Aortic Aneurysm

An aortic aneurysm is a weakening resulting in swelling in the main blood vessel of the body called the aorta. It is called a thoracic aortic aneurysm if it is in the chest or abdominal aortic aneurysm if found in the abdomen.

The cause of such aneurysm can be due to a variety of causes but mainly due to age related damage. This ballooning of the aorta causes increase in size with increasing chances of rupture over time.

People who have increased risk of developing an aortic aneurysms are:

• Over 60 years of age
• Smoker
• Hypertension
• Family history of an aneurysm
• History of coronary or peripheral arterial disease

Normally aneurysms do not cause any problems and are picked up during routine abdominal scans. Less often you can have symptoms like upper abdominal pain, back pain or a painful lump in your abdomen that is throbbing. Aortic aneurysms can be diagnosed with ultrasound scans but normally a CT Scan is needed for detailed planning of treatment. Aneurysms can occur in other places such as the development of mesenteric or carotid aneurysm. Treatment can involve surgery, peripheral angioplasty and/or stent grafting. Once an aneurysm is suspected or diagnosed, it is imperative to consult a vascular specialist for aortic aneurysm surgery at the earliest.

Some smaller aortic aneurysms do not need active treatment and can be followed up with repeated scans at intervals. An Abdominal / Thoracic aortic aneurysm can be safely treated by endovascular (minimally invasive) or open surgery depending on the anatomy of the lesion. A vascular surgeon is trained to offer you both solutions for best outcome. A ruptured aortic aneurysm is a surgical emergency and needs to be dealt with as soon as possible. The chances of survival after an aneurysm ruptures are as low 2 out of 10 people. The treatment modality can be endovascular or open depending on the patient condition and disease factors.

Health Tips

• Family History of aortic aneurysm- you must get screened for whether you have a hidden aneurysm
• Stop smoking
• Healthy, low-sodium diet
• Maintain weight
• Regular exercise
• Blood pressure and cholesterol control

How can I ensure I get successful care for my aortic disease

Aortic aneurysms can be complicated or simple in shape and typically occur in older people with other health conditions. The decision of when and how to treat is based on an assessment of multiple factors. The appropriate choice of treatment for you as a patient is decided only after this assessment. The best doctor for your aneurysm treatment is one who has expertise in surgery AND stent graft procedures so that the correct choice can be made for you. The procedure should be done in a hospital with the facilities and experts for dealing with any kind of problems related to the heart, lungs and kidneys that patients with aneurysms are prone to suffer.

International Publications On Aortic Surgery by Dr Robbie George and Team

• An Endovascular Filter to prevent embolization during aortic stenting. Journal of Vascular Surgery 63(2): 548-51.
• Contemporary management of symptomatic primary aortic mural thrombus. Journal of Vascular Surgery. 2014 Sep 22. S0741-5214(14)01623-1. doi:10.1016/j.jvs.2014.08.057
• Endovascular Exclusion of Complex Post-Surgical Aortic Arch Pseudoaneurysm using Vascular Plug Devices and a review of Vascular Plugs. Perspectives in Vascular Surgery and Endovascular Therapy (July 2013, DOI: 10.1177/1531003513501203) 
• Management of Symptomatic Thrombus in Non-Atherosclerotic/Non-Aneurysmal Aorta. Journal of Vascular Surgery Volume 57, Issue 5, Supplement, May 2013, Pages 43S 
• Surgical and endovascular treatment of occlusive aortic syndromes. J Cardiovasc Surg. (Torino). 2013 Feb;54 (1 Suppl 1):55-69.
• Acute thrombosis of abdominal aortic aneurysm presenting with lower limb ischaemia. ANZ J Surg. 2011 Dec;81(12):945-6