Video by Roy Greenberg, MD
Staff Surgeon, Department of Vascular Surgery
Director of Endovascular Research and the Cleveland Clinic Peripheral Vascular Core Laboratory
Specialties: Carotid artery surgery, thoraco-abdominal aortic repair/reconstruction, thoracic aortic aneurysm repair, abdominal aortic aneurysm repair, peripheral artery/vein repair/bypass surgery, aortic aneurysm stent repair, endovascular stent repair, endovascular stent research.
Hello. I’m Dr. Roy Greenberg, a vascular surgeon in the Miller Family Heart & Vascular Institute. Today, I’m going to talk about thoraco-abdominal aneurysms – what they are and how they are treated.
An aneurysm is an abnormal bulge in the wall of a blood vessel. Aneurysms can form in any blood vessel, but they occur most commonly in the aorta, which is the main blood vessel leaving the heart.
Thoraco-abdominal aneurysms, also known as TAAs, are a type of aneurysm that involves the aorta as it flows thru both the abdomen and chest.
Most TAAs are diagnosed incidentally, as there are rarely any noticeable symptoms. This has led them to be nicknamed the “silent killer.” TAAs are most frequent in males over the age of 65 who smoke or have a family history of cardiovascular or peripheral vascular disease, but can also occur in females and those without a history of vascular problems.
Thoracic aortic aneurysms are most related to atherosclerosis, a hardening of the arteries that damages the blood vessel walls. While your arteries are normally smooth on the inside, they can develop atherosclerosis as you age. When atherosclerosis occurs, a sticky substance called plaque builds up in the walls of the arteries. Whether the plaque build up in aneurysms is a cause of the aneurysm formation – or simply results from the abnormal blood flow patterns within an aneurysm remains to be determined.
TAAs are serious health risks because, depending on their location and size, the aneurysms may rupture or dissect, causing life-threatening internal bleeding. TAAs are the most complex type of aneurysms and treatment carries a risk of postoperative paralysis.
An aneurysm is treated depending upon its size, location and your overall health. Some small aneurysms are closely monitored by regular CT or MRI scans. However, large aneurysms, or those that are causing symptoms, require prompt treatment. The weakened section of the vessel can be surgically removed and replaced with a graft of artificial material. If the aneurysm is close to the aortic valve, a valve replacement may also be recommended during the procedure.
At Cleveland Clinic, our surgeons have extensive experience in repairing TAAs and are nationally known for publishing their findings. In addition, a great deal of pioneering work has been done in terms of device development to make the treatment for aneurysms less invasive. Specifically, our patients benefit from our knowledge on which type of repair will provide the best outcome and the fact that we can offer minimally invasive repairs not widely available.
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