111 Colchester Avenue
Main Campus, Main Pavilion, Level 5
Burlington, VT 05401-1473
Abdominal Aortic Aneurysm Care at the UVM Medical Center
The aorta is the largest blood vessel in the body, leading from the heart to the rest of the body. When a section of the aorta begins to weaken, the pressure of the blood flowing through the vessel causes it to expand or bulge. Aneurysms can develop anywhere along the aorta, but abdominal aortic aneurysms (AAA) are located in the abdomen.
If an aneurysm ruptures and forms a tear in the wall of the aorta, it can cause life-threatening bleeding. If you have an aneurysm, it will require consistent monitoring to ensure it doesn’t grow. A range of surgeries and procedures are available to treat large, fast-growing or symptomatic aneurysms and prevent a rupture.
At The University of Vermont Medical Center, we take a coordinated, team-based approach to diagnosing and treating abdominal aortic aneurysms.
As one of the leading vascular programs in the region, we offer:
- Specialized experts: Abdominal aortic aneurysms require expert diagnosis and ongoing monitoring and treatment by a team of specialists. The UVM Medical Center is home to a nationally accredited, non-invasive diagnostic laboratory staffed by highly skilled vascular technologists to help you get a fast, accurate diagnosis. If an aneurysm is detected, our vascular surgeons will determine what treatment is right for you and make sure you get the very best care, when and where you need it.
- Excellent outcomes: Our vascular surgery team tracks our patient outcomes in national registries. Our outcomes consistently meet — or exceed — national benchmarks, so you can rest assured that you’ve chosen a vascular surgery team with a proven track record of excellence.
- Advanced treatment options: We provide a range of treatment options to help you feel your best, including advanced interventional procedures and surgeries such as endovascular aneurysm repair. Our vascular surgeons are the only providers in Vermont offering catheter-based treatments as an alternative to open-thoracic surgery.
What Causes an Abdominal Aortic Aneurysm?
While the wall of the aorta is normally able to stretch and shrink as needed to adapt to blood flow, certain conditions can cause the wall to weaken, leading to an aneurysm. While the exact cause is unknown, the following risk factors are associated with abdominal aortic aneurysm:
- A family history of the condition
- Atherosclerosis (the hardening of the arteries)
- Inflammation of the arteries
- Tobacco use
- High blood pressure
Symptoms of an Abdominal Aortic Aneurysm
Most people with an abdominal aortic aneurysm do not experience symptoms. Symptoms may occur as the aneurysm gets bigger and begins to put pressure on the surrounding organs. The most common symptoms include:
- A pulsing feeling in the abdomen
- Unexplained, severe pain in the abdomen or lower back
If an abdominal aortic aneurysm ruptures, you will experience sudden, severe pain, an extreme drop in blood pressure and signs of shock. Without immediate treatment, it can quickly lead to death.
Diagnosing an Abdominal Aortic Aneurysm
Abdominal aortic aneurysms are often found by chance, during tests done for other reasons or during a routine physical exam.
If your doctor thinks you might have an abdominal aortic aneurysm, they will conduct a physical exam and order imaging tests to confirm the diagnosis and determine the location and size of the aneurysm.
Abdominal aortic aneurysm diagnosis and testing may include:
- Ultrasound imaging to create a video image of your blood vessels and measure their size
- Computed tomography (CT) scan to provide detailed images of your organs and determine if the aneurysm needs to be repaired and how it should be treated
Abdominal Aortic Aneurysm Treatment
The size, shape and growth pattern of your abdominal aortic aneurysm will determine the course of treatment your vascular surgeon recommends. Treatment of an aneurysm is based on the risk that it will burst (rupture).
Treatment for a small abdominal aortic aneurysm
Small aneurysms rarely rupture, so in most cases, the risks of having surgery outweigh the benefits. If you have a small abdominal aortic aneurysm, your vascular surgeon may recommend regular observation and monitoring to keep track of the aneurysm’s growth.
Your vascular surgeon may also recommend strategies for managing your aneurysm. They may prescribe medication to help lower blood pressure and cholesterol and suggest lifestyle changes to improve your heart health. These might include quitting smoking, being active, eating a heart-healthy diet and staying at a healthy weight.
Treatment for a large abdominal aortic aneurysm
If your abdominal aortic aneurysm is causing symptoms, is larger than 5.5 cm in men or 5 cm in women, or is growing quickly, it is more likely to rupture. In these cases, surgery to repair the aneurysm is often recommended.
Vascular surgeons at the UVM Medical Center offer two surgical options to repair abdominal aortic aneurysms at risk of rupturing. Your vascular surgeon can help you determine which procedure is best for you.
- Endovascular AAA repair (EVAR): In this minimally invasive procedure, your doctor will insert a man-made tube called a stent graft (endograft) through a small tube (catheter) into the artery in your groin. Using ultrasound and angiogram, the doctor will guide the catheter to your aorta and insert the stent graft. The endovascular stent graft strengthens the weakened aorta to prevent the aneurysm from rupturing. This procedure requires long-term follow-up care to monitor the stent graft.
- Open surgical repair: In an open surgical repair, your surgeon will make an incision in your abdomen to remove the damaged part of the aorta. They will then replace that section of the aorta with a synthetic tube-like device called a graft, which allows blood to pass easily.