How Is an Aneurysm Treated?
Aortic aneurysms are treated with medicines and
surgery. A small aneurysm that's found early and isn't causing symptoms may not
need treatment. Other aneurysms need to be treated.
The goals of treatment are to:
- Prevent the aneurysm from growing
- Prevent or reverse damage to other body
structures
- Prevent or treat a rupture or dissection
- Allow you to continue to do your normal daily
activities
Treatment for aortic aneurysms is based on the size
of the aneurysm. Your doctor may recommend routine testing to make sure an
aneurysm isn't getting bigger. This method usually is used for aneurysms that
are smaller than 5 centimeters (about 2 inches) across.
How often you need testing (for example, every few
months or every year) will be based on the size of the aneurysm and how fast
it's growing. The larger it is and the faster it's growing, the more often you
may need to be checked.
Medicines
If you have an aortic aneurysm, your doctor may
prescribe medicines before surgery or instead of surgery. Medicines are used to
lower blood pressure, relax blood vessels, and reduce the risk of rupture. Beta
blockers and calcium channel blockers are the medicines most commonly used.
Surgery
Your doctor may recommend surgery if your aneurysm
is growing quickly or if it reaches a size linked with an increased risk of
rupture or dissection.
The two main types of surgery to repair aortic
aneurysms are open abdominal or open chest repair and endovascular repair.
Open Abdominal or Open Chest Repair
The standard and most common type of surgery for
aortic aneurysms is open abdominal or open chest repair. It involves a major
incision (cut) in the abdomen or chest. General anesthesia is used for this
procedurethat is, you will be temporarily put to sleep so you don't feel
pain during the surgery.
The aneurysm is removed, and the section of aorta is
replaced with a graft made of material such as Dacron® or
Teflon.® The surgery takes 3 to 6 hours, and you will remain in
the hospital for 5 to 8 days.
It often takes a month to recover from open
abdominal or open chest surgery and return to full activity. Most patients make
a full recovery.
Endovascular Repair
In endovascular repair, the aneurysm isn't removed.
Instead, a graft is inserted into the aorta to strengthen it. This type of
surgery is done using catheters (tubes) inserted into the arteries; it doesn't
require surgically opening the chest or abdomen.
The surgeon first inserts a catheter into an artery
in the groin (upper thigh) and threads it to the aneurysm. Then, using an x ray
to see the artery, the surgeon threads the graft (also called a stent graft)
into the aorta to the aneurysm.
The graft is then expanded inside the aorta and
fastened in place to form a stable channel for blood flow. The graft reinforces
the weakened section of the aorta to prevent the aneurysm from rupturing.
Endovascular Repair
The illustration shows the placement
of an endovascular stent graft in an aortic aneurysm. In figure A, a catheter
is inserted into an artery in the groin (upper thigh). The catheter is threaded
to the abdominal aorta, and the stent graft is released from the catheter. In
figure B, the stent graft allows blood to flow through the aneurysm.
Endovascular repair reduces recovery time to a few
days and greatly reduces time in the hospital. However, doctors cant
repair all aortic aneurysms with this procedure. The location or size of the
aneurysm may prevent a stent graft from being safely or reliably placed inside
the aneurysm. |