Five things you should know about aortic aneurysms
Aortic aneurysms are known as a “silent killer” with good reason. Unless found by accident – usually during a routine, unrelated medical test – aortic aneurysms may go undetected until they rupture. It’s rare, but when they rupture, a person only has hours to live.
M Health Fairview Vascular Surgeon Nolan C. Cirillo-Penn, MD, shares five things everyone should know about aortic aneurysms.
What is an aortic aneurysm? How are they found?
Aortic aneurysms are a dilation and weakening in the wall of the aorta, which is the largest artery in the human body. The aorta supplies blood to the brain and entire body. If the aneurysm is not found and identified, it may burst, causing significant and often fatal bleeding.
A normal aorta is about 3 centimeters—or a little over 1 inch across. An aneurysm occurs when a portion of the aorta has enlarged to at least 1.5 times its normal size. Aortic aneurysms less than 4 centimeters in size have a low chance of bursting, but an aneurysm more than 5.5 centimeters in diameter has an increasing chance of rupturing in the next year.
Aortic aneurysms are dangerous because they’re often undetected until they burst. Most aneurysms found before a rupture are discovered by accident during an unrelated medical test.
What health factors increase your risk of an aortic aneurysm?
Men are at much higher risk of developing an aneurysm than women. When aneurysms do occur in women, they often first present as a rupture. 58 percent of aortic aneurysms diagnosed in 2018 were in men, according to the Centers for Disease Control and Prevention (CDC). A family history of aneurysms can also increase your risk. Smoking, obesity, age, and high blood pressure can all put a person at higher risk for aneurysms.
About 75 percent of abdominal aortic aneurysms happen in people with a history of smoking, according to the CDC. Nevertheless, it’s important to note that anyone—even people in excellent physical condition—can have an aortic aneurysm. Patients who have a history of aortic dissection – a condition from high blood pressure where the wall of the aorta “unzips” or splits – are also at risk of developing an aortic aneurysm. This condition impacts men and women.
Can you prevent an aortic aneurysm or reduce your risk?
People at higher risk for an aortic aneurysm can adopt heart-healthy lifestyle changes, including a healthy diet, more physical activity, and smoking cessation. Your doctor may also recommend medicines including statins, beta blockers, or other prescriptions that are generally helpful for the cardiovascular system.
How is an aortic aneurysm treated?
If the aneurysm is more than 4 centimeters in size, your doctor may recommend monitoring and some heart- and cardiovascular-healthy lifestyle changes. Smaller aneurysms rarely rupture and grow at an average rate of one-third of a centimeter each year.
If the aneurysm is more than 5.5 centimeters in size, or if it’s rapidly getting larger, your doctor may recommend surgery to repair the aneurysm. In many cases, doctors will run a catheter through your femoral artery in the groin to the site of the aneurysm in the aorta, then implant a stent graft. The stent graft reinforces the weakened aorta and eventually the aneurysm can shrink around the graft. This procedure is often done using a minimally invasive approach with essentially no incisions.
This approach allows for treatment of about 80 percent of abdominal aortic aneurysms. The remaining 20 percent of aneurysms are better treated with open surgery.
Although the majority of aneurysms are small and do not require surgery, the presence of an aneurysm may indicate the patient has related health concerns that need attention.
How is M Health Fairview uniquely positioned to treat this condition?
The M Health Fairview multidisciplinary care teams are leaders in successfully treating aortic aneurysms. Our uniquely equipped hybrid operating rooms and the high level of expertise our care teams possess allows us to treat both low- and high-risk patients. Many of our physicians are national and international leaders in the treatment of aortic aneurysms.
Because we offer state-of-the-art technology and care team expertise, we are leaders in providing aneurysm repair options for high-risk patients. Most repairs can be done without incisions or the stress of general anesthesia, which reduces the risk for patients with heart or lung problems. These advances mean even low-risk patients can get back to their daily routine faster.
M Health Fairview experts have developed a pilot program to help primary care doctors determine who should receive an ultrasound screening to detect aortic aneurysms on the basis of a number of health factors.
