3d rendered medically accurate illustration of the abdominal blood vessels

Abdominal aortic aneurysm: epidemiology and diagnosis

By Cristiano Antonino On Dec 12, 2022

Abdominal Aortic Aneurysm is a circumscribed dilatation of the aorta running through the abdomen, basically a widening of the artery beyond its caliber limits

The abdominal Aorta normally has a caliber that does not exceed 2-2.5 cm in diameter.

When it exceeds these limits we speak, up to 3 cm of Ectasia of the Aorta, from 3 cm and above of Abdominal Aortic Aneurysm (AAA).

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Epidemiology: which categories are most affected by abdominal aortic aneurysm?

Abdominal Aortic Aneurysm affects 4% of men and 1% of women after the age of 60-65 years, according to current statistics.

In practice, for every 1,000 men over the age of 60, there are certainly 40 men in the population with aortic aneurysm, and for every 1,000 women over the age of 60, there are certainly an equal number of 10 women suffering from it.

We also know that some categories of people are more at risk than others: for example, diabetics, the obese, the hypertensive, the hypercholesterolemic, smokers, and those who lead sedentary lives.

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Most of these 40 men and 10 women out of every 1,000 people over the age of 60 do not know they have an abdominal aortic aneurysm

The aneurysm, in fact, before it reaches a crucial point in size, is absolutely asymptomatic, that is, it gives no sign of itself.

Where it does, on the other hand, it can be the cause of major complications; but also because of its progressive and inevitable evolution, it is known that aneurysm leads, sooner or later, to rupture of the artery, a rupture that suddenly becomes a dramatic emergency, often the cause of death.

This is the reason why it is necessary to act on the prevention of the fatal complications of aneurysm, especially since the examinations are absolutely simple, free of harmful side effects, and accessible to all.

Information also plays a key role.

In the United Kingdom, for example, there is commendable public awareness that “Screening for aortic aneurysms in men over the age of 60-65 is beneficial in terms of reducing mortality.”

(US Preventive Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med 2005;142:198-202).

Prevention

Prevention consists of recognizing the presence or onset of Aortic Aneurysm in a person in time, diagnosing it, specifying its location (e.g., whether supra- or subrenal), and monitoring it periodically to follow its natural evolution.

Periodic checks are essential to avoid any complications and intervene surgically where there is a possibility of a rupture, thrombosis, dissection, or periaortic hematoma.

With careful and periodic ultrasound monitoring, it is possible to prevent the time of the most serious complication, aortic aneurysm rupture, with the risk of imminent death that it brings.

The most appropriate tool for recognizing (or ruling out) an aortic aneurysm and following its evolution is ultrasound with echocolordoppler

Computerized Axial Tomography (CT) or Magnetic Resonance Imaging (MRI) are also suitable, and sometimes necessary, but they are much less practical and manageable than ultrasound; moreover, they are impractical for screening or periodic monitoring, both because of the high cost and long waiting lists, but especially because of the contraindications and/or exposure to ionizing radiation that they inevitably (at least for CT) entail.

Abdominal aortic aneurysm, when is surgery necessary?

When dimensions greater than 5 cm in axial scanning are reached, it is necessary to refer the subject to a good vascular surgeon for surgery and thus calmly plan the best operative act to surgically resolve the serious pathology.

In this way, healthy condition and normal circulation in the body’s largest artery can be restored and life expectancy can be greatly increased.

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