Abdominal aortic aneurysm (AAA or triple A) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, back, or leg pain may occur. Large aneurysms can sometimes be felt by pressing on the abdomen. Rupture may result in pain in the abdomen or back, low blood pressure, or loss of consciousness, and often results in death
AAAs affects 2-8% of males over the age of 65. Rates among women are one-fourth as high. In those with an aneurysm less than 5.5 cm, the risk of rupture in the next year is below 1%. Among those with an aneurysm between 5.5 and 7 cm, the risk is about 10%, while for those with an aneurysm greater than 7 cm, the risk is about 33%. Mortality if ruptured is 85% to 90%.
A 72-year-old patient came to our emergency with complaints of sudden onset of weakness in both lower limbs. On investigation, patient was found to have a 12 cm Abdominal Aortic Aneurysm with signs of impending rupture towards Vertebra. That was the probable reason for his weakness, After consent, we did AAA- EVAR (Endovascular Aortic Repair) as this is the treatment modality of choice nowadays as Surgical correction carries high morbidity & mortality. We Implanted Stent Grafts (a special type of Stents covered by different types of fabric) in Aorta that continues in both lower limbs with extensions, thus creating an Artificial Aorta and bypassing the Aortic Aneurysm. The procedure was performed via Femoral Approach with minimal Femoral Cutdown. The patient was discharged day 3 post procedure. Follow up of patient was excellent.
Dr Rudradev Pandey
DM(Cardiology), FACC (USA)
Senior Consultant, Interventional Cardiology
Specialist, Structural Heart & Endovascular Interventions