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EVAR - Endovascular Aneurysm RepairWhat is Abdominal Aortic Aneurysm?AAA is an enlargement or “bulge” that develops in a weakened area within the largest 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). Beginning January 1, 2007, qualified seniors are eligible for a one-time AAA ultrasound screening as part of their Welcome to Medicare physical.* Should I be worried?AAA can be safely treated or cured with early diagnosis. Nearly 200,000 people in the United States are diagnosed with AAA annually; approximately 15,000 of these cases may be severe enough to cause death if not treated. This Medicare screening benefit is expected to save thousands of lives. Are there symptoms?Most people feel no symptoms, and an AAA is often detected when tests are conducted for other unrelated reasons. Those with symptoms describe them as:
What is the screening procedure?Medicare offers an ultrasound screening that is a painless, safe, and accurate way to detect AAA. What should I do if my screening indicates there is an AAA?See a vascular surgeon. They are the only physicians treating vascular disease today who can perform all the treatment options available, including medical management, minimally invasive endovascular angioplasty and stent procedures, and open bypass surgery. Only when you see a vascular surgeon who offers all treatment modalities will you be assured of receiving the care that is most appropriate to your condition. *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 is effective January 1, 2007.
Who qualifies for the Medicare screening?
How can you diagnose a AAA?AAA is an asymptomatic disease. Physical examination: With palpation, you may notice or feel a throbbing, tender mass in the middle or lower part of the patient’s abdomen. However, you may miss up to 80% of AAA if the diagnosis is limited to physical examination. Most of the time, AAA's are diagnosed too late, i.e. when they rupture. Ultrasound Scan: Ultrasound scan has proven to be a reliable and cost-effective way to diagnose a AAA.
An additional benefit of ultrasound examination is that you may help diagnose other vascular diseases:
Treatment Options
Pre & Post Operative Endovascular Stent Repair
Which treatment for which patients?Endovascular stent grafting should be proposed to AAA patients who:
Open surgery should be proposed to patients who refuse EVAR and are fit for open repair.
Patient Follow-upFollowing open surgery:
Following endovascular stent grafting:
Diagnosis of population at risk of AAA should be a priority concern.Palpation of the abdomen should be systematic in patients 50 years or older. Prescribing an ultrasound exam is suggested in patients over 55 with at least one of the following risk factors:
Information Courtesy of Medtronic TEVAR - Enodvascular Thoracic Aneurysm RepairA Thoracic Aortic Aneurysm or TAA is an enlargement of your body’s largest artery in the chest. Aneurysms can break and cause bleeding and death. A thoracic aneurysm is commonly caused by blood vessel disease called atherosclerosis. Your risk for atherosclerosis increases if you:
Certain diseases can also weaken the layers of the aortic wall and increase the risk of thoracic aortic aneurysms, including:
What Are the Symptoms of a Thoracic Aortic Aneurysm?Thoracic aortic aneurysms often go unnoticed because only half of those patients with thoracic aortic aneurysms complain of symptoms. Possible warning signs may include:
TEVAR is a new treatment option for patients with Thoracic Aortic Aneurysm. If you think you have a Thoracic Aneurysm ask your doctor about screening or evaluation.
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artery in the abdomen. The pressure generated by each heartbeat pushes against the weakened aortic wall, causing the aneurysm to enlarge. If the AAA remains undetected, the aortic wall continues to weaken, and the aneurysm continues to grow. Eventually, the aneurysm becomes so large, and its wall so weak, that rupture occurs. When this happens there is massive internal bleeding, a situation that is usually fatal. The only way to break this cycle is to find the AAA before it ruptures.
