The different types of aortic aneurysm treatment include monitoring the condition, administering medications, and performing surgery to repair damage. The appropriate course of treatment for a specific aneurysm depends on the severity of the condition and the symptoms it causes. In particular, aortic aneurysm treatment is related to the shape and location of the aneurysm.
The two most common types of aortic aneurysm are abdominal and thoracic aorta aneurysms. Abdominal aortic aneurysms, which account for nearly 75 percent of aortic aneurysm, occur in the part of the aorta that passes through the abdomen and feeds blood to the lower part of the body. A thoracic aneurysm occurs in the upper part of the body, above the diaphragm. They account for approximately 25 percent of all aortic aneurysms.
Other types of aneurysms include dissecting, fusiform, and saccular aortic aneurysms. A dissecting aneurysm causes a tear in the wall of the aorta, which in turn separates the three layers of the aorta. A fusiform aneurysm is considered a true aneurysm, as it causes a bulging throughout the entire circumference of the aorta. Saccular aneurysms appear as small, uneven blisters on the side of the aorta, and usually result from injury or an ulcer.
Minor, symptomless aneurysms require little more than careful monitoring, including imagining tests and echocardiograms once or twice a year. If the aneurysm remains small and never causes symptoms, then a physician will most likely hold off treatment. Aortic aneurysm treatment typically begins when the aneurysm grows or begins causing pain or other symptoms.
Medications used for aortic aneurysm treatment usually focus on keeping the blood flowing freely throughout the arteries. Beta blockers are used to lower blood pressure by slowing down the heart rate. When beta blockers are not sufficient at keeping blood pressure down, angiotensin II receptor blockers may be prescribed. Statins help keep cholesterol levels down, which reduces the risk of clogging in the arteries. Clogged arteries increase the risk of rupturing the aneurysm because the blood strains against the bulge.
Surgery is often recommended to prevent an aneurysm from rupturing, especially if the aneurysm is more than 2.2 inches in diameter. Patients with Marfan syndrome or another connective tissue disorder may need surgery for smaller aneurysms. The most common surgical interventions prescribed for aortic aneurysm treatment are open-chest surgery and endovascular surgery.
Open-chest surgery requires cutting open the abdominal or thoracic area, and requires significant recovery time — up to several months. During the procedure, a surgeon cuts through the skin and tissue in the chest to provide direct access to the anuerysm. The damaged section of the aorta is removed and replaced with an artificial graft, which is sewn into place using permanent sutures.
Endovascular surgery is less invasive and requires a shorter recovery time — approximately one to two weeks. During this procedure, the surgeon makes a small incision in the groin and threads a thin tube up into the artery affected by the aneurysm. Using an x-ray monitor for guidance, the surgeon threads a stent to the area weakened by the aneurysm and expands the metal frame to support the wall of the aorta. Blood flows through the stent, safely avoiding the aneurysm.
