Aortic Aneurysms

Aortic aneurysms can pose great risks if not managed in a timely manner as they involve the largest artery in the body, the aorta. Close monitoring and early intervention are important. Early diagnosis is key to successful treatment and avoiding rupture.

Pearl

Close monitoring of the aneurysm diameter is very important to avoid rupture.

What is an aortic aneurysm?

An aortic aneurysm is ballooning of the aorta. This can occur in the chest (thoracic aortic aneurysm) or in the belly (abdominal aortic aneurysms). The diameter of the aneurysm is the most important factor in determining the risk for rupture (bursting). The larger the aneurysm is, the higher the chance for rupture.

What are the symptoms of an aortic aneurysm?

Most aneurysms do not cause any symptoms until they burst. If they become symptomatic prior to bursting, though, the symptoms depend on the location of the aneurysm along the aorta:

Thoracic aortic aneurysm: An aortic aneurysm in your chest region can cause pain in your chest, upper back, neck, and jaw. You might also experience breathing difficulties and coughing.

Abdominal aortic aneurysm: An abdominal aortic aneurysm might result in lower back pain, groin pain, or abdominal pain. Your physician might notice a mass or lump while feeling your abdomen during a standard physical exam.

How is an aneurysm diagnosed?

Most are discovered incidentally during imaging for another reason. Some patients might have a pulsatile mass in the abdomen or extremities. Occasionally patients present with a ruptured (burst) or thrombosed (clogged up) aneurysm. Work-up usually includes an Ultrasound and/or a CT scan.

How is an aneurysm treated?

Our team an NTSS specializes in conservative aortic aneurysm management, focusing on non-invasive and minimally invasive approaches before moving on to surgical options.

Small aneurysms can be managed medically with blood pressure control and stress reduction. They are monitored regularly with an ultrasound every 6-12 months.

Larger aneurysms warrant closer follow-up and sometimes a CT with contrast (dye injected through the vein). If they enlarge beyond a certain diameter, enlarge too fast, or become symptomatic then our specialists can manage appropriately. Each aneurysm is unique and requires its own plan of repair.

Endovascular option:
This is the modern way of fixing aneurysms. It usually involves going through small cuts in the groin and placing a specialized stent that allows the blood to flow to the kidney and leg arteries without pressurizing the aneurysm.

Our specialists are well trained to use the most advanced stents available today. This includes the traditional stents used to fix simple aneurysms, as well as advanced devices to tackle special situations. Examples of these include:

  • Fenestrated endografts: These stents have special fenestrations (holes) in the graft material that correspond to the bowel and kidney vessels. This allows us to manage aneurysms with short necks that would have required open surgical repair in the past.
  • Polymer-based endografts: These devices use a special polymer resin to support the top of the endograft and seal when the neck of the aneurysm is short.
  • Iliac branch endografts: These are special endografts that help maintain flow to arteries supplying pelvic organs (which used to require a plug in the past causing problems to patients)

Open option:
If less invasive approaches are not effective or available in your case, the team might recommend open abdominal surgery or open chest surgery to repair your aorta with a tube-shaped synthetic graft. This is becoming less likely due to advancements in stent technology.

Why NTSS?

Our providers at NTSS have the experience to diagnose and manage aneurysms. We believe in medical management to delay the progression of aneurysm enlargement. We are also versed in managing the most complex aneurysms using the most advanced technologies to avoid rupture.