There are two types of aortic aneurysms. Thoracic aortic aneurysm is a type of aneurysm that forms in the thoracic part of the aorta. Abdominal aortic aneurysms occur in the abdominal part of the aorta. An abdominal aortic aneurysm develops when a blood-filled bulge develops in a particular area of the aortic walls. An aortic aneurysm can rupture and create various life-threatening complications.
The treatment for aortic aneurysms depend on the size of the aneurysm and its potential for rupture.
Treatment for small aortic aneurysms
· Aneurysms less than 5cm in diameter are called small aneurysm
· The risk of rupture of small aneurysms are very low.
· Watchful waiting is the first line of treatment
· An ultrasound scan is performed every five to six months to evaluate the size
· Lifestyle modifications are advised to reduce hypertension, one of the most important causative factors
· Smoking should be avoided
· Daily exercises should be practised.
Treatment for large aortic aneurysms
Aneurysms larger than 5.5 cm are referred to as large aneurysms. Aneurysm repair surgery is done if the enlargement occurs in a rapid manner.
There are two types of aortic aneurysm repair surgery.
Open repair surgery
The main steps involved this surgery are:
· A large incision is made in the abdomen to expose the aneurysm.
· The aneurysm is then opened till a healthy portion of the aorta is reached
· The aneurysm is then removed from both sides
· A Dacron graft is sutured to the healthy ends of the aorta
· Blood flow is reconstituted to assess the patency of the graft
· If satisfied, the surgical incisions are closed and sutured
· Drains are left in place to remove the fluids that accumulate in the surgical site
· The duration of the surgery will be about three to four hours. The patient will remain in the ICU for about two days. The hospital stay will be about 10 days.
Some of the common complications of open repair surgery are
· Deep vein thrombosis and pulmonary embolism
· Chest infections, especially in those who smoke
· Surgical wound infections
· Graft infections
· Oozing of fluids from the surgical wound
· Bowel problems
· Nerve injuries
Endovascular aneurysm repair surgery (EVAR)
This is a minimally invasive treatment. The complications of the surgery are less as compared to an open repair surgery. The main steps involved in an endovascular repair surgery are:
· Two small incisions are made in the groin to access the arteries
· By using imaging tools, a tiny stent like device is introduced into the area of aneurysm
· The stent is placed in the area of the aneurysm
· The stent contains small barbs with the help of which it attaches to the walls of the aorta
· The stent reinforces the aortic walls and excludes the aneurysm
Being a minimally invasive surgery, the recovery is much faster. Complications are also comparatively low.