What does an ultrasound of the abdominal aorta show

Abdominal Aortic Aneurysm - Detect Changes Early

What is an abdominal aortic aneurysm?

The main artery is called the aorta. It is through them that the blood flows from the heart into the body. With age, the tissue of the abdominal aorta can become less stable. This can cause a bulge. Experts speak of one Aneurysm. Those affected do not notice anything. The vessel wall is weaker at this point. Therefore, there is a risk that it will tear. Then you can bleed to death inside.

What are the causes?

Several circumstances can play a role in creating a bulge. These include, for example:

  • Smoke
  • high blood pressure
  • increased blood lipids
  • older age
  • hereditary predisposition

Who can be affected?

Aortic bulges are rare. They are most likely to occur in people over 65 years of age and significantly more frequently in men than in women: about 2 in 100 men between 65 and 75 years of age are affected. That is why the health insurance pays men over 65 years of age a one-time ultrasound examination for early detection. High-quality studies have shown: These men can benefit from the screening examination.

How often does an aneurysm tear?

A bulge in the abdominal artery rarely ruptures. But a crack is life-threatening. The sudden loss of blood leads to dizziness, loss of consciousness and ultimately to cardiovascular collapse. Whether an aneurysm ruptures depends, among other things, on how big it is. Rough estimates say:

  • If the bulge is 4 to 5 centimeters, around 3 in 100 people will tear.

  • If it is 5 to 6 centimeters tall, around 10 out of 100 people will tear.

  • If it is larger than 7 centimeters, around 60 out of 100 people will tear.

How fast the bulge grows also plays a role, whether people smoke, a lung disease (COPD) or have high blood pressure.

What are the benefits of early detection?

The purpose of the examination is to identify a bulge before it becomes dangerous. A subsequent operation can prevent the artery from tearing at this point. For men over 65 years of age, it has been proven that early detection and subsequent surgery can prevent cracks, emergency treatments and deaths. For 1,000 men who go to the screening examination within 13 years, the following estimate is available:

  • In about 20 out of 1,000 men examined, a bulge is found in the early diagnosis.

  • With early detection tears a bulge in about 4 out of 1,000 men examined. About 3 in 1,000 die from it.

  • Without early detection tears a bulge in about 7 out of 1,000 men examined. About 6 in 1,000 die from it.

The early detection and the subsequent operation saved 3 out of 1,000 men examined from a rupture of the abdominal artery and from death.

What are the risks?

The examination itself has no complications. But she can discover bulges that would never have become dangerous. These harmless changes cannot be clearly distinguished from dangerous ones:

  • Experts estimate: about every second aneurysm that is found through early detection is harmless. Those affected are regularly examined again. Maybe that's why they are unnecessarily afraid and would have been glad not to hear about it.

The investigation alone is of no use. Experts recommend surgery if the bulge is larger than 5.5 centimeters. Either an artificial piece of vessel or a tube is inserted into the artery. This procedure can have serious complications:

  • About 2 to 4 out of 100 people who have been operated on die as a result of the operation. Age and comorbidities play a role, but also the surgical technique and the experience of the surgeon.

  • The operation can lead to strokes, pneumonia or infections.

With a height of up to 5.5 centimeters, experts recommend no intervention, but regular checks. Affected people receive a troubling diagnosis that initially nothing is done about.

What you can do yourself

  • You should not undergo an examination just to be "reassured". In most cases it is normal. However, there is a change in around 20 out of 1,000 men examined.

  • Before you begin, be aware: If a bulge is discovered, would you be ready for preventive surgery? If not, the investigation will not benefit you.

  • Think carefully about your decision. The investigation is not urgent. Let the advantages and disadvantages be explained to you in detail and ask if you have not understood something.

  • Whether a bulge develops or tears can also depend on your lifestyle and concomitant diseases. Those who don't smoke and watch their blood pressure have a lower risk of dying from a ruptured aneurysm.
January 2018, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians