Aortic Aneurysm

An aortic aneurysm is a complex condition that can be dangerous. If you’re diagnosed with an aortic aneurysm, it’s critical to have an experienced team manage your care.

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Other hospitals from around the state regularly send their most complex cases to us for repair. And we were the first system in the nation to receive Joint Commission certification for aortic aneurysm treatment.

Because we’re often the first in the state to use new technologies, we offer the widest range of therapies. This lets us precisely tailor your treatment. For example, special FDA permission lets us adapt existing devices to make more effective repairs. We can create an approach that’s customized for you.

Aortic aneurysm types and symptoms

Your aorta, which travels through your chest and abdomen, is the largest blood vessel branching off your heart. An aortic aneurysm is a bulge in the wall of the aorta that can happen anywhere along the blood vessel.

Abdominal aortic aneurysms appear in the lower part of the aorta. This is the most common type.
Thoracic aortic aneurysms occur higher up on the aorta, in the chest.
Thoracoabdominal aneurysms extend from the chest to the abdomen.

Symptoms

Most people who have aortic aneurysms of any type don’t have symptoms. They’re often diagnosed when a provider notices the aneurysm on an image taken for another reason, like a CT scan for kidney stones.

If you have an aneurysm that ruptures, you might have the following symptoms:

Sudden, persistent pain in your back or abdomen that can be severe and feel like tearing sensation or can be dull and steady
Paleness
Sweating
A feeling of anxiety or doom

If you have these symptoms, call 911 or go to an emergency room immediately.

Should you be screened for an aortic aneurysm?

If an aortic aneurysm bursts, or ruptures, it can quickly cause fatal bleeding. Because these aneurysms often don’t cause symptoms before they rupture, you may need to be screened if you’re:

A man between age 65 and 75 and you have ever been a smoker
An adult of any age with a parent, brother, sister, or child who has had an aortic aneurysm

Screening for an aortic aneurysm is usually a one-time procedure. It could involve an ultrasound of your abdomen or an echocardiogram and a CT or MRI scan.

If you have a family history of aneurysms, you may also want to consider genetic testing.

Aortic aneurysm treatment from the UI Heart and Vascular Center

Every case of aortic aneurysm is unique. Our team creates a customized treatment plan for you that might include regular monitoring, medication, or repair.

Monitoring

If you have a small aortic aneurysm that’s growing slowly, your doctor will probably recommend an ultrasound every year.

If your aortic aneurysm gets larger than 5 cm in diameter or starts growing faster, you may need to have an ultrasound every six months. This is especially important if you’re a smoker or have a family history of ruptured aortic aneurysm.

Medications

Medications to lower your blood pressure or cholesterol can help slow the growth of an aortic aneurysm.

Beta blockers slow down your heart rate and lower your blood pressure.
Calcium channel blockers dilate, or widen, your blood vessels to lower your blood pressure.
Statins help reduce blockages in your arteries by lowering your cholesterol.

Repair

If monitoring and medications aren’t enough to manage your aortic aneurysm, your provider may recommend doing a procedure to repair it.

To determine which approach is right for you, your provider will consider your age, overall health, location of the aneurysm, and other factors. Your care team will use several tests, which could include a CT scan and angiography, to view your aneurysm and make a plan.

Open repair is a traditional surgery done while you’re under general anesthesia.

Your surgeon makes a large incision in your belly or chest.
Clamps are placed on the aorta above and below the aneurysm to stop blood from flowing through.
A fabric tube is stitched, or grafted, to the aorta to replace or reinforce the weak section.
You’ll spend a week to 10 days recovering in the hospital and will probably need two to three months to recover fully.
Open repair tends to last longer than endovascular repair. That can make it the best choice if you’re in good overall health and under age 70. It might also be used if your aneurysm is very close to other arteries.

Endovascular aneurysm repair, or EVAR, is a minimally invasive procedure performed through small incisions in your groin. It can be done under general anesthesia or local anesthesia.

Your surgeon uses imaging to guide a small fabric-covered tube, called a stent graft, through your arteries to the aneurysm.
When it’s in the right spot, the graft is expanded, like an umbrella opening. It seals off the aneurysm while letting blood flow through your aorta.
You’ll be in the hospital for one to two days. You should be fully recovered in two to three weeks.
EVAR is less invasive, less painful, and has less risk of complications than open repair. Older patients are often best suited for EVAR.

New treatments, custom-made for you

Complex aortic aneurysms require a team that can include vascular surgeons, cardiothoracic surgeons, critical care specialists, and others who work together closely to achieve the best outcome for you.

Our vascular surgeons were the first in Iowa to offer a new, complex EVAR technique called fenestrated-branched EVAR (F/BEVAR). With this approach, our surgeons make a custom graft for you. This procedure might be used if you aren’t in good enough health for open surgery but a standard EVAR repair wouldn’t work for your aneurysm.
You may also be eligible for a clinical trial of new aneurysm repair devices. Our vascular surgery team has been part of a number of trials that have led to new treatments.