Aortic aneurysm

An aortic aneurysm is a sack or spindle-shaped dilation of the aorta (main artery in the body). Dilation can occur in all parts of the aorta, both in the chest and in the abdomen. The abdominal aorta is most commonly affected by aortic aneurysms.

Aortic aneurysms are caused by a weakness in the wall of the aorta due to high blood pressure (hypertension), which then causes arteriosclerosis in the aorta. This arteriosclerosis leads in turn to a weakness in the wall of the aorta, causing it to dilate. Aortic dissection is a special type of aortic aneurysm in which a tear develops in the vascular wall and fills with blood, causing it to separate (dissect).

Men are affected by the disease far more frequently than women. Besides high blood pressure, excess weight, advanced age, smoking, high cholesterol and diabetes constitute further factors. In many cases, a genetic connective tissue weakness, Marfan syndrome, is responsible for the wall weakness in the aorta.

The great danger during an aortic aneurysm is a tear in the dilated section (aortic rupture). An aortic tear is an absolute emergency which is associated with a high rate of mortality. Unfortunately, aortic dilations often cause no or only few symptoms until a tear occurs. For this reason, they are often discovered by chance during a routine examination. Noticeable pulsations in the abdominal area, back pain or digestive symptoms may also point to an aortic aneurysm.

If there is a suspected aortic aneurysm, different examinations such as an ultrasound [aortography], computed tomography or an MRI are carried out.

The danger of an aortic tear increases as the aortic aneurysm grows in size. Aortic dilations 5 cm or larger in size require immediate surgery. Smaller aneurysms can be monitored so that any increase in size is recognised and treated in good time. Fissure formation in the vessel wall, i.e., aortic dissection, requires immediate surgery. The risk of rupture for this form of aortic aneurysm is also high. During the operation, the diseased aorta is either replaced with a vascular prosthesis or stabilised with a vascular support (stent). Find out more in the aorta surgery section.

Besides surgery, treatment of the underlying disease such as high blood pressure, diabetes or elevated cholesterol is part of the therapy for an aortic aneurysm.

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