What is aortic aneurysm?
An aneurysm is a blood vessel that has enlarged beyond its normal size. Aortic aneurysms usually occur in four distinct areas: the aortic root/ascending aorta, the aortic arch, the descending thoracic aorta and the abdominal aorta. Frequently, the disease involves more than one contiguous area.
As aortic aneurysms enlarge, they have a tendency to either dissect (form a partial tear in the aortic wall) or rupture (form a full tear in the wall). If an aneurysm tears, it usually causes severe pain corresponding to the area of the aneurysm. In some cases, aneurysms do not tear but instead expand rapidly, which frequently causes a dull, persistent pain. In both circumstances, prompt or emergency surgery is needed.
The greatest danger is that an aortic aneurysm may rupture and cause severe, life-threatening bleeding.
In individuals whose aortic aneurysms are asymptomatic, the decision to recommend surgery (open or endovascular) is based on a balance between two opposing risks—the risk of rupture and the risk of operation. If the risk of rupture outweighs the risk of operation, surgery is usually recommended.
The assessment of these risks requires a thorough understanding of the factors involved in aneurysmal rupture and significant surgical experience to accurately estimate the risk of every individual operation. Certain factors, such as age and presence of heart, lung or kidney disease, may impact not only the surgical risk, but also the risk of rupture.