Treatment

The goal of treatment is to prevent your aneurysm from rupturing. Generally, your treatment options are medical monitoring or surgery. Your doctor's decision depends on the size of the aortic aneurysm and how fast it's growing.

Medical monitoring

If your abdominal aortic aneurysm is small and you're not experiencing symptoms, your doctor may recommend medical monitoring, which includes regular appointments to make sure your aneurysm isn't growing, and management of other medical conditions that could worsen your aneurysm. Your doctor will also ask you about any signs or symptoms you may be experiencing that could be related to the aneurysm.

It's likely your doctor will order regular imaging tests to check on the size of your aneurysm. Expect to have an abdominal ultrasound at least six months after your aneurysm is diagnosed and at regular follow-up exams after the first imaging test. The frequency of your imaging tests depends on the size of the aneurysm, whether the aneurysm is growing and how fast it's growing.

Surgery

If you have an abdominal aortic aneurysm, surgery is generally recommended if your aneurysm is about 1.9 to 2.2 inches (about 5 to 5.5 centimeters) or larger. Doctors may also recommend surgery if the aneurysm is growing quickly. In addition, your doctor may recommend treatment if you're experiencing symptoms such as stomach pain or you have a leaking, tender or painful aneurysm.

Surgery options may include:

  • Open abdominal surgery. Open abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place.

    This procedure requires open abdominal surgery, and it will generally take you a month or more to fully recover.

  • Endovascular surgery. Endovascular surgery is a less invasive procedure used more frequently today to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta.

    The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm and expanded. The graft is fastened in place with the metal mesh that frequently has small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

    Recovery time is generally much shorter with this procedure than with open abdominal surgery, but endovascular surgery can't be done in about 30 percent of people with an aneurysm. Discuss with your doctor whether you're a candidate for this procedure. After endovascular surgery, you'll need to have regular follow-up imaging tests to ensure that the graft isn't leaking. Long-term survival rates are similar for both endovascular surgery and open surgery.

The options for treatment of your aneurysm will depend on a variety of factors, including location and size of the aneurysm, your age, and other existing conditions that may increase your risk of surgery or endovascular repair. Your doctor will discuss with you the most appropriate treatment for you.

March 23, 2016
References
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