Aortic Aneurysm (AAA)

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Treatment for Aortic Aneurysm (AAA)

An abdominal aortic aneurysm (AAA) is a bulge in the main blood vessel running from your heart to your tummy. 

Treatment for an abdominal aortic aneurysm is usually only needed if there’s a risk it could burst. Large aneurysms can be treated with surgery.

Booking your initial consultation will enable Liverpool Vascular Clinic to assess your condition and provide the advice and specific treatment that’s right for you.

The Treatment & Process

A full and comprehensive range of treatments are offered by the Liverpool Vascular Clinic who will assess and provide the appropriate treatment for you. Below are some of the most common treatments we offer.

Assessment

All treatment plans start with our assessment / initial consultation. This allows our specialists to fully understand your condition and work out the right path of treatment for you.

Screening

Screening for AAA involves a painless ultrasound scan of your tummy.  This is just like the scan pregnant women have.

The scan itself is a simple process…

  • You will be asked to lie down on a table and lift up or unbutton/loosen your top ( but don’t worry, you do not need to undress)
  • One of our experts will then rub a clear gel on your tummy and moves the ultrasound scanner over your tummy – images from the scan are displayed on a monitor and our expert will measure how wide your aorta is
  • The gel will then be wiped away leaving you to put your top back down
  • Liverpool Vascular Clinic will tell you the result straight away

The whole screening scan only takes 10 to 15 minutes.

Surveillance

Liverpool Vascular Clinic will determine how often you will need to have a scan which will depend on the size of your aneurysm. Whilst your AAA is small, you may only be asked for a scan once or twice a year. If your AAA grows to a size of greater than 5cm we will ask you to come for more frequent scans (every 3 months).

If your AAA begins to produce symptoms, or increases in size (as measured by our scan), Liverpool Vascular Clinic will arrange for you to speak to one of our surgeons as you may then need to consider the benefits and risks of having a planned operation to repair it.

Treatment

Liverpool Vascula Clinic will recommend the relevant treatment for your AAA depending on its size.

Rest assured, treatment is not always needed straight away if the risk of an AAA bursting is low.

Recommended treatments are as follows:

  • Small AAA (3cm to 4.4cm across) – scans are recommended once per year to check if it’s getting any larger; we will advise you about healthy lifestyle changes to help stop it from growing any further
  • Medium AAA (4.5cm to 5.4cm) – Liverpool Vascular Clinic recommends a scan every 3 months to check if it’s getting any larger; again, we will advise about healthy lifestyle changes
  • Large AAA (5.5cm or more) – We will advise about going to surgery to stop it from getting larger or if it’s at risk of bursting

Surgery

With larger >5.5 cm  AAA, we would consider surgery to strengthen it with a graft. Liverpool Vascular Clinic recommend this if the risk of it bursting is higher than the risk of complications from surgery.

There are 2 main types of surgery for an AAA:

  • Endovascular surgery (EVAR) – the graft is inserted into a blood vessel in your groin and then carefully passed up into the aorta
  • Open surgery – the graft is placed in the aorta through a cut in your tummy

Both techniques are equally good at reducing the risk of an AAA bursting, but each has its own advantages and disadvantages. Talk to your surgeon about which is best for you.

Liverpool Vascular Clinic will discuss in detail any procedure with you during  your consultations in advance of any surgery.

 

Re-Assess and discharge

Open AAA repair usually requires follow-up for 6 to 12 months whereas Endovascular repair will require lifelong surveillance in a specialist program. Usually this will be once a year once stable. This is a highly individualised decision as young patients or those with suspected connective tissue abnormality may require surveillance after open surgery also.

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Patient Reviews

"Following the discovery of abnormal blood pressure readings I was fortunate enough to be referred the consultant vascular surgeon Dr Neequaye.

Tests and scans revealed that I had a rare arterial plumbing configuration. Following discussion we decided that the condition would be managed medically with now annual checks and two yearly scans.

I am grateful for his level of expertise,the confidence this inspires and for the inclusive nature of our consultations. "

Mrs H from Liverpool

"I found him to be an extremely skillfull, cautious and approachable Vascular Surgeon and despite the challenges created by the pandemic left no stone unturned at the pre-op stage.

He was never rushed and always took time to explain, in layman’s terms, and sometimes with sketches precisely what he was proposing as the solution to my pending complex Aortic Aneurysm repairs.

My procedure took place in early June 2021, I now feel fit and well and extremely fortunate indeed that my Surgeon was Mr Simon Neequaye."

Brian D

"After struggling with the veins in my left leg for 8 years, deciding to proceed with treatment from Mr Neequaye was the best thing I ever did. He kept my calm throughout the procedure, and the results are better than I’d have imagined."

Imogen E