Aortic Aneurysm

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Aortic Aneurysm

Causes
Symptoms
Diagnosis
Treatment

Medically Reviewed By Dr. Meghav Shah Updated on August 1, 2024

The Aorta is the main arterial channel of the body arising from the heart. It supplies blood to all the organs of the body, including the brain, abdominal and pelvic organs and the limbs (both upper and lower limb)

The ballooning or expansion of the aorta is called an Aortic Aneurysm. Whenever the wall of the aorta (or for that matter any artery of the body) becomes weak due to any reason, the artery balloons or expands, this is called an Aortic Aneurysm. The Aortic Aneurysm can be classified depending on its location. When it is in the chest, it is called a thoracic aortic aneurysm, while when it is in the abdominal part of the aorta, then it is called an abdominal aortic aneurysm, commonly called AAA.

Causes of Aortic Aneurysm

There may be multiple causes predisposing to an Aortic Aneurysm, these include:

Advancing age
High uncontrolled blood pressure
Smoking
Certain genetic and hereditary conditions in which the vessel wall is weak
Infections causing weakening of the wall (including fungal and bacterial infections, tuberculosis)

Symptoms of Aortic Aneurysm

Quite often, the abdominal aortic aneurysm may be detected incidentally. This may be picked up on a routine screening test or when a CT or an ultrasound is done for another cause. Other symptoms include:

Abdominal pain
Chest pain on and off
Bleeding in stools or in cough – on and off due to leakage from a large aneurysm which is in proximity to the esophagus or bowel
Thombing sensation in your abdomen
Back pain or pain on walking
A clot may form in a large aneurysm – this clot may dislodge distally into the legs causing sudden onset pain, pallor and discolouration of the legs called acute limb ischemia (ALI). This clot can also dislodge into the brain arteries causing an acute stroke.
The most dreaded complication of an aneurysm is rupture due to increased pressure and thin walls of the aneurysm. Due to sudden rupture, the patient can bleed to death within minutes.
Consider the aneurysm to be a ticking time bomb. This is a life threatening condition and therefore, aortic aneurysms should be treated and/or followed up on a regular basis as per the criteria decided by your doctor.

Diagnosis of Aortic Aneurysm

An aneurysm may be picked up incidentally. For exact confirmation of the aneurysm, a CT angiogram is required. This is a special non invasive test called a CT Aortogram, where the exact size and location of the aneurysm is mapped out. This is useful for treatment planning.

Treatment Options for Aortic Aneurysm

Aneurysms which has no symptoms and is less than 5 cm in size is medically managed. This involves regular CT angiography every 6 months. Aneurysms which are more than 5 cm or which have symptoms like on and off pain, require treatment.

Depending on the location, size, the extent and proximity to vessels, treatment may vary between open and endovascular treatment.

Most abdominal aneurysms and aneurysms in the lower chest can be treated with stent graft placements. For aneurysms located close to the aortic origin, an open surgical approach may be required. Sometimes a combination of the two – hybrid approach may be required.