Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Aortic Abdominal Aneurysm (AAA)
- Vascular Surgery
- Medical Center Campus
- Main Pavilion, Level 5
- 111 Colchester Avenue
Burlington, VT, 05401 - Phone: 802-847-4548
- 1-877-817-5030
- Monday-Friday, 8 AM-5 PM
- Directions
What is Abdominal Aortic Aneurysm (AAA)?
An abdominal aortic aneurysm (AAA) occurs when a weakened area of the abdominal aorta (the largest artery in the abdomen) expands or bulges.
Normally
the aorta -- the largest artery carrying blood to the body -- is about 1
inch in diameter. With an AAA, the pressure of blood flowing through
the weakened area can cause it to stretch beyond its normal size. AAAs
pose a serious health risk. If they burst or rupture, they can cause
life-threatening internal bleeding.
The exact cause of abdominal
aortic aneurysms is unknown, but several factors can increase your risk
of developing them, including:
- Smoking
- High blood pressure
- Age: the risk increases as you age
- Family history: parent, brother or sister with AAA
The condition is more common in men than women.
While AAAs can be life-threatening, if they are diagnosed early before they cause symptoms, they can be effectively treated.
Abdominal aortic aneurysm treatment at Fletcher Allen
At Fletcher Allen, our highly skilled vascular and cardiovascular
surgeons, interventional radiologists and cardiologists work together as
a team, providing expert care for patients with abdominal aortic
aneurysms.
Our modern, state-of-the-art facility includes a
nationally accredited non-invasive diagnostic laboratory, where imaging
tests are done. Patients are often able to visit with a surgeon and have
an imaging study on the same day.
Fletcher Allen surgeons use
the latest technology and minimally invasive procedures to treat
abdominal aortic aneurysms. In addition, we are committed to
personalized, patient-centered care: every patient who comes through our
doors is seen and assessed by a surgeon, who is involved throughout
their care.
As a university hospital and health system, Fletcher
Allen provides care backed by research, which means you can be assured
that your care is based upon the latest thinking in the field. We are
committed to patient education, helping you become as informed as
possible throughout your care.
Diagnosis: Abdominal Aortic Aneurysms (AAA)
Abdominal aortic aneurysms have been called a "silent killer" because they often do not cause symptoms. Patients with symptoms may experience a pulsing feeling in the abdomen, or an unexplained, severe pain in the abdomen or lower back. An AAA may be discovered during a routine physical exam with your primary care doctor, by feeling a large mass in your abdomen. Often, the AAA may be detected if you are having an imaging test done for a different condition.
One-time screening benefit available
If you are 60 or older and have risk factors for developing an AAA, you may want to consider regular screening. Medicare offers a one-time ultrasound screening for abdominal aortic aneurysm for people with certain risk factors. Men who have smoked or men and women who have a family history of abdominal aortic aneurysm may be eligible for this benefit.
Diagnosing AAA at Fletcher Allen
Fletcher Allen’s vascular technologists and imaging specialists are specially trained in the latest technology to diagnose vascular problems. The process of diagnosis may involve the following:
- Abdominal ultrasound -- This test uses sound waves to produce a video image of your vessels, to check for a potential aneurysm. At Fletcher Allen, we offer this test in our non-invasive diagnostic laboratory, located in our Vascular Surgery offices, to provide greater convenience for patients.
- Computed Tomography (CT) scan -- Fletcher Allen offers
the most advanced CT technology available today, providing
comprehensive images of organs within seconds with a high degree of
accuracy. A CT scan may be recommended if your aneurysm has grown to a
certain size, to determine if it needs to be repaired.
Non-invasive vascular laboratory
Diagnosing vascular problems typically begins in our nationally accredited non-invasive diagnostic laboratory, conveniently located in the Vascular Surgery clinic at Fletcher Allen’s Ambulatory Care Center. Patients are often able to see a doctor and have a non-invasive test during a single visit.
Highly skilled technologists
The lab is staffed by registered vascular technologists -- highly skilled specialists with advanced training in non-invasive vascular imaging and testing. By focusing solely on vascular problems, these technologists bring an in-depth knowledge to the diagnosis of vascular patients.
Diagnosing the full range of vascular problems
The lab offers imaging and testing for the full range of vascular problems affecting all areas of the body. It provides two main types of testing -- physiological studies and ultrasound imaging. Both are non-invasive tests that are usually painless and relatively quick. They enable your physician to decide whether additional, more invasive tests are needed. These studies also can identify problems such as arterial atherosclerosis or vein disease.
- Physiological studies -- Studies that measure the amount of blood traveling through the vessels with and without exercise. They help determine if blockages exist.
- Ultrasound imaging -- An imaging study that uses sound waves to produce a video image of your blood vessels. Ultrasounds are used to check for a potential aneurysm, as well as blocked blood vessels in the neck, abdomen or extremities. In some cases, it may be the only test necessary to determine the need for an operation or stenting procedure.
Treatment: Abdominal Aortic Aneurysms (AAA)
Treatment for abdominal aortic aneurysms involves either regular
monitoring, or surgery. The treatment that is right for you will depend
upon the size, shape, and growth patterns of your aneurysm.
At
Fletcher Allen, our board certified and specially trained physicians
offer expert care in a personalized manner, working closely with
patients and their families. We offer the latest treatments and
therapies available for abdominal aortic aneurysms.
We are committed to patient education through all stages of your treatment. We want to make sure you and your family have all the information you need to make the best decisions about your care.
Observation
If your AAA is small, regular observation and monitoring may be all
that is required. Fletcher Allen vascular surgeons will monitor your
aneurysm on a regular basis with periodic ultrasounds, to detect any
changes in size.
If you have high blood pressure, blood
pressure medication may be prescribed by your primary care physician to
reduce pressure on the weakened area of the aorta.
In addition,
our vascular team can refer you to refer you to other services, such as
smoking cessation, that can help control growth of the aneurysm.
Surgery
If your aneurysm is causing symptoms, is larger than 5 or 5.5 centimeters, or is found to be growing, a surgical procedure may be needed.
Fletcher Allen vascular surgeons are highly trained in performing AAA
surgical procedures for abdominal aortic aneurysms. Patients can be
assured of working with experienced and knowledgeable surgeons, with
access to the latest, cutting-edge equipment.
There are two main types of surgery to repair an AAA. These include:
Open Repair
With an open surgical repair, your vascular surgeon will make an incision in your abdomen and replace the weakened part of your aorta with a synthetic tube-like device called a graft, which is sewn into place. The graft takes the place of the weakened part of the aorta. It allows blood to pass easily through the aorta.
Endovascular AAA Repair
This is a less invasive procedure known as endovascular AAA repair
(EVAR). With this surgery, vascular surgeons place a fabric and metal
tube called a stent graft (or endograft) into the weakened aorta. The
stent graft is placed through small incisions in your leg. The stent
graft is guided through a catheter – a long, thin tube – and placed into
the leg artery under X-ray guidance.
The endovascular stent graft strengthens the weakened section of the aorta to prevent the aneurysm from rupturing.
Shorter recovery time
Recovery time is usually shorter than for open surgery. Hospital
stays are reduced to 1 – 3 days. Long-term follow-up care is needed to
monitor the stent graft.
Whether or not you are a good candidate
for endovascular surgery depends on the shape of your aneurysm and other
factors. Your surgeon will help you decide the best method of treatment
for you.
