the groin. A small piece of tubing called a graft– made of metal mesh lined with fabric – is then guided up through the leg artery, into the swollen section of aorta, and sealed to the wall of the aorta at both ends. Reinforcing the aorta, reducing the risk of it bursting.
Professor Loftus has carried out over a thousand EVAR procedures and has one of the highest volumes of endovascular aortic practice in the UK, along with the best outcomes, as published on the national outcomes website.
Abdominal aortic aneurysm
An abdominal aortic aneurysm (AAA) is a swelling of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body. The abdominal aorta is the largest blood vessel in the body and is usually around 2cm wide – roughly the width of a garden hose. However, it can swell to over 5.5cm – what doctors class as a large AAA.
Depending on the size and the rate at which the abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Large aneurysms are rare, but can be very serious. If a large aneurysm bursts, it causes huge internal bleeding and is usually fatal.
The bulging occurs when the wall of the aorta weakens. Although what causes this weakness is unclear, smoking and high blood pressure are thought to increase the risk of an aneurysm.
AAAs are most common in men aged over 65. A rupture accounts for more than 1 in 50 of all deaths in this group and a total of 6,000 deaths in England and Wales each year.