Aortic aneurysm refers to a weak spot in the wall of the aorta, the major blood vessel leaving the heart. Most aortic aneurysms occur in the abdominal segment of the aorta; only 25 percent occur in the segment that runs through the chest (thoracic aorta), according to the Mayo Clinic. The diameter of the bulging spot indicates the risk of the aneursym rupturing and determines how aggressive treatment should be. Ruptured aortic aneurysm is rapidly fatal and even emergency surgery often fails.
Observation
According to the Mayo Clinic, most aortic aneurysms grow slowly. Often a person with an aortic aneurysm does not recognize the condition until it shows up on a test being performed for another reason. If the aneurysm is small---less than 4cm---there is no risk for rupture, according to the Merck Manual. Doctors often recommend a "watch and wait" approach in these cases, with ultrasounds every six months to a year to monitor the growth of the aneurysm.
Medication
For small aneurysms that do not merit surgery, or for larger aneurysms before surgery, a doctor might recommend medications to lower blood pressure and relax blood vessels. These medicines should relieve some of the force of the blood flowing through the aorta, decreasing the risk of rupture. The National Heart Lung and Blood Institute says that doctors most commonly prescribe beta blockers and calcium channel blockers for this purpose.
Open Surgery
If the aneurysm is 5cm or larger, your doctor will probably recommend surgery. In an open chest or open abdomen approach for thoracic and abdominal aortic aneurysms respectively, the surgeon makes a major incision, removes the aneurysm, and replaces the section with a graft of synthetic material. Open surgery is a major procedure involving a hospital stay of about five to eight days. Full recovery takes about a month.
Endovascular Repair
Depending on the size and location of the aneurysm, the surgeon might be able to perform a less invasive surgery to repair the aneurysm, rather than an open surgery to remove it. In endovascular repair, the surgeon inserts a catheter into an artery in the groin and threads it up to the site of the aneurysm. Once there, the tubular stent graft inside the catheter is released, expanded, and fastened in place. Made of woven material strengthened with metal mesh, the stent graft reinforces the aorta at the site of the aneurysm to prevent its rupture.
