Disease

Atherosclerosis is the thickening and hardening of arteries. Some hardening of arteries occurs naturally and is a slow, complex disease that starts in childhood and often progresses with age. The disease may progress resulting in blockages in the arteries that restrict oxygenated blood to critical organs of the body. This can result in a myocardial infarction (MI) if the blockages restrict flow to the heart, or a stroke if the blockages are in the neck restricting blood flow to the brain.

Atherosclerosis can also reduce the integrity and strength of the vessel wall, causing it to expand or balloon out. This is called an aneurysm. Aneurysms are commonly diagnosed in the aorta, which is the body's largest artery. The highest incidence of aortic aneurysms occur in the segment below the opening of the arteries that carry blood to the kidneys (the renal arteries) to where the aorta divides into the two iliac arteries that travel down the legs. This is referred to as an abdominal aortic aneurysm or AAA.

Once diagnosed, patients with AAA will be managed either by a combination of medical therapy and non-invasive monitoring, or undergo a major surgical procedure to repair the aneurysm. Abdominal aneurysmal disease, like many forms of cardiovascular disease, is predominantly an affliction of the elderly. Sufferers are most often male and are usually over 65. An article cited in the New England Journal of Medicine estimates that up to 9% of people over 65 years of age have an unsuspected and asymptomatic AAA.*

Symptoms:

Unfortunately, most patients with an aneurysm do not exhibit any symptoms and the first sign may well be a rupture of the aneurysm. When a AAA ruptures, patients will experience pain in the abdomen and back, fainting and loss of consciousness leading to shock and in some cases death. Most AAA's are diagnosed when a patient visits his/her doctor for some other condition. In some patients, it can be detected during a physical exam. In others, it may be during an x-ray for some other problem.

*Thompson, R.W., Detection and Management of Small Aortic Aneurysms, N Engl J Med, Vol. 346, No 19, May 9 2002, page 1484.