WHAT IS AN AORTIC ANEURYSM? The term, aneurysm actually means the dilation of a segment of an artery. It is a gradual process that occurs primarily in elderly people. It doesn't really occur in young people. It's primarily an aspect of aging as well as something else that makes our arteries weak.
Essentially our arteries are tube-like structures. Arteries are like pipes that carry blood to various parts of the body. The pipe becomes like a balloon because the artery weakens. This is an aneurysm .Naturally when something becomes like a balloon over the years, it becomes weaker and weaker. Eventually it can rupture. If it ruptures it is fatal. There is no chance of survival. So that is the reason why an aneurysm should be detected before the catastrophe happens. So that we can treat it.
HOW DO YOU DIAGNOSE AN AORTIC ANEURYSM? Diagnosis is really simple. If it is a large aneurysm one can feel it when one examines the belly of a person. The most common aneurysm is a abdominal aorta. Also, these should not be mistaken for a brain aneurysm which has no relation to this. If they are of a big size one can diagnose it by examining the patient. Otherwise in most people the best way to diagnose is by a simple ultrasound of the abdomen, also called a sonogram. It takes about 5 to 7 minutes to do the test. It is non-invasive and very simple.
WHO SHOULD BE TESTED FOR AN AORTIC ANEURYSM? Anyone who is about the age of 65 or 70 should have it done. In fact Medicaid pays for the screening of an aneurysm. Someone who is 70 who has a history of smoking should be tested. Another important indicator are people whose family has aneurysms -- anyone whose brother, sister or parents have had aneurysms. We see that there is a tendency in families to develop aneurysms. Thus there is a strong reason to do a screening or testing in these patients.
HOW DO YOU TREAT AN AORTIC ANEURYSM? The treatment is to take the weak part out and replace it with a synthetic tube. That is the conventional treatment and has been done for 50 or 60 years. Certainly is its a big operation. It is one of the biggest operations we do. The operation takes 4 to 5 hours or longer. Hospital stay is about 7 to 10 days. And the patient's convalescence is long. Going from the hospital to their home they are still very weak. The full recovery takes from 4 to 6 weeks.
Now we have a new treatment. Like everything else in medicine with the impact of technology %u2013 we have minimally invasive treatments. So we can now use these minimally invasive treatments for aneurysms. It's called endovascular treatment. Without opening the abdomen, we can actually put a graft inside the aneurysm. And this is called stent grafting. This can be done under spinal anesthesia. Patients can go home in 24 hours, It is a phenomenal change in the degree to the stress of a patient. It is amazing what we can offer a patient who is very sick and otherwise could not be operated upon.
HOW LONG WILL THE STENT LAST? This is suppose to be permanent. Obviously this is a new treatment where we have to monitor every patient. Every 6 months we do a CAT scan and follow them lifelong. The procedure was only approved in the United States by FDA in 2000. So this is only 7 years old. But worldwide, in Europe and the rest of the world, I would say they having been doing it for 10 to 12 years now. They are a little bit ahead because the FDA does not approve any treatment unless it is well-tested. So in the United States it has been approves since the year 2000 so for 7 years now. The experience shows that it is a very good treatment.