Aortic Aneurysm - Treatment - Treatment

Your doctor may recommend heart-healthy lifestyle changes, such as the following:

• Quitting smoking to slow the growth of the aneurysm
• Heart-healthy eating to help lower high blood pressure or high blood cholesterol
• Managing stress to help control high blood pressure, especially for thoracic aortic aneurysms. Your doctor may also suggest that you avoid heavy weightlifting and powerful stimulants, such as cocaine.

Your doctor may recommend medicines to treat an aortic aneurysm, including:

• Aspirin, especially if you have other cardiovascular risks
• Blood pressure medicines to lower blood pressure, slow down aneurysm growth, and lower the risk of rupture. These medicines include beta blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs).
• Statins to control cholesterol levels, and stop or slow the growth of aortic aneurysms

Depending on the cause or size of an aortic aneurysm or how quickly it is growing, your doctor may recommend surgery to repair it. Rupture or dissection of an aneurysm may require immediate surgical repair.

• Open surgical repair is the most common type of surgery. You will be asleep during the procedure. Your surgical team first makes a large incision, or cut, in your abdomen or chest, depending on the location of the aneurysm, then removes the aneurysm and sews a graft 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 less invasive than open surgical repair. This is because the surgical cut is smaller, and you usually need less recovery time. EVAR is used to repair abdominal aortic aneurysms more often than to repair 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.

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. The stent graft may also move after it is placed.
• Endoleak, which is a blood leak around the stent graft into the aneurysm. Endoleak may cause rupture of the aneurysm if not treated.
• Gastrointestinal bleeding, which rarely occurs if an abnormal connection forms between the aorta and your intestines after the repair. Blood may show up in your stool, or your stool may be black.
• Heart complications such as heart attack or arrhythmia
• Decreased blood flow to the bowels, legs, kidneys or other organs during surgery. This may lead to injury to these organs.
• Infection of the incision or the graft
• Kidney damage
• Spinal cord injury which may cause paralysis
• Stroke

• Research for Your Health will discuss how we are using current research and advancing research to treat people with aortic aneurysms.
• Living With will discuss what your doctor may recommend, including lifelong lifestyle changes and medical care to prevent your condition from recurring, getting worse, or causing complications.