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Aortic aneurysm

An aortic aneurysm is an enlargement of the aorta located on one of its 5 segments:

Anévrisme de l'aorte

The aortic aneurysm affects 6 to 7% of the overall population but there is a clear predominance toward men.

Symptoms

Mostly, the abdominal aortic aneurysm (AAA) is not responsible for any symptom. It is often found by accident, through a radiological examination carried out for another pathology:

Causes

Diagnosis

Scanner de l'aorteThere are several types of examinations to diagnose the abdominal aortic aneurysm:

The treatment is only envisaged when the abdominal aortic aneurysm exceeds 50mm and/or in case of abdominal or lumbar pains.

If the aneurysm’s size doesn’t justify the need of a treatment, a biannual or annual surveillance by ultrasound must be carried out. The choice and frequency of this examination depends on the size or morphology of the aneurysm.

Treatments

Endovascular

Endoprothèse-Stents Anévrisme The endovascular treatment has become the reference and first-line treatment if the conditions are in place.

It is a radio-surgical procedure – generally performed under general anesthetic – and consists in putting an endoprosthesis inside the aneurysm and securing it with stents.

This intervention only requires 2 small incisions in the groin area.

The endovascular treatment requires a very strict follow-up by scanner or Doppler Ultrasound in order to monitor the aneurysm’s exclusion and to make sure there are no endoleaks. The follow-up is biannual during the first 2 years, and then annual. Some endoleaks require a complementary treatment.

Conventional

The conventional surgical treatment consists in replacing the affected aorta by a prosthesis that is sewn after the abdomen has been opened (laparotomy).

The immediate outcomes require a few day long stay in resuscitation – as the complications’ rate is higher than the endoprosthesis – but the follow-up is more simple because there is no possible endoleaks.