Heart disease is the leading cause of death in the United States, so it tends to get the most attention in terms of awareness. Aortic aneurysms aren’t as widely discussed, but they should be. An aortic aneurysm is one of the most serious conditions affecting the aorta (your body’s largest artery), and can potentially be just as dangerous as heart disease.
One of the main reasons is that these bulges in the wall of the aorta rarely have warning signs. In fact, aortic aneurysms are often called “silent killers” because they are known to expand quietly until they reach a dangerous point, sometimes rupturing, which can be life-threatening.
Sometimes, aneurysms are discovered during routine heart screenings or imaging tests performed for another concern. When caught before rupture, the next step is to determine when to monitor an aortic aneurysm and when surgery is necessary. This decision is critical for protecting health and preventing complications.
Whether you or a loved one has been diagnosed with an aortic aneurysm or you want to stay proactive about vascular health, this blog provides a clear overview of what to know and what to do next.
You will learn:
- What an aortic aneurysm is
- The differences between abdominal and thoracic types
- The causes and risk factors of aortic aneurysms
- Possible signs of aortic aneurysms when symptoms are present
- How doctors diagnose aortic aneurysms
- The factors that guide monitoring vs. surgery
- What to expect from monitoring and surgical options if repair is needed
- Ways to catch an aortic aneurysm early
- When preventative screening is necessary
What Is an Aortic Aneurysm?
An aortic aneurysm is a weak, bulging area in the wall of the aorta, the body’s largest artery that carries blood from the heart to the rest of the body. While not a “disease of the heart muscle” itself, its close proximity to the heart and potential for life-threatening complications make it a significant concern within cardiovascular health.
Depending on where an aneurysm develops, it can interfere with blood flow to vital organs, the brain, or the legs by affecting branches of the aorta. In some cases, the wall may continue to weaken until it tears completely, leading to internal bleeding and a life-threatening rupture.
There are two main types of aortic aneurysms based on their location: abdominal or thoracic. This location plays a significant role in determining which complications might occur and how surgeons approach treatment. We will go over each type in detail next, outlining where each occurs, as well as the common causes, risk factors, and potential symptoms and complications of each.
Both types of aortic aneurysms are typically silent, meaning most people do not have any signs or symptoms as the weakening or bulging develops. If symptoms do occur, they may include vague symptoms such as chest, back, or abdominal pain, which are often dismissed as muscle strain, indigestion, or another minor issue.
Meanwhile, changes are still happening inside the vessel. Over time, the structural support of the aortic wall deteriorates. As the wall loses strength, the aorta gradually enlarges, expanding outward like a balloon.
In most people, this enlargement happens slowly over months or years, often at a rate of about 1–4 millimeters per year. In some, the size remains stable for long periods. In others, enlargement progresses more quickly, especially with uncontrolled high blood pressure or certain genetic conditions.
Either way, aortic aneurysms do not heal or shrink on their own, and as the vessel expands, the risk of serious complications rises. The most dangerous is rupture, which can cause sudden internal bleeding and is often fatal without immediate emergency care.
Fortunately, rupture is not inevitable. When an aneurysm is discovered early (often during heart screenings or imaging for another concern), doctors can either monitor it closely or perform surgery if the risk of the aneurysm rupturing in the next few years appears to outweigh the risks associated with the surgery. A little further down, we’ll discuss what doctors consider when determining whether to monitor and when surgery is necessary.
Types of Aortic Aneurysms: Abdominal and Thoracic
Aortic aneurysms are classified by where they develop along the vessel. The two main types are abdominal aortic aneurysms (AAA) and thoracic aortic aneurysms (TAA).
Location matters because it influences who is most at risk for more serious complications, what symptoms may appear, and how doctors decide on the best approach for monitoring or treatment.
Understanding Abdominal Aortic Aneurysms (AAA)
What is an Abdominal Aortic Aneurysm?
An abdominal aortic aneurysm (AAA) forms in the portion of the aorta that runs through the abdomen, just below the kidneys. It is the most common type of aortic aneurysm and can range in size and growth rate.
Because the abdominal aorta carries blood to the lower half of the body, an aneurysm in this location poses a serious risk if it continues to expand or ruptures, since blood flow to vital organs and the legs can be compromised.
What are the Symptoms of an Abdominal Aortic Aneurysm?
Most abdominal aortic aneurysms are silent. If symptoms do occur, they may include deep abdominal or back pain or a pulsing sensation near the navel. Because these symptoms can be vague, they are often dismissed until the aneurysm is found on imaging or grows large enough to cause more severe problems.
If you notice persistent abdominal or back pain or feel a strong pulsing sensation in your abdomen, it is important to seek medical attention. While these symptoms can be caused by other conditions, they may also signal an enlarging aneurysm that needs prompt evaluation.
Causes and Risk Factors of Abdominal Aortic Aneurysms
The exact cause of AAA is not fully understood, but it appears that they are most strongly linked to atherosclerosis, the buildup of plaque in the arteries that weakens vessel walls. Other risk factors include age (most common in people 65 and older), smoking, high blood pressure, high cholesterol, and family history of AAA.
Conditions that increase strain on the arteries, such as obesity and diabetes, may also contribute, as well as medical conditions such as blood vessel disease, connective tissue disorders, inflammation of the arteries, congenital defects, infection, and trauma. Additionally, men are more likely to develop AAAs. However, women are more prone to rupture.
For more, read “Are You At Risk For Abdominal Aortic Aneurysm.”
Understanding Thoracic Aortic Aneurysms (TAA)
What is a Thoracic Aortic Aneurysm?
A thoracic aortic aneurysm (TAA) develops in the portion of the aorta that runs through the chest. While less common than an abdominal aneurysm, it carries the same potential for life-threatening complications if it enlarges or ruptures.
The thoracic aorta is responsible for delivering blood to the head, neck, arms, and vital organs in the chest, so weakening in this segment can threaten circulation to multiple critical areas and lead to severe complications if left untreated.
What are the Symptoms of a Thoracic Aortic Aneurysm?
Most thoracic aortic aneurysms do not produce symptoms. When signs are present, they may include chest or upper back pain, coughing, hoarseness, or shortness of breath. In some cases, difficulty swallowing can occur if the expanding aorta presses against the esophagus.
Because these symptoms overlap with more common conditions, they are often overlooked unless the aneurysm is discovered through a heart screening or other unrelated testing. If you notice persistent chest or back discomfort or unexplained changes in breathing or voice, it is important to seek medical evaluation.
Causes and Risk Factors of Thoracic Aortic Aneurysm
Like AAAs, the exact cause of thoracic aortic aneurysms is not fully understood. However, they seem to be more often tied to inherited or structural conditions that weaken the connective tissue of the aortic wall. Marfan syndrome, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome are well-known contributors, as is being born with a bicuspid aortic valve.
Long-term uncontrolled high blood pressure puts added strain on the thoracic aorta and is also one of the most significant preventable risk factors. A family history of thoracic aneurysms or aortic dissection also raises the likelihood of developing one, which is why doctors may recommend imaging for close relatives when these conditions run in families.
Men appear to be affected slightly more than women, but both sexes can develop TAAs, especially when genetic or blood pressure factors are in play.
Abdominal vs Thoracic Aneurysms: Key Differences
While both abdominal and thoracic aortic aneurysms share the same underlying problem (a weakening of the aortic wall), they differ in several important ways.
- Location: AAAs form in the abdomen, below the kidneys, while TAAs develop in the chest.
- Symptoms: Both are usually silent, but when symptoms appear, they differ. AAAs may cause abdominal or back pain or a pulsing sensation near the navel. TAAs are more likely to cause symptoms such as chest or upper back pain, coughing, hoarseness, or difficulty swallowing.
- Risk factors: Regardless of type, aortic aneurysms can develop for many reasons, and risk factors for each type often overlap. However, AAAs are most strongly linked to smoking and atherosclerosis, while TAAs are closely tied to genetic connective tissue disorders, bicuspid aortic valve disease, and long-term high blood pressure.
- Who is affected: AAAs are far more common with age (65+) and especially in older men with a history of smoking. TAAs can affect younger individuals with inherited conditions as well as older adults with cardiovascular disease.
Because both abdominal and thoracic aneurysms can develop with little to no warning, imaging and screening play a critical role in finding them before they become dangerous.
How Are Aortic Aneurysms Diagnosed?
Aortic aneurysms are often diagnosed through imaging tests that allow doctors to see the size and shape of the aorta and detect any abnormal bulges. Because many aneurysms develop quietly without symptoms, if early diagnosis occurs, it’s typically during a heart screening or imaging for other health concerns.
However, a definitive diagnosis of an aortic aneurysm requires more advanced follow-up imaging. Your healthcare provider will choose the appropriate diagnostic test based on your symptoms, medical history, and the area of the aorta being evaluated.
Here are some of the most common diagnostic tools used:
- Ultrasound: An ultrasound is the primary tool for diagnosing abdominal aortic aneurysms. It uses sound waves to create images of the abdominal aorta and is the preferred initial test for detecting abdominal aortic aneurysms due to its safety, accuracy, and ease of use.
- Transesophageal Echocardiogram (TEE): Sometimes simply referred to as echocardiography, this is a more specific type of ultrasound test where ultrasound probes are placed in the esophagus, providing clearer images of the heart and thoracic aorta. TEE is especially helpful for detecting thoracic aortic aneurysms and related complications.
- Computed Tomography (CT) Scan: A CT scan provides detailed cross-sectional images of the aorta and surrounding areas, giving precise information on the size and extent of the aneurysm. It is often used to evaluate thoracic aneurysms or after an aneurysm is initially detected for detailed assessment.
- Magnetic Resonance Imaging (MRI): MRI uses magnetic fields and radio waves to produce detailed images of the aorta to assess both size and growth rate, especially in patients who need repeat imaging but want to avoid radiation exposure. An MRI is useful for patients who cannot undergo CT scans due to contrast allergies or radiation concerns.
- Arteriography (Angiography): This involves injecting a contrast dye into the arteries, followed by X-ray imaging to visualize the aorta and its branches. It provides detailed arterial images but is less commonly used today due to the availability of non-invasive techniques.
In addition to imaging, doctors consider a patient’s medical history, family history, and physical exam. In rare cases, a large abdominal aneurysm may be detected by feeling a pulsing mass in the abdomen during an exam.
Accurate diagnosis and measurement are essential because the size and growth rate of the aneurysm determine whether careful monitoring or surgical repair is the safest option.
Is There a Way to Prevent Aortic Aneurysms?
You cannot always prevent an aortic aneurysm, especially when genetics or family history play a role. But there are proven ways to lower risk and slow the growth of an existing aneurysm:
- Control blood pressure: High blood pressure is one of the biggest drivers of aneurysm growth. Keeping it in range reduces stress on the aortic wall.
- Quit smoking: Smoking is one of the strongest risk factors, particularly for abdominal aortic aneurysm. Stopping tobacco use lowers risk and slows progression.
- Manage overall vascular health: Controlling cholesterol, diabetes, and weight supports healthy blood vessels and reduces added strain on the aorta.
- Exercise: While there isn’t definitive proof that exercise prevents aortic aneurysms, it is well known to be good for your heart and can help manage risk factors that contribute to their development and potentially slow their progression.
- Stay on top of heart screenings: Regular imaging is the most reliable way to detect an aneurysm early, especially if you are in a higher-risk group, which we will discuss a little further down.
Is There a Way to Catch an Aortic Aneurysm Early?
Catching an aortic aneurysm early isn’t impossible, but it is challenging because most grow silently without symptoms. In many cases, the only way they are found is by chance during imaging for another concern. Regular heart screenings are your best bet for catching an aortic aneurysm early.
Who Should Be Screened for an Aortic Aneurysm?
Because most aortic aneurysms are silent and often discovered by accident, regular heart and vascular screenings are the only reliable way to catch them early.
Screening is recommended when the likelihood of finding an aneurysm outweighs the risks of unnecessary testing. The type of aneurysm also matters, since abdominal and thoracic aneurysms affect different groups of people and call for different screening strategies.
Abdominal Aortic Aneurysm (AAA) Screening Guidelines
- Men ages 65 to 75 who have ever smoked: This group has the strongest evidence for screening benefit and is advised to have a one-time abdominal ultrasound.
- Men ages 65 to 75 who have never smoked: Screening may still be suggested if there is a family history of aneurysm or other risk factors such as high blood pressure or vascular disease.
- Women ages 65 to 75 with risk factors: Routine screening is not universally recommended for all women, but if you have smoked or have a family history, you should talk with your doctor about screening.
- Anyone with a first-degree relative who has had an aneurysm: Doctors often recommend screening earlier and/or more regularly if there is a family history.
- People with certain genetic conditions: Those with connective tissue disorders that weaken the aortic wall, such as Marfan syndrome or Loeys-Dietz syndrome, should discuss early and ongoing screening with their physician.
Thoracic Aortic Aneurysm (TAA) Screening Guidelines
- People with genetic or connective tissue conditions: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, or bicuspid aortic valve disease often require regular imaging, sometimes starting in adolescence.
- First-degree relatives of someone with TAA or aortic dissection: Imaging with echocardiogram, CT, or MRI is often advised, even without symptoms.
- Patients with signs of aortic disease or a history of dissection: Screening with continued monitoring is recommended.
- Those with aneurysms in other locations (like an AAA): Doctors may also suggest thoracic screening, especially if other risk factors are present.
- Family history of sudden cardiac death or aortic catastrophe: Discuss screening with your physician.
How Are Aortic Aneurysms Screened?
Screening for an aortic aneurysm is done with imaging tests that allow doctors to see the size and shape of the aorta. The type of test depends on whether the concern is for an abdominal or thoracic aneurysm.
- Ultrasound: The most common and simplest test for abdominal aortic aneurysm. It’s quick, painless, and uses sound waves to create an image of the aorta.
- CT scan (Computed Tomography): Provides a more detailed picture and is often used if an aneurysm is suspected or to track changes over time.
- MRI (Magnetic Resonance Imaging): Another detailed imaging option, especially for thoracic aneurysms, without the radiation exposure of CT.
- Echocardiogram: A heart ultrasound that can also show parts of the thoracic aorta, particularly near the heart, and may be used when genetic conditions or valve problems are suspected.
These tests not only confirm whether an aneurysm is present but also help doctors decide how often follow-up imaging is needed and whether treatment is necessary.
Can You Live With an Aortic Aneurysm?
If diagnostics reveal you have an aneurysm, that is certainly a scary word to hear. It’s also shocking for most people, considering they typically occur without warning. The good news is that while all aneurysms have the potential to be serious, they don’t always result in complications or rupture that lead to death. You can live with an aortic aneurysm.
Of course, if you have an undiagnosed aortic aneurysm, there is always the possibility that it could suddenly rupture, resulting in a life-threatening emergency or even death. However, once an aneurysm is identified, there are effective ways to monitor and manage it before it reaches that point.
Many people assume that surgery is the only solution, but that isn’t always the case. Your doctor may recommend a watch-and-wait approach. In many situations, aneurysms can be managed safely with regular imaging, strict blood pressure control, and lifestyle adjustments. And when surgery is needed, less invasive options such as endovascular repair can reduce recovery time and lower risk compared to traditional open surgery.
When Should an Aortic Aneurysm Be Monitored and When Does It Need Surgery?
If an aortic aneurysm is diagnosed before rupture, it’s easy to assume that surgery is the automatic next step. But that isn’t always the case. What happens after diagnosis depends on several key factors.
1: Aneurysm Size
While not the only factor, the diameter of the aneurysm is one of the most important considerations. Doctors use established size thresholds to help determine when continued monitoring is safe and when surgical repair is the safer option.
- Abdominal aortic aneurysms (AAA): Small AAAs less than 5.5 centimeters in diameter are usually monitored with regular imaging rather than repaired right away. Surgery is generally recommended once an AAA reaches 5.5 cm or larger in men. In women, the threshold is often slightly smaller, around 5.0 to 5.4 cm, since rupture risk is higher at smaller sizes.
- Thoracic aortic aneurysms (TAA): Thresholds depend on location. For the aortic root and ascending aorta, surgery is usually recommended once the diameter reaches 5.5 cm, or sometimes 5.0 cm if there are added risk factors such as a family history of rupture, Marfan syndrome, or a bicuspid aortic valve. For descending thoracic aneurysms, surgery is often considered at 6.0 cm, though endovascular repair may be an option at slightly smaller sizes.
2: Growth Rate
Size matters, but how quickly an aneurysm is expanding can be just as important. Even if it hasn’t reached the typical size threshold, surgery may be necessary if it’s enlarging rapidly.
An aneurysm is typically considered stable if it grows less than 0.5 cm in six months or less than 1.0 cm in a year. Growth faster than this raises concern and often shifts the recommendation toward surgery.
- Abdominal aortic aneurysms (AAA): Rapid growth is defined as more than 0.5 cm in six months or more than 1.0 cm in a year.
- Thoracic aortic aneurysms (TAA): Rapid growth is usually defined as 0.5 cm in one year or 0.3 cm per year over two consecutive years. In patients with heritable conditions or a bicuspid valve, even 0.3 cm in a single year can be a reason to intervene.
3: Symptoms
While most aneurysms are silent, during the monitoring phase, it is essential to watch for possible warning signs.
Pain in the chest, back, or abdomen may indicate that the aneurysm is expanding or beginning to leak. Other red flags include shortness of breath, hoarseness, or difficulty swallowing if the enlarged aorta presses against nearby structures.
If the aneurysm ruptures, symptoms can escalate quickly. Severe, sudden pain, dizziness, fainting, or signs of shock such as rapid heartbeat, clammy skin, or confusion may occur. This is a medical emergency. A ruptured aneurysm requires immediate surgery, as it can be fatal within minutes to hours without intervention.
4: Overall Health
Even with size and growth rate in mind, doctors also consider the patient’s age, medical history, and general health when deciding whether to monitor an aortic aneurysm or move forward with surgery.
In some cases, monitoring is preferred if surgery would carry higher risks than the aneurysm itself. For example, older patients or those with serious health conditions may be managed with surveillance if surgery poses more danger than benefit.
In contrast, for otherwise healthy patients who can tolerate surgery well, operating sooner may be the safer choice. For instance, someone with a moderate-sized aneurysm and a strong family history of rupture, or a patient with a genetic condition that weakens connective tissue, might benefit from earlier surgical repair before the aneurysm reaches the typical size threshold.
Bottom Line
Aortic aneurysms don’t automatically require immediate surgery, but certain red flags make surgical repair the safest option. Doctors typically recommend surgery based on three main factors: aneurysm size, growth rate, and the presence of symptoms.
If the aneurysm is large, growing quickly, causing symptoms, or if you have risk factors that increase the chance of rupture, surgery is often advised. On the other hand, if your aneurysm is small, stable, and not causing symptoms, or if surgery would carry greater risks than monitoring, your doctor may recommend a watch-and-wait approach.
This strategy allows careful monitoring with imaging and medical management, giving doctors the chance to act before an aneurysm becomes dangerous while avoiding unnecessary surgery when the risk is still low.
How Doctors Monitor Aortic Aneurysms
If monitoring is the next best step, the exact plan and how often you see your doctor will depend on the aneurysm’s size, location (abdominal vs. thoracic), and your personal risk factors, such as family history or connective tissue disorders.
Monitoring does not mean doing nothing. It involves a structured plan of regular checkups, imaging, and medical management designed to keep the aneurysm under control and detect any changes before they become dangerous.
Evaluations and Regular Imaging
At each follow-up, your doctor will evaluate your overall health, check your blood pressure, and review any new symptoms. Imaging tests are the cornerstone of aneurysm monitoring because they allow doctors to track changes in size and growth over time.
How often imaging is needed depends on size, location, growth rate, age, and other health factors, but typical intervals include:
- Small AAAs (3.0–4.0 cm): ultrasound every 2–3 years
- Medium AAAs (4.0–4.9 cm): ultrasound or CT every 6–12 months
- Thoracic Aortic Aneurysms (TAA): CT or MRI every 6–12 months, depending on size, growth rate, and associated conditions
It’s vital not to skip these tests or appointments, even if you feel perfectly well, since aneurysms rarely cause symptoms until a complication such as rapid growth or rupture occurs. Imaging allows doctors to act before the aneurysm becomes life-threatening.
Lifestyle Modifications
Along with imaging, lifestyle changes can help slow aneurysm growth and reduce overall risk. Your doctor might recommend:
- Blood pressure control: Strict management of blood pressure is critical, since high blood pressure accelerates aneurysm growth.
- No smoking: Smoking is one of the strongest predictors of aneurysm progression and rupture. Stopping smoking is one of the most important steps you can take.
- Heart-healthy diet: Focus on fruits, vegetables, lean protein, whole grains, and limited saturated fats to support vascular health and lower cholesterol.
- Doctor-approved exercise: Regular, moderate activity helps overall cardiovascular health, but heavy lifting or intense straining should be avoided unless cleared by a physician.
- Cholesterol and diabetes management: Keeping cholesterol and blood sugar in normal ranges reduces vascular stress and lowers the risk of complications.
Medication
Medication can also play a role in protecting the aorta during the monitoring phase. While no drug can shrink an aneurysm, certain medications help reduce the risks that fuel enlargement:
- Antihypertensives: Drugs like beta blockers, ACE inhibitors, or angiotensin receptor blockers (ARBs) may be prescribed to lower blood pressure and reduce strain on the aortic wall.
- Cholesterol-lowering drugs: Statins may be used to reduce plaque buildup (atherosclerosis), a major contributor to abdominal aortic aneurysms.
- Other supportive medications: If you have diabetes, blood sugar management is essential, and additional medications may be recommended depending on your overall cardiovascular profile.
Bottom Line
For many patients, a watch-and-wait approach with regular imaging and lifestyle management is the safest option. Careful monitoring allows doctors to track changes over time and step in only if the aneurysm reaches a point where intervention is necessary. If changes are detected during monitoring, doctors can recommend surgery before the aneurysm poses an immediate danger.
When Surgery Is Necessary: Aortic Aneurysm Surgery Options, Recovery Timelines, and Follow-Up Steps
If your surgeon recommends surgery, the goal is to prevent rupture and other serious complications. The exact approach depends on several factors, including where the aneurysm is located.
Abdominal Aortic Aneurysm Repair
- Endovascular aneurysm repair (EVAR): A minimally invasive procedure where a catheter is inserted through small groin incisions and guides a stent graft to the aneurysm site inside the aorta. This strengthens the artery and prevents rupture. EVAR has a lower risk of complications, shorter hospital stays and recovery, and many patients resume normal activity within days. You still need lifelong imaging to ensure the repair remains sealed and the graft stays in position.
- Open Abdominal Aortic Aneurysm Repair: In open surgery, the surgeon makes a large incision in the abdomen, removes the damaged part of the aorta, and replaces it with a synthetic tube graft sewn into place. This is major surgery requiring general anesthesia and a hospital stay of about 5-7 days. Recovery may take several weeks.
To learn more, read “Abdominal Aortic Aneurysms: Treatment and Prevention.”
Thoracic Aortic Aneurysm Repair
- Thoracic Endovascular Aortic Repair (TEVAR): A less invasive option similar to EVAR, where a stent graft is inserted through small groin incisions and positioned in the thoracic aorta. TEVAR generally offers faster recovery and fewer complications, but may not be suitable for all patients, depending on anatomy and aneurysm location. Imaging follow-up is essential to check for issues like endoleak.
- Open Surgical Repair: Open surgery involves open-chest surgery with an incision through the sternum or between the ribs. The damaged aortic section is replaced with a synthetic graft while blood circulation is maintained with a heart-lung machine. Hospital stay is typically 7-10 days, and full recovery can take a few months.
Why Open Repair May Be Recommended Over Minimally Invasive Options
While endovascular repair (EVAR or TEVAR) is less invasive and often preferred, there are situations where open surgery remains the safer and more durable choice.
Doctors may recommend open repair if:
- The aneurysm’s anatomy is not suitable for a stent graft. If the aneurysm is too close to vital branches of the aorta, a graft cannot be securely placed.
- The patient is younger and otherwise healthy. Open repair has greater long-term durability, which may reduce the need for repeat interventions.
- There are complications with a prior endovascular repair. Issues such as graft leaks, migration, or failure may require conversion to open surgery.
- The aneurysm involves the ascending aorta or root. Endovascular repair is generally not an option in this location, so open repair is the standard approach.
Follow-Up After Aortic Aneurysm Repair
Monitoring continues after any aortic aneurysm repair. Exact steps vary as every surgical case will require a different protocol.
Generally, after EVAR or TEVAR, imaging is done relatively soon after surgery, typically at about one month post-op and again at one year, then at regular intervals for life. If the one-month scan shows a concern, an additional six-month check is often added.
After open repair, follow-up visits assess healing and circulation. Imaging is usually less frequent than after endovascular repair. However, many vascular guidelines suggest periodic imaging of the repaired aorta and the remaining segments. Your surgeon will determine frequency based on your unique situation.
Does Aortic Aneurysm Surgery Have Risks?
Most people do very well with aneurysm repair, but complications can happen. Most are rare, yet important to understand so that you can have an informed discussion with your surgeon. Risks also vary depending on whether the procedure is an open repair or an endovascular approach.
Potential Risks of Open Aortic Aneurysm Surgery (AAA and TAA)
Most risks are similar for open abdominal and thoracic aneurysm surgeries. These include:
- Bleeding during or after surgery
- Blood clots causing blockages in limbs or organs
- Infection of the surgical wound or graft
- Heart problems (heart attack, irregular heartbeat)
- Lung complications (pneumonia, breathing difficulties)
- Kidney injury or failure
- Need for prolonged hospitalization and longer recovery
- Need for additional surgeries if graft issues occur
- Risk of death based on overall health and urgency of surgery
Additionally, thoracic aneurysm surgery carries a higher risk of nerve or spinal cord injury due to proximity to spinal arteries and often requires the use of a heart-lung machine. These risks are rare or negligible with abdominal aneurysm surgery.
Potential Risks of Endovascular Repair (EVAR for AAA, TEVAR for TAA)
- Minimally invasive endovascular repairs share many common risks, including:
- Bleeding or bruising at the catheter insertion site
- Blood clots or embolism
- Infection at the access site
- Kidney injury from contrast dye
- Leakage around the stent graft (endoleak) requiring further treatment
- Graft migration or failure requiring additional procedures
- Possible incomplete aneurysm exclusion if anatomy is complex
While most risks overlap, thoracic aneurysms repaired with TEVAR may have a slightly higher chance of complications related to spinal cord blood supply compared to EVAR for abdominal aneurysms.
Finding the Right Care for Aortic Aneurysms in Middle Tennessee
If you ever experience sudden, severe chest, back, or abdominal pain, dizziness, or signs of shock, especially if you fall into any of the high-risk categories of aortic aneurysm, seek emergency care immediately; these can signal a rupture and are life-threatening.
In cases where an aneurysm is discovered and requires either monitoring or surgery, it’s best to seek the expertise of a vascular surgeon. These specialists not only diagnose and monitor aneurysms but also perform both open and endovascular repairs. In some cases, vascular surgeons also work alongside cardiologists and other specialists to ensure every aspect of your cardiovascular health is managed with precision.
Experience matters, and choosing a surgeon who regularly treats aortic aneurysms can make all the difference in outcomes. At The Surgical Clinic’s Vascular Surgery Division, our board-certified vascular surgeons bring decades of experience in diagnosing, monitoring, and repairing numerous vascular conditions, including aortic aneurysms.
Whether you need a second opinion on whether you should monitor or move forward with surgery, ongoing surveillance, or surgical repair, our team provides individualized care backed by the latest technology and collaborative expertise.
If you or a loved one has been diagnosed with an aortic aneurysm, or if you’re at higher risk and want peace of mind, schedule a consultation with our vascular team. Proper guidance today can prevent life-threatening complications tomorrow.
Final Thoughts
When it comes to the heart, coronary artery disease is often recognized as the leading cause of death, and it is. But aortic aneurysms can be just as dangerous, and unlike heart disease, they rarely provide warning signs until they reach a critical point. That’s what makes early detection and specialized care so important.
An aortic aneurysm doesn’t always require surgery, and it doesn’t always mean a negative outcome. With expert monitoring, many people live safely for years. For others, timely surgery provides the best protection. The key is understanding your risks and having a trusted team to guide you through every step.
At The Surgical Clinic, we have experienced vascular surgeons across multiple locations throughout Middle Tennessee. Schedule a consultation today to determine the safest next steps for your health.