Aortic & Aneurysm Disease
Aortic Aneurysm
Specialist assessment, surveillance and treatment of aortic aneurysms, including both endovascular and open surgical treatment where appropriate.
Surveillance, EVAR and open repair
Many aortic aneurysms are discovered before they cause symptoms. The appropriate plan depends on aneurysm size, growth, anatomy, symptoms and individual treatment risk.
Understanding Aortic Aneurysms
What is an aortic aneurysm?
The aorta is the largest artery in the body. It carries blood from the heart through the chest and abdomen before dividing into arteries supplying the legs.
An aortic aneurysm develops when part of the wall of the aorta becomes enlarged and expands beyond its normal diameter. The most common form treated by vascular surgeons is an abdominal aortic aneurysm, often shortened to AAA.
Many aneurysms cause no symptoms and are discovered during screening or imaging performed for another reason. The main concern is that an aneurysm may continue to enlarge and eventually become at risk of rupture.
An aneurysm may be found
- During abdominal aortic aneurysm screening
- Incidentally during an ultrasound or CT scan
- During investigation of abdominal or back symptoms
- During follow-up of known vascular disease
- During investigation of another aneurysm
- Following assessment of a family history
Surveillance
Not every aneurysm needs immediate surgery
Smaller aneurysms can often be monitored with regular imaging so that changes in size can be identified over time.
Measure the Aneurysm
Ultrasound or cross-sectional imaging is used to establish the size and location of the aneurysm.
Monitor for Growth
Repeat imaging may be recommended at appropriate intervals depending on the size of the aneurysm.
Review Treatment Need
Repair may be considered when the balance between aneurysm-related risk and treatment risk changes.
Most abdominal aortic aneurysms do not cause symptoms
This is why aneurysms are often discovered through screening or imaging performed for another reason. When symptoms do occur they may include persistent abdominal or back discomfort or a pulsating sensation in the abdomen.
Risk Factors
Who is more likely to develop an AAA?
Aortic aneurysms become more common with age and are associated with several cardiovascular and inherited risk factors.
Diagnosis
Assessing the size, shape and anatomy
Imaging is used to determine whether an aneurysm is present, how large it is, where it is located and whether treatment should be considered.
More detailed imaging is usually needed when planning repair so that the relationship between the aneurysm and surrounding arteries can be assessed accurately.
Ultrasound
Abdominal ultrasound is commonly used to diagnose and monitor abdominal aortic aneurysms.
CT Angiography
CT imaging provides detailed information about aneurysm anatomy and is commonly used when planning treatment.
Specialist Review
Imaging findings are considered alongside symptoms, general health, aneurysm growth and treatment risk.
Management
Treatment depends on the individual aneurysm
Management is based on aneurysm size, rate of growth, symptoms, anatomy and the patient's wider health.
Surveillance
Smaller aneurysms may be monitored with repeat imaging rather than repaired immediately.
Cardiovascular Risk Reduction
Smoking, blood pressure and wider cardiovascular health are important considerations in patients with aneurysmal disease.
Aneurysm Repair
When repair is appropriate, treatment may involve either endovascular or open surgery.
Aortic Aneurysm Repair
Endovascular and open treatment
The most appropriate type of repair depends on the anatomy of the aneurysm, overall health, expected durability and individual treatment risk.
EVAR
Endovascular aneurysm repair, or EVAR, is a minimally invasive technique in which a stent graft is introduced through the arteries and positioned inside the aorta to exclude the aneurysm from the circulation.
Open Aneurysm Repair
Open repair involves replacing the weakened section of the aorta with a surgical graft through an abdominal operation.
Open and endovascular aortic surgery
Mr Benaragama's vascular practice includes the assessment and treatment of aortic aneurysmal disease, with both open surgical and endovascular repair available where clinically appropriate.
Mr Shanka Benaragama
Consultant-led assessment from diagnosis to treatment
Mr Benaragama is a Consultant Vascular and Endovascular Surgeon at Royal Free London and University College London Hospitals.
His clinical expertise includes aortic and visceral artery aneurysms, alongside the full range of open and endovascular arterial intervention.
This allows aneurysm treatment to be considered within the wider context of vascular health, anatomy and individual treatment goals.
Aortic Aneurysm Emergency
A ruptured aneurysm is a life-threatening emergency
Call 999 immediately for sudden, severe abdominal or back pain, particularly if accompanied by collapse, loss of consciousness, severe breathlessness or other signs of serious illness.
If rupture is suspected, do not wait for a routine private consultation. Emergency hospital treatment is required.
Sudden severe pain or collapse in a person with a known aortic aneurysm requires immediate emergency assessment.
Frequently Asked Questions
Aortic aneurysm questions
What is an abdominal aortic aneurysm?
An abdominal aortic aneurysm is an enlargement of the section of the aorta that passes through the abdomen.
Do aortic aneurysms cause symptoms?
Many abdominal aortic aneurysms cause no symptoms and are discovered during screening or imaging for another reason. Larger aneurysms may occasionally cause abdominal or back discomfort or a pulsating sensation in the abdomen.
How is an abdominal aortic aneurysm diagnosed?
Ultrasound is the main test used to identify and measure an abdominal aortic aneurysm. More detailed CT imaging may be required when planning treatment.
Does every aneurysm need an operation?
No. Smaller aneurysms may be monitored with regular imaging. Repair is considered according to aneurysm size, growth, symptoms, anatomy and individual treatment risk.
What is EVAR?
EVAR stands for endovascular aneurysm repair. A stent graft is introduced through the arteries and positioned inside the aorta to exclude the aneurysm from the circulation.
What is the difference between EVAR and open repair?
EVAR is performed from within the blood vessels using a stent graft. Open repair involves an abdominal operation and replacement of the affected aortic segment with a surgical graft.
Which type of repair is best?
There is no single approach that is appropriate for every patient. The choice depends on aneurysm anatomy, age, overall health, operative risk and long-term considerations.
What should I do if I have sudden severe abdominal or back pain?
Sudden severe abdominal or back pain, particularly with collapse or loss of consciousness, can indicate a medical emergency. Call 999 immediately.
Aortic Aneurysm Consultation
Request a specialist vascular consultation
If an aortic aneurysm has been identified on a scan, you are undergoing surveillance or would like a specialist opinion about treatment, please contact the practice by email.
Email to Request a Consultation → benaragama.admin@lips.org.uk