Abdominal Aortic Aneurysm

by Jennifer Abney

Published: Mon, March 10, 2008 - 12:11 pm CST Last Updated: Mon, March 10, 2008 - 4:40 pm CST

Over 2 million people in the U.S. have an abdominal aortic aneurysm. Most don't even know it. And, when left untreated it is fatal in over 60 percent.

But, there is a move in the medical community to change that through screenings.

Terry McMillen was living with a silent killer that almost cost him his life.

"I woke up at 4 a.m. thinking i had a kidney stone and i asked to go to the hospital," said McMillen, "the next thing i know it is two days later and Dr. Damrich is waking me up."

Mr. Mcmillen had a ruptured abdominal aortic aneurysm. It is a bulge that forms in the largest blood vessel in the body, the aorta. It can lead to internal bleeding and even death.

"Mr. McMillen was a typical asymptomatic patient," said Dr. Michael Damrich with Cardiovascular Associates, "He describes kidney pain because as blood leaks from the aneurysm it leaks into the muscles of the back near the kidneys."

Only 18% of people who have a ruptured aneurysm actually survive.

"I am very lucky," said McMillen, "My chances of survival was less than winning the lottery."

Dr. Damrich says that this is the danger with AAA's, "Most people don't know they have one until it ruptures," said Damrich. But, screenings can change that.

"If you can catch it before it ruptures, its almost simple to fix in cardiovascular terms," said Dr. Damrich.

There are two options for patients with this condition. Open surgical repair, is when a synthetic graft is inserted through an incision in the abdomen. The option Dr. Damrich chose for Mr. McMillen was endovascular repair. It consists of two small incisions in the femoral artery. According to Dr. Damrich, he delivered a self expanding graft into the abdominal aorta via a catheter based system. The stint graft stays in the patient for life and is examined during follow up visits with a CT, ultrasound or MRI.

Mr. McMillen had at least one of the risk factors for this condition.

"My father had an aneurysm which he died from," said McMillen.

Risk factors include:

Being a man older than 60 years
Having an immediate relative, such as a mother or brother, who has had AAA
Having high blood pressure
Smoking
Your risk of developing AAA increases as you age.
AAA is more common in men than in women.

Screenings for AAA involve a noninvasive ultrasound scan that examines the size and blood flow of the abdominal aorta. It provides important information for doctors so that aneurysms can be caught and treated early. And, important information to Terry McMillen for 3 reasons.

"I have 3 older brothers," said McMillen, "I am making all of them get screenings."

Dr. Michael Damrich and his colleagues with cardiovascular associates believe strongly in the need for these screenings. So, they are offering free screenings this Wednesday, Thursday, and Friday at their office at 1901 Springhill Avenue in Mobile. Call 251.438.1200 to make an appointment. You should wear loose fitting clothing.

SYMPTOMS:

According to Vascularweb.org, although you may initially not feel any symptoms with AAA, if you develop symptoms, you may experience one or more of the following:

A pulsing feeling in your abdomen, similar to a heartbeat
Severe, sudden pain in your abdomen or lower back. If this is the case, your aneurysm may be about to burst
On rare occasions, your feet may develop pain, discoloration, or sores on the toes or feet because of material shed from the aneurysm

If your aneurysm bursts, you may suddenly feel intense weakness, dizziness, or pain, and you may eventually lose consciousness. This is a life-threatening situation and you should seek medical attention immediately.

S.A.A.V.E. Act:

Medicare is offering a one-time, free screening for AAA to qualified seniors as part of its Welcome to Medicare physical. This physical must be conducted within the first six months of enrollment in Medicare. Men who have smoked at least 100 cigarettes during their life, and men and women with a family history of AAA qualify for the Medicare screening.

Your vascular system, made up of your veins and arteries, allows life-giving blood to flow to your vital organs. Blood flows freely when this system is open, but as we age, our arteries tend to thicken, get stiffer, and narrow. To maintain an active lifestyle during our senior years, we need to make certain there are no weak areas or blockages in our vascular system. Medicare recognizes the importance of good vascular health and offers a free screening process to check for one of the vascular diseases, Abdominal Aortic Aneurysm (AAA). Qualified seniors are eligible for a one-time AAA ultrasound screening as part of their Welcome to Medicare physical.* cases may be severe enough to cause death if not treated. This Medicare screening benefit is expected to save thousands of lives.

* The Medicare AAA screening benefit became a law on February 8, 2006, as the Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act, a provision of S.1932, Deficit Reduction Act of 2005, also known as Budget Reconciliation. The law became effective January 1, 2007.

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