An aneurysm is simply a swollen artery, and can occur almost in any anywhere in the body. The most common site for them to occur is in the abdominal aorta – which is the large artery in the abdomen (tummy). The abdominal aorta is normally about 2cm (just under 1 inch), wide. In some people it becomes enlarged. The main risk is that if it gets very big (over 5 cm) it can burst, which is often fatal. They tend to grow slowly, but do not shrink.


Risk factors.

The recognised risk factors for the development of AAA are male gender, smoking and high blood pressure. These factors are not the whole story however, and it is possible to develop an AAA without having any of these risk factors.


The vast majority of patients with an AAA have no symptoms at all from it, usually the only reason they know of it is that it has shown up on a scan for some other reason.


Surgical treatment of an AAA is not without significant risk, and it is for this reason that small AAA are simply observed. They are not likely to cause any complications, and they may never grow enough to require invasive intervention. There are no specific medications know to slow, or reverse AAA growth, but it is known that good control of blood pressure and stopping smoking seem to reduce the size of AAA growing. There is also some evidence that the cholesterol drugs, statins, may slow AAA growth.

Surgery for AAA.

When an AAA reaches 5.5 – 6cm, consideration is given as to whether it requires fixing, and how this can be done. These can be complex decisions, made between the patient, and a number of medical specialists involved in the management of AAA. There are two broad methods for treating AAA.

Open surgery.

This requires a large incision in the abdomen (tummy), with replacement of the swollen portion of artery using an artificial graft. This requires temporary clamping of the aorta. This technique usually entails a stay in hospital of about a week, with full recovery taking 2-3 months. However, once the operation is done, the patient is essentially ‘cured’ and the graft does not need to be kept under watch.

Endovascular Aneurysm Repair (EVAR).

This relines the swollen artery from within, gaining access to the aorta through small cuts in the groin. This is a less stressful procedure for the body, patients are usually in hospital for 2-3 days, and the chance of major complications is less than with open surgery. However, not all patients are suitable for this type of repair – the aneurysm needs to be of a particular shape. The other downside is that the device used to reline the aorta needs kept under surveillance after the procedure lifelong. A small proportion of patients will need to undergo further procedures after the initial operation to keep the aneurysm sealed off.