Aortic Aneurysm
Treatment Overview
After you are diagnosed with an aortic aneurysm, your doctor will evaluate:
- Whether you need surgery.
- Whether you will be able to withstand a major surgery.
- Whether you can avoid surgery, at least for the present.
Factors such as the shape and flexibility of the aorta and heart valves are also considered in deciding how to treat an aortic aneurysm.
When surgery is recommended
Aortic aneurysms that are causing symptoms or enlarging rapidly are considered at risk of rupturing. Surgery is usually recommended if either of these factors is present.
In men, surgery is also typically recommended for abdominal aortic aneurysms
that are 5.5 cm or larger in diameter. In women, surgery may be recommended for smaller aneurysms. Some doctors perform surgery when the aneurysm is smaller, although the risk of rupture is considered low for aneurysms less than 5.5 cm in diameter.4, 5
Surgery is also recommended when a small aortic aneurysm grows more than 0.5 cm within 6 months.
Surgical repair of thoracic aortic aneurysms
The decision to have surgery, delay surgery, or not have surgery at all depends on other factors also. These factors may include older age or medical problems that make surgery more dangerous.
Medical treatment for aortic aneurysm
Smaller aneurysms (less than 5.5 cm in diameter) that are not at high risk for rupturing are generally treated with medicine used to treat high blood pressure, such as a beta-blocker. Beta-blockers may decrease the rate at which aneurysms grow. In general, the risks of surgery to repair smaller aneurysms outweigh the possible benefits, because smaller aneurysms rarely rupture.
If surgery is not done to repair your aneurysm, you will have regular tests to see if it is getting bigger.
You may need to take medicine to treat high cholesterol and high blood pressure. While these measures have not been proven to slow aneurysm growth, they can improve your life in other ways. These measures reduce your risk of dying from heart attack and stroke, which kills most (66%) people with aneurysms.6 For more information, see the topics High Cholesterol and High Blood Pressure (Hypertension).
Despite some claims, taking antioxidant vitamins has not been proven to reduce the risk of aneurysm or the risk of rupture.
Lifestyle changes for aortic aneurysm
Smoking increases the rate of aneurysm growth by 20% to 25% per year, which significantly increases the risk of rupture.6 Your doctor will strongly recommend that you stop smoking and possibly prescribe medicines and therapy to help you do so. Studies show that nicotine replacement therapy, use of the medicine bupropion (Zyban or Wellbutrin), and supportive therapy significantly increase long-term success in quitting.7 And if you use a nicotine replacement product or take bupropion or nortriptyline, you can double your chances of quitting for at least 6 months.8, 9 Another medicine called varenicline (Chantix) that blocks the effects of nicotine on the brain can also greatly increase your chances of quitting smoking.10 For more information, see the topic Quitting Tobacco Use. Avoid secondhand smoke too.
Your doctor will probably recommend that you make other lifestyle changes, such as following a heart-healthy diet, limiting alcohol, and exercising. Try to do activities that raise your heart rate. Exercise for at least 30 minutes on most, preferably all, days of the week.
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| Author: | Robin Parks, MS | Last Updated: March 7, 2008 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine David A. Szalay, MD - Vascular Surgery | |
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