Aortic Aneurysm Treatment
Treatment for your aortic aneurysm will depend on its size, location, and the factors that put you at risk. Small aortic aneurysms may be managed with healthy lifestyle changes. The goal is to slow the growth of the aneurysm and lower the chance of rupture or . Your healthcare provider may treat other medical conditions that raise your risk for rupture or dissection, such as high blood pressure, coronary heart disease, chronic kidney disease, and high blood cholesterol. Surgery may be recommended to repair large aneurysms.
Healthy lifestyle changes
Your provider may recommend heart-healthy lifestyle changes.
- Quit smoking. This is the most important part of your treatment to slow the growth of the aneurysm. The risk of rupture drops after smoking stops, especially in women. Visit Smoking and Your Heart and Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute's Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
- Heart-healthy eating helps lower high blood pressure or high blood cholesterol.
- Manage stress to help control high blood pressure, especially for thoracic aortic aneurysms. Your provider may also suggest that you avoid heavy weightlifting and powerful stimulants, such as cocaine.
- Get physical activity. Studies show that moderate physical activity does not raise the risk of rupture or growth of the aneurysm and can have health benefits. Talk to your provider to learn which level of physical activity is right for you.
Your provider may recommend some medicines.
- Aspirin, may be recommended, especially if you have other cardiovascular risks. This medicine may increase the risk of bleeding.
- Blood pressure medicines lower blood pressure. These medicines include beta blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs).
- Statins control cholesterol levels.
Procedures or surgery
Depending on the cause or size of an aortic aneurysm or how quickly it is growing, your provider may recommend surgery to repair it. Rupture or of an aneurysm may require emergency surgery.
- Open surgical repair is the most common type of surgery. You will be asleep during the procedure. Your doctor first makes a large cut in your stomach area or chest, depending on the location of the aneurysm. Then, the aneurysm is removed and a graft is sewn in its place. This graft is typically a tube made of leak-proof polyester. Recovery time for open surgical repair is about a month.
- Endovascular aneurysm repair (EVAR) is done by cardiac catheterization and is less invasive than open surgical repair. This is because the cut is smaller, and you usually need less recovery time. EVAR is used to repair abdominal aortic aneurysms more often than thoracic aortic aneurysms. During the procedure, your surgical team makes a small cut, usually in the groin, then guides a stent graft — a tube covered with fabric — through your blood vessels up to the aorta. The stent graft then expands and attaches to the aortic walls. A seal forms between the stent graft and the vessel wall to prevent blood from entering the aortic aneurysm.
Possible surgical risks
Complications of both types of aortic aneurysm repair can occur, and they may be life-threatening. These include:
- Bleeding and blood loss
- Blood clots in blood vessels leading to the bowel, kidneys, legs, or in the graft
- Damage to blood vessels or walls of the aorta when placing the stent graft or if the stent graft moves after it is placed
- Decreased blood flow to the bowels, legs, kidneys or other organs during surgery, which may lead to injury to these organs
- Endoleak, or a blood leak around the stent graft into the aneurysm, must be treated to prevent aneurysm rupture if it happens
- Gastrointestinal bleeding rarely occurs, but can happen if an abnormal connection forms between the aorta and your intestines after the repair
- Heart problems such as heart attack or arrhythmia
- Infection of the incision or the graft
- Kidney damage
- Spinal cord injury, which may cause paralysis