heart and blood vessel disorders
Thoracic Aortic Aneurysms
Treatment of Thoracic Aortic Aneurysms
Endovascular stent graft or traditional surgical repair Medications to reduce high blood pressure People are given CT examinations every 6 to 12 months so doctors can monitor the aneurysm and determine whether it is expanding. Patients are given a beta-blocker, calcium channel blocker, or another Medications for Treatment of High Blood Pressure to reduce the rate at which the aneurysms grows and to reduce the risk that it might rupture. For people who smoke, It is much better to treat a thoracic aortic aneurysm before it ruptures, so once it becomes 2½ inches (5.5 to 6.0 centimeters) wide or larger, doctors will recommend repair. In people who have Marfan syndrome, a rupture is more likely, so doctors may recommend surgical repair even for smaller aneurysms. The choice of aneurysm repair technique depends on many factors, including the person's age and general health and the anatomy of their aorta and aneurysm. In general, stent grafts are the first choice for thoracic aortic aneurysms because they are much less invasive, avoiding an open chest incision that is more painful and that requires longer recovery. Open surgery is less commonly done and generally only necessary when a stent graft does not fit the shape of the aorta. An endovascular stent graft is a hollow tube composed of fabric supported by a metal mesh that can be placed inside the aorta at the site of the aneurysm. To do an endovascular stent graft, doctors thread a long, thin wire through the large artery in the groin (femoral artery) and up to the dissecting area, Then they slide the stent graft over the wire and advance it to the site of the aneurysm within the aorta. Then they open the stent graft inside the damaged part of the aorta to form a stable channel for blood flow. The stent is left in place permanently. This procedure takes 2 to 4 hours, and the hospital stay is usually shorter than open surgery. The risk of death is less than 4% during stent graft repair of thoracic aortic aneurysms but is about 30 to 50% during a stent graft repair or surgery for a ruptured thoracic aneurysm. Untreated ruptured thoracic aortic aneurysms are always fatal. If syphilis or another infection is the cause of the aneurysm, doctors give antibiotics to treat the infection. Usually, the aneurysm must also be repaired. 