Aortic Aneurysm: Understanding the 'Silent Killer' and Its Treatment

Dr. Haitham Khater, head of aortic surgery at Beilinson Hospital in Petah Tikva, discussed aortic aneurysms, often called the 'silent killer,' during September, a month dedicated to raising awareness for the condition. The aorta, the body's main artery, carries blood from the heart to the rest of the body. Weakness in its wall can cause it to expand, posing a risk of rupture.

Khater explained that an aortic aneurysm occurs when the artery wall weakens, typically in the abdomen, causing it to balloon outwards. A rupture leads to severe internal bleeding and a 90% mortality rate. While a normal abdominal aorta is about 2 centimeters in diameter, the risk of rupture increases significantly when it expands beyond 5 centimeters. The condition is more common in men over 50, with a male-to-female ratio of 4:1, though it affects women as well.

Smoking is identified as the primary factor weakening the aortic wall, alongside high blood pressure, cardiovascular diseases, and genetics. In most cases, aneurysms are asymptomatic and discovered incidentally during routine check-ups or imaging tests. However, advanced cases may present with abdominal or back pain.

Diagnosis can be made via ultrasound, and a free screening is available for individuals aged 65 to 75 who are current or former smokers, as part of the national health services basket. Treatment depends on the aneurysm's size. Aneurysms up to 5 centimeters are typically monitored, while larger ones require surgical intervention.

Surgical options include open abdominal surgery or a less invasive endovascular approach using catheters. The catheter procedure, which involves placing stents to create a new pathway for blood and isolate the expanded section, is generally preferred due to fewer complications and easier recovery for the patient. Khater emphasized the critical importance of early detection in saving lives, reiterating the availability of free screenings for at-risk individuals.