Aortic Aneurysms are a bulge in the aorta, which is the main artery of the body responsible for supplying oxygenated blood to the circulatory system.
It is an excessively localized enlargement of an artery caused by a weakening of the artery wall.
The pressure of the blood pumping through it creates a weakened section which then bulges out like a balloon.
The Aortic Aneurysms can develop in any section of the aorta where the wall of the aorta is weak. Its location determines its “type.”
- ➡ An Abdominal Aortic Aneurysm occurs in the section of the aorta that passes through the abdomen. This is the most common type.
➡ Thoracic Aortic Aneurysms occur in the portion of the aorta located in the chest.
Risks related to Aortic Aneurysms
Aneurysms can grow over time. As it expands, it can start to cause symptoms.
➡ When it gets too large, it can rupture and cause life-threatening bleeding or instant death — without any earlier warning.
➡ A blood clot may also form in an aneurysm and small pieces of it 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 a stroke or a heart attack.
➡ In other vital organs, like the kidneys or liver, a piece of a 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 don’t have any symptoms at all. An aneurysm is usually discovered by X-ray during a routine health exam for some other, unrelated condition.
- Many 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, the most common are chest pain or abdominal pain. Depending on the location of an aneurysm, the pain may be intermittent or constant.
- Some people describe a pulsing sensation in the abdomen as a symptom of an Abdominal Aortic Aneurysm.
A ruptured aneurysm usually produces sudden, severe pain and other symptoms such as a loss of consciousness or shock, depending on its location and the amount of bleeding. This requires emergency treatment.
Most aortic aneurysms that are not causing any symptoms are often 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, the doctor may use ultrasound or CT scanning to diagnose it.
*If you have any symptoms of an aneurysm, call your doctor right away so your symptoms can be evaluated. If you feel your symptoms are a medical emergency, do not wait for an appointment. Call 911 immediately and ask to be transported to the nearest hospital.
CT scans or MRI are typically used to diagnose Thoracic Aortic Aneurysms.
- When a diagnosis is confirmed, a vascular specialist (specializes in disorders of the blood vessels) will use several different imaging tests to gather more information about it, such as its size, shape and precise location.
Additional diagnostic tests may include:
➡ High-resolution CT scan.
➡ Angiogram (an x-ray of the blood vessels)
➡ Transesophageal echocardiography (TEE), to record ultrasound images of the aorta from inside your esophagus
➡ Intravascular ultrasound (to study the inside of the blood vessels)
An Ultrasound is an effective preventive screening tool for diagnosis of an Aortic Aneurysm.
Guidelines from the Society for Vascular Surgery as well as from the Society for Vascular Medicine and Biology, recommend the following for preventive ultrasound screening:
➡ All men aged 60 to 85 years
➡ All women aged 60 to 85 years who have cardiovascular risk factors
➡ All men and women aged 50 and older who have a family history of abdominal aortic aneurysm
Some of the same risk factors for heart attacks also increase the risk of aortic aneurysms, including:
- Atherosclerosis (plaque in the artery walls)
- High blood pressure
- High cholesterol
- Inherited Defects (they cause weakness in the blood vessel walls).
- Bicuspid aortic valve injury or infection
- Marfan Syndrome, a relatively rare inherited disorder of the connective tissue, often leads to an aortic aneurysm.
The goal in treating aneurysms is to cut the risk of rupture because the risks increase with their size.
When an aneurysm reaches a critical size, it’s time for treatment.
- The rate at which an aneurysm is growing, the symptoms, age and other medical conditions present are also considered when planning treatment.
Treatments include open surgery or repair techniques. These are complex procedures that involve a team of doctors from different specialties working together.
- The doctor’s recommendation for treatment will depend on the site, shape, and size of an aneurysm.
Other factors such as age and overall health, as well as the imaging tests, are considered prior to a decision on specific treatment.
Open Surgical Repair
Open surgical repair is a proven treatment with very good long-term results.
- An incision is made in the chest or abdomen, depending on the location of an aneurysm.
- During the procedure, the bulging, diseased area of the aorta is lined with a synthetic graft that is stitched in place to connect it with the normal aorta on either side of the defective area.
- 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 stays average between 5 to 10 days.
- Some patients stay at a rehabilitation facility for a short time to complete their recovery. Most people return to their normal activities in 6 to 12 weeks.
With this approach (which is becoming the preferred treatment) the surgeon makes small incisions in the groin area to get access to the arteries that connect to the aorta.
➡ A guide wire 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 used to reinforce the weakened area of the aorta.
➡ The surgeon then moves the stent-graft in the catheter along the guide wire to the site of an aneurysm.
➡ There, the catheter is withdrawn and the stent-graft expands like a spring on either side of an aneurysm.
Once it’s securely in place, the stent-graft creates a new passageway for blood flow without pushing on the aneurysm.
Over time, the aneurysm will shrink because of the lack of pressure on it.
Advantages of Endovascular Repair
- The procedure typically only takes 1 to 3 hours.
- Patients can go home in a few days after the procedure
- There are smaller scars and less trauma compared with open surgical techniques
Most people return to their normal activities within 2 to 6 weeks after the procedure.
However, 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 watch the progress of the treatment by seeing you on a regular basis to perform a physical exam and diagnostic tests.
If you’ve been diagnosed with an aneurysm or have received aneurysm treatment, it’s important that you lead a heart-healthy lifestyle.
You can help improve your health by:
- Quitting smoking
- Treating high cholesterol
- Managing high blood pressure and diabetes
- Exercising regularly
- Eating a heart-healthy diet
- Maintaining a healthy weight
And, finally, a Registered Dietitian can work with you to develop a heart-healthy nutrition program to help you reach your weight loss goals.
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