Thoracic Aortic Aneurysms & Thoracoabdominal Aortic Aneurysms

An aneurysm is a permanent 'dilatation' or 'ballooning' of an artery to at least 150% of its normal size. Aneurysms can affect the aorta, the major artery of the body running through the chest and abdomen. An abdominal aortic aneurysm (AAA) is the most common type (see Abdominal Aortic Aneurysms). The thoracic aorta (in the chest) and thoracoabdominal aorta (involving the chest and abdomen) are less commonly involved.

Thoracic aortic aneurysms (TAAs) and thoracoabdominal aortic aneurysms (TAAAs) can occur in males or females, but are slightly more common in males. Major risk factors include advancing age, smoking, family history, and previous aortic dissection. 1 out of 3 patients have had a previous abdominal aortic aneurysm (AAA) repair.

Patients who have been diagnosed with an AAA should be investigated for a TAA or TAAA, and vice versa.

TAAs or TAAAs may be diagnosed incidentally during imaging for other indications. Patients sometimes experience chest, back or abdominal pain.

Rupture is the major risk associated with a TAA or TAAA. Rupture causes acute loss of blood in to the chest and/or abdominal cavity and is a life-threatening emergency. Even with emergency surgery, it is associated with a high rate of mortality.

It is common for old thrombus (clot) to line the walls of an aneurysm. Rarely, pieces of this clot (and sometimes new clot) can break free from the aneurysm and travel to the arteries in the abdomen or legs, blocking the flow of blood.

TAAs and TAAAs should be treated when they reach a size of 5.5 - 6cm diameter. Aneurysms can be treated at a size less than this if they cause symptoms or are growing rapidly.

Treatment for thoracic aneurysms can be with minimally-invasive endovascular treatment or open surgery. Mr Milne has a special interest in the minimally-invasive treatment of complex aneurysms. Treatment selection depends on the anatomy of the aneurysm, patient age, and existing medical conditions. The choice of treatment is discussed in detail with Mr Milne during the pre-operative consultation.

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