How is a thoracic aortic aneurysm treated?
Treatment for an aneurysm depends on its size, location and your overall health.
Watchful Waiting and Medication
If the thoracic aortic aneurysm is small and not causing any symptoms, your physician may recommend “watchful waiting.” By closely monitoring your condition with CT or MRI scans every 6-12 months, the aneurysm will be watched for signs of changes.If you have high blood pressure, your physician will prescribe blood pressure medication to lower your overall blood pressure and the pressure on the weakened area of the aneurysm. Additionally your physician may prescribe a “statin” (or cholesterol lowering medication) to maintain the health of your blood vessels.
Aortic aneurysm surgically removedand replaced with a graft.
If the thoracic aortic aneurysm is large or causing symptoms, you will need prompt treatment to prevent a rupture from occurring. 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 (the valve that regulates blood flow from the heart into the aorta), a valve replacement may also be recommended during the procedure.
Repairing the aneurysm surgically is complex and requires an experienced thoracic surgical team. However, neglecting the aneurysm presents a higher risk. Repairing a thoracic aneurysm may require open-chest surgery, general anesthesia and a minimum hospital stay of five days.
Instead of an open aneurysm repair, your surgeon may consider a newer procedure called an endovascular aneurysm repair (EVAR, TEVAR, TA-EVAR). Endovascular means that surgery is performed inside your aorta using thin, long tubes called catheters. By entering through small incisions in the groin, the catheters are used to guide and deliver a stent-graft through the blood vessels to the site of the aneurysm. The stent graft is then positioned in the diseased segment of aorta to “reline” the aorta like a sleeve to divert blood flow away from the aneurysm.
This endovascular approach is currently used to treat abdominal and descending thoracic aneurysms, and is being evaluated as a treatment for thoracoabdominal and arch aneurysms. While current results are positive, further research is needed to determine who the best candidates for this type of procedure may be.
Your surgeon will advise you regarding the best option for treating your thoracic aneurysm.