New Study Offers Guidelines For Operating On Aneurysms

Larry Stokes has an abdominal aortic aneurysm. Doctors discovered it during heart surgery seven years ago.

"They've been following it ever since and now, it's been getting bigger," Stokes said.

An abdominal aortic aneurysm is an enlargement of the aorta, the main blood vessel that goes from the heart down to the legs. If the wall of the blood vessel becomes weak, it can bulge and possibly rupture.

Surgeons can repair the aneurysm before it ruptures, but the procedure itself is risky, especially for people with other health problems. In the past, surgery has been a difficult decision to make. Now, there are updated guidelines for deciding when to operate and when to leave an aneurysm alone.

Researchers followed nearly 200 patients who had large abdominal aortic aneurysms, along with other medical conditions, such as heart failure or kidney disease.

Doctors monitored them for three years to see how large the aneurysms could grow before the risk of rupture outweighed the risk of surgery.

"We found that for the patients with the smaller aneurysms that we followed, from 5.5 to 6.9 centimeters, one in 10 ruptured within a year," cardiologist Dr. Frank Lederle said.

For aneurysms that reached 8 centimeters or larger, 25 percent ruptured within the next six months. Doctors say the study, published in the

Journal of the American Medical Association

, will help them decide whether surgery is necessary.

Stokes sees his doctor every three months. Due to his heart condition, he and his doctor have decided against surgery at this time.

The new guidelines also recommend that patients see their doctors at least every six months to have their aneurysms evaluated through physical exams, ultrasound or CT scans.