How can a man manage an abdominal aortic aneurysm at age 69?

Question

Hello doctor,

I am a 69-year-old male. My AAA was detected by accident 7 years back when I had an MRI scan for chiropractic treatment on my spine or thigh; a subsequent ultrasound revealed a 3.8 cm AAA; my GP referred me to a local hospital vascular surgeon. I have been told by my physician not to worry.

Should I go for a second opinion?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query.

I understand your concerns. Higher blood pressure, COPD, and tobacco use are very important risk factors for rupture. The most important preventive step for rupture or complications of AAA is to stop smoking, which you have already done. So coming to medications, Aspirin, and Atorvastatin have some evidence of preventing complications of AAA, and should be given. BP control is very important, which in your case is good, as reported.

Based on the size of the AAA, the risk of rupture in AAA < 4 cm in size is 0 % per year. Your case is 3.8 cm. A growth rate of more than 5 mm in 6 months or more than 1 cm per year should be repaired irrespective of the size. Your case is 1 cm over 4 years. Regarding your date for follow-up ultrasound at 4 months; the following is a well-accepted standard protocol based on AAA size.

Based on the form or shape of AAA. A saccular outpouching from the aorta has a higher risk of rupture and should be repaired earlier. All this information is from statistics and has an error margin of less than 5 %. Thus, I have tried to put down the risks involved and hope it fills the knowledge gaps and helps you gain some confidence in your practitioner's advice.

I hope this has helped you.

Thank you.