Abdominal aortic aneurysm – what dat mean Wikipedia?

Abdominal aortic aneurysm – what dat mean Wikipedia?

So, I have a triple A (AAA) = abdominal aortic aneurysm.

I want to understand:

  1. what it is,
  2. why I have it,
  3. when it becomes dangerous,
  4. how it can be fixed,
  5. where the fix is in my body, and…and…
  6. who gonna do it.

My first stop was my third cardiologist. I say third because my first cardi be tryin’ to frightin’ me into surgery. Oh, you have dangerous cholesterol levels (210). Oh, you need an immediate EKG, stress test, CT scan. Oh, you had a heart attack (shadow on the film). Second cardi be sayin’ don’t you be eatin them dead animals. Eat statins. I do. Why are you here? Where is your scan. Oh, your AAA got bigger. No biggy. Back to the third. Third cardi be sayin’ your second cardi say you havin’ all dem 140 BPs (a single instance). Statins, plaque, AAA, oh my!

AAA is enlargement of abdominal aorta to 3 cm (1.2 inches) or greater. Typically found in men over 50 who smoke. Prevention in non-smokers include treating high: blood pressure, cholesterol and weight. Surgery recommended when AAA grows to > 5.5 cm. Repair may be open surgery or EVAR. The procedure involves the placement of an expandable stent graft within the aorta to treat aortic disease without operating directly on the aorta. Risk of rupture when less than 5.5 cm is below 1% in next year.

EVAR procedure: The procedure can be performed under generalregional (spinal or epidural) or even local anesthesia. Access to the patient’s femoral arteries can be with surgical incisions or percutaneously in the groin on both sides. Vascular sheaths are introduced into the patient’s femoral arteries, through which guidewires, catheters and the endograft are passed.

Without being a smoker, genetics is the most likely explanation for a AAA. High blood pressure contributes to AAA progression. CT scan has 100% success detecting AAA. A rupture occurs when mechanical stress (peak wall stress, PWS) exceeds wall strength (peak wall rupture risk, PWRR). PWS/PWRR are more reliable than diameter in assessing rupture risk.

A diameter between 3 and 5 cm is classified as moderate. For s non-smoker the only prevention mentioned is hypertension treatment. A repeat ultrasound should be repeated every three years for diameters between 3 and 3.9. Intervention when growth is more than 1 cm/year or diameter bigger than 5.5 cm. Medication includes BP and lipid. Repair prior to 5.5 cm is not supported by evidence. EVAR has the benefit of lowering aneurysm related mortality.

A AAA under 4 cm with a growth rate of 0.39 cm/yr has a rupture risk of zero. If over 3.9 but under 5, 0.5-5%. Rupture risk accuracy improves with both PWS/PWRR. The post-operative mortality rate is 1-6% for AAA repaired before rupture.

A biomechanics based approach may be more suitable than current diameter approach. Tortuous anatomies are more complex. Protection against AAA in mice has been discovered in the lab. Another mice study showed that progression and survival can be improved with targeted treatment.

Did I accomplish my stated goals from my first paragraph? Let’s look.

  1. What is it?: AAA is enlargement of abdominal aorta to 3 cm (1.2 inches) or greater.
  2. Why is it?: I’m over 50 and may have high blood pressure (not), cholesterol (some), overweight (slightly).
  3. When is treatment? When diameter exceeds 5.5 cm and PWS exceeds PWRR.
  4. How is treatment administered? Place an expandable stent within the aorta (EVAR).
  5. Where the fix is? Under anesthesia, through the femoral artery
  6. Who gonna do it? Cardiologist who treats AAA > 5.5 cm with EVAR after using both diameter and biomechanical assessment.

By Jove, I think we’ve got it.

2 thoughts on “Abdominal aortic aneurysm – what dat mean Wikipedia?”

  1. Very concerning condition but, thank goodness, treatable! Take care and stay healthy and safe!

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