The aorta is the large artery that carries oxygen-rich blood from the left ventricle of the heart to other parts of the body
An aortic aneurysm is a bulge in the aorta that develops in areas where the aorta wall is weak. The pressure of the blood pumping through it causes the weakened section to bulge out like a balloon.
An aneurysm can develop in any section of the aorta. The location of the aneurysm determines its type:
Abdominal aortic aneurysms occur in the section of the aorta that passes through the abdomen. These are the most common type of aortic aneurysm.
Thoracic aorta aneurysms portion of the aorta in the chest. A thoracic aortic aneurysm can develop in the aortic root, the ascending aorta, aortic arch (the section of the aorta in the chest that bends) or descending aorta.
Aneurysms can grow in size over time. As an aneurysm expands, it can start to cause symptoms. When an aneurysm gets too large, it can rupture and cause life-threatening bleeding or instant death — without any prior warning.
A blood clot may also form in the aneurysm. Small pieces of a blood clot can break off and travel throughout the body. If a fraction of a clot gets stuck in a brain or heart blood vessel, it can cause stroke or heart attack. In other vital organs, like the kidneys or liver, a piece of blood clot can disrupt normal function. At the least, a clot fragment that blocks blood flow in the legs, feet or arm can cause numbness, weakness, tingling, or coldness,light-headedness or localized pain.
Most patients with aortic aneurysms do not have any symptoms at all. The aneurysm is usually discovered by X-ray during a routine health exam for some other, unrelated condition. Many aortic aneurysms will grow slowly for years before they are large enough to cause symptoms. Even large aneurysms may not cause any symptoms. When symptoms do occur, pain in the chest or abdomen is most common, depending on the aneurysm’s location. Pain may be intermittent or constant. Some people describe a pulsing sensation inthe abdomen as a symptom of an abdominal aortic aneurysm. A thoracic aortic aneurysm may cause back pain, shortness of breath or difficulty swallowing. Symptoms of thoracic aneurysm are most common when the aneurysm is in the aortic arch.
A ruptured aneurysm usually produces sudden, severe pain and other symptoms such as a loss of consciousness or shock, depending on the location of the aneurysm and the amount of bleeding. A ruptured aneurysm requires emergency treatment.
Most aneurysms that are not causing any symptoms often are discovered by X-ray during a routine health exam for some other, unrelated condition. In other cases, an aneurysm is discovered when it has grown large enough to cause symptoms that send the person to the doctor. If an abdominal aortic aneurysm is suspected, your doctor may use ultrasound or CT scanning to diagnose it.
CT scanning or MRI typically are used to diagnose thoracic aortic aneurysms. When the diagnosis of an aortic aneurysm is confirmed, a vascular specialist will use severaldifferent imaging tests to gather more informationabout it, such as its size, shape and precise location.Additional diagnostic tests may include:
Abdominal ultrasound is an effective preventive screening tool for abdominal aortic aneurysm thatshould be used in those individuals who have a high risk for aortic aneurysm.
we follow screening recommendations from the Society for Vascular Surgery and the Society for Vascular Medicine and Biology. Under these guidelines, abdominal ultrasound screening is recommended for thefollowing patients:
Some of the same risk factors for heart attackalso increase the risk of aortic aneurysm, including:
Injury or infection also can cause an aneurysm to develop if the aorta walls weaken as a result. Inherited DefectsAn increasing number of people are at riskof aortic aneurysm due to inherited defects thatcause weakness in the blood vessel walls. Marfansyndrome, an inherited disorder of the connectivetissue, is a relatively rare condition that often leadsto an aortic aneurysm.
Treatments for aortic aneurysms include open surgery or endovascular repair techniques. These arecomplex procedures that involve a team of doctorsfrom different specialties working together..Your doctor will recommend the best treatmentfor you depending on the location, shape and size ofyour aneurysm, other factors such as your age andoverall health and information from imaging tests.
If you have an aneurysm that involves a long section of the aorta or multiple aneurysms, the bestapproach may be a combination of open surgery and endovascular repair..
During open surgical repair, an incision is made in the chest or abdomen, depending on thelocation of the aneurysm. During the procedure, thebulging, diseased area of the aorta is lined with asynthetic graft that is stitched in place to connect itwith the normal aorta on either side of the defectivearea. When the procedure is completed, the new,synthetic section of the blood vessel functions like a normal, healthy aorta.The procedure generally takes between 3 and 5 hours, and the hospital stay averages between 5 to 10 days. Most peoplereturn to their normal activities in 6 to 12 weeks.Open surgical repair is a proven treatment with verygood long-term results.
The endovascular approach is rapidly becoming the preferred treatment for abdominal aorticaneurysm and also is becoming more available forthe treatment of thoracic aortic aneurysm .The endovascular repair procedure, thesurgeon makes small incisions in the groin area toaccess the arteries that connect to the aorta. A guidewire is inserted through the arteries and guided into the affected area of the aorta.
Using X-ray guidance, the surgeon inserts the stent-graft inside a catheter (a long, thin tube)over the guide wire. The stent-graft is a fabrictube supported by metal wire stents (also called ascaffold) that is used to reinforce the weakened area of the aorta. The surgeon then moves the stent-graft inthe catheter along the guide wire to the site of theaneurysm. There, the catheter is withdrawn andthe stent-graft expands like a spring on either sideof the aneurysm. Once it is securely in place, the stent-graft creates a new passageway for blood flow without pushing on the aneurysm. Over time, theaneurysm will shrink because of the lack of pressure on it.
The procedure typically takes 1 to 3 hours Patients can go home in a few days after theprocedure. There are smaller scars and less traumacompared with open surgical techniquesMost people return to their normal activities in 2 to 6 weeks after the procedure. Patients who have an endovascular stent-graft must return to their doctor regularly to have the position of the stent-graft monitored by a CT scan.
Your doctor will want to see you on a regular basis to perform a physical exam and diagnostictests. Your doctor will use the information gainedfrom these visits to monitor the progress of yourtreatment. Ask your doctor how often to schedule follow-up appointments. If you have been diagnosed with an aneurysm or have received aneurysm treatment, it is important that you lead a heart-healthy lifestyle. Your healthcare team can help you achieve your goals, but it is up to you to take your medications as prescribed, keep your follow-up appointments and be an activemember of the treatment team. You can helpimprove your health by:
