Aortic aneurysm - complications and treatment

Aortic aneurysm: possible complications

Depending on the localization of the outpouring, the following unwanted side effects of aortic aneurysms are known: complications that can be explained by mechanical pressure on surrounding structures, such as hoarseness due to damage to the laryngeal nerves, dysphagia and respiratory distress. However, the growing aneurysm can severely affect the blood flow to other organs or to the arms and legs.

If blood clots form in the swollen aneurysm sacs, these can also be the starting point for embolisms, for example, into the brain and thus from strokes. The most serious complication of all aneurysm forms is certainly when the aneurysm bursts. This emergency situation is survived by the patient in the fewest cases.

Treatment of an aortic aneurysm

The following treatment options are available for the aortic aneurysm:

  • Drug therapy of hypertension
  • Open operation
  • Inserting a vascular prosthesis from the groin (endovascular operation)

Drug therapy of the aortic aneurysm

If it is possible to control risk factors such as high blood pressure, lipid metabolism or overweight with medication or other measures, the aortic aneurysm can not be cured, but the course of the disease can be favorably influenced in most cases.

The main aim of the treatment is to prevent the critical enlargement of the aneurysm to more than 5 to 6 cm in diameter, thereby reducing the likelihood that the aneurysm will burst.

Open surgery of the aortic aneurysm

For the treatment of the aortic aneurysm two operative procedures are available. In the so-called open vascular surgery, the abdominal aorta is exposed and the part with the aortic aneurysm replaced by a vascular prosthesis - consisting of a plastic tube. Although this operation is very stressful for the patient, it provides safe healing so that further controls are unnecessary.

Since an emergency operation in the ruptured aortic aneurysm is successful in the fewest cases, the treating physician after diagnosis of an aortic aneurysm mainly has the task to control the development of the aneurysm by regular follow-up examinations and to determine the right time for the operation.

In individual cases, the risk of the operation itself must be weighed against each other - especially in elderly patients with additional heart or lung disease - as well as the risk of not undergoing surgery and thus accepting a possible bursting of the aortic aneurysm.

Endovascular operation of the aortic aneurysm

An alternative method of treatment, which does not involve the opening of the abdominal wall and thus represents a much lower burden on the patient, has become established over the last few years.

A vascular prosthesis (stent-prosthesis) is introduced into the vascular system via the inguinal artery and thus the area of ​​the aneurysm is lined and stabilized from the inside.

However, a disadvantage of this treatment is the need for lifelong regular control. In addition, several follow-up procedures may be necessary because the stents are not indefinitely durable and may have leaks over time.

Not every patient and not every aneurysm is eligible for this procedure. However, in patients who can not undergo surgery because of their age or other conditions, insertion of the vascular prosthesis is often the only treatment option available.

Preventive measures

For the prevention of aortic aneurysms essentially all measures are suitable, can be prevented by the vascular disease or at least can be favorably influenced in their course. These include weight management for overweight, quitting smoking, effective treatment of high blood pressure or diabetes, dietary measures for lipid metabolism disorder or gout, reduction of mental stress factors and regular physical training.

Unfortunately, genetic factors as the cause of aortic aneurysms today can not be influenced by medical treatment or personal behavioral rules.

Since January 2018, legally insured men over the age of 65 are entitled to a one-off check-up for the early detection of aneurysms of the abdominal aorta. Because this group has a particularly high risk for aortic aneurysms. During the examination, the doctor performs an ultrasound of the abdomen, which allows him to measure the thickness of the abdominal aorta and thus to detect a possible change in the main artery.

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