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Aortic Aneurysms

What is an aneurysm?

When a weakened or defective area of blood vessel expands or bulges to any significant degree, it is called an aneurysm. Such bulges stem from a weakness or defect in the wall of the aorta and tend to grow bigger over time.

The greatest danger is that the aneurysm will burst or rupture, causing uncontrollable bleeding or hemorrhaging. If the internal bleeding is serious enough, it can result in shock or even death.

Types of Aneurysms

Aortic Aneurysms

Most aneurysms take place in the aorta, your body's main artery and the one that carries blood away from your heart to the rest of your body.

Abdominal Aortic Aneurysms (AAA)

About three-quarters of aortic aneurysms occur in the abdominal area.

Location in the Abdomen
When aneurysms are located on the part of the aorta found in your abdomen, they are called aortic abdominal aneurysms (AAA). The abdominal aorta supplies blood to the lower part of your body. In the abdomen, just below the naval, the aorta splits into two branches, called the iliac arteries, which carry blood into each leg.

Pressure Can Cause Bulge
In an AAA, the pressure from blood flowing through the aorta can cause a weakened part of the aorta to bulge, similar to a balloon. A good analogy is a bubble in a garden hose. A normal aorta is about one inch (or 2 centimeters) in diameter.

Bulge Can Cause Rupture
An AAA can stretch the aorta far beyond its safety margin as it expands, resulting in a rupture. These ruptures are extremely dangerous and can cause life-threatening bleeding. Each year, about 200,000 Americans are diagnosed with AAAs. Of them, about 15,000 have AAAs that are considered serious enough to cause death from rupture if not treated. Fortunately, if diagnosed early, AAAs can be treated safely and effectively.

Thoracic Aortic Aneurysms (TAA)

About one-quarter of aortic aneurysms occur in the thoracic region.

Runs Through Your Chest
A thoracic aortic aneurysm (TAA) is an enlargement of the part of the aorta that runs through your chest. The aorta is the largest artery in your body and carries blood away from your heart to all the parts of your body.

About 25 percent of aortic aneurysms occur in the chest, with the rest occurring in the abdomen. TAAs can involve the aortic root, the ascending aorta, aortic arch or, most commonly, the descending aorta. Occasionally, an aneurysm may involve the aorta as it flows through both the chest and the abdomen. These are called thoracoabdominal aortic aneurysms.

TAAs Can Rupture or Burst
Thoracic aortic aneurysms (TAAs) are a serious health risk because, like abdominal aortic aneurysms, they can rupture or burst. Ruptured aneurysms can cause severe internal bleeding, leading quickly to shock or death.

In one type of TAA, the walls of the aorta become weak and a section near the heart becomes enlarged. As a result, the valve between the heart and aorta cannot close properly and blood leaks backward into the heart.

Each year, thoracic aortic aneurysms affect about 15,000 people in the United States. Some people may have more than one TAA and some also have an abdominal aortic aneurysm (AAA). Only about 20 to 30 percent of patients who make it to a hospital with a ruptured TAA will survive. That's why early treatment to prevent rupture is so important for such aneurysms, particularly large ones.

Peripheral Aneurysms

Peripheral aneurysms are those that affect arteries other than the aorta or the brain.

Location in the Body

  • Most peripheral aneurysms occur in the popliteal artery, which runs down the back of your lower thigh and knee.
  • Less frequently, peripheral aneurysms can develop in the femoral artery of your groin, the carotid artery in your neck or even in the arteries in your arms.
  • Having a peripheral aneurysm in one leg increases the risk that you will also have one in your other leg.
  • A peripheral aneurysm also increases the chances of having an aortic aneurysm.

Less Likely to Rupture
Aortic aneurysms are potentially very dangerous since they can burst or rupture, resulting in shock or even death. Peripheral aneurysms are less likely to rupture.

Forms Blood Clots
The most common complication stemming from a peripheral aneurysm is the formation of blood clots that may block blood flow either by the aneurysm itself clotting or by a clot from within the aneurysm breaking off and traveling through the blood stream to lodge in another artery.

Can Compress Nerves
Peripheral aneurysms, particularly if large, can also compress nearby nerves or veins and cause pain, numbness or swelling.

Cerebral Aneurysms

Aneurysms may also occur in the  brain, called cerebral aneurysms.

Who treats aneurysms?

  • Thoracic aortic aneurysms are generally treated by cardiac surgeons.
  • Abdominal aortic and peripheral aneurysms are usually treated by vascular surgeons.
  • Cerebral aneurysms are typically treated by neurosurgeons.
  • The combination of thoracic and abdominal aneurysms is usually treated by cardiac and vascular surgeons working together.

Contact Information

Cardiac Surgery
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
Lowry Medical Office Building, 2A
110 Francis Street
Boston, MA 02215