Abdominal Aortic Aneurysm (AAA) in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Abdominal Aortic Aneurysm (AAA)
Dr. Ilya Khantalin in Nice
Abdominal aortic aneurysm (AAA) is a potentially serious vascular condition, characterized by an abnormal dilation of the wall of the aorta, the main blood vessel that carries blood from the heart to the rest of the body. When an abdominal aortic aneurysm ruptures, it becomes a life-threatening emergency. As a vascular surgeon in Saint-Laurent-du-Var, Dr. Ilya KHANTALIN offers detailed explanations about this condition, its causes, symptoms, diagnosis, treatments, and follow-up indications.
Arterial diseases are now managed using modern techniques validated by the Haute Autorité de Santé (French National Authority for Health), with an approach that favors innovation and adherence to recognized surgical protocols.
Vascular diseases are classified as Long-Term Illnesses (Affections de Longue Durée – ALD), allowing for 100% coverage by the French Social Security system.
What is an Abdominal Aortic Aneurysm?
Vascular Surgeon in Saint-Laurent-du-Var
The abdominal aorta is the portion of the aorta that runs through the abdomen. Several visceral arteries branch off from this segment: the celiac trunk, superior mesenteric artery, renal arteries, and inferior mesenteric artery. An abdominal aortic aneurysm forms when this section of the blood vessel dilates abnormally, thereby increasing the risk of rupture. This condition affects men more frequently than women and becomes more common with age, particularly after the age of 65.
Several factors can increase the risk of developing AAA and aneurysm rupture. The most common include:
- Chronic high blood pressure: Excessive pressure on the aortic wall encourages dilation and may lead to rupture.
- Smoking: Tobacco use accelerates the process of atherosclerosis and weakens arterial walls.
- Atherosclerosis: The presence of cholesterol plaques in the arteries weakens the aortic wall. High levels of total cholesterol, LDL, and triglycerides are often observed.
- Family history: A genetic predisposition may increase vulnerability to aneurysm formation.
- Advanced age: Aging arteries are more susceptible to dilation.
Diagnosis and Treatments of Abdominal Aortic Aneurysm (AAA)
Vascular Surgery Specialist in Saint-Laurent-du-Var
Rupture of Abdominal Aortic Aneurysm: A Life-Threatening Emergency
The rupture of an abdominal aortic aneurysm is a critical emergency requiring immediate medical attention. When ruptured, blood spills into the abdomen, causing massive hemorrhage. Symptoms can appear suddenly, sometimes after months or even years without warning signs. Rupture typically causes intense, sudden abdominal pain, often described as “tearing” or “stabbing,” possibly radiating to the back. Other symptoms include nausea, weakness, general malaise, dizziness, and a drop in blood pressure, which may result in shock.
A ruptured AAA can be fatal without prompt medical intervention. This is why consulting a vascular surgeon urgently, in the presence of suspicious symptoms, is essential. Rapid diagnosis and emergency treatment are necessary to save the patient’s life.
Indications for Treatment of Abdominal Aortic Aneurysms
Managing an abdominal aortic aneurysm depends on its size, progression, and the presence of symptoms. In general, surgical intervention is considered only when the aneurysm exceeds a certain size threshold, as defined by medical guidelines. However, in the event of rupture, surgery may be indicated regardless of aneurysm size.
The diagnosis of ruptured AAA relies on clinical signs and paraclinical examinations. Common symptoms include: abdominal and back pain, malaise with loss of consciousness, and neurological issues in the lower limbs (paraplegia).
The most commonly performed exam is a CT angiography (Angio CT) of the aorta and lower limbs.
Monitoring
If the aneurysm is small (generally less than 5 cm in diameter), regular follow-up is implemented to monitor its progression. Ultrasound or CT scans may be performed every six to twelve months to check for size changes. In cases of rapid growth or symptom onset, surgery may be considered.
Surgical Treatment
The treatment of abdominal aortic aneurysm involves a surgical procedure that can be done either via open surgery or endovascular repair (placement of a stent graft).
- Open Surgery: A conventional operation involving an abdominal incision to remove (flatten) the aneurysm and replace the dilated section of the aorta with a synthetic graft. This graft may extend to the iliac or femoral arteries. This procedure requires general anesthesia and several days of hospitalization.
- Endovascular Surgery (EVAR): A less invasive method involving the insertion of a stent graft via the arteries, usually through the femoral artery. This approach is quicker, involves a shorter hospital stay (sometimes as little as 24 hours), and a faster recovery than open surgery. It is often preferred for older patients or those with high surgical risk.
The decision between these two techniques depends on the patient’s overall health, the size and location of the aneurysm, and the patient’s and surgeon’s preferences.
Follow-Up After AAA Rupture
- Regular follow-up consultations with the vascular surgeon and other specialists, such as a cardiologist.
- Routine imaging: Exams such as CT angiography of the aorta and lower limbs, and arterial ultrasound of the aorta and lower limbs, are performed to monitor the integrity of the aorta and the proper placement of the stent graft.
- Blood pressure monitoring: Blood pressure control is essential since hypertension could compromise the repaired aorta.
- Infection prevention: Patients who have undergone major surgery require follow-up to detect potential infections, particularly at the surgical wound or stent insertion site.
- Rehabilitation: In some cases, cardiac or physical rehabilitation may be recommended to help patients regain activity and avoid future complications.
The rupture of an abdominal aortic aneurysm is a medical emergency requiring prompt and effective treatment. Thanks to advancements in surgical techniques, endovascular repair has significantly improved outcomes for patients with this condition. However, prevention—based on early detection and risk factor control—remains a fundamental component of care.
Dr. Ilya KHANTALIN, vascular surgeon in Saint-Laurent-du-Var, is available for consultations and to provide follow-up care for patients at risk or diagnosed with abdominal aortic aneurysms.