Cardiovascular and Interventional Radiological Society of Europe
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Aortic aneurysm/dissection

Overview

The aorta is the largest vessel in your body, delivering blood from your heart to the rest of your body. An aneurysm is when the aorta is enlarged beyond its normal size. The wall of the aorta consists of three layers. A tear in the inner layer is called a dissection.

Symptoms

Many patients with aneurysms and dissections do not experience any symptoms. When they do cause symptoms, patients usually experience pain in the chest between the shoulders, in the abdomen or in the back. If the aneurysm or dissection leaks, patients bleed internally and may suddenly feel weak or collapse.

Diagnosis

If you have a large aneurysm in your abdomen, your doctor may be able to diagnose it by physically examining you. If you have an aneurysm of the aorta in your chest, your doctor may be able to diagnose it using some form of imaging. Ultrasound can be used to diagnose aortic aneurysms of the chest or abdomen. CT and MRI can diagnose aneurysms of any part of the aorta.

Treatment

The treatment you will be given depends on the size of the aneurysm or tye and effect of dissection, the symptoms you experience and the rate of change. The aim of treatment is to prevent the affected area from rupturing or, if it has already ruptured, to treat the rupture.

Small aneurysms can be managed conservatively by imaging follow-up. Aneurysms which are large or are still growing may be managed by minimally invasive approaches, which place a prosthetic tube (also known as a stent graft) inside the aneurysm to protect its weak walls. This can be performed with image guidance using a keyhole approach (that is, the procedure can be performed through a tiny opening) from arteries, usually from the top of your legs.
Alternatively, another treatment option may be open surgery, in which a doctor will stitch in a prosthetic tube to replace the weakened aorta.