The aortic aneurysm, whether in the chest or abdomen, despite causing few symptoms and evolving silently, is a serious disease located in the largest and most important artery in the body, whose function is to distribute blood to all organs.
According to the Brazilian Society of Angiology and Vascular Surgery (SBACV), the disease in the abdominal portion of the vessel is three to seven times more frequent than in the thorax, being more common in men, mainly white. To clarify the issue, we obtained the opinion of vascular surgeon and interventional radiologist Dr. Airton Mota Moreira, from Carnevale Interventional Radiology Teaching and Research, CRIEP.
What is an aortic aneurysm?
It is a disease characterized by abnormal dilatation of the aorta, with an increase in diameter by more than 50% of its original size. This disease is more frequent in patients with atherosclerosis, where there is fat accumulation and consequent loss of wall integrity.
The presence of predisposing factors such as eating errors, smoking, obesity, diabetes mellitus or a sedentary lifestyle can accentuate its severity.
How can I tell if I have an aortic aneurysm?
Aortic aneurysm can be completely asymptomatic. However, the effect of dilation can determine compression in adjacent structures. When there is compression on the intestine, symptoms such as constipation or diarrhea may occur. When there is compression of the urinary tract, there may be a greater predisposition to urinary infections.
However, severe pain, especially in the posterior region of the back, in the lumbar region or even in the lower limbs, can be an important warning sign, as it can mean acute growth of the aneurysm or its rupture, and will require that the doctor be notified. immediately.
The diagnosis of the aneurysm is based on the patient’s clinical history and physical examination, but is confirmed by means of tomography, magnetic resonance or ultrasound.
What is the treatment for aortic aneurysm?
Once diagnosed, the decision for the right time to treat the aneurysm will be based on your risk of rupture. Aneurysms at greater risk for rupture have a diameter equal to or greater than 5.5 cm and/or rapid progression. There are two possible treatments: surgical or endovascular.
No surgical treatmentwhich is classically better known and has a longer history of follow-up, the abdomen is opened, the aneurysm is approached, a prosthesis is sewn to the walls of the aorta above and below the aneurysm, communicating normal areas.
Endovascular treatment is more recent, but it has excellent results, especially for patients with a higher risk of complications. In it, everything is done through the inside of the vases. After puncturing one of the groin arteries, a prosthesis with a metallic skeleton and synthetic coating is positioned, with its ends fixed in the normal portions of the vessel above and below, to exclude dilation.
What are the advantages of endovascular treatment?
The option for the endovascular technique should consider whether there is a greater clinical risk for the patient to undergo surgical treatment, as observed in very elderly patients and, mainly, active smokers or with decompensated chronic obstructive pulmonary disease or cardiac alterations.
In these patients, there is real benefit, with a lower risk of death in the immediate period after the procedure, in addition to a shorter and better postoperative recovery. In these situations, endovascular treatment, which is less invasive, is the most appropriate.
What are the recommendations after treatment?
After endovascular treatment of the aortic aneurysm, all patients will be followed up by means of periodic imaging tests to monitor the integration of the prosthesis to the body, since the specific phenomena of the vessel wall may determine changes in its positioning.
The aortic aneurysm, whether in the chest or abdomen, despite causing few symptoms and evolving silently, is a serious disease located in the largest and most important artery in the body, whose function is to distribute blood to all organs.
According to the Brazilian Society of Angiology and Vascular Surgery (SBACV), the disease in the abdominal portion of the vessel is three to seven times more frequent than in the thorax, being more common in men, mainly white. To clarify the issue, we obtained the opinion of vascular surgeon and interventional radiologist Dr. Airton Mota Moreira, from Carnevale Interventional Radiology Teaching and Research, CRIEP.
What is an aortic aneurysm?
It is a disease characterized by abnormal dilatation of the aorta, with an increase in diameter by more than 50% of its original size. This disease is more frequent in patients with atherosclerosis, where there is fat accumulation and consequent loss of wall integrity.
The presence of predisposing factors such as eating errors, smoking, obesity, diabetes mellitus or a sedentary lifestyle can accentuate its severity.
How can I tell if I have an aortic aneurysm?
Aortic aneurysm can be completely asymptomatic. However, the effect of dilation can determine compression in adjacent structures. When there is compression on the intestine, symptoms such as constipation or diarrhea may occur. When there is compression of the urinary tract, there may be a greater predisposition to urinary infections.
However, severe pain, especially in the posterior region of the back, in the lumbar region or even in the lower limbs, can be an important warning sign, as it can mean acute growth of the aneurysm or its rupture, and will require that the doctor be notified. immediately.
The diagnosis of the aneurysm is based on the patient’s clinical history and physical examination, but is confirmed by means of tomography, magnetic resonance or ultrasound.
What is the treatment for aortic aneurysm?
Once diagnosed, the decision for the right time to treat the aneurysm will be based on your risk of rupture. Aneurysms at greater risk for rupture have a diameter equal to or greater than 5.5 cm and/or rapid progression. There are two possible treatments: surgical or endovascular.
No surgical treatmentwhich is classically better known and has a longer history of follow-up, the abdomen is opened, the aneurysm is approached, a prosthesis is sewn to the walls of the aorta above and below the aneurysm, communicating normal areas.
Endovascular treatment is more recent, but it has excellent results, especially for patients with a higher risk of complications. In it, everything is done through the inside of the vases. After puncturing one of the groin arteries, a prosthesis with a metallic skeleton and synthetic coating is positioned, with its ends fixed in the normal portions of the vessel above and below, to exclude dilation.
What are the advantages of endovascular treatment?
The option for the endovascular technique should consider whether there is a greater clinical risk for the patient to undergo surgical treatment, as observed in very elderly patients and, mainly, active smokers or with decompensated chronic obstructive pulmonary disease or cardiac alterations.
In these patients, there is real benefit, with a lower risk of death in the immediate period after the procedure, in addition to a shorter and better postoperative recovery. In these situations, endovascular treatment, which is less invasive, is the most appropriate.
What are the recommendations after treatment?
After endovascular treatment of the aortic aneurysm, all patients will be followed up by means of periodic imaging tests to monitor the integration of the prosthesis to the body, since the specific phenomena of the vessel wall may determine changes in its positioning.
