Diagnosis

Abdominal aortic aneurysms are often found during an examination for another reason or during routine medical tests, such as an ultrasound of the heart or abdomen.

To diagnose an abdominal aortic aneurysm, doctors will review your medical and family history and do a physical exam. If your doctor suspects that you have an aortic aneurysm, specialized tests, such as the following, can confirm it.

  • Abdominal ultrasound. This test is most commonly used to diagnose abdominal aortic aneurysms. You lie on a table while a technician moves a wand (transducer) around your abdomen. Ultrasound uses sound waves to send images to a computer screen.
  • CT scan. This painless test can provide your doctor with clear images of your aorta, and it can detect the size and shape of an aneurysm.

    During a CT scan, you lie on a table inside a doughnut-shaped machine. CT scanning generates X-rays to produce cross-sectional images of your body. You might have contrast dye injected into your blood vessels that makes your arteries more visible on the CT pictures (CT angiography).

  • MRI. In this test, you lie on a movable table that slides into a machine. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of your body. You might have a dye injected into your blood vessels to make them more visible (magnetic resonance angiography).

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, your doctor will decide on the need for an abdominal ultrasound, usually based on other risk factors, such as a family history of aneurysm.

There isn't enough evidence to determine whether women ages 65 to 75 who ever smoked cigarettes or have a family history of abdominal aortic aneurysm would benefit from abdominal aortic aneurysm screening. Ask your doctor if you need to have an ultrasound screening based on your risk factors. Women who have never smoked generally don't need to be screened for the condition.

Treatment

The goal of treatment — either medical monitoring or surgery — is to prevent your aneurysm from rupturing. Which treatment you have depends on the size of the aortic aneurysm and how fast it's growing.

Medical monitoring

Your doctor might recommend this option if your abdominal aortic aneurysm is small and you don't have symptoms. You'll have regular appointments to check if your aneurysm is growing, and treatment to manage other medical conditions, such as high blood pressure, that could worsen your aneurysm.

It's likely you'll need regular imaging tests to check on the size of your aneurysm. Expect to have an abdominal ultrasound at least six months after your aneurysm is diagnosed and at regular follow-up exams.

Surgery

Repair is generally recommended if your aneurysm is 1.9 to 2.2 inches (4.8 to 5.6 centimeters) or larger or if it's growing quickly. Also, your doctor might recommend surgery if you have symptoms such as stomach pain or you have a leaking, tender or painful aneurysm.

Depending on several factors, including location and size of the aneurysm, your age, and other conditions you have, repair options might include:

  • Open abdominal surgery. This involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place. Full recovery is likely to take a month or more.
  • Endovascular repair. This less invasive procedure is used more often. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded into your aorta.

    The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm, expanded and fastened in place. It reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

    Endovascular surgery isn't an option for about 30 percent of people with an aneurysm. After endovascular surgery, you'll need regular imaging tests to ensure that the repair isn't leaking.

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 disease.

Lifestyle and home remedies

For an abdominal aortic aneurysm, your doctor will likely suggest that you avoid heavy lifting and vigorous physical activity so as not to increase blood pressure excessively, which can put more pressure on your aneurysm.

Stress can raise your blood pressure, so try to avoid conflict and stressful situations. If you're going through a particularly emotional time in your life, let your doctor know because your medications might need to be adjusted to keep your blood pressure levels from going too high.

Preparing for your appointment

If you're concerned about having an abdominal aortic aneurysm, make an appointment with your family doctor.

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 restrict your diet. Before an ultrasound or echocardiogram, for example, you might need to fast.

Make a list of:

  • Your symptoms, including any that may seem unrelated to an abdominal aortic aneurysm, and when they began
  • Key personal information, including a family history of heart disease or aneurysms
  • All medications, vitamins or other supplements you take, including doses
  • Questions to ask your doctor

For an abdominal aortic aneurysm, questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • What tests will I need?
  • What treatments are available, and 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 doctor 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 seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have you ever smoked?

Abdominal aortic aneurysm care at Mayo Clinic

March 15, 2019
  1. Dalman RL, et al. Overview of abdominal aortic aneurysm. https://www.uptodate.com/contents/search. Accessed Jan. 21, 2019.
  2. Spryngerd M, et al. Screening program of abdominal aortic aneurysm. Angiology. Jan. 17, 2019; e1. https://doi.org/10.11770003319718824940. Accessed Jan. 21, 2019.
  3. Abdominal aortic aneurysms (AAA). Merck Manual Professional Version. http://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/abdominal-aortic-aneurysms-aaa. Accessed Jan. 21, 2019.
  4. Final recommendation statement abdominal aortic aneurysm: Screening. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/abdominal-aortic-aneurysm-screening. Accessed Feb. 5, 2019.
  5. Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 6, 2019.
  6. Connolly HM (expert opinion). Mayo Clinic, Rochester, Minn. March 11, 2019.

Related

Associated Procedures