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Abdominal Aortic Aneurysm, Rupture
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Aortic aneurysm

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Cardiovascular System

From MayoClinic.com


Treatment for an aortic aneurysm depends on its size and location and your general health. If your aortic aneurysm is small and you have no symptoms, your doctor may suggest a watch-and-wait approach. In general, people with small abdominal aneurysms — less than 2 inches (about 5 cm) in diameter — can be safely monitored with ultrasound and don't require surgery to repair the weakened section of artery until the risk of rupture outweighs the risk of surgery.

However, if you have an abdominal or chest aneurysm that is large or enlarging rapidly, is leaking or is showing signs that rupture is likely, you'll probably need surgery. The two main types of surgery for an aortic aneurysm are:

  • Open abdominal or chest surgery. This standard operation repairs an aortic aneurysm. It involves your doctor opening your abdomen or chest and stopping blood flow in the aorta so that the damaged section can be replaced with a synthetic tube (graft), which is sewn into place. Although this surgery is generally successful, because it requires an incision in your abdomen or chest, the recovery time is lengthy. Recovery may take longer than 6 weeks, including a weeklong stay in the hospital.

  • Endovascular surgery. Doctors at major medical centers are using this newer procedure on abdominal aortic aneurysms. In the procedure, a synthetic graft is attached to the end of a thin tube (catheter) that's inserted into your bloodstream, usually through an artery in your leg. The catheter is threaded upstream to your aorta and used to position the graft, which is basically a woven tube covered by a metal mesh, at the site of the aneurysm. Once in place, the graft is inflated and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm. Although endovascular surgery reduces recovery time to a few days, it still carries risk. And long-term results are unknown. Still the procedure may benefit those who need surgery to repair an aortic aneurysm but are at high risk of complications because of pre-existing medical problems.

A ruptured aortic aneurysm may be repaired with emergency surgery. But the outcome generally is less successful than if the problem is detected and treated before rupture. Many people who experience a ruptured aortic aneurysm die before they reach the hospital. Of those who have emergency surgery to fix a ruptured aortic aneurysm, only about half survive.

Fortunately, most aortic aneurysms never rupture. And doctors continue to research new methods to diagnose and treat aortic aneurysms. For example, researchers are studying a small sensor device that could be implanted within an aortic aneurysm to help doctors gauge whether an aneurysm is enlarging and at what rate.


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