FREQUENTLY ASKED QUESTIONS

What is an ANEURYSM?

An aneurysm is a balloon-like swelling which develops in the wall of a weakened blood vessel.

Section A -- AORTIC ANEURYSMS

What is an AORTIC ANEURYSM?

The aorta is the largest artery in the body. It starts at the heart and passes through the chest to the abdomen. Aortic aneurysms can develop anywhere along the aorta. Once an aneurysm has started to develop, it slowly expands in diameter over a period of several years. As an aneurysm grows larger, the wall of the artery thins. When the strength of the aneurysm wall becomes too weak the wall can break, resulting in a ruptured aneurysm. Blood loss from a ruptured aneurysm is usually large and rapid. In most cases, aortic aneurysms cause no symptoms until they rupture; at which point they cause sudden, severe abdominal and/or back pain, sometimes loss of consciousness, and shock due to severe blood loss. Despite best efforts, most patients die soon after aneurysm rupture.

What causes AORTIC ANEURYSMS?

The exact cause of aortic aneurysms has been difficult to identify with certainty. Although it is thought that family history (Of all patients with aortic aneurysms, approximately 20% are eventually found to have a family member that was, or is, also affected.), smoking, hypertension, and high blood cholesterol are probably the most important risk factors. It is not yet clear how these factors interact to cause the development of aneurysms. Once an aortic aneurysm is known to be present, the best guides to its risk of rupture are size, progressive growth, or any symptoms that might suggest the aneurysm is dangerously close to rupturing.

Who is most at risk?

Abdominal aortic aneurysm (AAA - pronounced Triple-A) is about four times more common in men than in women and more common among Caucasian men than African-American men. AAA is the third leading cause of sudden death in men in the U.S. An estimated 2.7 million Americans over age 60 currently have AAA.

How are AORTIC ANEURYSMS detected?

Patients sometimes detect an aneurysm by feeling a pulsating mass in the abdomen, or it may be found by their physician during a routine physical examination. The best way to detect unsuspected aortic aneurysms is by an ultrasound or CAT scan of the abdomen. . Ultrasound is quick, relatively inexpensive, non-invasive, and accurate ; if the aorta can be seen, the presence of an aneurysm can be identified or excluded. CAT scans of the abdomen remain the most accurate tests for aortic aneurysm, both for initial detection and for determining aneurysm size. They provide information equal to MRI scans.

How are AORTIC ANEURYSMS treated?

Once an aneurysm is detected, a decision must be made as to the best treatment for each individual patient. This decision is primarily based on the size (diameter) of the aneurysm as a reflection of its risk for rupture. On average, most aneurysms increase in size by 0.5-cm diameter each year. For patients with small aneurysms, observation and careful follow-up is recommended. It is equally important to stop smoking and maintain good blood pressure control. For patients at risk of rupture, aortic aneurysm operations involve replacement of the aneurysmal part of the aorta with an artificial graft. The most commonly used grafts are made of Dacron or Teflon. This operation is done under general anesthesia.

A newer, less invasive repair has evolved in recent years. Endovascular devices (stints) are inserted through the arteries in the groin, fed up into the aneurysm site and deployed through a catheter. Hospital stays as well as recovery time are typically much shorter.

What are the results of treatment for ABDOMINAL AORTIC ANEURYSMS?

While the chances of surviving a ruptured aneurysm are poor, elective aneurysm surgery survival rates are quite good when the surgery occurs in centers where the operation is performed routinely.

If aneurysms are so deadly, why hasn't more been done on aneurysm research?

The study of aneurysms was not funded for many years because scientists thought they were just a late, degenerative stage of hardening of the arteries. That concept is changing. Work from diligent researchers has persuaded more and more scientists that in many instances there is a genetic predisposition toward developing aneurysms.

Is there an advocacy group working toward positive, long-range goals in the ANEURYSM realm?

Aneurysm Outreach Inc., a non-profit organization, was created to raise public awareness about the threat of aneurysms, especially the fact that certain families have a predisposition toward their occurrence, to stimulate and support genetic research and to establish a support network for those affected or at risk and their families. AOI is dedicated to mobilizing people and resources to eradicate aneurysms.

Will Aneurysm Outreach Inc. support ALL aneurysm arenas?

Yes

Why create a patient/family database and support network?

• to provide a place for dialogue among those with a common interest;
• to gather statistics to be used in research;
• to create a strong and unified advocacy group in order to accomplish AOI's mission of eradicating aneurysms.