An aneurysm is a bulging, weakened area in the wall of a blood vessel, resulting in an abnormal widening or ballooning of the vessel. An aneurysm can develop in any blood vessel in the body, including the vessels in the brain, the kidneys, the intestines, the aorta, the spleen, and the legs.
Aneurysms most commonly occur in the aorta, the largest blood vessel in the body and the main artery that carries blood from the heart to the chest and abdomen. If the wall of the aorta becomes weak and damaged, the force of the blood pumping from the heart may cause the aortic wall to bulge or balloon. Most aortic aneurysms have no symptoms. The major risk of an aortic aneurysm is a tear (dissection) or rupture, resulting in life-threatening internal bleeding. Aortic aneurysms can appear in a portion of the aorta located in the abdomen (called an abdominal aortic aneurysm) or a portion of the aorta located in the chest (called a thoracic aortic aneurysm).
Risk factors for aortic aneurysm development include:
One-time screening for abdominal aortic aneurysms using ultrasound imaging is recommended for men between 65 and 75 years of age with a history of smoking, even if they have no symptoms. Men 60 years of age and older with a family history of abdominal aortic aneurysm may also be tested.
Small aortic aneurysms can be monitored, and, in some cases, medications can be used for treatment. Aortic aneurysm repair, however, is typically recommended when the aneurysm becomes at greater risk for rupture due to size or rate of growth. Repair procedures can be done numerous ways, including traditional aortic aneurysm surgery and endovascular repair. The approach depends on the patient’s individual needs.
Traditional aortic aneurysm surgery is performed by replacing the diseased portion of the aorta with a graft, which is sewn into place. This approach is durable and well-tolerated by most patients, however, it requires a large incision and a five- to seven-day hospital stay with complete recovery in four- to six-weeks on average.
Endovascular (stent-graft) repair of aortic aneurysms is performed through a small incision in the groin. Imaging is used to guide a catheter with the graft to the weakened area of the wall of the aorta. The graft is then expanded against the wall. Patients generally return home two days after endovascular repair and are monitored in regular follow-up visits to check for any complications.
Patients who are elderly or have complex medical conditions may not be good surgical candidates. In these cases, endovascular repair is a viable therapeutic option. Newer approaches to endovascular repair are designed for patients with more challenging anatomy. Previously, these patients were limited to open surgical repair. In some cases, a combined open and endoscopic repair can be used.
At Brigham and Women's Hospital, a multidisciplinary team of experts in the Aortic Disease Center provides advanced aortic disease care and the latest treatment options, supported by a robust research program. The Aortic Disease Center at BWH is comprised of experts in cardiac surgery, vascular and endovascular surgery, cardiology, vascular medicine, cardiovascular imaging, and cardiac and vascular anesthesia. Together, these specialists offer evaluation and treatment for all complex aortic diseases and acute aortic emergencies.
The Carl J. and Ruth Shapiro Cardiovascular Center at BWH is one of the most advanced centers of its kind in the New England region. Bringing together the full range of cardiovascular services in one building, the Center provides the technology and infrastructure to enable seamless and coordinated care for all cardiovascular patients.
BWH has long been committed to not only the care of our patients, but also the many other needs that they and their families have. This philosophy of patient- and family-focused care – involving systems and services that emphasize healing in a comfortable, relaxed environment – is a guiding force behind the care we provide at the Center.
BWH is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. Our Inpatient Satisfaction Survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and where we could improve. We pride ourselves in the Quality of Patient Care we provide and how we compare with other hospitals.
If you believe you should have an evaluation and would like to schedule an appointment with one of our experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.
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