Aortic Aneurysm

Aortic Aneurysm is not a term, a layman reads about until after a discussion with a doctor for oneself or a dear one. We understand that you have had introduction about the condition, and we shall attempt to make this article comprehensive for you to be able to take informed decision.

What’s an Aneurysm?

Aneurysm is bulging, dilation or ballooning of blood vessel due to degeneration or weakening in portion of walls of blood vessels. It mostly happens as pressure of the blood flow forces the weakened part of the blood vessel to bulge out, though one should note that there may be other reasons as well for weakening of the blood vessel walls. Like a balloon, aneurysm increases in size thereby stretching the walls of the blood vessel thinner and compromising the flexibility of the vessel.

Types of Aneurysms:

Aortic Aneurysm
Cerebral Aneurysm
Popliteal Artery Aneurysm
Venous Aneurysms

In this article, we shall detail on the Aortic Aneurysms.

What’s an Aorta?

Aorta is the largest artery in human body which carries oxygenated blood from heart to the rest of the body. It originates from left ventricle of heart and extends down till lower abdomen.

An aorta is about a foot long and about an inch in diameter at its widest point. As the aorta descends towards pelvis, the diameter reduces to about 2 centimetres.

Walls of the aortic nerve is normally less than 4 millimetres thick, which it should be noted is among the thickest in human body. Reason for such thickness of Aortic walls is that directly handles significant pressure of oxygenated blood flow as it is pumped from the heart to the whole body.

We must note that there are more arteries in human body, and they are susceptible to aneurysm as well, however we dedicate this article to the most common aneurysm and hence do not detail into those segments.

Aortic Aneurysms

When the wall of Aorta weakens and start bulging, it called Aortic Aneurysm. Sometimes the aorta does not develop a bulge instead gets a tear in the inner layer hence blood starts leaking into the layers of the aorta itself; such condition is referred as Aortic Dissections.

Aortic dissections are more critical medical condition and while it may happen for various reason, an untreated aortic aneurysm significantly increase the risk of developing serious aortic dissection.

There are few subdivisions of Aortic Aneurysm primarily basis the location of the bulging in the aorta.

Thoracic Aortic Aneurysm (TAA) – Chest Segment
Abdominal Aortic Aneurysm (AAA) – Abdominal Segment
Thoracoabdominal aneurysms (TAAAs) – Aneurysms that coexist in both segments of the aorta (thoracic and abdominal)
Visceral Artery Aneurysms – Aneurysms can also occur in the branches coming off the aorta which supply blood to the vital organs, such as the liver, spleen, kidneys and intestines.

Different Shapes of Aneurysm

Aneurysms are also classified basis the shape of bulge in the artery. The shape of the bulge helps to identify the true aneurysm is described as

Fusiform – More common type of aneurysm, it involves ballooning on all sides of the artery.
Saccular – Saccular shaped aneurysm bulges only on one side of the artery.

There is one more type of medical condition which though not classified as true aneurysm but sometimes pose similar risk and require specialist assessment. It is referred as ‘Pseudoaneurysm’. Pseudoaneurysm is due to an artery injury that pierces the wall of a blood vessel. The opening in the blood vessel allows blood to leak out and pool in the surrounding tissue. It may look like an aneurysm, but your blood vessel wall won't stretch into the bulge that characterizes a true aneurysm.


Blood is considered flow of life in human body & aorta is primary artery to supply blood to all the organs of the human body and hence any alteration in its form may severely hamper the blood circulation leading to organ failures like heart attack, stroke or even death.

Once formed the aneurysm will slowly increase in size and the aortic walls will get weaker; leading to rupture or dissection. It’s a serious medical condition which should not be ignored and should be medically managed by specialists like interventional radiologists.

In case the oxygenated blood supply is reduced due to aneurysm, it may also lead to tissue-death resulting in Necrosis – another potentially serious medical condition. Such potential outcomes warrant that any suspected incidents should be evaluated by specialist doctor.

Causes of These Aneurysms?

There is no one answer to this. Aneurysms have been statistically correlated with various conditions which independently or jointly contribute to weakening of artery walls.

Some of the causes for aortic aneurysms are:

Family History: A person is 20% likely to have aneurysm if someone in close relation has had the condition. It is worth to note that the chances
Genetics i.e., any inherited connective tissue disorders
Atherosclerosis: a medical condition in which arteries harden up due to plaque build up.
Infections especially ones which may lead to inflammation in arteries

In case Abdominal Aortic Aneurysm (AAA), some additional factors also have been observed which contribute to probability of occurrence

Age (Above 60)
High Blood Pressure
High Cholesterol

It’s an interesting fact that males are 4-5 times more likely to get AAA in a general population. However, women having the medical condition have 20% more probability of rupture then men.


Regrettably, most aortic aneurysms are asymptomatic.

Patients may or may not get pain at the site of aneurysm and level of pain may indicate the criticality of the condition but unless diagnosed clinically, aneurysms can not be identified with certainty.
Depending on the location of the aneurysm, very few patients also have reported hoarseness in voice, trouble swallowing

As the symptoms may look like any other condition, it is best to be evaluated by medical specialists.

Being an asymptomatic & potentially fatal medical condition, the aortic aneurysm is also classified as “Silent Killer”.


Most Aortic Aneurysms are discovered post rupture or accidentally while patients are being evaluated for entirely different condition or undergoing detailed medical check-up.

Due to the nature of medical condition, it is strongly advised to have yourself evaluated for any development of aneurysm as part of yearly medical check-up. Such evaluation should be mandatorily done for person above 50 years of age.

If being done under regular medical check up programs, you may not need any special investigation (hence no additional cost) and the ongoing investigations done by specialists can help diagnosing any adverse development.

Once doctor suspects of Aortic Aneurysm, patient will need to undergo investigations like Ultrasound, a CT or MRI or an angiogram to accurately assess the medical condition and device a treatment plan. The choice of investigation shall depend on the preliminary medical assessment by the specialist doctor.


A small aneurysm or one that doesn't cause actionable symptoms may not require surgical treatment until it reaches a certain size or is growing in size over a short period. Your doctor may recommend "Watchful Waiting."

Watchful Waiting shall include an ultrasound, CT scan or other relevant test every 6 months to closely monitor the aneurysm, and medication to treat the underlying condition like blood pressure or cholesterol levels.

As explained earlier, Aorta is a thick & flexible artery with its diameter varying as it descends to the lower abdomen. Though not a standard medical practice but a general guidance, bulging which is more than 1.5 times of the normal diameter in the section is considered a stage which requires medical interventions.

When the aneurysm has reached a size, as per assessment by a specialist, benefits of repairing the aneurysm outweigh the risks associated with interventional procedures, doctor shall provide you with treatment options as mentioned below. It should be noted that basis the location, size of aneurysm and the overall medical condition of the patient, some of the options may not be available for a given patient.

Aortic Aneurysm Open Surgical Repair: An incision is made to directly visualize and repair the aneurysm. A cylinder-shaped tube which is called a graft may be used to repair the aneurysm. This is sewn to the artery, connecting the two ends of the artery at the site of the aneurysm. The open repair is considered the surgical standard for an aortic aneurysm repair. Grafts are made of various materials, such as Dacron (textile polyester synthetic graft) or polytetrafluoroethylene (PTFE, nontextile synthetic graft).

Endovascular aneurysm repair (EVAR). EVAR is a procedure that requires only small incisions in the groin along with the use of X-ray guidance and specially designed instruments to repair the aneurysm. With the use of special endovascular instruments and X-ray images for guidance, a stent-graft is inserted via the femoral artery and advanced up into the aorta to the site of the aneurysm. A stent-graft is a long cylinder-like tube made of thin metal mesh framework (stent), while the graft is made of various materials, such as Dacron or PTFE. The graft material may cover the stent. The stent helps to hold the graft open &in place thus reducing pressure on the blood vessel and prevents rupture.

EVAR is technologically advanced and more preferred modern line of treatment. However location of the bulge, health condition of the patient governs the choice of treatment plan & hence discuss the treatment options available with you with specialist doctors like interventional radiologist who are endovascular specialist.

Success Rate For The Treatment of Aortic Aneurysm

The chance of survival post Aortic Aneurysm Surgery is more than 95%, if done before the rupture. However, the survival rate for a ruptured aneurysm is 70% to 55% only. The major threat initiates from complications like organ failure due to rupture. It should though be noted that while in case of rupture the survival rate may seem lower, in case of no treatment, the rupture shall certainly lead to death of the patient.

Hence it is important to have the surgical treatment as soon as the doctor advises it. If the patient is fortunate to have knowledge of the aneurysm before the rupture event, it is highly recommended that patient is under regular review with the specialist doctor.

Post Surgery Recovery

Recovery from the surgical treatment is normal and usually patients make full recovery in two weeks. Patients may be advised to avoid strenuous activity or heavy lifting for some time.

Some patients do experience drop in levels of appetite for few weeks but that’s considered normal. However one should regularly follow-up with the treating doctor.

Lifestyle changes post Aneurysm surgery

While there is no definite cause identified for onset of an aneurysm, lifestyle changes have been observed to bring benefits for the patient.

Quit Smoking.
Eat Heart healthy diet as it helps in controlling blood pressure, cholesterol etc thus ensuring wellbeing of blood vessels.
Regularly Exercise as advised by your doctors.