Thoracic Aortic Aneurysm

An aortic aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. There are two types:

• Abdominal aortic aneurysm
• Thoracic aortic aneurysm

Most develop in the blood vessel that passes though the abdomen. These are known as abdominal artery aneurysms. But approximately 25 percent develop where it passes through the aorta, the main blood vessel in the chest.

We call these thoracic aneurysms. They can grow and rupture, causing massive internal bleeding and death, if not treated.

What Causes a Thoracic Aortic Aneurysm?

The most common cause of a thoracic aortic aneurysm is hardening of the arteries (atherosclerosis). This condition is more common in:

• Men and women with a family history of aortic aneurysms
• Men older than 60 years of age
• People who use tobacco
• Those with a history of heart or peripheral artery disease
• People with high blood pressure

How Do Doctors Treat This Condition?

Vascular surgeons at the Heart Lung Vascular Institute at the University of Tennessee Medical Center offer a stenting procedure to treat this condition.

The minimally invasive procedure uses endografts, a hollow, fabric-covered tube that takes the pressure off the aorta. This lets blood pass through it without pushing on the weakened, bulging artery.

They insert the endograft through a catheter, or tube, inserted in the abdomen or groin. This eliminates the need for the traditional large, open incision in the chest wall.

“This procedure has many advantages for the patient over the traditional open surgery,” according to Vascular Surgeon Michael Freeman, MD. “The size of the incision is much smaller, and you have less of a risk of infection. There also is less recovery time and less blood loss.”

Paraplegia, or paralysis, is a major concern for traditional open surgery. That’s because the blood supply is cut off to the lower half of the body during the procedure.

“As a surgeon, you are always concerned about any surgery that intentionally blocks blood flow to parts of the patient’s body,” said Vascular Surgeon Scott Stevens, MD.

“With the stent, you don’t have to block blood flow to the spinal cord, liver and kidneys. That means our patients have less risk of paraplegia than in traditional surgery.”

According to a medical study, the risk of paraplegia drops from 14 percent to 3 percent with use of the stent.

The procedure takes about two hours. Most patients go home in one or two days.