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Spring 2006

Aneurysms Detected and Treated Earlier

Aneurysms are silent killers - seldom do they present symptoms until it's too late. The most common type, abdominal aortic aneurysm - an abnormal widening in the aorta - is rarely felt until there is a rupture, which is frequently fatal. Other types of aneurysms in the smaller arteries of the legs can clot - also without warning - impairing the blood supply to the leg, which can result in amputation.

The good news is that routine examinations in a doctor's office can usually detect an aneurysm before these problems occur, and new minimally invasive treatment approaches have dramatically reduced the pain, average hospital stay and recovery time following repair of these blood-vessel bulges. At UCLA, imaging-guided endovascular surgical techniques are being used to treat many patients with aneurysms. They turn a surgery that once required two weeks in the hospital followed by three to five months of recovery time to one in which many patients are out of the hospital in one to two days and return to full physical activity within a month, according to Peter F. Lawrence, M.D., director of UCLA's Gonda (Goldschmied) Vascular Center, and chief of vascular surgery at UCLA.

"There has been an evolution in devices for the treatment of abdominal aortic aneurysms. We are able to use smaller and smaller catheters that can be passed from the groin arteries, enabling us to attach a graft or stent above and below the aneurysm and repair the vessels," explains William Quinones, M.D., UCLA vascular surgeon who has pioneered methods of aneurysm repair. A similar approach is used to repair aneurysms in the chest (thoracic) and behind the knee (popliteal). Most moderate-sized abdominal aortic and popliteal aneurysms can be detected by doctors in a physical examination or on an ultrasound, says David A. Rigberg, M.D., UCLA vascular surgeon. Thoracic aneurysms are usually found in X-rays or computed tomography scans.

Guidelines suggest that physicians screen their patients who are at the highest risk for aneurysms, especially males over 65 with a history of smoking. Other risk factors include hypertension, or a family or a personal history of an aneurysm. An ultrasound screening test can indicate if the aorta is enlarged, and the approximate risk of rupture. "Aneurysms have become much easier to repair," says Dr. Rigberg, "so it's important to find and treat them before there are complications. Anyone with reason to be concerned should raise this issue with his or her physician."

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