Abdominal Aortic Aneurysm: Ultrasound and Surgery Save Lives | NDR.de – Handbook

Famous people such as Albert Einstein, Thomas Mann, Leonid Brezhnev and Charles de Gaulle died of a ruptured abdominal aorta. They had no prior knowledge of the deadly danger in their bodies. Men are primarily affected by enlargement of the abdominal aorta – it is usually detected only by chance during an ultrasound scan. Experts estimate that more than 200,000 people in this country suffer from a defect in the abdominal aorta that can rupture at any time without warning.

Prevention: ultrasound examination for men 65 and older

That’s why doctors recommend a preventive medical examination for all men over the age of 65 and for younger people at increased risk. International experience shows that an ultrasound of the abdominal artery cuts the number of deaths and emergency operations in half. Because if the aneurysm is caught early with this simple, painless examination, the doctor can significantly reduce the risk with preventive measures. The costs for this test are paid by health insurance companies for men 65 and over.

Risk factors for an abdominal aortic aneurysm

The main risk factors for aneurysm are smoking, high blood pressure and atherosclerosis. A genetic predisposition or general weak connective tissue can also lead to vasodilation. The larger the aneurysm, the greater the risk of it bursting someday.

With a diameter of four to five centimeters, the risk of a fissure is three percent per year, from five centimeters more than 15 percent. If the aneurysm bursts, help is too late for 80 percent of sufferers – they bleed to death within a few minutes.

The abdominal artery prosthesis prevents a burst

To prevent bursting, a prosthesis is inserted into the abdominal aorta during the aortic aneurysm – either via a catheter with a prosthetic stent or in an open procedure with a tightly sutured prosthesis. You are now raising the blood pressure on the wall of the affected blood vessel, so that its expansion decreases over time.

Comparison of surgical methods: advantages and disadvantages

Doctors use two different surgical methods to insert an artificial limb into an artery. Surgical methods have these advantages and disadvantages:

• The Kathetereingriff Less stressful and risky for the patient than open surgery. One out of every 100 people who undergo catheterization surgery does not survive the procedure, with open surgery it is one in 25. However, with the minimally invasive method, follow-up interventions are required in up to 40 percent of cases because leaks can occur. . Therefore, patients should be examined closely after the procedure – for life at least once a year, using computerized tomography (CT) and associated radiation exposure.

• At Open surgery A large incision in the abdomen is required to sew the prosthesis tightly into the main artery. The process is extremely stressful for the patient, however the prosthesis is inserted tightly and securely afterwards – no further investigations are required. For this reason, vascular surgeons prefer open surgery for younger and more fit patients, while the catheter procedure is primarily used in older and debilitated people for whom open surgery can be very stressful.

OP is the best in specialized vascular centers

Whether open or through catheter: An operation on the abdominal artery is very complex and demanding. Therefore, both operations should only be performed in specialized vascular centers with experienced experts and all necessary specialized specialties on site in order to prepare for any complications.

The decision to operate only after assessing the risks

Since the operation itself is risky, treatment guidelines specify the diameter through which the aneurysm should be performed, since the risk of surgery is less than the risk of it bursting. This critical limit is 5.5 cm for men and 5 cm for women. However, if the aneurysm grows more than 1 centimeter per year, surgery should be done early.