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When you think of an aneurysm, what’s the first thing that comes to mind? If you’re like most people, you’d probably say the brain, or a stroke.

You wouldn’t be wrong, but you’d also be missing something. That’s because an aneurysm – a weakened, bulging portion of an artery – can occur in lots of other places besides your brain.

A lesser-known (but frequently deadly) location? Your aorta. Specifically, your abdominal aorta, which runs through your body’s midsection.

“Aortic aneurysms are a silent killer,” says vascular surgeon Frank Arko, III, MD, of Carolinas HealthCare System’s Sanger Heart & Vascular Institute. “They generally have no symptoms. But once they rupture, you have about an 80 percent chance of dying.”

What’s an AAA?

We’re not talking about the roadside car service. In this case, an AAA is an abdominal aortic aneurysm.

About the width of a garden hose, the aorta is your body’s largest blood vessel. It runs from your heart down through your abdomen before branching off to your legs, delivering oxygen-rich blood all along the way.

When a section of your abdominal aorta gets weak, it can balloon out and eventually rupture – leading to life-threatening bleeding. (Check out the infographic below.)

“Imagine piercing a hole in a water hose that’s turned on full blast,” says Dr. Arko. “A huge amount of water would start gushing out. That’s basically what’s happening inside your body.”

“Stop the Bleeding”

That’s exactly what happened to 75-year-old Curtis Kuykendall. It came on suddenly, while he was teaching Sunday school at church.

“I felt this tremendous pain across my back,” he says. His wife took him to the emergency room at Carolinas HealthCare System Blue Ridge-Morganton, where a CT scan revealed he had a ruptured AAA. Right away, his doctor initiated the system’s special protocol for treating AAAs.

Called Code Rupture, the protocol quickly mobilizes advanced care teams across different Sanger Heart & Vascular Institute locations. So while Curtis was on a helicopter headed to Carolinas Medical Center in Charlotte, Dr. Arko and his fellow care providers were getting prepared.

“All of us – surgeons, doctors, nurses, anesthesia – we were there and ready before he ever got here,” he says. “We knew we had to move as quickly as possible to stop the bleeding.”

The speed and coordination paid off. The team had Curtis’ bleeding under control in about 20 minutes, and within an hour, they had his aorta completely repaired.

“We go through the groin and insert a balloon to stop the bleeding,” says Dr. Arko. “We can actually fix you without opening up your abdomen at all.”

Catching a Silent Killer

Dr. Arko says Curtis’ case is pretty typical in terms of who experiences AAAs. “Older adults with any history of smoking and a family history of aneurysms are most at risk,” he says. Other strong risk factors? High blood pressure and obesity.

Most of the time, patients don’t have any symptoms. That’s why Dr. Arko says screening is so important. “If we can fix the aneurysm before it ruptures, the outcomes are so much better,” he says.

Curtis realizes he’s one of the lucky ones. He had no warning signs before his rupture, and he knows things could have ended differently.

“I know how close I came to dying,” he says. “I think about it every day.”

Want to learn more about what happened to Curtis? Watch his story.