An aortic aneurysm is an abnormal, localized dilation of the aorta — the main artery carrying blood from the heart to the rest of the body. Like an over-inflated balloon, the weakened arterial wall progressively expands until it eventually ruptures — an event associated with 80% mortality if the patient reaches hospital at all. The key to survival is early detection and timely intervention.

Types and Locations

  • Abdominal Aortic Aneurysm (AAA): Most common — affects the aorta below the renal arteries
  • Thoracic Aortic Aneurysm (TAA): Less common but equally dangerous
  • Popliteal Artery Aneurysm: Behind the knee — causes limb-threatening clots

Why Is It Called the "Silent Killer"?

Over 75% of AAAs cause no symptoms whatsoever until rupture. The aneurysm slowly expands over years, detected only if an incidental ultrasound or CT scan is performed for another reason.

Risk Factors

  • Smoking — the most important single risk factor, responsible for up to 90% of AAAs
  • Male sex (4:1 male-to-female ratio)
  • Age over 65 years
  • Hypertension and hyperlipidemia
  • Atherosclerosis
  • Family history of aortic aneurysm
  • Genetic conditions — Marfan syndrome, Ehlers-Danlos syndrome

⚠️ Symptoms of Rupture — Emergency

Sudden severe pain in the abdomen, back or flank, accompanied by collapse, pallor and shock — this is a ruptured aneurysm. Survival depends on reaching a vascular surgical centre within minutes. Call emergency services immediately.

Screening and Monitoring

A single abdominal ultrasound is recommended for all men aged 65+ who have ever smoked — it detects AAA early when treatment is safe and elective rather than emergency.

  • <3 cm: Normal — no follow-up needed
  • 3–4.4 cm: Ultrasound every 12 months
  • 4.5–5.4 cm: Ultrasound every 3–6 months, risk factor optimization
  • ≥5.5 cm (men), ≥5 cm (women): Intervention recommended
  • Any size growing >0.5 cm in 6 months: Early intervention

Treatment Options

  • EVAR (Endovascular Aneurysm Repair): A stent-graft is deployed inside the aneurysm via catheters through groin incisions — no large abdominal incision, same-day or next-day discharge, minimal blood loss
  • Open Surgical Repair: Traditional approach — replacing the aneurysm sac with a prosthetic graft via a laparotomy — reserved for cases not anatomically suitable for EVAR

✅ Stop Smoking Now

Smoking cessation is the single most effective intervention to slow aneurysm growth. It reduces AAA expansion rate by up to 40%. If you smoke and are over 65 — get an ultrasound today.

Want to Be Screened for Aortic Aneurysm?

Contact Dr. Mohamed Haggag for an abdominal ultrasound assessment and personalized monitoring plan

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