Abdominal Aortic Aneurysm

Abdominal aortic aneurysm is an enlargement of a weak area of your aorta. This type of abdominal aortic disease affects the part of your aorta located in your abdomen.

At the UPMC Heart and Vascular Institute our surgeons in the Division of Vascular Surgery are experts in treating abdominal aortic aneurysms using minimally invasive repair or replacement techniques depending on the severity of your condition. We take a team approach to quickly and accurately diagnose your condition and develop a treatment plan that's right for you.

Contact the UPMC Heart & Vascular Institute

Request an appointment online, call 1-855-UPMC-HVI (876-2484), or email us.

What Are Abdominal Aortic Aneurysms?

Abdominal aortic aneurysm occurs when the large blood vessel that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward.

Although this can happen to almost any artery in the body, it is most common in the abdominal aorta located below your chest and before the aorta branches into the iliac arteries.

Abdominal aortic aneurysm risk factors

Abdominal aortic aneurysms can develop in anyone and may also run in families. They are most often seen in men over 60.

Additional factors that increase your risk of abdominal aortic aneurysm include:

  • Atherosclerosis, or hardening of the arteries
  • High blood pressure
  • High cholesterol
  • Obesity
  • Smoking
  • Chronic obstructive pulmonary disease or emphysema

Injury and connective tissue diseases, such as Marfan syndrome, can also increase the risk.

Complications of abdominal aortic aneurysms

Abdominal aortic aneurysms can have serious complications if they burst, or rupture.

The larger the aneurysm, the more likely it is to rupture and can result in life-threatening internal bleeding if not treated immediately.

For this reason, early diagnosis of abdominal aortic aneurysms and regular surveillance imaging are important to prevent serious complications such as rupture.

Why choose UPMC's Division of Vascular Surgery for care?

  • Our experience — our experts perform hundreds of procedures every year. UPMC also is a major referral center for patients with complicated conditions or who need additional operations.
  • Our vascular surgeons — specialists in minimally invasive therapies for abdominal aortic aneurysms, which they helped pioneer for the entire vascular system.
  • Our coordinated treatment approach — our team of surgeons works closely with other specialists throughout the Heart and Vascular Institute to ensure a comprehensive and coordinated approach to treatment.

For an appointment with a UPMC vascular surgeon, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

Learn More About Abdominal Aortic Aneurysms

From our Health Library at UPMC.com

From the Society for Vascular Surgery

Abdominal Aortic Aneurysm Symptoms and Diagnosis

Aneurysms develop slowly over many years.

Most people with abdominal aortic aneurysm do not feel symptoms.

When symptoms do occur, the signs of an abdominal aortic aneurysm can include:

  • A pulsating mass or lump in your abdomen, similar to beating heart.
  • Severe pain in your abdomen or back that comes on suddenly. This can be a sign that the aneurysm is about to rupture.

A ruptured abdominal aortic aneurysm may cause a person to feel dizzy, weak, or to pass out. These types of symptoms can indicate a life-threatening situation and may require immediate medical care.

Diagnosing abdominal aortic aneurysms

If you are at high risk of developing an abdominal aortic aneurysm, or if your doctor suspects one, you'll need to undergo a thorough physical exam where your doctor will perform a screening and assess the level of your condition.

Your doctor at the UPMC Heart and Vascular Institute will examine your abdomen and evaluate pulses in your legs.

He or she may also find:

  • An abdominal mass
  • A stiff or rigid abdomen
  • A pulsating sensation in the abdomen

Following your exam, your doctor may order additional tests and procedures to help confirm the aneurysm and determine the size of your aorta.

The care team at the Heart and Vascular Institute uses the following imaging tests to help diagnose abdominal aortic aneurysm:

  • Duplex ultrasound scanning — this pain free, cost effective test uses ultrasound waves to create images of the aneurysm.
  • Computerized tomographic (CT) scan — uses cross-sectional x-rays, post-processed by a computer to create detailed 3D images of your aorta.
  • Magnetic resonance imaging (MRI) — uses a large magnetic field, radio waves, and computers to create detailed images of your aorta.

Testing results

Your doctor or nurse will tell you when to expect your test results and will call you when they're available.

For an appointment with a UPMC vascular surgeon, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

Learn More About Abdominal Aortic Aneurysm Symptoms and Testing

From our Health Library at UPMC.com

UPMC Patient Education Materials

Abdominal Aortic Aneurysm Treatment

The main treatment goal for an aortic aneurysm is early diagnosis and prevention of rupture. Less than 40 percent of people survive a ruptured abdominal aortic aneurysm.

The UPMC Heart and Vascular Institute offers a full range of state-of-the-art treatment strategies for abdominal aortic aneurysms, such as surgical repair or replacement of the aorta.

We create a customized treatment plan, which includes an assessment of:

  • The location of the abdominal aortic aneurysm and how extensive the disease is.
  • Your overall health, including focused evaluation of your heart, kidneys, and lungs.
  • The size of the aneurysm.

Based on our findings, we may recommend one of the following treatment options:

  • Aneurysm is Small — less than 5 centimeters (about 2 inches) and you have no symptoms
    • Regular follow-up visits to closely monitor the abdominal aortic aneurysm.
    • Duplex ultrasound scan every 6 to 12 months to assess the aneurysm's size.
    • Lifestyle changes, such as quitting smoking and controlling blood pressure and cholesterol.
  • Aneurysm is Small and you have high blood pressure
    • Medication to lower blood pressure.
  • Aneurysm is Large — more than 5 centimeters (about 2 inches) and you have no symptoms
    • Minimally invasive or open surgery to repair the abdominal aortic aneurysm before it ruptures.

Our experience in treating abdominal aortic aneurysms

UPMC’s highly skilled vascular surgeons — who are among the nation’s most experienced — routinely treat abdominal aortic aneurysms through:

  • Minimally invasive endovascular stent graft procedures
  • Traditional (open) surgery
  • “Hybrid” procedures, combining open surgery, surgical repair, and endovascular techniques

Whether open or endovascular, surgeons will use a graft to replace the weakened part of your heart.

A graft is a tube that:

  • Allows blood to flow through your aorta without putting pressure on the damaged wall of your aneurysm.
  • Strengthens the aorta.
  • Stops the aneurysm from rupturing. Over time, the aneurysm usually will shrink.

Minimally invasive endovascular stent graft procedures

Depending on the location and shape of the abdominal aortic aneurysm, your vascular surgeon may consider an endovascular stent.

Endovascular stent grafting (EVAR) is a minimally invasive procedure that surgeons perform "inside the vein" using catheters.

During the procedure, your UPMC surgeon:

  • Inserts catheters through small needle punctures in your groin.
  • Advances a wire and catheter carrying the endovascular stent graft (synthetic metal mesh and fabric tube) inside your blood vessels to the weakened spot in your aorta.

The stent graft expands outward and sits tightly against the wall of the aorta, relining the weakened portion of the aorta.

Most people recover quickly and can often go home the next day.

EVAR vs. traditional open abdominal aortic aneurysm repair

  • Pros
    • Reduces your hospital stay to two to three days.
    • Requires less recovery time.
  • Cons
    • Requires more follow-up visits and CT scans to ensure that the graft continues to function properly.
    • Is more likely to require periodic maintenance procedures.

Approximately 80 percent of people with abdominal aortic aneurysm are candidates for this technique.

Of those who may not be candidates for a regular EVAR, UPMC participates in numerous advanced abdominal aortic aneurysm clinical trials and expands the indications for repair.

Traditional (open) surgery for abdominal aortic aneurysms

Many open aneurysm repairs are successful for the long term with few complications.

We advise surgery when:

  • The aneurysm reaches approximately 5 centimeters (about 2 inches) in diameter.
  • Smaller aneurysms cause symptoms or enlarge under observation.

Abdominal aortic aneurysms occur in the large blood vessel that supplies blood to the abdomen, pelvis, and legs.

In open surgical aneurysm repair, your UPMC surgeon makes an incision to gain access to your abdomen. The surgeon then removes the damaged portion of the aorta, and replaces it with a fabric graft.

Hospital stay is usually 5 to 7 days.

Recovery time is 6 weeks to 3 months for a complete recovery, depending on your circumstances.

For an appointment with a UPMC vascular surgeon, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

Learn More About Abdominal Aortic Aneurysm Treatments

From our Health Library at UPMC.com