Loyola Medicine expert detects and treats abdominal aortic aneurysm

Reviewed by Kate Anderton, B.Sc. (Editor)Feb 16 2020

When 64-year-old Robert Johnson of Highland, Indiana thought he had kidney stones, he visited his primary care physician who couldn't see anything of concern. He pushed, saying "I'm not making up this pain. It's waking me up every night." When his urologist sent him for a CT scan, they found a large abdominal aortic aneurysm (AAA). He had an emergency surgery and a stentgraft was placed to cover the aneurysm and prevent it from rupturing.

After seven years with the stentgraft in place, Mr. Johnson went to the hospital with the same pain. His cardiologist sent him to Loyola Medicine for treatment, knowing that the problem was beyond the scope of the care the community hospital could provide. "Dr. Bechara at Loyola told me that I was having pain because the aneurysm was eroding into one of my blood vessels in the abdomen which brings blood back to the heart. I was very fortunate that my aneurysm came with pain because I was able to seek medical treatment."

Carlos Bechara, MD, is a vascular surgeon at Loyola who performs both open and minimally invasive aneurysm surgery.

The most important thing for us to provide patients and physicians is education and awareness about AAAs. An aneurysm is "a ballooning of the vessels, the larger it gets, the thinner the wall of the blood vessel gets. It's important to detect it before it ruptures. Not all patients are lucky like Mr. Johnson - some patients present with rupture as their first symptom, so it is very crucial to detect an aneurysm before this occurs."

Dr. Carlos Bechara, MD, vascular surgeon at Loyola Medicine

Aneurysms can be detected with an ultrasound or CT scan. Patients most at risk for AAAs are men over age 65 who have smoked cigarettes and/or have a strong family history of aneurysm. For these patients, a one-time screening is recommended. The goal of detection and treatment is to prevent the aneurysm from rupturing.

Support for patients at Loyola with AAAs includes vascular and cardiac surgeons and a full spectrum of therapies for aneurysms regardless of location. Dr. Bechara explains, "Surgical treatment for an AAA can be performed through open surgery or endovascular surgery. During open surgery, the damaged section of the aorta is removed and a graft is put in its place to restore blood flow." Medical monitoring is recommended for patients who have small asymptomatic aneurysms. In addition, Loyola also recommends and supports patients in making lifestyle modifications. Dr. Bechara adds, "Patients worry when they have a small aneurysm that it will rupture. The risk is very small. You can do moderate exercise and live a normal life. But the most important thing a patient can do is stop smoking. Smoking can cause aneurysms to continue to enlarge and rupture."

Dr. Bechara has particular expertise in caring for patients with aneurysms in the chest and abdomen, as well as patients with vascular diseases. He provides a variety of medical, endovascular and surgical interventions for his patients. He also performs clinical research on aneurysms, particularly complex aneurysms in the chest and abdomen. His research was cited in the most recent guidelines established by the Society of Vascular Surgery's (SVS) for screening and treatment of AAAs. Dr. Bechara is a member of SVS as well as the American College of Surgeons.