An abdominal aortic aneurysm refers to an enlargement of the abdominal aorta. If the blood vessel is enlarged and starts to leak blood or rupture, it will cause severe abdominal and lower back pain. This is a serious medical emergency that necessitates emergency surgery. Unfortunately, there is no way to reverse the damage. A prominent symptom from a rupture is severe, persistent low back pain, and pain in and around the abdomen. Treatment for an abdominal aortic aneurysm depends on the possible complications that could develop. Approaches for treatment:
- Nonsurgical treatments like anti-biotics calcium channel blockers and exercise along with monitoring are used for individuals that have a low risk of rupture.
- If an aneurysm is not found until it becomes an emergency, then surgery to repair the ruptured artery is absolutely necessary. If ruptured or there is a high risk of rupturing is considered an emergency.
- If a rupturing aneurysm has been diagnosed, some treatment/management will be implemented to prevent severe/fatal bleeding.
Cardiac
For low-risk cases, lifestyle changes and possible medication/s may be recommended to slow the development. Small aneurysms are monitored using ultrasound. This can be every 6 to 12 months depending on the size and growth rate of the artery.
Medications for lowering blood pressure and cholesterol could be prescribed. This is to limit the amount of plaque buildup in the aorta and reduce any pressure on the arterial walls. Quitting smoking and removing tobacco altogether whether dip, chew, vape is a significant action an individual can do to minimize the risk of aortic rupture. Other lifestyle changes involve maintaining a healthy diet and regular exercise will help lower blood pressure and cholesterol levels decreasing the chance of rupture.
Surgery
Surgical treatment when necessary is to stop a rupture if leaking blood or to prevent a rupture. Surgery requires replacing the damaged portion of the aorta with a stent-graft. This is an artificial artery made from a high-tech mesh/fabric. There are two standard surgical treatments:
Open Repair
Open repair is the most common surgical treatment. It takes the enlarged portion of the aorta removes it and replaces it with a stent-graft. Open surgery repair consists of the following:
- The incision is made in the abdomen at the site of the aneurysm.
- The aorta gets clamped with the blood temporarily blocked from flowing through the damaged portion.
- The damaged part is removed.
- A tube graft is placed where the damaged portion was.
If the damage was not severe and does not require the removal and complete replacement, then less invasive options will be offered.
Endovascular Aortic Aneurysm Repair
EVAR endovascular aneurysm repair surgery is a minimally invasive procedure. There is no need for a large abdominal incision or removal of the damaged portion of the artery. This procedure does not require blood flow stoppage, which places less stress on the heart. Endovascular surgery involves:
- A fluoroscopy or live X-ray is used. This is so the surgeon can look at the repair, and guide the stent into place.
- 2 small incisions are made in the groin.
- A catheter is inserted into the femoral artery in the groin and guided to the abdominal aorta.
- Through the catheter, the stent is guided to the aneurysm.
- Once it reaches the aneurysm, it is compressed and closed.
- The stent is placed in position, and the wireframe is expanded to fit the artery.
- The stent is sewn/secured into place at both ends.
- Once in place, the blood gets redirected from the enlarged area and flows only through the stent-graft. This takes the pressure off the artery's walls and allows for size reduction over time, and decreases the risk of rupture.
The procedure is not an option for individuals with an aorta that cannot be accessed safely through the femoral arteries. Or if the artery is severely damaged that the aneurysm portion needs to be replaced. And if the aneurysm is too big or complex where an open repair is a more favorable option.
Follow Up
Follow-up monitoring is necessary after any aortic aneurysm surgical procedure. This is to ensure the stent works and the aorta is functioning without a high risk of rupture. Individuals will be advised to maintain a healthier heart and cardiovascular system. A surgeon/doctor will suggest:
- Diet adjustments
- Regular exercise
- Quitting smoking/tobacco intake
- Taking cholesterol and blood pressure medication
- Chiropractic/Physical therapy for any spinal misalignment, herniation, sciatic nerve compression back pain relief.
Sciatic Pain Relief
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