What Are My Treatment Options for a Thoracic Aortic Aneurysm?
If your aneurysm has been discovered early, is still small (less than 5.5 centimeters), and you have no symptoms, surgery may not yet be necessary. In this case, your vascular surgeon will closely monitor the growth of your aneurysm every 6-12 months by obtaining CT scans. Additionally, it is important to quit smoking and control your risk factors, such as keeping your blood pressure or high cholesterol under control with medication.
Once your aneurysm has reached 5.5-6 centimeters, the risk of rupture is much higher, and surgery is recommended. Your vascular surgeon will decide what the best options are for you at that time and discuss complications and risks. There are two choices for treatment:
- Traditional Open Repair of TAA: An incision is made into your chest or just under the breastbone to visualize the area of the aneurysm. The aneurysm is opened, and a cylinder-like tube called a graft is placed within the aorta to repair it. Ultimately, the weakened area of the artery is relined with a sleeve of material to strengthen it and prevent rupture of the aneurysm. At times, there is also involvement of the aorta adjacent to the heart. If this is the case, sometimes heart surgery may be required at the same time. Hospital stay with this procedure is about 7-10 days, with full recovery depending on other conditions present.
- Endovascular Repair of TAA: This repair may only be used if the location and shape of the aneurysm is suitable to allow for correct deployment of the graft. It is a less invasive approach than traditional surgery, with this repair involving only a small incision in the groin. Endovascular means that the procedure uses long thin tubes inside your body called catheters. Under guidance of an x-ray, a small catheter is placed through the groin incision and used to pass a cylinder-like tube called a graft up into the aneurysm. This graft is placed so that the ends fit neatly into the non-diseased portion of the artery at the opposite ends of the aneurysm. This is relining the weakened area of the aorta with a strong sleeve of material, thus preventing rupture of the aneurysm. Hospital stay for this procedure is 2-3 days, with full recovery about 1 week.