The arteries are the vessels through which our blood is forcefully pumped away from the heart. These passageways are pliable and elastic, controlling and regulating the highly pressurized blood being constantly pushed through them. Without our arteries in proper working condition, we would not survive, as they allow us to get blood to our limbs, brain and other organs.
The aortic artery (aorta) is the largest in the body. It runs down the entire length of the body, and is characterized by various sections. The abdominal aorta is the longest of these sections, descending from the chest cavity into the abdomen. The abdominal aorta passes near the spine and eventually splits in two, becoming the left and right iliac arteries.
The aorta, like all arteries of the body, is subject to atherosclerosis. In addition to atherosclerosis, the abdominal aorta is exposed to intense pressure with every heartbeat, which increases its chances of weakening. A weakened abdominal aorta can succumb to stretching of the walls, tearing, or even rupturing. In 2014, aortic aneurysms were the primary cause of death of 9,863 people, and contributed to over 17,000 deaths in the US. Two-thirds of these deaths occurred in men, and that prevalence increases with age. Dr. Ginkel performs abdominal aortic aneurysm repair, or what we call endovenous AAA repair, a minimally invasive procedure that will correct the ballooning of the aortic artery. This is done by placing a stent tube graft within the aneurysmal segment, reducing the expanding forces of pressure in the area, and helping to protect you from a life-threatening event.
Abdominal Ultrasound to Detect Aortic Aneurysm
An ultrasound can look into deeper vascular and cardiac conditions in a noninvasive manner, detecting potentially serious problems within the cardiovascular system. An abdominal ultrasound will focus on the aorta and renal arteries so as to pinpoint any abnormalities. If Dr. Ginkel knows that you have a history of abdominal aortic aneurysm in your family, or that you have smoked most of your life, he will likely require this exam to be sure that your abdominal aorta is in good condition. Should there be any areas of the abdominal aorta that appear weak, Dr. Ginkel will measure their risk of rupture based on location and severity. Treatments will vary based on risk. Most often blood pressure control and yearly observation are appropriate, however, in severe cases, endovascular repair is an available treatment option at Midcoast Cardiovascular Associates.
The examination of the abdominal aorta is not routine, but it is recommended when risk factors are present:
- Previous history of aneurysm elsewhere on the body
- A history of smoking
- If you are a male and over the age of 65
Since there are usually no symptoms when an aortic aneurysm develops, they are often found once they have already substantially developed. However, you may notice some symptoms beforehand, including back pain, exertional leg pain, intense abdominal pain, and/or nausea. In this case, you will need to go directly to the hospital for an evaluation. Dr. Ginkel will offer this imaging exam if he finds these factors increase your chances of an abdominal aneurysm.
Abdominal Aortic Aneurysm (AAA) Repair
Endovascular AAA repair is minimally invasive and can create a support system around the abdominal aortic aneurysm. During your abdominal ultrasound, Dr. Ginkel will measure the growth of the aneurysm and determine when a support graft is needed. If the abdominal aortic aneurysm is large enough to create a measurable risk of rupture you should schedule a repair procedure. This risk is assessed not only by current aneurysm size (approximately two inches), but also the rate of increase in size. Abdominal aortic aneurysm repair requires two small incisions into the femoral artery, where a catheter (fitted with a mesh graft) is delivered to the abdominal aorta. At this point, the graft is expanded to help relieve pressure from the aneurysm. Once the blood is flowing steadily through the area, the pressure on the aortic wall is diminished, and the aneurysm will shrink around the graft.
Schedule your assessment with Dr. Ginkel if you have a history of abdominal aortic aneurysm or have risk factor present. Call for an appointment at 805-354-0112.