A thoracic aortic aneurysm, an abnormal bulge in a weakened wall of the aorta in the chest area, can cause a variety of symptoms and often life-threatening complications. Due to the serious risks it presents, timely diagnosis and treatment of a thoracic aneurysm are critical.

The standard surgical treatment for thoracic aortic aneurysms is open-chest aneurysm repair, but Cleveland Clinic surgeons are now able to treat many thoracic and thoracoabdominal (occurring in the lower part of the thoracic aorta and the upper part of the abdominal aorta) aneurysms with a minimally invasive procedure called an endovascular stent graft.

What is an endovascular stent graft?

Endovascular means that surgery is performed inside your aorta using thin, long tubes called catheters. 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 deployed in the diseased segment of the aorta and "relines" the aorta like a sleeve to divert blood flow away from the aneurysm.

An endovascular stent graft is a fabric tube supported by metal wire stents (also called a scaffold) that reinforces the weak spot in the aorta. By sealing the area tightly with your artery above and below the aortic aneurysm, the graft allows blood to pass through it without pushing on the aneurysm.

Who is a candidate for endovascular repair of a thoracic aneurysm?

You may be eligible for endovascular stent grafting if your thoracic aneurysm has not ruptured and the aneurysm is 5 centimeters or more in size.

Your physician can determine if aortic aneurysm repair is the best treatment by performing one or a combination of imaging studies, which may include:

  • High resolution, computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Angiography (an x-ray of the blood vessels)
  • Transesophageal echocardiography (TEE), to record ultrasound images of your heart from inside your esophagus, or food pipe
  • Intravascular ultrasound

Physical characteristics of the aorta and the aortic aneurysm itself are very important in determining if endovascular aorta repair is the best treatment.

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