An abdominal aortic aneurysm is a bulge in the aorta, the main artery carrying blood from the heart, where it passes through the abdomen. The aorta is normally about 2 cm wide here, and a width of 3 cm or more is called an aneurysm.
Most aneurysms grow slowly and silently. The concern is rupture, which causes massive internal bleeding. Risk of rupture rises with size, so small aneurysms are watched with scans and larger ones are repaired as a planned operation.
Symptoms
- Usually no symptoms, with the aneurysm found on a scan done for another reason
- A pulsing feeling in the abdomen, near the navel
- Persistent deep pain in the abdomen or lower back
- Tenderness over the aneurysm
- Rarely, painful or discoloured toes from small clots travelling downstream
Causes and risk factors
The aortic wall weakens as its elastic fibres break down. Smoking is by far the strongest avoidable factor. Others are age over 65, male sex, high blood pressure, high cholesterol, other arterial disease and a close relative with an aneurysm. Rarely the cause is an inherited connective tissue condition such as Marfan syndrome, or infection or inflammation of the artery wall.
How it is diagnosed
- Abdominal ultrasound: A quick, harmless scan that measures the aorta accurately. It is used for screening and for surveillance.
- CT angiography: Shows the exact shape, the neck below the kidney arteries and the leg arteries. It decides whether a stent graft is possible.
- Heart, lung and kidney assessment: ECG, echocardiogram, breathing tests and blood tests estimate the risk of an operation.
Treatment options
- Surveillance: Aneurysms under 5.5 cm in men, and around 5.0 cm in women, are usually re-scanned every 3 to 12 months depending on size.
- Risk factor control: Stopping smoking slows growth. Blood pressure treatment, a statin and an antiplatelet medicine reduce heart attack and stroke risk.
- Endovascular repair (EVAR): A fabric-covered stent is passed up through the groin arteries to line the aneurysm. Recovery is faster, but lifelong scan follow-up is needed and further procedures are sometimes required.
- Open surgical repair: The weakened section is replaced with a synthetic graft through an abdominal incision. Recovery takes longer, but the repair is durable with less follow-up.
- Complex repair: Fenestrated or branched stent grafts for aneurysms involving the kidney arteries, done in specialised units.
When it is urgent
Sudden severe pain in the abdomen, back or flank, particularly with faintness, sweating, a fast pulse or collapse, may be a rupture. Call the emergency services immediately. This cannot wait and is never a reason to travel.
Travelling to Türkiye for treatment
Planned repair of an aneurysm that has reached the treatment threshold can reasonably be done abroad, as can a second opinion on whether EVAR or open surgery suits your anatomy. Bring your CT images on a disc or link. Expect about 7 to 10 days for EVAR and 2 to 3 weeks for open repair before flying. After EVAR you need regular scans for life, so confirm who will do them at home. Small aneurysms under surveillance need no travel.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
At what size is repair advised?
Usually 5.5 cm in men and about 5.0 cm in women, or sooner if it is growing quickly (more than about 1 cm a year) or causing symptoms.
Can I fly with an aneurysm?
Commercial flying is generally considered safe with a stable, symptom-free aneurysm. Ask your vascular specialist if yours is large.
Is EVAR better than open surgery?
EVAR has lower early risk and quicker recovery. Open repair needs fewer later procedures. Age, fitness and the shape of the aneurysm decide.
Should my relatives be checked?
Brothers, sisters and children over about 50 are often advised to have a one-off ultrasound.