An aneurysm is a blood vessel that has enlarged beyond its normal size. Aortic aneurysms usually occur in four distinct areas: the aortic root/ascending aorta, the aortic arch, the descending thoracic aorta and the abdominal aorta. Frequently, the disease involves more than one contiguous area.
As aortic aneurysms enlarge, they have a tendency to either dissect (form a partial tear in the aortic wall) or rupture (form a full tear in the wall). If an aneurysm tears, it usually causes severe pain corresponding to the area of the aneurysm. In some cases, aneurysms do not tear but instead expand rapidly, which frequently causes a dull, persistent pain. In both circumstances, prompt or emergency surgery is needed.
The greatest danger is that an aortic aneurysm may rupture and cause severe, life-threatening bleeding.
In individuals whose aortic aneurysms are asymptomatic, the decision to recommend surgery (open or endovascular) is based on a balance between two opposing risks—the risk of rupture and the risk of operation. If the risk of rupture outweighs the risk of operation, surgery is usually recommended.
The assessment of these risks requires a thorough understanding of the factors involved in aneurysmal rupture and significant surgical experience to accurately estimate the risk of every individual operation. Certain factors, such as age and presence of heart, lung or kidney disease, may impact not only the surgical risk, but also the risk of rupture.
In the great majority of cases, aortic aneurysms are asymptomatic, meaning they are discovered incidentally by scans of the chest or abdomen, without the presence of symptoms.
In certain cases, aneurysms may be symptomatic. As an aneurysm enlarges, it sometimes compresses adjacent structures and organs. For example:
The diagnosis of aortic aneurysms is established with the use of specialized imaging tests such as computed tomographic (CT) scan or magnetic resonance imaging (MRI) and often with echocardiograms (ECC/EKG).
At Lankenau Heart Institute we utilize these diagnostic tools to obtain detailed information on the location and size of the aorta and aortic aneurysms.
Depending on the size and rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Learn about abdominal aortic aneurysm surgery, abdominal aortic aneurysm repair and other treatment options.
Endovascular repair (also called endovascular stenting) is one of the most recent advancements in aortic surgery. It is used in patients whose anatomy is "favorable"—that is, their aneurysms or dissections do not span any major arteries.
For patients with thoracoabdominal aneurysms, elective surgery is recommended if the aortic diameter exceeds 6.0 cm.
Genetic evaluation is becoming an important part of personalized care, as many health conditions have a genetic basis and genetic test results can help to guide medical decisions. Our genetic counselors provide consultations related to cancer genetics, cardiovascular genetics and prenatal genetics.
