Aortic dissection, aortic aneurysm - The aorta - Life after an aortic dissection
An abdominal aortic aneurysm ( AAA ) (often referred to as a 'triple A') is very dangerous as it can lead to an abdominal aortic dissection. When an aortic dissection involves the abdominal aorta, compromise of the branches of the abdominal aorta is possible. In abdominal aortic dissections, compromise of one or both renal arteries occurs in up to 8% of cases.
Aortic Dissection is generally divided into 2 broad catergories:
Type A (ascending) from where the aorta leaves the heart up to (and sometimes past) the aortic arch. This is a deadly medical emergency and is generally only treated with immediate surgery.
Type B Involves the descending aorta (distal to left subclavian artery origin), without involvement of the ascending aorta or aortic arch. Generally treated with medication.
An abdominal aortic dissection is neither a Type A or a Type B dissection. It occurs when a abdominal aortic aneurysm (AAA) ruptures which is generally extremely life-threatening as large amounts of blood are released into the abdominal cavity which can lead to death within minutes.
An abdominal aortic aneurysm is generally described as a localised dilation or 'ballooning out' of the abdominal aorta that exceeds the normal diameter of the abdominal aorta by over 50 percent. Around 90 percent of abdominal aortic aneurysms occur below the kidneys, however they can also occur above the kidneys or at the same level as the kidneys. Abdominal aortic aneurysms can also extend to include either one or both of the iliac arteries in the pelvis.
Abdominal aortic aneurysms occur most commonly in men between 65 and 75 years of age with an even higher risk with smokers. Generally no symptoms are present with abdominal aortic aneurysms although they can cause pain in the abdomen and back or the legs. Symptomatic and large aneurysms (i.e., those greater than 5.5 cm in diameter) are usually dealt with by one of several surgical methods, with aneurysms under this threshhold treated with medication. One of the fastest growing medical treatments now is using a stent to repair the aneurysm (however this procedure is only suitable in certain circumstances).
In the UK, the NHS
(National Health Service) have acted with great
responsibility to set up a NATIONAL SCREENING program
for all men in the UK 65 and over. The phased roll-out of the
programme nationally began in 2009 with an anticipation
by 2013 there will be around 42 local programmes that will
cover the whole of England.
AAA screening programmes are also planned for Wales, Scotland and Northern Ireland. Each local AAA screening programme in England operates as a collaboration between commissioners, hospital trusts and vascular networks.
Men are invited for ultrasound screening during the year they turn 65. Men over 65 who have not previously been diagnosed with an aneurysm can self refer directly to their local programme. Screening is only available to men aged 65 and over because the condition is much more common in men than women and risk also increases with age. To find out whether screening is available yet where you live, please visit for a list of current local programmes and their associated contact details.
Read the most recent newsletter for the NHS abdominal aortic aneurysm screening program.
*And most IMPORTANTLY remember - See your doctor (!) or specialist urgently for ANY MEDICAL ADVICE if you need information or further direction on what to do about AAA.