SINGAPORE: More people are susceptible to aortic aneurysms as patients suffering from chronic diseases like diabetes and heart problems increase.
The Singapore General Hospital (SGH) said it sees three to four patients with the condition every week.
An aortic aneurysm is a bulge in a section of the aorta, the body’s main artery that supplies oxygen—rich blood to the rest of the body. It’s almost always fatal when the aneurysm ruptures.
A significant number of patients do not make the cut for the conventional stent operation which can be done to prevent the aneurysm from rupturing.
Two years ago, taxi driver Wong Hon Meng was admitted into hospital with stones in his gall bladder.
And it was a blessing in disguise for the 73—year—old.
It was then that doctors discovered he had an aneurysm that was about 4.4 centimetres.
Back then, the aneurysm had not yet reached dangerous levels. Experts usually recommend surgery if it is more than five centimetres in width. This, as anything that’s five to six centimetres will have a five to 10 per cent risk of rupture and after two years, it’s 10 to 20 per cent.
Mr Wong said: "The scan showed that the aneurysm was about 6.1 centimetres, I felt my back was pulled and was in pain. The pain doesn’t stop.
"My mother also had this condition. She’s someone who loved food, but she suddenly stopped eating so I asked why and she told me her back was hurting. It was so bad that my children and I had to send her to hospital and the doctor said they couldn’t save her because the aneurysm ruptured."
Like his mother, many patients with the silent killer go undetected.
Consultant at the General Surgery Department at SGH Dr Benjamin Chua said: "There are some other symptoms that patients sometimes present with. Most significant is abdominal pain with back pain, lower back pain. This can sometimes be confused with conditions of the spinal bones of the back, but sometimes in aneurysm it’s the underlying cause.
"Other times they can present with pain in walking certain distance, with the inability to walk further than maybe 50, 100 metres and that’s because the aneurysm contains blood clots that are showered down into the legs."
Another symptom is a pulsating mass in the stomach.
Doctors said about three to five per cent of the population have this condition. And of these, men aged 60 years and above are more prone to it.
About 30 to 40 per cent of patients, however, do not qualify for the standard stent graft operation and for these patients, the minimally invasive treatment is now available.
With endovascular surgery, the patient goes under light sedation instead of general anaesthesia, which reduces the risk of heart attack or stroke during the operation.
Dr Chua said: "Previously if we had discovered an aneurysm years ago, the operation of choice was open repair and this would involve making an incision in the abdomen and exposing the aorta, and then stitching the graft. Now that sounds relatively straightforward, except the fact that the patient would be under general anaesthesia. This sometimes put a strain on the heart and can precipitate a heart attack inter—operatively, or even a stroke sometimes."
In February this year, Mr Wong went for the new surgery.
Dr Chua said: "We make small little puncture holes in the artery. From there, through a series of wires, across the aneurysm, we then deploy a stent inside the artery to cover the aneurismal portion from the inside."
With the conventional method, patients normally recover in about a months’ time but with the new method patients can resume their daily activities within two weeks.
Mr Wong said: "There are barely any scars. The five incisions are really tiny so you can’t really tell."
The mortality rates are also lower for endovascular repair than open repair.
Studies have shown that endovascular repair reduces the risks of leakage from 50 per cent to 20 per cent, compared to an open repair.
But stent grafts alone can cost up to S$25,000.
So Dr Chua urged the public to be more vigilant, keep their chronic diseases under control and maintain a healthy lifestyle.
As for Mr Wong, who suffers from high blood pressure and high cholesterol, going for regular check ups is now a must having realised it’s hereditary.
On his part, Mr Wong now makes it a point to go for an hour—long walks almost every day.
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