The aorta is the main vessel of the human body providing blood to all organs. An aortic aneurysm is a "ballooning" in this main blood vessel that can lead to rupture or dissection.
Each year, 15,000 Americans die due to ruptures of these aneurysms, often without ever having symptoms. Another 100,000 are diagnosed before rupture, typically as the result of an incidental imaging procedure.
The incidence of abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) has increased substantially in recent decades.
What is an Aneurysm?
An aneurysm arises when part of an artery wall weakens, then expands. Aneurysms can happen anywhere in the body, but usually occur in your aorta, the main artery that ships blood from your heart to the rest of your body. The stomach is the most common site, where the condition is known as an abdominal aortic aneurysm (AAA). Aneurysms also may occur in the brain (cerebral), behind the knee (popliteal artery), intestines (mesenteric artery), the spleen (splenic artery) or the chest (thoracic artery).
What are the Risk Factors for Aortic Aneurysm?
Although many risk factors for aortic aneurysms have been identified, the exact cause remains unknown. Risk factors for aortic aneurysms include:
- High blood pressure
- High cholesterol
- Genetic factors
- Male gender
Causes of Aortic Aneurysm
Some aneurysms may be congenital, while others may be due to injury or aortic disease. A family history, obesity, high blood pressure, high cholesterol, emphysema and smoking (past or present) may boost your risks of developing an aneurysm. Having COPD, atherosclerosis and a lower-extremity occlusion can also lead to an aneurysm.
AAA is the third leading cause of death in males over 60, so regular screening of at-risk patients is essential.
Symptoms & Diagnosis of Aortic Aneurysm
Aneurysms can develop slowly over many years and often are asymptomatic. One that is close to the skin’s surface may hurt and swell, with a visible throbbing mass.
When an aneurysm ruptures, you experience pain, dizziness, nausea, vomiting, clammy skin, rapid heart rate, shock or plunging blood pressure. This is a medical emergency. Call 9-1-1 to seek prompt attention if belly or back pain is extreme and unrelenting.
Physicians at Memorial Hermann’s heart and vascular centers can detect an aneurysm with state-of-the-art imaging such as angiogram (an X-ray test in which a catheter is threaded into an artery up from the groin), MRI (magnetic resonance imaging), CT (computerized tomography) scans or abdominal duplex ultrasound. Medicare offers free AAA screening for qualified, at-risk patients.
Memorial Hermann physicians team with McGovern Medical School at UTHealth faculty members, combining the expertise of cardiothoracic and vascular surgeons and other specialists to ensure patients with aneurysms get coordinated, evidence-based care with the best possible outcomes.
Abdominal aortic aneurysm (AAA)
Symptoms of abdominal aortic aneurysm (AAA):
- A pulsating feeling near the belly button
- Deep pain in the abdomen
- Deep pain on the side of the abdomen
- Back pain
Abdominal aortic aneurysm (AAA) may be diagnosed using the following exams:
- Abdominal ultrasound
- CT scan of abdomen
- Angiography of aorta
Thoracic aortic aneurysm (TAA)
Symptoms of thoracic aortic aneurysm (TAA):
- Hoarseness of voice
- Difficulties swallowing or breathing
- Neck swelling
- Pain in the chest, shoulder, neck, jaw or upper back
- Clammy skin
- Nausea or vomiting
- Rapid heart rate
Thoracic aortic aneurysm (TAA) may be diagnosed using the following exams:
- Chest x-ray
- Chest CT scan
- Intravascular ultrasound
- Diagnostic angiogram
- Transesophageal echocardiogram
Surgery & Treatments of Aortic Aneurysm
Some aneurysms need surgery to strengthen weak artery walls, such as an endovascular abdominal aneurysm repair (EVAR). In this minimally invasive approach, tiny cuts in the groin allow doctors to thread a catheter through a vein or aorta. A fabric-covered metal mesh stent is then placed at the aneurysm’s weakest spot. Patients remain conscious under local anesthesia and may experience less blood loss and pain compared with a more invasive approach. Typically, the technique lowers the risk of mortality and allows patients to go home sooner and recover faster. Most people resume normal activity a week or so following their procedure.
Not all aneurysms need surgery. Doctors may monitor small ones with imaging scans once or twice yearly. Statins, antihypertensive drugs and beta blockers may slow aneurysm growth and prevent complications.
Traditional surgery for aortic aneurysm repair is done in stages, requiring multiple procedures.
Thanks to innovative techniques developed by surgeons at the Heart & Vascular Institute-Texas Medical Center and University of Texas Health Science Center (UTHealth) Medical School, the aortic aneurysm repair can now be completed with minimally invasive surgical techniques, which means patients have lower morbidity rates, shorter recovery times and can usually resume normal activity a week after surgery.
These surgeries include:
Aortic Diseases Treated
Our affiliated physicians provide preoperative, operative, and critical care for all diseases of the aorta including:
- Abdominal aortic aneurysms
- Aortic root aneurysms
- Ascending aortic aneurysms
- Transverse aortic arch aneurysms
- Descending thoracic aortic aneurysms
- Thoracoabdominal aortic aneurysms
- Acute and chronic aortic dissections
- Atheromatous disease of the aorta
- Coarctation of the aorta
- Marfan syndrome
- Familial thoracic aortic aneurysms and dissections
- Ehlers-Danlos syndrome
- Bicuspid aortic valve
To learn more about aortic aneurysms, our cardiologists, or treatment facilities, please use our contact form here. Schedule an appointment with a Memorial Hermann Cardiologist online or by calling (713) 222-2273.