Thoracic Aortic Aneurysm & Dissecting Aortic Aneurysm
Thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) is a bulging of the major blood vessel in the chest that leaves the heart to supply blood to the chest and the entire lower half of the body. A special type of aneurysm called a “dissection” (or dissecting aortic aneurysm) occurs when the inner lining of the vessel wall tears and blood leaks into the wall of the artery. The blood then travels (“dissects”) between the layers to expand them, sometimes leading to rupture.
While not as common as abdominal aortic aneurysms (AAA), they are every bit as dangerous.
Causes and Treatment Options
Like AAA, the most common cause of a thoracic aortic aneurysm is atherosclerosis. Other causes include prior trauma and some uncommon inherited diseases. The aneurysms are more common in those with high blood pressure, cholesterol elevation, a smoking history, obesity and a family history of aneurysms. Thoracic aneurysms affect about 15,000 people per year in the United States. When the thoracic aneurysm ruptures, less than 10% of people even make it to the hospital alive. Of those that make it to the hospital, only 20-30% survive. These numbers emphasize how important it is to discover a thoracic aortic aneurysm or dissecting aortic aneurysm before it ruptures. They may be found on a routine chest X-ray.
Similar to AAA, treatment of a thoracic aortic aneurysm or dissecting aortic aneurysm usually occurs when the vessel enlarges beyond 5 cm (about 2 inches). Treatment is traditionally done with open surgical approaches. More recently, many of these aneurysms can be repaired using a stent-graft(also called EVAR, for Endo-Vascular Aneurysm Repair). This new technology allows treatment of many of these aneurysms using catheters advanced from the groin areas. Only a small incision in the groin is necessary, and recovery is generally 2-3 days rather than several weeks or even months.
As with the open repair, several potential complications can occur. The complication rate of the EVAR patients is lower than the open surgical patients but potential risks include bleeding, infection, stroke, paraplegia, leaking and respiratory failure. In addition, EVAR placement will require lifelong follow-up to make sure the graft remains functional. In general, CAT scans will be obtained at annual intervals. The doctors of VIR specialize in this new therapy and will coordinate your treatment and necessary follow-up. For an appointment, please call our office in Chicago, Illinois at (630) 856-7460 or contact us for more information on thoracic aortic aneurysm treatment.
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