Symptoms and Clinical Presentation

AAAs typically remain asymptomatic until they rupture. However, some individuals may experience:

• A pulsating sensation near the navel

• Persistent deep abdominal pain on either side

• Back pain

• Sudden abdominal discomfort radiating to the legs, pelvis, or buttocks

• Warm or clammy skin

• An increased heart rate

• In severe cases, signs of shock or loss of consciousness

 

Classification of AAA

AAAs are generally classified by size and growth rate, both of which are crucial in determining the risk of rupture and guiding treatment decisions:

• Small AAAs:
  Typically less than 5.5 cm in diameter and slow-growing. These aneurysms are usually managed with regular monitoring via abdominal ultrasonography.

• Large or Rapidly Growing AAAs:
  Those exceeding 5.5 cm in diameter or showing rapid expansion pose a higher risk of rupture and often require prompt surgical intervention.

 

Diagnostic Approach

Diagnosis of an AAA generally involves a combination of:

• Physical Examination:
  A clinical evaluation to detect abnormal pulsations.

• Imaging Modalities:

  • Abdominal Ultrasonography: A non-invasive method for initial screening and regular monitoring.

  • Computed Tomography (CT) Scan: Provides detailed imaging to determine the exact size and extent of the aneurysm.

  • Magnetic Resonance Imaging (MRI): An alternative for detailed vascular imaging without radiation exposure.

 

Risk Factors

The development of an AAA is influenced by several risk factors, including:

• Demographic Factors:
  Male gender, advanced age (over 60), and family history of aneurysms or heart conditions.

• Lifestyle Factors:
  Sedentary lifestyle and tobacco smoking.

• Medical Conditions:
  Obesity, high cholesterol, atherosclerosis, and high blood pressure—especially in individuals aged 35 to 60.

• Other Factors:
  Abdominal trauma or previous abdominal surgeries may also contribute.

 

Treatment Options

The management strategy for AAA is tailored according to its size, growth rate, and the patient’s overall health:

• Monitoring:
  Small, slow-growing AAAs are typically managed with regular imaging studies until they reach a size or stage where intervention is required.

• Surgical Repair:

  • Open Aneurysm Repair:
    Involves a large abdominal incision to replace the weakened section of the aorta with a graft made of durable materials like polyester fabric or polytetrafluoroethylene.

  • Endovascular Aneurysm Repair (EVAR):
    A minimally invasive alternative where a stent graft is delivered through a small groin incision into the femoral artery. This procedure is often preferred for infrarenal AAAs and is associated with shorter recovery times.

  • Fenestrated Stent Grafts:
    Utilized for complex aneurysms that involve the renal arteries, these customized devices have openings to maintain kidney circulation while providing structural support.

 

Medical Care in India

India has established itself as a global destination for advanced, high-quality medical care, including the treatment of AAA. Key benefits include:

• State-of-the-Art Facilities:
  Modern hospitals equipped with the latest technology allow for both open and endovascular AAA repairs.

• Expertise:
  Cardiovascular and vascular surgeons in India, many with international training, are proficient in handling complex procedures.

• Cost-Effectiveness:
  Compared to Western countries, treatment for AAA in India is considerably more affordable.

• Medical Tourism:
  Excellent standards of care and lower costs have made India a preferred destination for patients from around the world.

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Abdominal Aortic Aneurysm is a potentially fatal condition that requires prompt diagnosis and individualized treatment. Advances in both surgical and endovascular techniques have significantly improved outcomes for AAA patients. At Mahadev Heart Care, Bangalore, we are dedicated to delivering personalized, expert cardiovascular care using the latest technologies to ensure safe and effective treatment. If you suspect you have an AAA or are at risk, please contact us for a comprehensive consultation and assessment.