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:
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.
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.
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 procedure—that 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.
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.
The illustration shows the placement of an endovascular stent graft in an aortic aneurysm. In