Aneurysm Treatment, Surgery, Procedures & Prevention Options

Aneurysms in the upper chest are operated on, whereas aneurysms in the lower chest and below the stomach may not be life threatening and are watched carefully. Aneurysms less than 5 centimeters (about 2 inches) rarely rupture and do not require surgery, whereas aneurysms greater than 2½ inches may rupture and require surgery.

Patients suffering from smaller or stable aneurysms and aneurysms that are far from the heart, require regular check ups. The aneurysms are regularly tracked and the patients may live with aneurysms if they do not grow for years. Medications such as beta-blockers are prescribed to lower the blood pressure in patients who cannot risk a surgery. However, surgery becomes inevitable if the dissection starts to leak blood or cause blockage or gets bigger (4).

1. Open Aneurysm Repair: This procedure is adopted if an aneurysm is larger than 2 inches or 5 centimeters and enlarging while under steady observation. In this procedure an incision is made in the abdomen and the weakened part of aorta is replaced with a tube-like aortic graft made of a strong, durable, man-made plastic material, such as Dacron ® or Teflon ® thus allowing the free flow of blood (2).

2. Endovascular Stent Graft: In this least invasive procedure, small incisions are made in the groin area and thin, long tubes called catheters are threaded through the blood vessels. The movement of this catheters, fabric and metal tubes called endovascular stent grafts (or endograft), to the exact location of aneurysm are monitored using live x-ray pictures that are viewed on a video screen (2).

3. Coil Embolization or Endovascular Coiling: In this procedure, a patient’s vascular system is visualized using real time X-ray technology called fluoroscopic imaging and a catheter guided from the femoral artery (i.e., artery in the leg) into aneurysm in the head. Tiny platinum coils threaded through a catheter are guided to the aneurysm with the help of fluoroscopic imaging, blocking the blood flow into the aneurysm and preventing rupture. This process of endovascular filling the aneurysm is called embolization (8).

4. Microvascular Clipping: In this procedure, a section of the skull is removed and aneurysm are located, along with the feeder artery, with the help of a microscope. Once this is done, a small, metal, clothespin-like clip is placed on the aneurysm’s neck halting the blood supply. The clip remains in place and prevents future bleeding. In a related procedure, a similar occlusion (blocking) is done and flow of blood rerouted away from the damaged artery (6).

Prevention Methods

1. What is an Aneurysm? National Heart Blood and Lung Institute, US Department of Health & Human Services, National Institutes of Health.
2. Abdominal Aortic Aneurysm. VascularWeb, Society for Vascular Surgery, December, 2007.
3. Aortic Aneurysms, The Society of Thoracic Surgeons, 2007.
4. Aneurysms and Dissections, Texas Heart Institute at St. Luke’s Episcopal Hospital, Texas Heart Institute Journal.
5. Thoracic Aortic Aneurysm, Cleveland Clinic, Heart and Vascular Institute, 2007.
6. Cerebral Aneurysm Fact Sheet, National Institute of Neurological Disorders and Stroke, December 2007.
7. Aneurysms, Health Encyclopedia – Diseases and Conditions, 2008.
8. Brain Aneurysm Resources, Treatment options, The American Society of Interventional and Therapeutic Neuroradiology (ASITN).

Conditions & Diseases: Cardiovascular System

Aneurysm

Treatment Options

Prevention Methods