Abdominal Aortic Aneurysm - Medical Malpractice Lawyers

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Abdominal Aortic Aneurysm - Medical Malpractice

An abdominal aortic aneurysm is a widening of a portion of the descending aorta in the abdomen. The aorta is the largest artery of the heart that is under the most pressure from the beating of the heart. There is a thoracic portion and an abdominal portion of the aorta and each can be involved in getting an aneurysm. Aortic aneurysms can involve anywhere in the length of the aorta but most are in the abdomen. Ninety percent are found below the level of the renal arteries, which go to the kidneys. About two-thirds of all abdominal aortic aneurysms involve a part of the iliac vessels as well. Most aortic aneurysms are wide around the entire circumference of the aorta (called "fusiform"). A few are saccular, meaning they are wide only around a portion of the circumference of the aorta.

Aortic aneurysms are most common after the age of sixty and they are five times more likely in men than in women. The condition of abdominal aortic aneurysm occurs in about five percent of all men. Risk factors for abdominal aortic aneurysms include a smoking history, which also increases the risk of developing a rupture of an abdominal aortic aneurysm. High blood pressure and high cholesterol increase one's risk for the disease. Diabetics have a high risk of developing an aortic aneurysm.

The most common cause of abdominal aortic aneurysms includes arteriosclerosis or hardening of the arteries. This causes 80 percent of cases of aortic aneurysms. Other causes of abdominal aortic aneurysms include having a familial tendency for developing this condition. Those with a family history tend to get the disease at a younger age than those without a family history. There are genetic conditions of connective tissue like Marfan's syndrome and Ehlers-Danlos syndrome that weaken the walls of the abdominal and thoracic aorta. Physical trauma to the aorta can cause an abdominal aortic aneurysm and certain types of arteritis can result in the disease. Fungal infections associated with IV drug use, syphilis, immunodeficiency and heart valve surgery can predispose a person to having an abdominal aortic aneurysm.

Abdominal aortic aneurysms have no symptoms unless they rupture. They can be incidentally found on ultrasound or CT scan of the abdomen and are felt as a pulsatile mass on palpation of the abdomen. There can be pain associated with having an aneurysm which radiates to the back. The pain can be steady or intermittent. The pulsation can be felt by the person if the aneurysm is big enough. The rupture of the aneurysm is associated with the symptoms and signs of severe back pain, abdominal distension and low blood pressure or shock.

The best ways to diagnose an abdominal aortic aneurysm is to do an ultrasound which can show the width of the aorta at various intervals. An ultrasound has about a 98 percent accuracy in finding abdominal aortic aneurysms. A CT scan can show the findings as can an MRI exam but these are usually incidental findings during a scan for another reason. During a physical examination, the doctor looks for the presence of a pulsatile mass in the abdomen but they are difficult to find on physical examination. A stethoscope can sometimes hear a bruit in the back or abdomen of an affected person. An MRA or magnetic resonance angiography can show the aorta and other large vessel sizes. Aneurysms that are greater than 5.5 cm in diameter are the most dangerous for the person who has one.

The major complication of an abdominal aortic aneurysm is rupture of the vessel at the site of the aortic aneurysm. It is a relatively lethal complication and is the thirteenth cause of death in the United States. The profuse bleeding of a rupture causes a quick onset of shock. Death occurs in most patients who have an abdominal aortic rupture, even with surgery. Another complication is a clot forming within the aortic aneurysm that breaks off and goes to another body area. It can block vital blood flow to the area, most commonly in the legs.

The abdominal aortic aneurysm repair occurs to prevent the rupture of the aneurysm. The doctor opens the abdomen and finds the aorta. The aneurysm part of the aorta is removed and a Dacron tube replaces the removed portion of the aorta. It is sewn into place so that a thinner aorta is found in the abdomen. Endovascular surgery can also be done. This goes into the arterial system with stents that are guided into the aneurysm. The stent is affixed to the inner wall of the aorta. If an abdominal aortic aneurysm is leaking or threatening to rupture, the operative risk is about fifty percent-worse if there is kidney failure occurring as a result of the aneurysm.

You can also do nonsurgical management of the aortic aneurysm by stopping smoking, lowering blood pressure, lowering cholesterol numbers, and close monitoring of the aneurysm.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here