An abdominal aortic aneurysm is a weakening in the lower part of the body’s main artery, which begins just below the diaphragm and extends through the abdomen, where it supplies oxygen-rich blood from the heart to the stomach, intestines, kidneys and legs. Over time, the continual pressure of blood flowing through the aorta can cause the weakened area of its wall to expand and bulge outward, forming an aneurysm. This condition is relatively common, especially in older adults. Often, it develops slowly and does not cause noticeable symptoms in its early stages.

What Are the Types of Abdominal Aortic Aneurysms?

Abdominal aortic aneurysms are generally classified based on their shape and location. The types include:

Fusiform Aneurysm

The most common type of abdominal aortic aneurysm is a fusiform aneurysm, which is a symmetrical, spindle-shaped bulge that extends along a small section of the artery. The dilation occurs on all sides of the vessel, creating a uniform appearance. This type of abdominal aortic aneurysm usually develops in the infrarenal aorta, which is located just below the kidneys.

Saccular Aneurysm

A saccular aneurysm is an uncommon type of abdominal aortic aneurysm that may appear as an outpouching or sac on one side of the aorta. Often irregular in shape, the sac may form as a result of trauma, infection or a localized defect in the vessel wall. Due to its unique structure, a saccular aneurysm may carry a heightened risk of rupture.

Infrarenal, Juxtarenal and Suprarenal Aneurysms

Abdominal aortic aneurysms are also categorized based on their position relative to the renal arteries. The types include:

• Infrarenal aneurysms – Occur below the renal arteries (most common)
• Juxtarenal aneurysms – Located near the renal arteries, but do not extend above them
• Suprarenal aneurysms – Extend above the renal arteries and may affect nearby branches of the aorta

What Are the Causes and Risk Factors for Abdominal Aortic Aneurysms?

An aneurysm develops when the wall of an artery becomes weakened and loses its strength and flexibility. Several underlying processes can directly cause this type of degeneration in the abdominal aorta. These include:

• Age-related degenerative changes – The aortic wall naturally loses its strength and flexibility over time, contributing to the gradual breakdown of the vessel’s structural integrity.
• Atherosclerosis – The most common cause of abdominal aortic aneurysms, atherosclerosis involves the buildup of fatty deposits, cholesterol and other substances along the arterial walls. This process can erode the aortic lining and reduce the elasticity of the vessel, making it more vulnerable to bulging.
• Chronic inflammation – Inflammatory processes within the aortic wall can break down its structural proteins, such as elastin and collagen. This can weaken the wall over time, particularly in an individual with ongoing vascular inflammation.
• Connective tissue disorders – Certain inherited conditions, such as Marfan syndrome and Ehlers-Danlos syndrome, can affect the body’s connective tissues, including those that support blood vessels. This may allow the aorta to weaken and expand abnormally.
• Infection or trauma – In rare cases, an infection (mycotic aneurysm) or physical trauma to the abdomen can damage the aortic wall and result in an aneurysm.

Risk factors for abdominal aortic aneurysms include:

• Advanced age – The risk of developing an abdominal aortic aneurysm increases significantly after age 65, particularly when other cardiovascular risk factors are present.
• Gender – Studies show that men are more likely to develop abdominal aortic aneurysms than women. The reason is unknown.
• Genetics – A family history of aneurysms may increase the risk. While some cases are linked to specific gene mutations (monogenic), many are believed to result from a complex interplay of multiple genes and environmental factors (polygenic).
• High blood pressure – Chronic hypertension places added stress on the aortic wall, increasing the likelihood of vessel weakening and aneurysm formation.
• High cholesterol and cardiovascular disease – Elevated cholesterol levels and existing heart or vascular disease are associated with processes that can contribute to aneurysm development.
• Tobacco use – Smoking is one of the strongest modifiable risk factors for heart disease. It directly damages blood vessels and accelerates the progression of atherosclerosis.

What Are the Warning Signs and Symptoms of an Abdominal Aortic Aneurysm?

Most small and moderately sized abdominal aortic aneurysms do not cause noticeable symptoms. In many cases, the condition is discovered incidentally during an imaging test performed for an unrelated reason.

As an abdominal aortic aneurysm grows, it can begin to press on the surrounding organs and tissues. This may cause:

• A feeling of fullness or other discomfort in the abdomen
•  Persistent, deep pain in the abdomen or lower back
• A pulsating sensation near the navel

These symptoms are often vague and can be easily mistaken for another, less serious condition, such as a muscle strain or indigestion. Therefore, it is important to promptly discuss any unusual changes with a physician.

A ruptured abdominal aortic aneurysm can lead to life-threatening internal bleeding and requires emergency medical attention. Warning signs include:

• Dizziness, fainting or shock
• Nausea or vomiting
• Pain that spreads from the abdomen to the pelvis, buttocks or legs
• Rapid heart rate or low blood pressure
• Sudden-onset, severe abdominal or back pain

Because the symptoms of an abdominal aortic aneurysm are often absent or subtle until the condition progresses and becomes serious, routine screening is often recommended for those at increased risk. Early detection can allow for careful monitoring and timely treatment before complications occur.

How Is an Abdominal Aortic Aneurysm Diagnosed?

The diagnostic process for an abdominal aortic aneurysm may include:

Physical Examination

During a routine medical checkup, the physician may detect a pulsating mass in the abdomen or hear a whooshing sound (bruit) when listening through a stethoscope. This abnormal sound can result from turbulent blood flow through a narrowed or obstructed artery. However, this finding is not always present and may be difficult to detect if the aneurysm is small or the patient is obese.

Ultrasound

An abdominal ultrasound is the most common and reliable tool for diagnosing an aortic aneurysm. This noninvasive imaging test is widely available and can be highly accurate in measuring the size of the aorta and any abnormal dilation. Ultrasound may be used for the initial diagnosis as well as the ongoing monitoring of a known aneurysm.

Computed Tomography (CT)

A CT scan can provide detailed cross-sectional images of the aorta and surrounding structures. This imaging test can be especially useful for evaluating a large aneurysm, assessing the risk of rupture and planning surgical intervention. The procedure may be performed with contrast dye (CT angiography) for enhanced image clarity.

Magnetic Resonance Imaging (MRI)

MRI may be used in certain cases where radiation exposure is a concern or when more precise imaging is needed. Like a CT scan, it can help the physician evaluate the size, shape and extent of an aneurysm in detail.

How Is an Abdominal Aortic Aneurysm Treated?

Treatment can vary based on the size of the aneurysm, how quickly it is progressing and whether it is causing symptoms. The primary goals are to prevent rupture and manage any associated risks. Options may include:

Monitoring and Medical Management

A small, asymptomatic aneurysm can often be managed through routine monitoring, which may involve periodic ultrasound or CT scans to track any changes in its size. Additionally, the patient will likely be advised to:

• Consume a heart-healthy diet and exercise as appropriate
• Manage blood pressure and cholesterol levels
• Stop smoking (if applicable)

If needed, the physician may also prescribe medications, such as beta-blockers or statins, to reduce stress on the aortic wall and lower the risk of aneurysm growth.

Surgery

Surgical treatment may be considered for an aneurysm that is relatively large (5.5 centimeters or greater in diameter), growing rapidly or causing disruptive symptoms.

The two main surgical approaches are:

Open Surgical Repair

After making a large incision in the abdomen, the surgeon will remove the weakened section of the aorta and replace it with a synthetic graft. This procedure is well established and effective, but it may involve a long recovery.

Endovascular Aneurysm Repair (EVAR)

EVAR involves making a small puncture in the groin, the surgeon will insert a long, flexible tube (catheter) and guide it through the aorta to reach the aneurysm. Using the catheter and special surgical tools, the surgeon will place a fabric tube supported by metal mesh (endograft stent) inside the aneurysm. The stent will serve as a “pipe,” reinforcing the weakened area of the aortic wall and relieving pressure to help prevent rupture. This minimally invasive procedure typically involves a shorter recovery time than open surgery and is often preferred for patients at heightened surgical risk.

What Are the Possible Complications and Long-Term Effects of an Aortic Aneurysm?

If not identified and managed appropriately, an aneurysm can lead to serious, potentially life-threatening complications. Even with treatment, some patients may face long-term effects that require lifestyle adjustments and ongoing medical care. 
Possible complications of an abdominal aortic aneurysm include:

Aortic Rupture

The most serious risk associated with aneurysms is rupture. If a weakened section of the aorta bursts, it can cause massive internal bleeding, leading to shock and possibly death if not treated immediately. As an aneurysm grows and expands, the risk of rupture increases.

Aortic Dissection

Though rare, an aneurysm may cause a tear in the inner layer of the aortic wall. Known as an aortic dissection, this complication may cause severe chest or abdominal pain and compromise blood flow to vital organs.

Blood Clots and Embolism

An aneurysm can promote the formation of blood clots along the inner wall of the aorta. Clots can potentially break loose and travel through the bloodstream, potentially creating arterial blockages and causing serious complications, such as stroke, kidney damage and limb ischemia.

Infection 

Though uncommon, an aneurysm can become infected. Known as a mycotic aneurysm, this serious complication may require surgical intervention and long-term antibiotic use.

Complications After Surgical Repair

Both open and endovascular aneurysm repair carry certain risks, including bleeding, infection and issues related to the heart, lungs and kidneys. Additionally, after EVAR, the graft may move out of position or an endoleak may develop if blood continues to flow into the aneurysm sac. This complication may require monitoring or further intervention.

Can Abdominal Aortic Aneurysms Be Prevented?

Not all aneurysms can be prevented, especially in genetically predisposed individuals. However, certain lifestyle changes and medical interventions can significantly reduce the risk of developing the condition or slow its progression. These include:

Avoiding Tobacco Use

Of all modifiable risk factors, smoking contributes most directly to the development and progression of abdominal aortic aneurysms. This harmful habit contributes to atherosclerosis, weakens the arterial walls and increases the risk of aneurysm growth and rupture. Quitting tobacco can greatly reduce these risks.

Managing Blood Pressure and Cholesterol Levels

Hypertension places added stress on the aortic wall, increasing the risk of weakening and dilation. To help protect the aorta, it is important to control blood pressure through proper nutrition, regular exercise and medications if needed. Additionally, maintaining healthy cholesterol levels can reduce the progression of atherosclerosis, a common underlying cause of aneurysms.

Maintaining a Healthy Lifestyle

Positive habits such as consuming a nutritious diet, engaging in regular physical activity and achieving and maintaining a healthy body weight can support overall vascular health and help preserve the integrity of the arterial walls.

Controlling Chronic Conditions

Managing longstanding health conditions, such as diabetes and peripheral artery disease (PAD), can lower the risk of aneurysm development and related complications.

Undergoing Physician-Recommended Screenings

For a high-risk individual, such as a male aged 65 or older with a history of smoking, a physician may recommend regular abdominal ultrasound screenings to help identify aneurysms. Early detection can allow for close monitoring and timely treatment before serious complications develop.

Living With an Abdominal Aortic Aneurysm

An aneurysm is a chronic condition that requires ongoing monitoring, lifestyle adjustments and a commitment to maintaining good cardiovascular health. Although a small or slow-growing abdominal aortic aneurysm may cause few or no symptoms, regular medical oversight will still be necessary.
For many patients, living with an abdominal aortic aneurysm may involve:

Lifestyle Changes

After being diagnosed with an abdominal aortic aneurysm, the patient will likely be advised to:

• Control blood pressure and cholesterol levels
• Eat a heart-healthy diet
• Stay physically active
• Stop smoking (if applicable)

The physician may also instruct the patient to limit heavy lifting and other strenuous activities to avoid putting excess pressure on the aorta. These positive habits can help slow the growth of an aneurysm as well as reduce overall cardiovascular risk.

Medications 

If the patient has hypertension or high cholesterol, the physician may prescribe medications, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers or statins. Adhering to the prescribed treatment regimen can help support vascular health and reduce the risk of aneurysm progression and rupture.

Medical Follow-Up

An individual with a small aneurysm will typically be advised to undergo imaging tests, such as ultrasounds or CT scans, every six to 12 months. These regular checkups will allow the physician to monitor the growth of the aneurysm and determine if or when surgical intervention is needed. Keeping these appointments is essential for reducing the risk of complications.

Post-Surgical Considerations

If the patient undergoes open or endovascular aneurysm repair, the recovery period will typically involve several weeks of restricted activity followed by long-term monitoring. After EVAR, ongoing imaging will be needed to allow the physician to monitor the position and function of the graft.

Stress Reduction

For some people, knowing that an aneurysm is present can cause anxiety or uncertainty. For instance, a patient may be concerned about the effects of physical activity, their long-term health and whether the aneurysm will grow and rupture. Regular follow-up care and ongoing communication with a trusted physician can help reduce stress and promote confidence in managing the condition.

Benefit From World-Class Care at TGH

TGH is proud to be the only academic health system in the Tampa Bay region included on the list of “100 Hospitals and Health Systems with Great Heart Programs” compiled by Becker’s Hospital Review, a leading healthcare business news and analysis platform. This national recognition highlights our dedication to delivering advanced, high-quality cardiovascular care through innovation and expertise, and we consistently achieve outcomes that exceed national averages. In addition, we have been recognized as one of the Nation's Best Hospitals for Heart & Vascular Care by U.S. News & World Report for 2025-2026.

To learn more about abdominal aortic aneurysms or to schedule a consultation with a specialist at our nationally recognized Heart and Vascular Institute, please call (800) 844-3900 or email heart-vascular@tgh.org.