An aneurysm is a potentially serious condition and can be life-threatening. Aneurysms can develop in any artery in the body. The Vascular Center staff includes several specialists who are trained in the diagnosis and treatment of aneurysms. The Vascular Center offers some of the most innovative treatments in the region for aneurysms.

What is an aneurysm?

An aneurysm is a weakening in the wall of an artery which causes a protrusion or “ballooning” of the artery wall. Aneurysms can form in any artery of the body, including the brain. Most aneurysms occur in the aorta. The aorta is the largest artery in the body and supplies blood from the heart to the lower extremities.

An aneurysm is serious depending on where it is located and how big it is. Treatment options are considered based on your age, health, the size of your aneurysm, and its location. Small aneurysms are often watched and studies are done regularly to detect growth. A ruptured aneurysm requires immediate medical attention and can be life threatening.

What causes an aneurysm?

The exact cause of aneurysm formation is not fully known. It is believed that the proteins which provide support to the artery wall break down, causing a weakening, which eventually leads to the aneurysm. High blood pressure, family history, and cigarette smoking play a prominent role in the formation and rate of growth of aneurysms, as does atherosclerosis (hardening of the arteries).

Aortic aneurysm

While an aortic aneurysm is less common than a heart attack, it is more frequently fatal. Eighty percent of aortic aneurysms produce no symptoms until they rupture. Ruptured aortic aneurysms can be surgically repaired, but most patients die before they reach the hospital. Approximately 25, 000 Americans die annually from aortic aneurysms.

Aortic aneurysms usually enlarge slowly. Approximately half of all aortic aneurysms remain small and never require treatment. Since they do not produce symptoms, they are often found incidentally when a patient is having testing for another condition. If an aneurysm is small (less than 4 centimeters or 2 inches) it may qualify for observation with regular CT scans or abdominal ultrasounds.

Who is at risk for developing an aortic aneurysm?

Aneurysms of the aorta can occur in any individual, but those at greatest risk include men over the age of 50, smokers, individuals with high blood pressure, heart disease, high cholesterol, or chronic obstructive pulmonary disease (COPD), and those with a family history of aortic aneurysms. Patients with conditions such as Marfan syndrome or Ehlers-Danlos syndrome are also at high risk of developing an aortic aneurysm.

Screening of individuals which fall into high risk categories should be done in the early to mid-60’s or sooner if you have an inherited condition. Screening can be done with an abdominal ultrasound, a CT scan, or an MRA.

Treatment options

Once an aortic aneurysm has been diagnosed and you and your surgeon have made the decision to treat the aneurysm, types of repair should be discussed. There are two types of repair for aortic aneurysms.

Endovascular Aortic Aneurysm Surgery

In this surgery, an incision is made in the groin and a catheter is threaded to the area of the aneurysm. A man-made stent-graft is then deployed within the aneurysm. This takes the stress off the weakened, aneurismal area of the aorta, because the blood flows through the stent. Patients who are being considered for this surgery must have an aortic aneurysm that is able to accommodate a stent-graft. Precise measurements of the aneurysm will be taken with a special CT scan, to determine this. If a patient is able to have an endograft repair of their aortic aneurysm, they will be followed for life with regular CT scans and abdominal x-rays to make sure the stent-graft doesn’t leak or change position. Recovery from this procedure is rapid, and patients are often discharged from the hospital within 2 days.

Open Surgical Repair of Aortic Aneurysm

In this surgery the patient’s chest or abdomen is opened via a large incision and the aneurysm is repaired by sewing man made material into the aorta. This is a fairly extensive, invasive surgery, and patients generally are in the hospital for 5-7 days afterwards. Recovery from this surgery is more prolonged, with patients reporting 4-6 weeks before they feel “normal” again.