Abdominal aortic aneurysm
Aneurysm of the abdominal aortaRecognise early
The risk of enlargement (aneurysm) of the abdominal aorta is greatly increased from a certain age and so Preventive screening is recommended from the age of 65. The precautionary screening is completely painless The diameter of the abdominal aorta is determined using an ultrasound device. This diameter can then be used to determine the percentage risk of a rupture.
Sometimes this screening examination can already lead to a earlier point in time be - for example, when a familial predisposition to this disease or there is abdominal and back pain for which there is no other explanation.
Diagnosis & Therapy
Regular checks make sense
Dilation of the abdominal aorta is Man from a cross diameter of 5.0 cm and with the Woman from a diameter of 4.5 cm a dangerous clinical picture, because if the abdominal aorta bursts, there is an immediate risk of death. Danger to life. Since an aneurysm of the abdominal aorta often does not cause any pain even at these critical diameters, the abdominal aorta should be examined from a certain age. regularly examined can be detected. Even smaller bulges below this critical diameter that have already been detected can thus be detected for progressive growth. control.
It is important to always assess on an individual basis whether an aneurysm poses a risk to the patient. surgical intervention justified. The decision always depends on the individual case and the overall condition of the patient. Many patients also find it a burden if they know about an existing extension and would like to have a Removal of the aneurysm.
Should the decision be surgical intervention If the patient's abdominal aorta is dilated, both a classic surgical procedure with abdominal incision and replacement of the dilated abdominal aorta with a polyester prosthesis (so-called. Tube or Y prosthesis) or interventional stent placement via two small skin incisions in the groin (so-called. EVAR = Endovascular aortic repair).
The Stent insert is included Significantly gentler The surgical procedure is less invasive and involves fewer complications, but is not an option for every type of aneurysm.
In my practice, I take the time for a Comprehensive dialogue and a detailed ultrasound examination and inform you in detail about the advantages and disadvantages of surgical treatment of the abdominal aorta.
Frequently asked questions on the topic of "Abdominal aortic aneurysm"
An abdominal aortic aneurysm is an enlargement of the abdominal aorta. By definition, an abdominal aortic aneurysm is defined as an enlargement of the abdominal aorta from a diameter of 1.7 cm in women and from a diameter of 2.0 cm in men. There are several reasons why an aneurysm can develop in the abdominal cavity: high blood pressure, smoking or increased blood lipids as well as diabetes mellitus can lead to wall damage of the abdominal aorta with subsequent dilation of the vessel diameter. However, aneurysms of the abdominal aorta are also often genetic and are frequently inherited, particularly in the male line (father - son).
The examination for the presence of an abdominal aortic aneurysm is very simple: the diameter of the abdominal aorta can usually be easily determined within a few seconds using a painless ultrasound. If the abdominal aorta is enlarged by more than 4 cm, it is advisable to use imaging such as computer tomography (CT) to determine the exact size, as ultrasound can sometimes underestimate the true diameter of the aneurysm. If there is an aneurysm of the abdominal aorta, an examination of the popliteal arteries should always be included, as there is a connection between an aneurysm of the abdominal aorta and an enlargement of the popliteal artery.
An aneurysm of the abdominal aorta with a diameter of less than 5 cm in men or less than 4.5 cm in women and no symptoms (abdominal or back pain) is initially treated conservatively. This means optimising the risk factors and, in particular, good blood pressure control and stopping smoking. However, the size of the tumour should then be monitored regularly using ultrasound. If invasive treatment becomes necessary, the aneurysm is now generally sealed from the inside using minimally invasive intervention with a covered stent graft (so-called EVAR = endovenous aortic repair). The abdominal aorta is accessed via the vessels in the groin. The classic operation with an abdominal incision and an open repair and sewing in of a prosthesis is only necessary in the rarest of cases.
The statutory health insurance companies recommend an examination for an abdominal aortic aneurysm from the age of 65. However, if there is a family history, it also makes sense to have an examination at a younger age, as aortic aneurysms are often passed on genetically to the next generation.
An aneurysm of the abdominal aorta is dangerous because it can burst and lead to life-threatening bleeding. The risk of the aneurysm rupturing increases with the diameter of the abdominal aorta. For men with a diameter of 5.0 cm or more and for women with a diameter of 4.5 cm or more, the risk is around 5 per cent per year. Treatment is therefore advisable from this diameter.
Impressions of the practice
