Diagnosis
Abdominal aortic aneurysms are often found when a physical exam or imaging test is done for another reason.
To diagnose an abdominal aortic aneurysm, the health care provider examines you and reviews your medical and family history.
Tests to diagnose an abdominal aortic aneurysm include:
- Abdominal ultrasound. This is the most common test to diagnose abdominal aortic aneurysms. Sound waves are used to show how blood flows through the structures in the belly area, including the aorta.
- Abdominal CT scan. This test uses X-rays to create cross-sectional images of the structures inside the belly area. It can create clear images of the aorta. This test also can detect the size and shape of an aneurysm.
- Abdominal MRI. This imaging test uses a magnetic field and computer-generated radio waves to create detailed images of the structures inside the belly area.
During some CT and MRI scans, a liquid called contrast may be given through a vein to make the blood vessels show up more clearly on the images.
Screening for abdominal aortic aneurysm
Being male and smoking significantly increase the risk of abdominal aortic aneurysm. Screening recommendations vary, but in general:
- Men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening using abdominal ultrasound.
- For men ages 65 to 75 who have never smoked, the need for an abdominal ultrasound is based on other risk factors, such as a family history of aneurysm.
Women who have never smoked generally don't need to be screened for abdominal aortic aneurysm. There isn't enough evidence to say whether women ages 65 to 75 with a history of smoking or a family history of abdominal aortic aneurysm benefit from screening. Ask your health care provider if screening is right for you.
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Treatment
The goal of abdominal aortic aneurysm treatment is to prevent an aneurysm from rupturing. Treatment may involve:
- Frequent health checkups and imaging, called medical monitoring or watchful waiting.
- Surgery.
Which treatment you have depends on the size of the abdominal aortic aneurysm and how fast it's growing.
Frequent health checkups
If the abdominal aortic aneurysm is small and isn't causing symptoms, you may only need frequent health checkups and imaging tests to see if the aneurysm is growing.
Typically, a person with a small, symptom-free abdominal aortic aneurysm needs an ultrasound at least six months after diagnosis. Abdominal ultrasounds also should be done at regular follow-up appointments.
During the regular checkups, a health care provider also checks for conditions, such as high blood pressure, that could make an aneurysm worse.
Surgery and other procedures
Surgery to repair an abdominal aortic aneurysm is generally recommended if the aneurysm is 1.9 to 2.2 inches (4.8 to 5.6 centimeters) or larger, or if it's growing quickly.
Repair surgery also may be recommended if you have symptoms such as stomach pain or have a leaking, tender or painful aneurysm.
The type of surgery done depends on:
- The size and location of the aneurysm.
- Your age.
- Your overall health.
Abdominal aortic aneurysm treatment options may include:
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Endovascular repair. This treatment is most often used to repair an abdominal aortic aneurysm. A surgeon inserts a thin, flexible tube, called a catheter, through an artery in the groin area and guides it to the aorta. A metal mesh tube on the end of the catheter is placed at the site of the aneurysm. The mesh tube, called a graft, expands, and strengthens the weakened area of the aorta. This helps prevent rupture of the aneurysm.
Endovascular surgery isn't an option for everyone with an abdominal aortic aneurysm. You and your health care team should discuss the best repair option for you. Regular imaging tests are done after this treatment to make sure the blood vessel isn't leaking.
- Open surgery. This is major surgery. A surgeon removes the damaged part of the aorta and replaces it with a graft, which is sewn into place. Full recovery may take a month or more.
Long-term survival rates are similar for both endovascular surgery and open surgery.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
Your health care provider may tell you to avoid heavy lifting and vigorous physical activity. These activities may cause extreme increases in blood pressure, which can worsen an aneurysm.
Emotional stress also can raise blood pressure. Try to avoid conflict and stressful situations. If you're feeling stressed or anxious, let your care provider know. Together you can come up with the best treatment plan.
Preparing for your appointment
Make an appointment with your health care provider if you are concerned about your risk of an abdominal aortic aneurysm. If you're having severe pain, seek emergency medical help.
Here's some information to help you get ready for your appointment.
What you can do
When you make the appointment, ask if there's anything you need to do in advance, such as avoid food or drinks for a period of time.
Make a list of:
- Your symptoms, including any that may seem unrelated to an abdominal aortic aneurysm, and when they began.
- Important personal information, including a family history of heart disease or aneurysms.
- All medicines, vitamins or other supplements you take. Include the dosages.
- Questions to ask your health care provider.
For an abdominal aortic aneurysm, questions to ask your health care provider include:
- What's the most likely cause of my symptoms?
- What tests will I need?
- What treatments are available? Which do you think would be the best treatment for me?
- Do I need regular screenings, and if so, how often?
- I have other health conditions. How can I best manage these conditions together?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your health care provider is likely to ask you questions, including:
- Do your symptoms come and go, or do you always feel them?
- How severe are your symptoms?
- Does anything improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Have you ever smoked?