The Role of Interventional Radiology in Evaluating Abdominal Aortic Aneurysms

The Role of Interventional Radiology in Evaluating Abdominal Aortic Aneurysms (AAA ) Background information on AAA

An Abdominal Aortic aneurysm (AAA ) is a condition in which the abdominal aorta (a large blood vessel that supplies blood to the abdomen , pelvis and the lower limbs ) becomes large and ballooning leading to the development of several symptoms . The condition more often occurs in males compared to females . It occurs more frequently above the age of 60 . When the aortic aneurysm is larger in size , it is more likely to rupture causing life-threatening problems . This is

a medical emergency requiring critical care . This complication is present in about 20 of the people affected with AAA . Another complication of AAA is aortic dissection in which the innermost membrane of the blood vessel ruptures due to the intense pressure causing blood to be filled within the wall of the artery . The exact cause of the dis has still not been understood clearly , but several risk factors may be present including :-

Hypertension

High cholesterol levels

Obesity

Emphysema

Genetic factors

Smoking (Albright JL . 2006 Hallett JW . 2008

Individuals affected with AAA initially may not have any symptoms Symptoms of the condition usually develop suddenly due to rupture of the wall or breakage of the innermost wall . Some of the symptoms that can develop in AAA include :-

Abdominal pain (which may be severe , consistent and radiates to the legs , groin and the buttocks region

Pulsations in the abdomen palpitations

Nausea and vomiting

Anxiety and agitation

Abdominal rigidity

Cold and clammy skin

Presence of an abdominal mass

Excruciating pain in the limbs and back , when the AAA ruptures

Fatal outcomes in the case of ruptured AAA (Albright JL . 2006 Hallett JW . 2008

Treatment options for AAA

When the AAA is small in size (less than 5 centimeters , no treatment is required . Antihypertensive drugs may be needed to prevent any further complications from developing . Besides , if the individual has any risk factors that can worsen the condition , it needs to be rectified immediately (such as giving up smoking , weight reduction , lowering cholesterol levels , etc . Periodic evaluations have been recommended to ensure that any risks can be identified and immediately taken care off (Albright JL . 2006 Hallett JW . 2008

Surgery is required if the AAA is larger than 5 .5 centimeters in size as the risk for rupture or dissection is present . The Aneurysmal defect is repaired by inserting a surgical graft . This can be performed by two method namely the conventional approach or the endovascular approach In the conventional approach , general anesthesia is utilized . A surgical incision is made below the breast bone , the aneurysm defect identified , and the graft material sutured in position . The entire procedure takes about 5 hours and a stay of at least a week in the hospital is required . The second approach is the endovascular stent grafting in which regional anesthesia is administered and a catheter is introduced through the femoral artery present in the groin region . This catheter contains the stent graft . It...