“Blood was pouring from Andrew’s ruptured aorta into the free space inside the belly,” says Gabriel Abraham Wallace, MD, a board certified vascular surgeon and director of Vascular Surgery at Northwestern Medicine Bluhm Cardiovascular Institute at Palos Hospital. “He was dying in front of us. He needed immediate surgery to save his life.”

About Abdominal Aortic Aneurysms (AAAs)

The abdominal aorta, which is about the size of a garden hose, carries blood away from the heart to the lower parts of the body. The vessel wall can weaken and bulge, and if left untreated, the aneurysm can burst. AAAs usually have no symptoms until they rupture. At this point, they can cause sudden death or:

• Sudden and severe abdominal or back pain
• Fainting or dizziness
• Clamminess
• Nausea or vomiting
• Rapid heart rate

“Rapid treatment is the difference between life and death with a ruptured aorta,” says Dr. Wallace. “85% of people with an aortic rupture will die, with 50% not even making it to the hospital. But if the AAA is found with screening it can be fixed preventatively, often with a minimally invasive option and a one-night hospital stay.”

There were 150,000 global deaths attributable to aortic aneurysms in 2020, a 26% increase from 2010, according to 2023 statistics from the American Heart Association.

Research also shows that men* are more likely than women to have an abdominal aortic aneurysm.

Risk factors include:

• Smoking
• High blood pressure
• Family history of aneurysm
• Age

You should get screened with an annual ultrasound for an AAA if you fall into one of these categories:

• Men ages 50 and older with a first-degree relative with AAA
• Men ages 65 and older with a smoking history of 100 or more cigarettes in their lifetime
• Women ages 65 to 75 with a first-degree relative with AAA or a smoking history of 100 or more cigarettes in their lifetime

Talk to your primary care clinician if this applies to you.

Treatment for AAAs

When caught early, treatment involves a minimally invasive surgery to reline the aorta and prevent it from rupturing. “If we know about an aneurysm before it ruptures, we can often treat it and have the patient go home the next day,” says Dr. Wallace. “There are usually no symptoms until it may be too late, so that is why screening is so important.”

If an AAA is caught late after it ruptures, treatment involves emergency surgery and a much longer recovery.

Dr. Wallace has developed a streamlined lifesaving protocol just for this type of emergency. All the necessary equipment is already assembled in a kit for minimally invasive treatment of a ruptured AAA, and is ready for quick deployment. When an aortic rupture is diagnosed, Dr. Wallace sends a text to the operating room team, and they open everything in the kit while he and the medical teams stabilize and transfer the patient.

Through two small incisions in the groin, and without opening Andrew’s stomach, Dr. Wallace stopped the bleeding and repaired the aorta using a minimally invasive technique called endovascular aneurysm repair (EVAR). During the procedure, small flexible tubes called catheters are inserted through the arteries in the groin up to the aorta using X-ray guidance. Often, and in Andrew’s case, the patient does not even require general anesthesia.

After a balloon is inserted to stop the bleeding from the inside, Dr. Wallace relines the inside of the aorta with a stent graft, a tube made of thin metal mesh covered with a thin polyester fabric delivered in a catheter. When the stent graft reaches the aorta, it is released from its delivery catheter and fastened into place to reline and repair the aorta’s wall, stop the internal bleeding, and restore normal blood flow.

“It all came on so suddenly. We just thought it was back pain. We had no idea it was related to his heart,” says Carol DeLuca, Andrew’s wife. “Andrew is doing well, and with daily exercise he has continued to improve his health and regain his quality of life. He is looking forward to golfing once the weather warms up.”

*Scientists do not always collect information from participants about gender identity. To avoid misrepresenting the results of this research, we use the same terminology as the study authors.

Learn more about aortic aneurysms.