The aorta, the body's largest artery, is the main blood vessel carrying oxygen-rich blood from the heart to the rest of the body. Emerging from the heart, the aorta branches upwards and downwards, bringing oxygen and nutrients to the head, arms, chest, abdomen and legs.
It starts when a portion of the aorta's wall weakens. Over time, blood pressure causes this weak area to stretch and balloon out, forming an aneurysm. Aneurysms can burst (rupture), causing serious internal bleeding, potentially life-threatening blood clots, and if untreated, death. An aortic aneurysm can occur in three places:
- Thoracic aortic aneurysms (TAA) are in the section of the aorta passing through the chest.
- Thoraco-abdominal aneurysms are in the portion of the aorta leading from the chest into the abdomen.
- Abdominal aortic aneurysms (AAA) occur in the abdominal section of the aorta.
Emphysema, chronic high blood pressure, atherosclerosis (hardening of the arteries), and smoking; as well as certain genetic disorders, such as Marfan's syndrome, may increase a person's risk. Children or siblings of people with aortic aneurysm are at higher risk.
Symptoms can be a vague pain in the chest or abdomen. Thoracic (chest) aortic aneurysm can produce a constant cough or hoarseness. Abdominal aneurysm can cause a heartbeat-like pulsating feeling in the abdomen, or deep pain in the abdomen or lower back. Sudden, severe chest pain or abdominal/back pain can indicate an aneurysm is about to rupture. This requires emergency medical attention.
Since many people with aortic aneurysms are symptom-free, those at increased risk should be regularly screened. Many aneurysms are discovered during an imaging test for an unrelated problem; but very few during a physical examination. Common diagnostic tests are: ultrasound, computerized tomography (CT) scan and magnetic resonance imagery (MRI). Patients with a history of smoking are approved for a one time Medicare-covered screening.
MONITORING PLUS MEDICATION
Upon evaluating the size of an aneurysm–and it's risks for rupture–a physician may choose to monitor the aneurysm in combination with medication to lower high blood pressure.
MINIMALLY INVASIVE TECHNIQUES
- Endovascular Stent Graft Repair: A fabric and metal mesh tube permanently inserted into the aorta, lets blood flow without putting pressure on the damaged wall of the aneurysm.
- Fenestrated Endograft: Used for aortic aneurysms near branches. A tube with holes walls off the damaged aneurysm, while preserving blood flow to nearby arteries.
OPEN SURGERY OPTIONS
During these procedures the affected area is opened through the chest or abdomen and the weakened section of the aorta replaced with a fabric tube.