Vein Institute of NJ - Helpful Articles

Aortic Aneurysms: Types and Management

The best thing to do with an aneurysm is to avoid it. Seems like sound advice, right? Prevention is usually the best course of medical treatment. But, we know, stopping an aneurysm may not be in the cards sometimes.

So, understanding the type of aneurysm you have, if you should have it repaired, and if so, what are the repair options available becomes the next best course of action.

In our previous post, we introduced you to the basics of aneurysms, why they are known as the “silent killer”, and how to potentially prevent them. Now, we want to explore the different types of aneurysms and how to best manage them.

What Kind of Aneurysm Do You Have?

As a proud member of The Cardiovascular Care group, we focus on two types of aneurysms: Abdominal Aortic Aneurysms and Thoracic Aortic Aneurysms. (There is a third type called Cerebral which is treated within the Neurology field.)

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Abdominal Aortic Aneurysms: It occurs when the wall of the aorta – the large blood vessel that carries blood away from the heart – ruptures. Sometimes mistaken for a heart attack, an abdominal aortic rupture can be felt in the chest and jaw and involve a sudden pain in your abdomen or back, fainting, difficulty breathing and weakness on one side of the body.

Thoracic Aortic Aneurysms: This aneurysm occurs in the portion of the aorta that passes through the chest. Some symptoms to look for include upper back pain, hoarseness, shortness of breath, tenderness or pain prior the rupture.

Should I Have My Aneurysm Repaired?

Determining if and when an aneurysm should be repaired generally begins with monitoring them on a regular basis. In fact, many patients we see at The Cardiovascular Care Group do not need to be operated upon and, therefore, simple monitoring is the best “therapy”.

Several factors are important in determining when to intervene with the size being only one of the factors. The rate of growth is important as are the other medical conditions a patient might have in addition to their overall age and health. The cause of aneurysms will also have an effect on their treatment. The majority are caused by a weakening of the artery wall over time due to the aging process. However, an infection, trauma or even immunologic issues can cause an artery to widen to the point where it can rupture. These aneurysms can be lethal if not recognized and treated.

No one can predict exactly when (or even if) an aneurysm will rupture. This is why it’s extremely important you be evaluated, taking into account your medical and family history, and most importantly, your wishes. Some patients choose to leave the aneurysm in place accepting the risk of it rupturing, while others prefer to be proactive and have it repaired.

How Do You Repair an Aneurysm?

To repair an aneurysm, we first have to detect it. As mentioned in our post, Aneurysms: The “Silent Killer”, most aneurysms, unfortunately, have no symptoms to detect. However, if you fall into the risk categories based on age, family history and lifestyle, you can get a noninvasive imaging study done to visually inspect your arteries and our doctors can provide a diagnosis.

Aneurysms can be repaired endovascularly, using stent grafts or with a more invasive open operation. The type of operation is often dependent on the anatomy of the aneurysm in relation to important vessels in the abdomen and chest that need to be preserved. The patient's age as well as ability to follow-up is also critically important when making this decision.

The stent graft is a small metal-supported piece of fabric that is made to fit the size of the artery. It is placed in the body through a small puncture in the groin arteries. Using an x-ray, it is guided into position and secured. The stent will remove pressure from the weakened artery and greatly reduce the chance that it will rupture.

Some aneurysms require a traditional open surgical repair which is generally more involved and requires an incision in the abdomen to replace the weakened artery with a cloth tube.

Look for our next blog post where we will talk further about endovascular aneurysm repair (EVAR).

In the meantime, if you have any questions or concerns about aneurysms, please schedule an appointment with one of our vascular physicians today.

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