Treating an aortic aneurysm is necessary to prevent it from rupturing.
Aneurysms
Aneurysms form balloons in weakened arteries of our bodies, potentially causing life-threatening problems such as a stroke.
Although aneurysms can form in any weakened artery, they commonly occur in the arteries of the brain and in the aorta, the central artery that extends from your heart through the center of your abdomen and chest.
Certain medical conditions, such as high blood pressure, can weaken the arteries, which deliver oxygenated blood from our heart to the rest of our bodies. The pressure of blood traveling through the arteries can lead to this balloon-like bulge.
You can have an aneurysm for years without symptoms or problems. Others can have an aneurysm that pops, which can lead to a stroke if bleeding occurs in the brain.
Ruptured aneurysms must be treated quickly, usually within minutes, or it can become deadly: about 50% of all ruptured aneurysms are fatal.
Recently Answered
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Dr. David W. Drucker, MD , Cardiology (Cardiovascular Disease), answered on behalf of St. Mary Medical CenterSee All 2 AnswersPatients with abdominal aortic aneurysms that need to be treated have two excellent options. Open surgical repair or endovascular stent graft placement. Open surgery can be very effective and was the standard for many decades. A vascular surgeon or other type of surgeon makes an incision. They find the aneurysm and they put a brand new tube in. This excludes the aneurysm and you normally don't have to worry about it again. An issue with surgical aneurysm repair, is that it is more invasive, requiring an abdominal incision. This may increase the risk of some complications as well as prolong hospitalization and recovery time. In addition, some patients with other medical issues (severe lung disease, advanced age, previous abdominal surgeries, severe cardiac disease) may not be good candidates for open repair.
Endovascular stent graft therapy is a minimally invasive way to treat abdominal aortic aneurysms. Through two small incisions in the groin area or completely percutaneously, the physician can implant a covered stent that lines the inside of the blood vessel. This allows blood to flow through the stent but exclude any more flow into the aneurysm. The nice part about this procedure is that it works well and it’s easier to recover from. Most people spend one or two days in the hospital, return to fully functional more quickly and have lower complication rates. These stents must be monitored for the rest of the patient’s life to ensure that they continue to do their job. The choice between surgery and minimally invasive options should be made after a full discussion of al options with the patient’s physician.
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
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Dr. David W. Drucker, MD , Cardiology (Cardiovascular Disease), answered on behalf of St. Mary Medical CenterSee All 11 Answers
Aortic aneurysms are part of the spectrum of peripheral arterial disease (PAD). An aneurysm occurs when cholesterol deposits cause a weakening of the blood vessel wall, which causes an enlargement. The majority of aortic aneurysms are completely without symptoms -- about 75 percent of patients who have aneurysms have no symptoms at all. Because of this, the aneurysms themselves are often found completely incidentally. A typical example of this is when a patient comes to the hospital with a kidney stone. The doctor gets an x-ray, or sometimes a computed tomography (CT) scan, and he or she finds an aneurysm in the abdominal aorta. At that point, the doctor will assess the aneurysm's size and location and decide which treatment, if any, makes the most sense.
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
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If a patient has a known aneurysm and surgery is advised, the decision to delay or forego surgery increases the risk for rupture or dissection, both of which are serious emergencies with far poorer outcomes than elective surgery. Moreover, emergency procedures are commonly performed at the hospital that is closest in proximity to where the patient developed symptoms. Many of these hospitals may not offer the same level of care and results as an Aortic Center of Excellence.
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While both aortic aneurysms and dissections are potentially life threatening, they can be effectively treated when caught in time. Aortic surgery may be elective (scheduled) or performed on an emergency basis. Elective surgery is performed to prevent complications of aortic disease such as aortic valve incompetence, aortic rupture, and aortic dissection. Elective procedures include replacement of the aortic root, reconstruction of the aortic arch, and replacement of a portion or the entire thoracic, and possibly thoracoabdominal, aorta.
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Many aortic aneurysm surgeries can be performed with minimally invasive methods. Compared with traditional surgery, minimally invasive approaches may be associated with reduced pain, less scarring, and shorter recovery time. Most aneurysms of the aortic root can be done through skin incisions of approximately 5 cm, although surgeons never compromise a patient's safety to achieve a cosmetic result.
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Brigham and Women's Hospital answeredOpen repair of an abdominal aortic aneurysm (AAA) -- a bulging, weakened area in the wall of the aorta (the largest artery in the body) -- involves an incision of the abdomen to directly visualize the aortic aneurysm.
Once you are home after an abdominal aortic aneurysm repair, it will be important to keep the surgical area clean and dry. Your physician will give you specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, in the event they were not removed before leaving the hospital.
The surgical incision may be tender or sore for several days after an aneurysm repair procedure. Take a pain reliever for soreness as recommended by your physician.
You should not drive until your physician tells you to. Other activity restrictions may apply.
Notify your physician to report any of the following:
- Fever and/or chills
- Redness, swelling, or bleeding or other drainage from the incision site
- Increase in pain around the incision site
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
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See All 2 AnswersNot all aneurisms require surgery, but the larger it grows, the more surgery becomes necessary.
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Most patients recover quickly from endovascular surgery—in most cases, remaining the hospital for less than two days.
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Brigham and Women's Hospital answeredSee All 2 Answers
Open repair of an abdominal aortic aneurysm (AAA)—a bulging, weakened area in the wall of the aorta (the largest artery in the body)—involves an incision of the abdomen to directly visualize the aortic aneurysm. Abdominal aortic aneurysm repair requires a stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, an abdominal aortic aneurysm repair follows this process:
- You will be asked to remove any jewelry or other objects that may interfere with the procedure.
- You will be asked to remove your clothing and will be given a gown to wear.
- You will be asked to empty your bladder prior to the procedure.
- An intravenous (IV) line will be started in your arm or hand. Additional catheters will be inserted in your neck and wrist to monitor the status of your heart and blood pressure, as well as for obtaining blood samples. Alternate sites for the additional catheters include the subclavian (under the collarbone) area and the groin.
- You will be positioned on the operating table, lying on your back.
- The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you are sedated, a breathing tube will be inserted through your throat into your lungs and you will be connected to a ventilator, which will breathe for you during the surgery.
- A catheter will be inserted into your bladder to drain urine.
- The skin over the surgical site will be cleansed with an antiseptic solution.
- Once all the tubes and monitors are in place, the physician will make an incision (cut) down the center of the abdomen from immediately below the breastbone to below the navel or across the abdomen from underneath the left arm across to the center of the abdomen and down to below the navel.
- The physician will place a clamp on the aorta above and below the site of the aneurysm. This will temporarily interrupt the flow of blood.
- The physician will cut open the aneurysm sac and suture into place a long tube called the graft. This will connect both ends of the aorta together.
- The clamps will be removed and the physician will wrap the wall of the aneurysm around the graft, suturing the aorta back together.