Last updated on January 10, 2022
Content By: Dr. Nikita Toshi BDS, Assistant Manager (Medical Review), Dr. Ritu Budania MBBS, MD (Pharmacology) Head, Medical Affairs &
Last updated on January 10, 2022
An aneurysm (bulging of a blood vessel) can be a frightening problem to have. Fortunately thanks to advancements in the field of medicine, there are new procedures for abdominal aortic aneurysm treatment that are often life-saving. Abdominal aortic aneurysms affect the aorta, one of the largest arteries in the body. Any damage to the aorta can be dangerous and needs to be dealt with immediately.
It can sometimes be difficult to spot the condition in the initial stages but there are a set of symptoms one can be mindful of. Learn about the diagnosis and treatment methods for Abdominal aortic aneurysms in India recommended by experts to maintain your health at all times.
An aneurysm (bulging of a blood vessel) can be a frightening problem to have. Fortunately thanks to advancements in the field of medicine, there are new procedures for abdominal aortic aneurysm treatment that are often life-saving. Abdominal aortic aneurysms affect the aorta, one of the largest arteries in the body. Any damage to the aorta can be dangerous and needs to be dealt with immediately.
It can sometimes be difficult to spot the condition in the initial stages but there are a set of symptoms one can be mindful of. Learn about the diagnosis and treatment methods for Abdominal aortic aneurysms in India recommended by experts to maintain your health at all times.
Written by
BDS, Assistant Manager (Medical Review)
Reviewed by
MBBS, MD (Pharmacology) Head, Medical Affairs
An aneurysm is a bulge that forms on an artery wall. It usually forms due to three common reasons:
A weakness in the artery wall, usually caused by the hardening of the arteries, also known as atherosclerosis.
High blood pressure.
Injury and infection of the blood vessel.
Your aorta runs through the centre of your body from your chest to your abdomen, similar to your spine. Along its length, it can be split into two sections, the thoracic aorta which runs the length of your chest and the abdominal aorta which is behind your abdomen. An aneurysm that forms on the walls of the abdominal aorta is known as an abdominal aortic aneurysm.
Research has indicated that abdominal aneurysms are more common in older people. Over 60% of abdominal aortic aneurysms happen in people who are over 75 years old and those with hypertension and smoking habits are more likely to get it. Abdominal aortic aneurysms are less common in women, who account for roughly 25% of all cases.
Once detected, it may be possible to treat the aneurysm using surgery depending on the circumstances. It is important to deal with the aneurysm before it ruptures, as a ruptured aneurysm causes heavy internal bleeding that can be fatal. However, aneurysms can show no initial symptoms and in such cases, doctors may prefer to do medical monitoring until there is a risk of rupture.
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The key factor when it comes to treatment for an abdominal aortic aneurysm is to detect it before it can rupture. There are a few warning signs you should pay attention to and some routine check-ups that can help to find it before it becomes a problem.
Abdominal aortic aneurysm symptoms vary from person to person depending on the location and size of the aneurysm. Some people may have absolutely no symptoms, while others can have one or many of the following abdominal aortic aneurysm symptoms:
Difficulty in breathing – Shortness of breath is more common with chest-related aortic aneurysms, but it can present in people with abdominal aortic aneurysms as well.
Deep pain in or around the belly area – An unexplained pain in your abdomen is one of the more prominent abdominal aortic aneurysm symptoms. If you have such pain without any injury or strain, you should visit a doctor.
Backache – While back pain is fairly common among people with a sedentary lifestyle, backache associated with abdominal aortic aneurysms can be more sudden and difficult to understand.
Dizziness and fatigue – If you find yourself feeling down and disoriented without any cause. If you have this symptom along with any of the other symptoms, it can point to an aortic aneurysm.
Feeling of pulsations near the belly button – This will feel like you have caught a pulse in your abdomen, just like how your fingers catch a pulse when pressed against your neck or wrist.
If you’ve got two or more of the above symptoms, it may be a good idea to get yourself checked. Since aneurysms can present with very few symptoms, paying attention to the combination of abdominal aortic aneurysm symptoms can help you detect it early and to put yourself at ease.
The larger an aneurysm becomes, the more likely you will feel the symptoms, but the likelihood of a ruptured aortic aneurysm increases with its size.
Aneurysms are more likely to rupture once they become larger than 5.5 cm. However, aneurysms can grow without causing symptoms or distress, therefore it is difficult to say when symptoms will present. Instead of looking for symptoms, it is better to get routine checkups once a year to make sure you are not at risk.
In case of an emergency, you should call an ambulance and describe the symptoms that the patient is having. A ruptured aneurysm can cause internal bleeding and a heavy drop in blood pressure. Therefore, it is crucial to get the patient to a hospital with emergency services and a blood bank. If you are able to safely transport the patient, then it is vital to take them immediately to a medical facility. Keep an eye on the patient’s blood pressure with a BP home monitor and note down the readings if possible. This may be able to help the doctors evaluate the situation and plan their next step.
An abdominal aortic aneurysm, if diagnosed early, can be managed by several treatment methods. However, when an unnoticed aneurysm on the abdominal artery ruptures, it can cause the following complications:
Severe internal bleeding
An aneurysm is a bulging or ballooning of blood vessels that have grown occurred at a weak spot in the walls of an artery. A ruptured aortic aneurysm is therefore likely to cause a lot of blood loss in a short period of time.
Lower life expectancy or death
A ruptured abdominal aortic aneurysm is among the most lethal surgical emergencies with a mortality rate of around 90%. This is why it is important to detect and apply for treatment before the risk for rupturing becomes too high.
Heart attack
A ruptured abdominal aortic aneurysm can cause clots to be released into the bloodstream. If these clots make their way to the heart or block arteries, then there is a significant risk of a heart attack.
A ruptured aortic aneurysm causes large quantities of blood to go out of the cardiovascular system. The loss of blood can cause kidney injury when the kidneys do not get enough blood from the heart.
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An aneurysm is created by a weakness in the wall of the arteries. The weakness could be caused by any of the following reasons:
High blood pressure has been shown to increase the risk of damage to your blood vessels. This damage creates weaknesses in the artery walls and increases the risk of an aneurysm forming. The most common causes of high blood pressure include smoking, stress, lack of physical activity, and being obese.
Blood vessel diseases
Diseases that affect the blood vessels may cause damage to the arterial walls. This damage causes weaknesses in the walls, which creates an opportunity for aneurysms to form.
Trauma
Weaknesses in the artery walls can also be caused by injury. If you have been in any accidents, especially where your body has been pierced or severely injured, it is a good idea to get a checkup after a few months or a year to see if any aneurysms have developed.
An infection near the aorta
Infections damage the cells of the body. If an infection adjacent to the aorta spreads and damages the blood vessel, it can cause a weakness in the arterial wall where an aneurysm can grow.
Atherosclerosis
Of all the factors that can cause an aneurysm, this is the one where we have the most control. Atherosclerosis is a hardening of the arteries with a plaque that is formed by fats and cholesterol. This buildup of plaque is usually caused by a lack of physical activity and a poor diet that has high levels of sodium (salt), cholesterol and unsaturated fats. Atherosclerosis increases your blood pressure and the risk of clots forming in your blood. Atherosclerosis prevention involves adopting lifestyle changes like quitting smoking, staying physically active, managing stress and following the diet chart for heart patients.
A healthy lifestyle is one of the best ways to reduce the risk of disease and ailments. Whether an aneurysm develops or not is difficult to control, but you can reduce your risk significantly by improving your lifestyle.
A balanced diet is built around heart-healthy foods like fruits, vegetables, whole grains, dairy and lean meats. It is important to avoid processed foods and grains, especially the kind you find in fast food and junk foods.
According to WHO, adults should restrict their salt intake to less than 5 grams a day and adults who have hypertension or an increased risk of cardiovascular disease should reduce their salt intake to less than 2.5 grams a day.
Here’s a list of foods that you should eat and those you should avoid. It is important to note that dietary restrictions vary greatly from person to person based on individual health needs. It is suggested to consult your doctor and nutritionist to understand the best diet plan for yourself.
| Foods to Eat | Foods to Avoid/Restrict | |
|---|---|---|
| Leafy Greens | Lettuce, spinach, cabbage, cauliflower, kale, broccoli | |
| Vegetables | Low glycemic index vegetables – green peas, tomatoes, cucumber, beans, brinjal, capsicum | High glycemic index veggies – Potato, sweet potato, beetroot, carrots |
| Fruits | Berries, oranges, apples, papaya, guava | High glycemic index fruits – Bananas, mangoes, grapes and dates |
| Nuts | Almonds, walnuts, macadamia nuts, pistachios | Salted nut mixture or too many nuts in one serving |
| Seeds | Flax seeds, fenugreek seeds (methi), sunflower seeds, hemp seeds, chia seeds | |
| Dairy | Low-fat yoghurt, toned/skim milk, cheese | Flavoured yoghurt, cream, mayonnaise, sandwich spreads, salad dressings |
| Meats | Lean meats – grilled fish, chicken breast | Processed red meats, Deep-fried meat |
| Eggs | Egg whites | Yolk of the egg |
| Grains | Quinoa, multi-grain bread, buckwheat, oats, barley, rye | White bread, white rice |
| Oils | Sunflower oil, canola oil, peanut oil, olive oil, ghee, sesame oil in limited quantity | Hydrogenated oils found in deep-fried foods like chips, french fries, packaged snacks, coconut oil, margarine, vegetable shortening, butter |
| Beverages | Fresh fruit and vegetable smoothies without sugar – preferable those that have a low glycemic index, buttermilk, lime water | Sodas and packaged juices |
Smoking and drinking alcohol can cause atherosclerosis over a period of time. This can lead to hypertension and an increased risk of damage to the blood vessels.
Keeping an eye on your blood pressure can help you find out if you have hypertension and allows you to implement corrective measures before it becomes a problem. A blood pressure monitor at home can make it really easy to check your blood pressure and keep a track of your lifestyle.
According to WHO, a lack of physical activity is one of the leading causes of conditions like diabetes, hypertension and increased risk of cardiovascular diseases.
WHO recommends at least 150 minutes of exercise a week to manage the risk of lifestyle diseases like diabetes and hypertension. Brisk walking for 25 – 40 minutes a day can improve your overall health significantly.
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Fortunately, there are several ways to diagnose and apply for treatment of an abdominal aortic aneurysm in India. Your doctor might start with:
Getting examined by a doctor can help you detect a variety of medical issues before they become problems. A proper physical exam can give the doctor an indication of an abdominal aortic aneurysm which can be confirmed with additional testing.
Your doctor might also ask you for a detailed medical history as that can be very helpful when diagnosing abdominal aortic aneurysms. Details of previous diseases and injuries which could have damaged blood vessels can help your doctor evaluate the necessary treatment option for your condition.
There are several ways of checking for an aneurysm that are non-invasive and quite accurate. However, each situation is different and requires an appropriate approach. Some tests are done to check the risk of an aneurysm, while some are done to confirm whether or not you have one. They include:
| Type of Test | How it is done | What does the doctor check for? |
|---|---|---|
| Blood tests |
|
|
| Abdominal ultrasound |
|
|
| CT Scan |
|
|
| MRI |
|
|
| Angiography |
|
|
Blood tests
They are usually done to assess your risk of aneurysms. High levels of cholesterol and triglycerides as well as abnormal readings on your red blood cell parameters can indicate atherosclerosis, which is a risk factor for abdominal aortic aneurysms.
Abdominal ultrasound
Your doctor might do an ultrasound to get a view inside the abdomen to check for an abdominal aortic aneurysm. The test is conducted by pressing an ultrasound wand against your abdomen which creates sound waves into your body and generates a sonar picture of how the blood flows through the aorta. The picture shows up live on a monitor so that the doctor or ultrasound technician can understand what’s going on. This is a non-invasive way of diagnosing abdominal aortic aneurysms without causing patients any distress.
Computed tomography
Commonly known as a CT scan, a computed tomography imaging scan uses x-rays to make cross-section images of the inside of the body. It is capable of creating clear images of the aorta and measuring both the size and shape of an aneurysm.
During the CT scan, you will be asked to lie as still as possible on a table that moves into a tunnel-like machine. Depending on the situation, contrast dye is injected into your blood to make it easier to see the blood vessels. After the scanning is complete, you will be taken out of the tunnel and the technicians or the doctors will examine the imaging to see if you have an aneurysm or any other abnormalities in your body.
CT scans use small amounts of radiation which are safe for most people, but if you are pregnant, the doctor is likely to recommend that you take an MRI scan instead. Certain contrast dyes can cause negative reactions in some patients, however, these are rare occurrences.
MRI
Magnetic resonance imaging scanning, known more popularly as the MRI scan is a method that uses computer-generated radio waves and a magnetic field that bounce off of the water molecules and fat cells in your body. It provides more detailed imaging than a CT scan but is usually more expensive.
Similar to the CT scan, you will be asked to lay down on a table and you will go into a tunnel where the scan happens. If you have a pacemaker or any other medical implants, make sure the doctors or technicians are aware of it before you enter the MRI machine. The sound inside the tunnel during the scan is quite loud, so you may want to wear earplugs to drown out the sound and keep yourself calm while you lie still to get a good scan.
Angiography
X-rays do not provide a clear picture of the blood vessels, so a contrast dye is injected into the bloodstream to make the blood vessels appear more clearly on the imaging. X-ray imaging created using angiography are known as angiograms. During this process, a catheter is inserted into an artery through which the contrast dye is fed into the blood vessels.
The angiography is concluded when there are enough images to see clearly how the blood flows through the cardiovascular system. Any detours or abnormalities in the blood flow are investigated to check for aneurysms. It typically takes between half an hour to 2 hours to complete an angiography and there are usually no side effects. Some people may react negatively to certain contrast dyes.
Consult your doctor and get a risk assessment for abdominal aortic aneurysms. It is recommended for people who are over 65 years to be screened once every 2 or 3 years.
If your risk factors are significant, your doctor is likely to recommend an ultrasound exam to check the abdominal artery for any abnormalities.
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There are several options for aneurysm repair and abdominal aortic aneurysm treatment in India. Here’s what you need to know about the various methods:
Typically, aortic aneurysm surgery is avoided until the aneurysm reaches a size of around 5.5 cm. Exceptions to this are when there is a higher risk of rupture or if the aneurysm is growing at a quick pace. Pain or discomfort due to the aneurysm is another reason to proceed to a surgical route for treatment.
This is the most commonly used surgical procedure in treatment for an abdominal aortic aneurysm. In this procedure, the surgeon inserts a thin flexible catheter into the leg and guides it through the cardiovascular system into the abdominal aorta.
How is it done?
In this procedure:
This procedure is fairly effective, but it may not be an option in cases where there are complications with the treatment for an abdominal aortic aneurysm. Even after the repair of the aneurysm, it is important to be vigilant and get regular imaging tests to ensure that the graft is securely in place and that the aneurysm isn’t leaking.
This is a more comprehensive solution in treatment, but because it is an open abdominal surgery with certain risks, your doctor will only recommend it in situations where it is appropriate.
How is it done?
In this procedure, the damaged part of the abdominal artery is removed and replaced with a graft. The graft treats the artery and allows the aneurysm to be cut out completely. The major drawback of this surgery is the recovery time which can be more than a month depending on the circumstances.
Both endovascular repair and abdominal surgery are excellent treatments for an abdominal aortic aneurysm with similar success rates.
Until there are symptoms or significant risk of a ruptured aortic aneurysm, doctors prefer to avoid conducting a surgical repair of aneurysms and instead, keep an eye on the aneurysm through regular checkups and imaging tests. Aneurysms that are small and not growing quickly are not considered dangerous and the focus in these cases is on managing blood pressure and other risk factors.
Medical monitoring of an aneurysm involves around 2-3 ultrasound imaging tests a year after the diagnosis and routine checkups to monitor blood pressure. Consult your doctor to find out how to best manage any symptoms and risks specific to your condition.
If the doctor recommends aortic aneurysm treatment without surgery, here’s what you can do to lower the risk of a ruptured aortic aneurysm along with medical monitoring.
Avoid heavy lifting
Lifting heavy objects and vigorous physical exercise can cause your blood pressure to increase for a short period of time and create pressure on your abdomen when your muscles contract. Both these factors increase the risk of a ruptured aortic aneurysm, so it is best to exercise in a light and controlled manner. Consult your doctor to find out what you should avoid based on the location and size of your aneurysm.
Find ways to manage stress and life’s pressures
When you are stressed, your body secretes a hormone called cortisol which elevates your blood pressure. By reducing and managing the stress in your life, you will be actively lowering the risk of a ruptured AAA.
Going to therapy or counselling or even following a self-help book with mental health techniques can go a long way towards lowering your blood pressure.
Monitoring your food intake and blood pressure regularly
Adopting a heart-healthy diet is one of the best ways to manage your blood pressure and lipid profile. By reducing your consumption of processed foods, fried foods, sugars and salt, your blood pressure can be managed very effectively even without medication. You can also follow the diet chart for heart patients after consulting a dietician.
While you make changes to your lifestyle, it is also a good idea to monitor your blood pressure regularly to see if it is getting closer to normal. If your blood pressure is elevated or in a hypertensive stage despite your efforts to control it, consult your doctor to find out how to manage it through other methods.
In conclusion, diagnosing abdominal aortic aneurysms before they rupture is the key to successfully treating or managing the condition. In a majority of cases, treatment for an abdominal aortic aneurysm is successful and patients go on to live normally without compromising their quality of life.
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Blood tests are used as a screening method for the risks of an aneurysm. Certain markers in your blood working along with your blood pressure can indicate to a doctor that you should try an imaging test to see if you’ve got an aneurysm.
People over the age of 65 should get checked for an aneurysm at least once and then more regularly depending on the recommendations of a doctor. Those with a high risk of developing aneurysms due to factors such as age, obesity, hypertension, smoking, drinking and genetic conditions should get screened to assess risk and then tested if a doctor recommends it.
The warning signs of an aneurysm can vary from person to person but the most commonly noted symptoms of an unruptured aneurysm are as follows:
After an open abdominal aortic aneurysm surgery, you may need over a month to heal completely. An endovascular repair procedure, on the other hand, takes significantly less time and aside from avoiding strenuous physical activity and certain foods, you should be able to function normally in a short time as recommended by your doctor or surgeon.
After open abdominal aortic surgery, you will need to rest and recover for a month or maybe more. Once you have fully healed from the surgical wounds, you should be able to live a normal life. Consult your doctor to understand how the surgery will affect you specifically.
Treatments for an abdominal aortic aneurysm in most cases are very effective and many patients go on to live a good quality life post-surgery. Endovascular repair is a very effective treatment, but it does not remove the aneurysm from the arterial wall. Open abdominal aortic aneurysm surgery removes the aneurysm completely and addresses the weakness in the arterial wall. After the recovery period, you will be able to live a completely normal life.
When an aneurysm reaches around 5.5 cm in size, it may become necessary to treat it through surgery. Aortic aneurysm surgery may also be needed if the aneurysm is growing too fast or if your doctor decides that the risk of a ruptured abdominal aortic aneurysm is high.
Aortic aneurysm treatment without surgery is essentially the management of blood pressure combined with routine screening and imaging tests. Many aneurysms end up being harmless and do not have any negative effect on the patient. However, it is important to keep an eye on it to make sure any risk of a ruptured abdominal aortic aneurysm is addressed on time.
If the aneurysm is detected before it ruptures, then the chances of survival are good depending on the location and size of the aneurysm. Getting the right kind of treatment in time can help you make a full recovery.
Ruptured aneurysms are surgical emergencies with a mortality rate of around 90%. Even with quick response times and rushing the patient to the hospital, the rupture of a major artery causes rapid internal bleeding that can cause the body’s systems to fail before emergency operative treatment can be administered.
Avoid all processed foods, fast foods and reduce your salt intake. Your diet must restrict unsaturated fats, cholesterol and excess sodium, all of which are contributors to atherosclerosis, high blood pressure and most cardiovascular diseases.
Examples – Food made from maida (refined wheat flour), white bread, white rice, french fries, pickle, deep-fried chicken, etc.
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