An aneurysm is a bulge in the artery wall. The vessel wall is weakened by hypertension, hardening of the arteries (atherosclerosis), tobacco use, trauma, or other causes, which causes it to balloon outward from the pressure of the blood flow.
If an aneurysm bursts, it can cause heavy and life-threatening internal bleeding. Aortic aneurysms can also lead to blood clots, heart attack, stroke, and leakage of blood.
Aneurysms can form in arteries anywhere in the body, but most often occur in the aorta. The aorta is the body’s largest blood vessel; it starts in the heart and continues through the chest and abdomen to the legs.
If an aneurysm occurs in the lower section of the aorta, it is called an abdominal aortic aneurysm. If it occurs in the portion of the aorta in your chest, it is called a thoracic aortic aneurysm.
Symptoms of an Aortic Aneurysm
An aneurysm may expand slowly or quickly, or may stay the same size for many years. They often develop without any warning signs. Sometimes people experience symptoms from an aneurysm that may include:
- Pulsing sensation in the abdomen
- Stomach pain or tenderness
- Back pain
A ruptured aneurysm is an urgent medical emergency. Some signs of a burst aneurysm are:
- Intense, sudden pain in the abdomen
- Low blood pressure
- Fast pulse
An aortic aneurysm is most often detected during a routine exam or while testing for another condition, like an ultrasound or X-ray. If you suspect you have an aneurysm, your doctor will confirm the diagnosis with an aortic ultrasound or echocardiogram. Smokers and patients over the age of 60 are more at risk for this condition and should be regularly screened for an aortic aneurysm.
It is important to closely monitor aortic aneurysms when they are diagnosed. However, they often remain small and never rupture. If your aneurysm is quickly growing, very large, leaking, or painful, it might require surgery.
Aneurysms that are at high risk of rupturing or that have already ruptured will immediately be operated on. There is a much more successful outcome before the vessel has already burst.
Treatment of an Aortic Aneurysm
The treatment will depend of the size and severity of the condition, as well as the health of the patient. Initial treatment may be to prescribe medication to lower blood pressure and relax blood vessels, which will reduce the risk of a rupture. Some of the more common medications are beta blockers and calcium channel blockers.
Aortic Endovascular Stent Grafting
This procedure includes an implantation of a small metal cylinder called a stent into the artery to provide a strong new vessel wall. A thin tube called a catheter is guided up the aorta to the aneurysm site. A small balloon on the end of the catheter widens the vessel to help the stent fit into place. The catheter is then removed, and over time the aneurysm will shrink around the stent.
Open Aneurysm Repair
For this procedure, an incision will be made in the abdomen to remove the diseased section of the artery and replaced with a synthetic tube graft.
Innovative new laparoscopic techniques allow minimally invasive approaches to aneurysm repair that only require small incisions in the groin for femoral artery access. A thin tube with a camera is placed into the artery and guided up to the site of the aneurysm so the surgeon can see the inside of the vessel, which eliminates the need for traditional open surgery. Your doctor will determine the right course of treatment for you based on a thorough evaluation of your health and your condition.
Prevention of an Aortic Aneurysm
Aortic aneurysms are not always preventable, but there are certain steps that patients can take to lessen their risk. These steps include:
- Avoid or quit smoking
- Exercise regularly
- Maintain a healthy blood pressure
- Lower cholesterol and fat