Vascular and Endovascular Sciences

Vice President:
Vascular Access Society of India

Editorial Board:
Annals of Vascular Surgery

Asian Society of Vascular Surgery

Medanta Hospital, Gurugram, Haryana 122001


Dr. Tarun Grover
Dr. Tarun Grover
Peripheral Vascular & Endovascular Sciences

Abdominal Aortic Aneurysm

What is an abdominal aortic aneurysm or AAA?

An Abdominal Aortic Aneurysm or AAA is an abnormal swelling or bulge in your abdominal aorta. The aorta is your body's largest artery and carries oxygen-filled blood from your heart to all parts of your body. In your abdomen, the aorta splits into the iliac arteries, which carry blood to your legs and lower areas of your body.

The abdominal aorta normally ranges in diameter from 2 to 2.5cm, roughly the size of a rupee coin. An aneurysm can cause it to grow to several times its natural size, weakening it, and possibly causing it to rupture, depending on the size. A rupture can lead to internal bleeding, and possibly death.

What causes an abdominal aortic aneurysm?

Abdominal aortic aneurysms are most often caused by a weakening in the aorta, resulting from vascular disease, traumatic injury or a genet, defect.

In addition, as you age, continuous high blood pressure can cause the aorta to bulge out, thin and weaken, resulting in an aneurysm. Those primarily at risk are men over 60, smokers, and those with a family history.

What are the prevalence and risk factors of an abdominal aortic aneurysm?

Your risk for an abdominal aortic aneurysm increases if you:

What are the symptoms of an abdominal aortic aneurysm?

Abdominal aortic aneurysms may go unnoticed initially because patients may not feel any symptoms.

The most common are pain in the

possibly spreading to the groin, buttocks, or legs, the pain may be deep aching, gnawing, and/or throbbing, and may last for hours or days

if it is an inflamed/infected aortic aneurysm

How is an abdominal aortic aneurysm treated?

Treatment for an abdominal aneurysm depends on its size, location and your overall health If your doctor feels the aneurysm is at risk to burst or rupture. the treatment is generally either open surge, or endovascular surgery, a newer and less invasive treatment.

Conventional open surgery

In conventional or open surgery, the surgeon reaches the aneurysm through a large incision in the abdomen. The weakened section of the vessel, where the aneurysm has formed, is usually surgically removed and replaced with a synthetic material.

Open surgery is usually performed under general anesthesia and takes about three or four hours to complete. Repairing the aneurysm surgically is complex and requires an experienced vascular surgical team. After your surgery, you would normally stay in the Intensive Care Unit a day or two, and then another five to seven days in the hospital, depending on how your body heals. Your recovery time may be about 3 to 6 months before you feel able to resume your normal activities.


Abdominal stem-grafting In recent years, an alternate treatment known as endovascular abdominal stem-grafting has been developed. It involves two small incisions in the groin area, where the stem-graft is inserted into the femoral artery via a catheter to reline the abdominal aorta. By avoiding major surgery, this less invasive procedure may result in less blood loss, less trauma to the heart valve, fewer days of hospitalization and a potentially faster recovery time.

Abdominal aortic aneurysms are often diagnosed by chance during exams or tests done for other reasons, like routine medical checkups such as a chest X-ray or ultrasound of the heart or abdomen, etc. However, if your doctor suspects that you have an aortic aneurysm, specialized tests can confirm it. These tests might include:

What to expect after the surgery?

After you operation you may be taken to an intensive care unit (ICU) or a high dependency unit (HDU), Where you will be closely monitored for a day or two. You may have a tube in your mouth, which will pass into your windpipe (trachea) and will be connected to a ventilator (a machine to help you breathe). This will be removed once you are alert and can breathe by yourself.

You may need pain relief to help with any discomfort as the anaesthetic wears off. You many have a catheter to drain urine from your bladder into a bag. You may also have fine tubes running out from you r wound. These drain fluid into another bas and are usually removed after a day of two.

Once you are stable you will be taken back to a lower dependenday ward where nurses will continue to monitor you until you are ready to be discharged from hospital.

If you have dissolvable stitches, the length of time they will take to disappear depends on the type you have. They usually disappear within a couple of months.

When you are ready to go home you will need to arrange for someone to drive. Try to have a friend or relatives saty with you for the first 24 hours.

You nurse will give you some advice about caring for your healing wound before you go home. You may be given a date for a follow up appointment.