Abdominal Aortic Aneurysm
An abdominal aortic aneurysm develops when the wall of the aorta—the largest blood vessel in the body, which carries blood from the heart to all major organs—weakens and bulges, in a localized and permanent way. The blood pressure causes a progressive enlargement of the affected segment, eventually reaching the risk of rupture, a highly dangerous event.
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On this page
- What Is Abdominal Aortic Aneurysm?
- What Are the Symptoms of Abdominal Aortic Aneurysm?
- How Do You Diagnose Abdominal Aortic Aneurysm?
- How Do You Treat Abdominal Aortic Aneurysm?
What Is Abdominal Aortic Aneurysm?
An aortic aneurysm is a dilation in a section of the aorta, the main artery of the body, which carries oxygen-rich blood from the heart to the rest of the organism. Because the section where the aneurysm forms becomes excessively enlarged and weakened, it can rupture. If the aorta ruptures, it can cause severe bleeding that may quickly lead to death.
Aneurysms can develop in any part of the aorta:
- Abdominal aortic aneurysm is the most common and develops in the abdominal region. Here, the aorta supplies blood flow to the abdominal organs, including the liver, intestines, and kidneys, as well as to both legs.
- Thoracic aortic aneurysm is less common. It can affect the ascending aorta, the aortic arch, or the descending aorta, which supply blood to the brain, the arms, and the organs of the chest.
- Pseudoaneurysm a dilation that does not involve all three layers of the aortic wall, it is often caused by trauma.
What Are the Symptoms of Abdominal Aortic Aneurysm?
In most cases, an abdominal aortic aneurysm is asymptomatic, and it is often discovered by chance during tests performed for other reasons. Only rarely can deep, sharp, and persistent pain appear in the back, chest, or abdomen, sometimes radiating to the groin, buttocks, or legs.
The situation changes dramatically in the event of a rupture: symptoms become sudden and severe – intense abdominal and lower back pain, anemia, and a drastic drop in blood pressure due to the massive internal bleeding caused by the rupture.
The onset of these symptoms requires immediate hospitalization. In cases of severe bleeding, the patient can rapidly go into shock and, if not treated promptly, the rupture of an aortic aneurysm can be fatal.
This is why it is essential to know your risk factors and discuss them with your doctor to assess the need for targeted screening for early diagnosis, that can be life‑saving.
How Do You Diagnose Abdominal Aortic Aneurysm?
Since abdominal aortic aneurysms are almost always asymptomatic, they are often diagnosed incidentally during examinations or tests performed for other health issues. If the doctor suspects the presence of an aneurysm, they may prescribe diagnostic tests, including:
- Abdominal ultrasound or color‑Doppler ultrasound.
- Abdominal computed tomography (CT scan).
- Magnetic resonance angiography (MRA).
- Echocardiogram.
Risk Factors for Abdominal Aortic Aneurysm
The wall of the aorta is normally very elastic to adapt to blood flow. Certain risk factors can weaken it and lead to the development of an aneurysm, including:
- Atherosclerosis (buildup of cholesterol, calcium, and other substances within the inner lining of an artery).
- High cholesterol.
- Diabetes.
- Age (over 60).
- Family history.
- Genetic factors.
- Smoking.
- Infections.
- High blood pressure.
- Obesity.
- Male sex.
- Trauma.
How Do You Treat Abdominal Aortic Aneurysm?
If an abdominal aortic aneurysm is diagnosed, the doctor will refer you to a vascular surgeon, who will define a treatment plan based on the aneurysm’s size and growth rate, as well as your medical history and other risk factors.
Small Aneurysms (less than 5 cm)
Small anuerysms have a low likelihood of rupture and usually do not require immediate treatment. A conservative approach is typically recommended, which includes:
- Regular ultrasound monitoring to track the size and growth rate of the aneurysm and eventually schedule surgery if needed.
- Drug therapy to control blood pressure.
- Lifestyle modifications: quitting smoking, following a heart‑healthy diet, maintaining a healthy weight, controlling cholesterol, related conditions (e.g., diabetes, heart disease), and engaging in physical activity.
Large or Rapidly Growing Aneurysms (greater than 5–5.5 cm)
Large or rapidly growing aneurysms carry a higher risk of rupture and may require an elective surgical procedure. The two main options are:
- Open surgical aneurysm repair – A procedure performed under general anesthesia, lasting approximately 3–6 hours, with a postoperative hospital stay of about 5–8 days. It is a definitive treatment but carries a higher mortality risk in patients with severe comorbidities. For this reason, it is generally reserved for younger patients with good overall health and considered low surgical risk.
- Endovascular aneurysm repair (EVAR) – A less invasive procedure performed under epidural anesthesia, lasting 2–5 hours, followed by a shorter hospital stay, typically 1–2 days.
The choice between the two techniques requires a thorough evaluation of the patient’s overall clinical condition — particularly the presence of comorbidities affecting the heart, lungs, or kidneys—as well as the aneurysm’s characteristics: size, growth rate, and morphology.
Reviewed April 2026.