Also known as Abdominal Aortic Aneurysm (AAA), Thoracic Aortic Aneurysm (TAA)

An aneurysm is a balloon-like bulge in an artery. Arteries are blood vessels that carry blood from your heart to your organs. Aortic aneurysms are aneurysms that occur in the aorta, the main artery that carries oxygen-rich blood to your body. This health theme focuses on two types of aneurysms affecting the aorta: abdominal and thoracic aortic aneurysms.

The aorta has thick walls that can withstand normal blood pressure. However, certain medical problems, genetic conditions, and trauma can damage or weaken these walls. The force of the blood pressing against the weakened or damaged walls can cause an aneurysm.

An aortic aneurysm can become large and rupture or split. A split is called a dissection and, like a fracture, is life-threatening. Early diagnosis and treatment can prevent serious or life-threatening complications. However, aortic aneurysms can develop and become large before they cause symptoms. Doctors can slow the growth of an aortic aneurysm with drugs or repair it with surgery if it is found before it ruptures or dissects.

Symptoms

An aortic aneurysm may not cause any signs or symptoms until the aneurysm ruptures or dissects. The types of symptoms that occur before a rupture depend on the location of the aneurysm and whether it has grown large enough to affect other parts of your body. An aneurysm that ruptures or decomposes is life-threatening.

Therapy

Treatment for your aortic aneurysm will depend on its cause, size and location, and the factors that put you at risk. Small aortic aneurysms can be treated with healthy lifestyle changes or medications. The goal is to slow the growth of the aneurysm and reduce the risk of rupture or dissection. Your doctor can treat other medical conditions that increase your risk of fracture or dissection, such as high blood pressure, coronary artery disease, chronic kidney disease, and high blood cholesterol. Surgery may be recommended to repair large aneurysms.

Healthy lifestyle changes

Your doctor may recommend lifestyle changes such as:

• Quit smoking to slow aneurysm growth
• Heart-healthy foods to help lower high blood pressure or high blood cholesterol
• Dealing with stress to control high blood pressure, especially for thoracic aortic aneurysms. Your doctor may also recommend that you avoid heavy weight lifting and powerful stimulants, such as cocaine.

Medicines

Your doctor may recommend drugs to treat an aortic aneurysm, including:

• Aspirin , especially if you have other cardiovascular risks
• Blood pressure drugs are an external link to lower blood pressure, slow aneurysm growth and reduce the risk of rupture. These drugs include beta blockers, angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).
• Statin external link to control cholesterol levels and stop or slow the growth of aortic aneurysms

Procedures or surgery

Depending on the cause or size of an aortic aneurysm or how fast it is growing, your doctor may recommend surgery to repair it. A rupture or dissection of an aneurysm may require immediate surgical repair.

• Open surgical repair is the most common type of surgery. You sleep during the procedure. Your surgical team will first make a large incision or cut in your abdomen or chest, depending on the location of the aneurysm, then remove the aneurysm and sew a graft in place. This graft is typically a tube made of leak-proof polyester. The recovery time for open surgical repair is approximately one month.
• Endovascular aneurysm repair (EVAR) is less invasive than open surgical repair. This is because the surgical cut is smaller and you usually need less recovery time. EVAR is more commonly used to repair abdominal aortic aneurysms than to repair thoracic aortic aneurysms. During the procedure, your cThe surgical team makes a small cut, usually in the groin, and then routes a stent-graft - a tube covered with fabric - through your blood vessels to the aorta. The stent-graft then expands and attaches to the aortic walls. A seal forms between the stent-graft and the vessel wall to prevent blood from entering the aortic aneurysm.

Possible complications related to surgery

Complications from both types of aortic aneurysm repair can occur and can be life-threatening. These include:

• Bleeding and blood loss
• Blood clots in blood vessels leading to the intestines, kidneys, legs, or in the graft
• Damage to blood vessels or walls of the aorta when placing the stent graft. The stent-graft can also move after it is placed.
• Endoleak, which is a blood leak around the stent-graft in the aneurysm. Endoleak can cause rupture of the aneurysm if not treated.
• Gastrointestinal bleeding, which rarely occurs if there is an abnormal connection between the aorta and your intestines after the repair. Blood may appear in your stool or your stool may be black.
• Heart complications such as a heart attack or arrhythmia
• Reduced blood flow to the intestines, legs, kidneys, or other organs during surgery. This can lead to injury to these organs.
• Infection of the incision or graft
• Kidney damage
• Spinal cord injury that can cause paralysis
• Stroke