Materiały źródłowe

• #1 Treatment of thoracic aortic aneurysm

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5879515/

  The diameter of thoracic aortic aneurysm (AA) is at least 1.5 times that of a normal thoracic aorta (1). […] Persons with thoracic AA must be counseled about smoking cessation and referred to a smoking cessation program with either use of nicotine replacement, varenicline, or bupropion (3). […] Dyslipidemia must be treated. Atorvastatin 40 to 80 mg daily or rosuvastatin 20 to 40 mg daily should be administered to persons with thoracic AA (4). […] Hypertension must be controlled to decrease myocardial infarction, stroke, heart failure, death from cardiovascular causes, and aortic dissection (3,7-12). The blood pressure in persons with thoracic AA should be lowered to less than 130/80 mmHg. A beta blocker plus an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker should be administered to these persons (3,7).

• #1 Thoracic aortic aneurysm – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/drc-20350193

  The goals of treatment for a thoracic aortic aneurysm are to: […] Treatment for thoracic aortic aneurysm may include: […] Surgery is generally recommended for thoracic aortic aneurysms about 1.9 to 2.4 inches (about 5 to 6 centimeters) and larger. Surgery may be recommended for smaller aneurysms if you have a family history of aortic dissection or a condition linked to aortic aneurysm, such as Marfan syndrome. […] Types of surgeries and procedures for thoracic aortic aneurysms include: […] Open surgery to repair a thoracic aortic aneurysm involves removing the damaged part of the aorta. The damaged part is replaced with a synthetic tube, called a graft, which is sewn into place. […] In endovascular thoracic aortic aneurysm repair, the surgeon inserts a thin, flexible tube called a catheter through an artery in the groin area and guides it to the aorta. A metal mesh tube called a graft is placed at the aneurysm site. Small hooks or pins hold it in place. The graft strengthens the weakened part of the aorta to prevent rupture of the aneurysm. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #1 Thoracic Aortic Aneurysm: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17552-aorta-thoracic-aortic-aneurysm

  Small aneurysms may only need conservative treatment. This includes medications to manage underlying conditions and regular imaging tests. But if your aneurysm is larger or growing fast, you may need surgery to lower your risk of potentially fatal complications. Healthcare providers tailor treatment (and its timing) to your needs to give you the best chance of a good outcome. […] Aorta surgery is the definitive way to treat thoracic aortic aneurysms. Providers use many different surgical approaches, including: […] Traditional open surgery. Traditional aneurysm repair involves an incision down the middle of your chest. Your surgeon removes the damaged part of your aorta and replaces it with a fabric tube (graft). This approach treats aneurysms in your ascending aorta as well as complex aneurysms in your chest and belly.

• #1 Thoracic Aortic Aneurysm: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17552-aorta-thoracic-aortic-aneurysm

  If the aneurysm is small and not causing symptoms, you may not need surgery right away. Instead, your provider will monitor your condition (watchful waiting). Theyll also prescribe medications to lower your risk for complications. […] Treatment can greatly improve your outlook and give you the chance to live a long, healthy life.

• #1 Management of thoracic aortic aneurysm in adults – UpToDate

  https://www.uptodate.com/contents/management-of-thoracic-aortic-aneurysm-in-adults

  Management of thoracic aortic aneurysm in adults […] Thoracic aortic aneurysm (TAA) can be due to degenerative, inflammatory, or genetically mediated etiologies. Among these, degenerative aneurysm related to hypertension is the most common. The natural history of TAA is one of progressive expansion, the rate of which depends upon the location of the aneurysm and its underlying cause. Although most TAAs produce no symptoms, patients who become symptomatic or have complications related to the aneurysm (eg, acute aortic regurgitation, dissection, aortic rupture, infection) should undergo repair. […] Conservative management of asymptomatic TAA aims to lessen stress on the aorta and limit further aortic expansion. Asymptomatic patients who do not meet the criteria for repair also require ongoing aneurysm surveillance. Any patient with additional clinical risk factors (eg, Marfanoid habitus, positive family history) should be evaluated for possible underlying genetic conditions known to be associated with thoracic aortic aneurysm and dissection (TAAD). Where expertise in the management of thoracic aortic disease is not available, the patient should be transferred to a high-volume cardiovascular center with a multidisciplinary aortic team to provide the best possible outcome.

• #1 Aortic Aneurysms: Nonsurgical Treatments

  https://www.healthline.com/health/heart-health/aortic-aneurysm-treatment-without-surgery

  Nonsurgical treatments for aortic aneurysms, such as medications and lifestyle changes, focus on reducing your risk of an aneurysm growing larger or bursting. […] Surgery is the main treatment for large aneurysms or those that are growing rapidly. Nonsurgical treatments may be an option for small and some medium-sized aortic aneurysms. […] Nonsurgical treatments for aortic aneurysms fall into two general categories: medications and lifestyle changes. […] Medications for aortic aneurysms aim to prevent the aneurysm from getting larger or bursting. […] Blood pressure medications lower the pressure that blood flow places on your artery walls. […] Statins lower your cholesterol levels, slowing the progress of atherosclerosis, an important risk factor for aortic aneurysms. […] Low-dose aspirin may also be used in people with aortic aneurysms that began with atherosclerosis.

• #1 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Specific treatment will be determined by your physician based on: […] Surgical treatment options for thoracic aortic aneurysms […] Thoracic aortic aneurysm open repair […] Endovascular aneurysm repair (EVAR) […] Non-surgical treatment options for thoracic aortic aneurysms […] Controlling or modifying risk factors: Steps such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese, and controlling dietary fat intake may help to control the progression of the aneurysm […] Medication: To control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] The specific services available to your patients suffering from aortic diseases include: […] Use of endovascular stent grafts for the treatment of thoracic aortic aneurysms and aortic dissections

• #1 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. Because the risk of rupture is proportional to the diameter of the aneurysm, aneurysmal size is the criterion for elective surgical repair. […] Elefteriades published the natural history of TAAs and recommended elective repair of ascending aneurysms at 5.5 cm and descending aneurysms at 6.5 cm for patients without any familial disorders such as Marfan syndrome. […] Patients with Marfan syndrome or familial aneurysms should undergo earlier repair, when the ascending aorta grows to 5.0 cm or the descending aorta grows to 6.0 cm. […] Rapid expansion is also a surgical indication. Growth rates average 0.07 cm/y in the ascending aorta and 0.19 cm/y in the descending aorta.

• #1 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  Thoracic aortic aneurysm surgery is a procedure to treat a bulge (aneurysm) in the thoracic aorta. The aorta is the large blood vessel that carries blood away from your heart. The thoracic aorta is the portion of the aorta in your chest. You may have open surgery or thoracic endovascular aortic repair (TEVAR). […] Thoracic aortic aneurysm surgery is a treatment for a bulge (aneurysm) in the part of your aorta that runs through your chest (thoracic aorta). […] Not everyone needs surgery for a thoracic aortic aneurysm. Whether you need surgical treatment depends on several factors, including the aneurysms size, your symptoms and your overall health. […] There are two procedures to treat a thoracic aortic aneurysm: Open thoracic aneurysm repair is an open surgery that requires a long incision along the side of your chest. Your surgeon removes the damaged portion of the aorta and replaces it with synthetic material (graft). Thoracic endovascular aortic repair (TEVAR) is a minimally invasive procedure. Your surgeon reaches your aorta by placing a small, hollow tube (catheter) through a blood vessel in your groin. They use the catheter to place a small mesh device (stent) that repairs the diseased portion of the aorta and restores proper blood flow.

• #1 Thoracic Aortic Aneurysm | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/thoracic-aortic-aneurysm

  Treatment options for ascending, arch, descending and root aortic aneurysms may include: […] Surgery, including both open and endovascular options […] Thoracic aortic aneurysms sometimes require complex open-heart surgery, including the use of hypothermic circulatory arrest (HCA), a technique that uses very cold body temperatures to temporarily stop blood flow to the area of the aorta being operated on. […] For many patients with descending thoracic aortic aneurysms, an endovascular treatment known as thoracic endovascular aortic repair (TEVAR) is an alternative to conventional open-heart surgery. […] We are also one of a few centers that offers descending thoracic aortic repair and maintain very favorable outcomes despite the complexity of the procedure. […] We continue to discover innovative and improved treatment options for aortic diseases.

• #1 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  Your provider may recommend thoracic aortic aneurysm surgery to lower your risk of an aneurysm rupture. TAAs dont always rupture. They are life-threatening if they do. […] Your provider uses imaging scans to decide if you need surgery for a thoracic aortic aneurysm. They often use CT scans to monitor the aneurysm size. Your provider may recommend surgery if the aneurysm is larger than 5.5 centimeters or has grown more than 0.5 centimeters in six months. […] Thoracic aortic aneurysm surgery significantly reduces your risk of an aneurysm rupture, which is a life-threatening emergency. Your healthcare provider typically recommends surgery when the risks of a rupture outweigh the risks of surgery. […] Most people are back to their usual routine within two to three months after thoracic aortic aneurysm surgery.

• #1 What’s the Best Treatment for an Aneurysm?

  https://www.everydayhealth.com/aneurysm/guide/treatment/

  When deciding on treatment for a thoracic aortic aneurysm, your doctor will consider the size and growth rate of the aneurysm, as well as your symptoms. Because the risk of rupture is directly related to the diameter of the aneurysm, the size of the aneurysm is an important factor when opting for elective surgery. (10) […] The two main operations to repair a large, leaking, or ruptured aortic aneurysm include open-chest, or abdominal repair and endovascular stenting. […] Once the patient is put under general anesthesia, the surgeon makes a large incision in the chest or abdomen. The aneurysm and a portion of the aorta are removed, and the section of the aorta is replaced with a graft made from a synthetic material, such as Dacron or Teflon. […] Unlike open repair, endovascular stenting doesn’t remove the aneurysm. After administering general anesthesia, the surgeon threads a catheter into the artery through the groin and into the location of the aneurysm. […] The stent also reinforces the weakened section of the aorta, which helps prevent rupturing. […] If the aneurysm is uncomplicated, the recovery time for endovascular stenting is much shorter than it is for surgery: one to three days versus 7 to 10 days, Teitelbaum says.

• #1 Thoracic Aortic Aneurysm – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/heart-vascular/aortic-disease/thoracic-aortic-aneurysm

  Treatment options for an aortic aneurysm may include one or more of the following: […] Controlling or modifying risk factors: Quit smoking, control blood pressure, manage blood sugar is diabetic/pre-diabetic to help slow the progression of the aneurysm […] Observation: Routine CT scans to monitor the size and rate of growth of the aneurysm […] Medication: Decrease factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] Open Aneurysm Repair: Replacement of the diseased area of the aorta with a fabric graft […] Endovascular Aneurysm Repair: A minimally invasive alternative to the open repair […] Hybrid Aneurysm Repair: Combination of open surgery and endovascular to repair the aorta. […] Our NEXUS Aortic Arch Clinical Study is investigating the safety and effectiveness of the NEXUS aortic arch stent graft system treatment option.

• #1 Management of thoracic aortic aneurysm in adults – UpToDate

  https://www.uptodate.com/contents/management-of-thoracic-aortic-aneurysm-in-adults

  We agree with major cardiovascular society guidelines from the American College of Cardiology, American Heart Association, and Society of Vascular Surgery that recommend repair for all symptomatic thoracic aortic aneurysm (TAA; ruptured, associated with dissection, causing pain). […] In general, repair of asymptomatic TAA is not recommended until the risk of rupture or other complications exceeds the risks associated with repair. Asymptomatic TAAs are selected for repair depending upon diameter, location, expansion rate, family history of rupture/dissection, and the presence of associated coronary artery disease or valve pathology requiring surgical intervention, with special considerations depending on the presence of underlying contributing etiologies (eg, connective tissue disorders, bicuspid aortic valve, familial thoracic aortic aneurysm/dissection). For patients who meet the criteria for repair, survival is improved for open surgery compared with medical therapy alone. This should also be the case for endovascular repair, given that endovascular repair compares favorably with open surgery. Asymptomatic patients with TAA who do not meet the criteria for repair are managed medically with routine surveillance.

• #1 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1809

  Small aneurysms may not need treatment. But you will need regular checkups to see how fast the aneurysm is growing. An aneurysm may be repaired with a procedure or a surgery if it is large, growing quickly, or causing symptoms. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #1 Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure

  https://www.upmc.com/services/heart-vascular/services/procedures/tevar

  Endovascular repair is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery. […] TEVAR is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection in your chest without open surgery. […] You may be a candidate for TEVAR if you have a thoracic aortic aneurysm or aortic dissection in your chest that is large or growing. […] TEVAR is used to repair thoracic aortic aneurysms. […] TEVAR does involve some risk. […] Complications of TEVAR may include: Infection, Bleeding, Blood vessel injury, Aortic dissection, Aneurysm rupture, Stent failure or migration during deployment, Kidney damage from dye used during surgery to guide stent placement, Paralysis of the lower body. […] Treatment may involve either: Watchful waiting, Your doctor will monitor your condition with CT scans and control your blood pressure with drugs. […] Surgery, Your doctor will recommend TEVAR or an open chest aortic aneurysm repair. […] After TEVAR, many patients can live full, active lives with routine follow-up care. […] The TEVAR is a highly successful procedure for reducing the risk of aortic rupture.

• #1 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  In TEVAR, the rates of successfully placing the stent are as high as 99%. Thoracic aortic aneurysm open surgery is also a highly successful procedure. […] Thoracic aortic aneurysm surgery is a procedure to repair a balloon or bulge in your thoracic aorta. There are two types of thoracic aortic aneurysm surgery: open surgery and TEVAR. The type of surgery you have depends on multiple factors, including the size of the aneurysm and your overall health. Thoracic aortic aneurysm surgery is a lifesaving procedure for many people.

• #1 A New Treatment Approach for Deadly Aneurysms > News > Yale Medicine

  https://www.yalemedicine.org/news/abdominal-aortic-aneurysm-treatment

  One direction is to study ways to decrease inflammation around the aorta with medicines, says Dr. Guzman. […] The most obvious way to prevent aortic aneurysms is to get people to stop smoking, he says, adding that tobacco smoking accounts for about 75% of all abdominal aortic aneurysms, and its also a risk factor for thoracic aneurysms.

• #2 Thoracic aortic aneurysm – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/drc-20350193

  The goals of treatment for a thoracic aortic aneurysm are to: […] Treatment for thoracic aortic aneurysm may include: […] Surgery is generally recommended for thoracic aortic aneurysms about 1.9 to 2.4 inches (about 5 to 6 centimeters) and larger. Surgery may be recommended for smaller aneurysms if you have a family history of aortic dissection or a condition linked to aortic aneurysm, such as Marfan syndrome. […] Types of surgeries and procedures for thoracic aortic aneurysms include: […] Open surgery to repair a thoracic aortic aneurysm involves removing the damaged part of the aorta. The damaged part is replaced with a synthetic tube, called a graft, which is sewn into place. […] In endovascular thoracic aortic aneurysm repair, the surgeon inserts a thin, flexible tube called a catheter through an artery in the groin area and guides it to the aorta. A metal mesh tube called a graft is placed at the aneurysm site. Small hooks or pins hold it in place. The graft strengthens the weakened part of the aorta to prevent rupture of the aneurysm. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #2 Thoracic aortic aneurysm | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/thoracic-aortic-aneurysm?content_id=CON-20122020

  Treatment of a thoracic aortic aneurysm depends on the cause and size of the aneurysm and how fast it’s growing. Treatment may range from regular health checkups to emergency surgery. A thoracic aortic aneurysm that ruptures or causes a tear called a dissection is a medical emergency that can lead to death. […] The goals of treatment for a thoracic aortic aneurysm are to: Stop the aneurysm from growing. Prevent aortic rupture. […] Treatment for thoracic aortic aneurysm may include: Regular health checkups, sometimes called watchful waiting. Medicines. Surgery. […] Surgery is generally recommended for thoracic aortic aneurysms about 1.9 to 2.4 inches (about 5 to 6 centimeters) and larger. Surgery may be recommended for smaller aneurysms if you have a family history of aortic dissection or a condition linked to aortic aneurysm, such as Marfan syndrome.

• #2 Thoracic aortic aneurysm – BHF

  https://www.bhf.org.uk/informationsupport/conditions/thoracic-aortic-aneurysm

  How is a thoracic aortic aneurysm treated? Treatment of a thoracic aortic aneurysm varies from regular health checks to emergency surgery. The type of treatment depends on the cause, size, location and growth rate of the thoracic aortic aneurysm. Your doctor will talk to you about the best option for you. If you have been diagnosed with a thoracic aneurysm, it is likely that you’ll be monitored with echocardiograms and CT scans every six or 12 months, to see if there are signs of changes in your aneurysm. How fast the aneurysm grows (if at all) will be different for everyone. […] Medicines may be prescribed to control risk factors such as high blood pressure and high cholesterol. These may include: angiotensin receptor blocker, beta blockers, statins. […] Other treatments include: Endovascular aortic aneurysm repair (EVAR). This involves tubes called stents put into your arteries to let blood flow freely. Your surgeon may recommend heart surgery (if your thoracic aneurysm has grown too much, causes symptoms, or if you have Marfan syndrome.) This involves removing the section of the aorta where the aneurysm is and replacing it with a new aorta made of synthetic (man-made) material, called a graft. Personalised external aortic root support (PEARS). This procedure can be offered to people with Marfan syndrome where the bottom of the aorta is very big. A special sleeve is made to put around the aorta to stop it getting bigger.

• #2 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Specific treatment will be determined by your physician based on: […] Surgical treatment options for thoracic aortic aneurysms […] Thoracic aortic aneurysm open repair […] Endovascular aneurysm repair (EVAR) […] Non-surgical treatment options for thoracic aortic aneurysms […] Controlling or modifying risk factors: Steps such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese, and controlling dietary fat intake may help to control the progression of the aneurysm […] Medication: To control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] The specific services available to your patients suffering from aortic diseases include: […] Use of endovascular stent grafts for the treatment of thoracic aortic aneurysms and aortic dissections

• #2 Thoracic Aortic Aneurysm | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/thoracic-aortic-aneurysm

  During the „watchful waiting” period, the vascular surgeon will monitor the growth of the aneurysm every 6 to 12 months by obtaining serial CT or MRI scans or ultrasounds. Once the aneurysm grows to a significant size and is at risk of rupturing, the benefits of repairing the aneurysm become greater than the risks and complications of surgery, or of not fixing the aneurysm altogether. […] Vascular surgeons at UCSF Medical Center perform both conventional open surgical repair, as well as minimally invasive endovascular repair for aneurysmal disease. The type of procedure performed is determined by the patient’s medical status and the characteristics of the aneurysm. […] The conventional open surgical repair of aneurysms involves opening the abdominal cavity in the case of an abdominal aortic aneurysm, and sewing a synthetic graft inside the aneurysm to the artery above and below it to prevent the aneurysm from rupturing – in essence, relining the weakened aorta with a sleeve of material to strengthen the aorta.

• #2 Treatment of thoracic aortic aneurysm

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5879515/

  If there are symptoms suggesting thoracic AA expansion, surgical intervention should be considered. If the ascending thoracic aorta or aortic sinus diameter is 5.5 cm or more in an asymptomatic surgical candidate who has a degenerative thoracic AA, chronic aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, mycotic aneurysm, or pseudoaneurysm, surgery should be performed (3). […] If thoracic aorta dissection develops, decrease aortic shear stress and decide which persons should have surgical intervention or endovascular repair (3). Beta blockers are the initial drug of choice for lowering blood pressure, ventricular rate, dP/dt, and stress on the aorta (3,18,19).

• #2 Aortic Aneurysms: Nonsurgical Treatments

  https://www.healthline.com/health/heart-health/aortic-aneurysm-treatment-without-surgery

  If you have an aortic aneurysm, a doctor will also recommend adopting lifestyle changes that promote heart health. […] Lifestyle changes for aortic aneurysm include quitting smoking, focusing on a heart-healthy diet, getting regular physical activity, and reducing stress. […] For small and some medium-sized aortic aneurysms, regular monitoring may be recommended. […] If your aneurysm is being monitored, a doctor may use nonsurgical treatments to improve your cardiovascular health and reduce the risk from your aneurysm. […] To date, there isn’t a nonsurgical treatment that can reliably shrink or slow the growth of aortic aneurysms. […] Nonsurgical treatments for aortic aneurysms include medications and lifestyle changes. But there currently aren’t any nonsurgical treatments that are guaranteed to slow the growth of aortic aneurysms. […] Surgery is still the main type of treatment for large aortic aneurysms or those that are growing quickly.

• #2 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment may be summarized as follows: Increased aortic size, Rapid aortic growth, Symptomatic aneurysm, Traumatic aortic rupture, Acute type B aortic dissection with associated rupture, leak, distal ischemia, Pseudoaneurysm, Large saccular aneurysm, Mycotic aneurysm, Aortic coarctation, Bronchial compression by aneurysm, Aortobronchial or aortoesophageal fistula. […] Aneurysm surgery has no strict contraindications. […] For patients with acute aortic dissection of the ascending aorta, emergency operation is required. […] Patients with acute dissection of the descending aorta do not necessitate surgical intervention unless complicated by rupture, malperfusion, progressive dissection, persistent recurrent pain, or failure of medical management. […] Most aneurysm repairs involve aortic replacement with a Dacron tube graft.

• #2 Thoracic aortic aneurysm | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/thoracic-aortic-aneurysm?content_id=CON-20122020

  Types of surgeries and procedures for thoracic aortic aneurysms include: Open surgery. Most people with a thoracic aortic aneurysm have this major surgery. A surgeon removes part of the aorta damaged by the aneurysm. It’s replaced with a tube, called a graft, which is sewn into place. […] Endovascular aortic aneurysm repair (EVAR). This treatment is a less invasive option to open surgery. That means it uses small surgical cuts and may allow a faster recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and guides it to the aorta. A graft on the end of the catheter goes where the aneurysm is. Small hooks or pins hold the graft in place. The graft strengthens the weakened part of the aorta. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #2 Thoracic Aortic Aneurysm and Aortic Dissection

  https://www.massgeneral.org/condition/thoracic-aortic-aneurysm

  Detailed information on thoracic aortic aneurysms, including description of a thoracic aortic aneurysm, causes, symptoms, diagnosis, treatment, and full-color anatomical illustrations […] Treatment may include surgery to fix or remove the aneurysm. Or a metal mesh coil (stent) may be inserted. This is to support the blood vessel and prevent rupture. […] Treatment may include: […] Surgery. […] Thoracic aortic aneurysm open repair. The type of surgery will depend on the location and type of aneurysm, and your overall health. For an aortic root, ascending aorta, or aortic arch aneurysm, 1 large cut (incision) may be made through the breastbone. The aneurysm is removed and a graft placed. If an ascending aneurysm involves damage to the aortic valve of the heart, the valve may be fixed or replaced during the procedure. For a thoracic descending aneurysm, 1 large cut may be made. It may go from the back under the shoulder blade, around the side of the rib cage, to just under the breast. This lets the surgeon see the aorta directly to fix the aneurysm.

• #2 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  The use of CSF drainage is selective among most centers. […] Spinal cord ischemia is an uncommon complication following TEVAR, but its development can be identified by a preoperative renal insufficiency. […] Brain protection methods used during DHCA include intraoperative EEG monitoring, evoked somatosensory potential monitoring, hypothermia, and antegrade and retrograde cerebral perfusion. […] Patients who have undergone ascending aneurysm repairs are observed for signs of coronary ischemia, particularly if the coronary ostia were reimplanted, and for signs of aortic insufficiency when the aortic valve is repaired. […] Paraplegia is the main concern in patients who have had descending TAA or TAAA repairs. […] Acute postoperative renal dysfunction may be due to extended periods of ischemic cross-clamping or to hypothermic circulatory arrest.

• #2 Thoracic Aortic Aneurysm | Vascular Center | UC Davis Health

  https://health.ucdavis.edu/vascular/diseases/thoracic_aortic_aneurysm.html

  Repair of the aneurysm involves removing the distended portion of the aorta and replacing it with a tube called a graft. The cylinder-like graft, which is made of polyester fabric, is sewn in place. A hospital stay of between seven and 10 days is usually required if no complications occur. Complete recovery and return to a normal routine takes two to three months. […] Endovascular aneurysm repair (EVAR) is a less-invasive surgical treatment that involves a small incision in the groin and the insertion of a stent graft through a catheter placed in the femoral artery. Physicians use X-ray imaging to guide the stent graft to the diseased area. The graft is then expanded inside the aorta and held in place by metallic stents rather than stitches. Blood now flows through the stent graft, and blood-flow is excluded from the dilated segment of the aorta.

• #2 Thoracic Aortic Aneurysm | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/thoracic-aortic-aneurysm

  Treatment options for ascending, arch, descending and root aortic aneurysms may include: […] Surgery, including both open and endovascular options […] Thoracic aortic aneurysms sometimes require complex open-heart surgery, including the use of hypothermic circulatory arrest (HCA), a technique that uses very cold body temperatures to temporarily stop blood flow to the area of the aorta being operated on. […] For many patients with descending thoracic aortic aneurysms, an endovascular treatment known as thoracic endovascular aortic repair (TEVAR) is an alternative to conventional open-heart surgery. […] We are also one of a few centers that offers descending thoracic aortic repair and maintain very favorable outcomes despite the complexity of the procedure. […] We continue to discover innovative and improved treatment options for aortic diseases.

• #2 Thoracic Aortic Aneurysm Repair | CTVS Central Texas – CTVS Texas

  https://ctvstexas.com/about-ctvs/our-services/cardiac-services/thoracic-aortic-aneurysm-repair/

  Your surgeon will use your state of health and the size and location of the aneurysm to determine which treatment option is best for you. […] Hospital stays for this procedure range from 1 to 3 days. You can expect to make a full recovery within 1 to 2 weeks. You will need a follow-up CT scan every 4 months for the first year after your procedure. After one year, you will require annual CT scans.

• #2 Aortic Aneurysm | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/aortic-aneurysm

  Thoracic endovascular aortic repair (TEVAR), for aortic aneurysms in the chest. Learn more about TEVAR. […] Our surgical teams are leaders in the field of aortic aneurysm repair. Some of the procedures we perform include: […] Open repair of a thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) is a highly complex surgery. The surgeon removes the aneurysm and replaces it with a graft. During repair of the descending thoracic aorta, our team freezes the nearby nerves using a special technique called cryoablation. This reduces pain and the need for narcotic pain medications. […] Our skilled surgical teams can sometimes minimize invasiveness by using a customized hybrid approach that combines open and catheter-based procedures. Hybrid procedures are useful when multiple areas of the aorta are involved. They allow one area to be reached with a catheter from a smaller surgical opening elsewhere.

• #2 Integrated Aortic Program | Thoracic Aneurysm Program

  https://www.valleyhealth.com/services/integrated-aortic-program

  Living with an aortic aneurysm can be stressful, but when managed properly, patients can enjoy an excellent quality of life. […] Our well-established diagnostic, surgical and surveillance program offers comprehensive care for patients with aortic aneurysm. […] Our cardiology department embraces a holistic approach focused on and tailored to each patient, and the team is committed to high-quality care and patient safety, using leading-edge research to offer patients the latest treatments and clinical advice. […] For patients who have a large or unstable aneurysm, surgery may be recommended. […] Accurate imaging is important to establish a diagnosis and determine the best treatment for an aortic aneurysm. […] At Valley, our team uses evidence-based guidelines and newly-developed techniques to assess each patients aortic aneurysm and develop an individualized treatment plan.

• #2 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #2 Thoracic Aneurysm Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/761627-treatment

  In patients with symptoms suggestive of thoracic aortic aneurysm (TAA), prehospital care should consist of ensuring adequate airway and ventilation, providing oxygen via a nonrebreather mask, placing two large-bore intravenous lines, and providing continuous cardiac monitoring. […] Patients who are unstable (often those with a ruptured aneurysm or dissection) may require airway protection, mechanical ventilation, and aggressive fluid resuscitation. Timely communication between prehospital care providers and the receiving hospital is important in ensuring that the proper resources are available and brought to bear rapidly. […] Provide aggressive blood pressure control. Beta-blockers and nitrates are commonly used. […] For patients who are hemodynamically unstable, provide the following: Aggressive fluid resuscitation (including blood products), placing an arterial line in the right radial artery (or in the left radial artery, if the systolic blood pressure on the left is higher), especially in patients who may have dissection or in those who are receiving intravenous nitroprusside and/or esmolol, correction of coagulopathy, immediate surgical consultation.

• #2 Thoracic aortic aneurysm – BHF

  https://www.bhf.org.uk/informationsupport/conditions/thoracic-aortic-aneurysm

  If you need surgery to repair your thoracic aortic aneurysm you will be seen in a special clinic. At the clinic, you may need to have some routine tests such as X-rays and blood tests. You’ll have the opportunity to ask questions about the surgery and your after care. Write your questions down before you attend so you remember what to ask. Depending on the type of surgery you have, most people will recover well and return to their normal life. Your healthcare professional will talk you through what’s expected during your recovery such as your exercise plan and when you can go back to work.

• #2 Thoracic Aortic Aneurysm: Symptoms, Causes, Treatment, More

  https://www.healthline.com/health/thoracic-aortic-aneurysm

  TAAs require prompt treatment to minimize your risk of a life threatening rupture. Depending on how large an aneurysm is, a doctor may recommend: […] Medications can help lower pressure around your aneurysm and reduce the chances of it rupturing. […] Emergency surgery is vital for a ruptured aneurysm. A doctor may recommend preventive surgery if an aneurysm is at risk of rupturing in the future. […] The American College of Cardiology and American Heart Association recommend preventive surgery if the aneurysm is in the ascending aorta and greater than 5.5 centimeters (cm), or 2.17 inches (in), across. Or, if its in the descending aorta and greater than 6.0 cm (2.4 in) across. […] Three types of surgery are used to treat TAAs: […] Treating a TAA early before it requires emergency surgery gives you the best chance of having a positive outcome. […] The 5-year survival rate for those who have preventive surgery is about 85%, but its only about 37% in people who have emergency surgery.

• #2 Aortic Aneurysm Treatment at Emory Heart & Vascular

  https://www.emoryhealthcare.org/services/heart-vascular/treatments/aortic-aneurysm-treatment

  The cardiovascular experts at Emory Heart Vascular offer a wide range of treatments for aortic aneurysms. We will work with you to find the right therapy that meets your needs. […] Our specialists may first try to treat and control your aneurysm with medication. Medications to lower your blood pressure and cholesterol can help. But you still may need surgery. In those cases, our experts offer a variety of traditional, endovascular and minimally invasive procedures to fix your aortic aneurysm. These include: Aortic Root Surgery, Mechanical Composite Root Replacement, Reimplantation Valve Sparing Root Replacement, Tissue Valved Conduit Repair, Ross Procedure. […] Emory aortic surgeons perform more than 700 open and endovascular aortic procedures annually and perform more aortic dissections than any other medical center in Georgia. In addition to performing surgeries for a high volume of patients, our physicians also treat patients who simply need medical management alongside those who need more complex treatments. […] Our pioneering surgeons are also involved in many clinical trials that look at new aortic devices and treatments. This research gives you access to therapies that may not be available anywhere else.

• #2 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. Because the risk of rupture is proportional to the diameter of the aneurysm, aneurysmal size is the criterion for elective surgical repair. […] Elefteriades published the natural history of TAAs and recommended elective repair of ascending aneurysms at 5.5 cm and descending aneurysms at 6.5 cm for patients without any familial disorders such as Marfan syndrome. […] Patients with Marfan syndrome or familial aneurysms should undergo earlier repair, when the ascending aorta grows to 5.0 cm or the descending aorta grows to 6.0 cm. […] Rapid expansion is also a surgical indication. Growth rates average 0.07 cm/y in the ascending aorta and 0.19 cm/y in the descending aorta.

• #2 Thoracic aortic aneurysm – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/care-at-mayo-clinic/mac-20350197

  Mayo Clinic doctors trained in blood vessel conditions (vascular specialists), blood vessel surgery (vascular surgeons), heart and blood vessel surgery (cardiovascular surgeons), chest surgery (thoracic surgeons), heart and blood vessel conditions (cardiologists), imaging (radiologists), and other healthcare professionals have experience evaluating and treating thoracic aortic aneurysms and other types of aortic aneurysms. […] Mayo Clinic’s thoracic surgeons are experienced in thoracic aortic aneurysm repair. […] Surgeons treat thoracic aortic aneurysms using endovascular surgery, open-chest surgery, aortic root surgery and other treatments. Mayo doctors have experience performing surgery to treat a thoracic aortic aneurysm located anywhere in the thoracic aorta. […] At Mayo Clinic, experienced healthcare professionals evaluate and interpret test results. Mayo Clinic has state-of-the-art laboratory and imaging facilities. Healthcare professionals at Mayo use advanced technology to accurately diagnose thoracic and abdominal aortic aneurysms and determine the type of surgery needed, if any.

• #3 Thoracic aortic aneurysm: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001119.htm

  There is a risk that the aneurysm may open up (rupture) if you do not have surgery to repair it. […] The treatment depends on the location of the aneurysm. […] For people with aneurysms of the ascending aorta or aortic arch: Surgery to replace the aorta is recommended if an aneurysm is larger than 5 to 6 centimeters (approximately 2 inches). […] For people with aneurysms of the descending thoracic aorta: Major surgery is done to replace the aorta with a fabric graft if the aneurysm is larger than 6 centimeters (2.3 inches). […] Endovascular stenting is a less invasive option. A stent is a tiny metal or plastic tube that is used to hold an artery open. Stents can be placed into the body without cutting the chest. However, not all people with descending thoracic aneurysms are candidates for stenting.

• #3 Thoracic Aortic Aneurysm: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17552-aorta-thoracic-aortic-aneurysm

  Thoracic endovascular aortic repair (TEVAR). This minimally invasive option treats aneurysms in your descending aorta. Your surgeon makes small cuts near your groin to access your femoral artery. Then, they use a catheter to guide the graft to the aneurysm and put it in place. […] Your provider will determine if and when you need surgery based on the following factors: The aneurysms size and location. How fast the aneurysm is growing. Whether the aneurysms causing symptoms, and how severe they are. Your underlying medical conditions. […] If the aneurysm is large or causing symptoms, youll need prompt surgery to prevent it from rupturing. Aneurysm size matters because the larger an aneurysm gets, the more likely it is to rupture. In general, providers decide its time for surgery if your aneurysm is 2 to 2.2 inches wide, or if its growing about a half-centimeter in diameter each year.

• #3 Thoracic aortic aneurysm – BHF

  https://www.bhf.org.uk/informationsupport/conditions/thoracic-aortic-aneurysm

  How is a thoracic aortic aneurysm treated? Treatment of a thoracic aortic aneurysm varies from regular health checks to emergency surgery. The type of treatment depends on the cause, size, location and growth rate of the thoracic aortic aneurysm. Your doctor will talk to you about the best option for you. If you have been diagnosed with a thoracic aneurysm, it is likely that you’ll be monitored with echocardiograms and CT scans every six or 12 months, to see if there are signs of changes in your aneurysm. How fast the aneurysm grows (if at all) will be different for everyone. […] Medicines may be prescribed to control risk factors such as high blood pressure and high cholesterol. These may include: angiotensin receptor blocker, beta blockers, statins. […] Other treatments include: Endovascular aortic aneurysm repair (EVAR). This involves tubes called stents put into your arteries to let blood flow freely. Your surgeon may recommend heart surgery (if your thoracic aneurysm has grown too much, causes symptoms, or if you have Marfan syndrome.) This involves removing the section of the aorta where the aneurysm is and replacing it with a new aorta made of synthetic (man-made) material, called a graft. Personalised external aortic root support (PEARS). This procedure can be offered to people with Marfan syndrome where the bottom of the aorta is very big. A special sleeve is made to put around the aorta to stop it getting bigger.

• #3 Thoracic Aneurysm Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/761627-treatment

  In patients with symptoms suggestive of thoracic aortic aneurysm (TAA), prehospital care should consist of ensuring adequate airway and ventilation, providing oxygen via a nonrebreather mask, placing two large-bore intravenous lines, and providing continuous cardiac monitoring. […] Patients who are unstable (often those with a ruptured aneurysm or dissection) may require airway protection, mechanical ventilation, and aggressive fluid resuscitation. Timely communication between prehospital care providers and the receiving hospital is important in ensuring that the proper resources are available and brought to bear rapidly. […] Provide aggressive blood pressure control. Beta-blockers and nitrates are commonly used. […] For patients who are hemodynamically unstable, provide the following: Aggressive fluid resuscitation (including blood products), placing an arterial line in the right radial artery (or in the left radial artery, if the systolic blood pressure on the left is higher), especially in patients who may have dissection or in those who are receiving intravenous nitroprusside and/or esmolol, correction of coagulopathy, immediate surgical consultation.

• #3 Treatment of thoracic aortic aneurysm

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5879515/

  The diameter of thoracic aortic aneurysm (AA) is at least 1.5 times that of a normal thoracic aorta (1). […] Persons with thoracic AA must be counseled about smoking cessation and referred to a smoking cessation program with either use of nicotine replacement, varenicline, or bupropion (3). […] Dyslipidemia must be treated. Atorvastatin 40 to 80 mg daily or rosuvastatin 20 to 40 mg daily should be administered to persons with thoracic AA (4). […] Hypertension must be controlled to decrease myocardial infarction, stroke, heart failure, death from cardiovascular causes, and aortic dissection (3,7-12). The blood pressure in persons with thoracic AA should be lowered to less than 130/80 mmHg. A beta blocker plus an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker should be administered to these persons (3,7).

• #3 Thoracic aortic aneurysm | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/thoracic-aortic-aneurysm?content_id=CON-20122020

  Types of surgeries and procedures for thoracic aortic aneurysms include: Open surgery. Most people with a thoracic aortic aneurysm have this major surgery. A surgeon removes part of the aorta damaged by the aneurysm. It’s replaced with a tube, called a graft, which is sewn into place. […] Endovascular aortic aneurysm repair (EVAR). This treatment is a less invasive option to open surgery. That means it uses small surgical cuts and may allow a faster recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and guides it to the aorta. A graft on the end of the catheter goes where the aneurysm is. Small hooks or pins hold the graft in place. The graft strengthens the weakened part of the aorta. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #3 Thoracic Aortic Aneurysm Repair | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/t/thoracic-aortic-aneurysm-repair.html

  During open aneurysm repair, your surgeon makes an incision in your chest and replaces the weakened portion of your aorta with a fabric tube, called a graft. The graft is stronger than the weakened aorta and allows blood to pass through it without causing a bulge. […] For extensive or complex thoracic aneurysms, sometimes heart surgery is required at the same time as open aneurysm repair depending upon the particular situation. […] Following the surgery, you may stay in the hospital for five to 10 days. If your aneurysm is extensive or complex, or if you have other conditions such as heart, lung or kidney disease, you may require two to three months for a complete recovery.

• #3 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  Thoracic aortic aneurysm surgery is a procedure to treat a bulge (aneurysm) in the thoracic aorta. The aorta is the large blood vessel that carries blood away from your heart. The thoracic aorta is the portion of the aorta in your chest. You may have open surgery or thoracic endovascular aortic repair (TEVAR). […] Thoracic aortic aneurysm surgery is a treatment for a bulge (aneurysm) in the part of your aorta that runs through your chest (thoracic aorta). […] Not everyone needs surgery for a thoracic aortic aneurysm. Whether you need surgical treatment depends on several factors, including the aneurysms size, your symptoms and your overall health. […] There are two procedures to treat a thoracic aortic aneurysm: Open thoracic aneurysm repair is an open surgery that requires a long incision along the side of your chest. Your surgeon removes the damaged portion of the aorta and replaces it with synthetic material (graft). Thoracic endovascular aortic repair (TEVAR) is a minimally invasive procedure. Your surgeon reaches your aorta by placing a small, hollow tube (catheter) through a blood vessel in your groin. They use the catheter to place a small mesh device (stent) that repairs the diseased portion of the aorta and restores proper blood flow.

• #3 Thoracic Aortic Aneurysm | Vascular Center | UC Davis Health

  https://health.ucdavis.edu/vascular/diseases/thoracic_aortic_aneurysm.html

  The hospital stay is usually one to two days and some patients return to their normal activities within about a week. However, EVAR may not be for everyone. Patients must have arterial anatomy compatible with the available stent grafts and delivery systems. The Vascular Centers specialists are experienced with EVAR, routinely receiving referrals from area physicians faced with the most challenging cases.

• #3 Aortic Aneurysm

  https://www.uabmedicine.org/specialties/aortic-aneurysm/

  Depending on arterial anatomy and cause of the aneurysm, thoracoabdominal aneurysms may be treated with endovascular, open, or hybrid techniques. […] Abdominal aortic aneurysms, often referred to as AAA, are the most common type of aortic aneurysm and develop in the section of the aorta below the diaphragm and within the abdomen. […] UAB Medicines vascular and cardiac specialists provide expert treatment of aortic aneurysms using minimally invasive endovascular procedures, open surgical reconstruction, or a combination of both techniques, depending on the location and cause of the aneurysms. […] Repair of complex aneurysms often requires a multidisciplinary approach involving both vascular and cardiac surgeons. […] We maintain an operating room designed specifically for vascular procedures, where we are able to perform hybrid aortic aneurysm repairs, combining both open surgery and minimally invasive endovascular techniques and maximizing the benefits of both. […] Our commitment to innovation and discovery often means that patients have access to advanced new treatments long before they are available to the general public.

• #3 Thoracic aortic aneurysm – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thoracic-aortic-aneurysm/

  Unstable patients (e.g., in the case of rupture): emergency TAA repair (see Thoracic aortic aneurysm rupture) […] Symptomatic patients: urgent TAA repair […] Asymptomatic patients: Aneurysm surveillance […] Elective TAA repair when size or growth thresholds are passed […] All patients: conservative management with reduction of cardiovascular risk factors […] Open surgical repair (OSR) is recommended for patients with TAA of the ascending aorta and aneurysms involving the aortic arch. For patients with descending thoracic or thoracoabdominal aortic aneurysms, thoracic endovascular aneurysm repair (TEVAR) or OSR can be performed. […] Open surgical repair is a major operation with high associated morbidity and mortality. […] Indications: preferred in young patients with few comorbidities and low surgical risk and patients with connective tissue disorders

• #3 Repair of a Thoracic Aortic Aneurysm | Society for Vascular Surgery

  https://vascular.org/your-vascular-health/your-care-journey/treatments/repair-thoracic-aortic-aneurysm

  Best results are achieved by thoracic or vascular surgeons who have experience with this difficult surgery. The purpose of treatment is to prevent rupture and the escape of blood into the chest cavity. If a TAA ruptures, 50-80 percent of patients do not survive. […] The only way to predict the risk of rupture is to measure TAA size or diameter. This is usually done with a CT scan. The weaker the aorta gets, the larger it gets. When a threshold is reached, elective repair is recommended for most patients to prevent rupture. […] Endovascular Repair: Through a small incision in your leg the vascular surgeon inserts a sleeve on the inside of the aorta, and advances the sleeve to the aneurysm. The sleeve takes the pressure off the wall and prevents it from expanding or possibly leaking. This is the preferred procedure because patients recover quicker and easier. However, available sleeves are often incompatible with the patients anatomy and open surgery is necessary.

• #3 Thoracic Aneurysm Open Surgery (Sternotomy) | University of Utah Health

  https://healthcare.utah.edu/cardiovascular/programs/aortic-disease/thoracic-aortic-aneurysm/surgery

  Thoracic aneurysm open surgery is a treatment for a thoracic aortic aneurysm (TAA), a bulge in your aorta. […] We operate on a thoracic aortic aneurysm using either an open approach similar to open-heart surgery or a minimally invasive technique called thoracic endovascular aneurysm repair (TEVAR). […] Your surgeon will discuss your specific risks during your initial visit. […] During the procedure, your aortic surgeon will replace the weak part of your aorta with a graft, a piece of synthetic material that serves as an artificial blood vessel. […] Your surgical team will recommend that you follow healthy lifestyle habits to increase your overall health before the operation, such as eating a well-balanced diet and exercising at least 30 to 60 minutes daily. […] You will usually spend one to three nights in the cardiovascular intensive care unit (ICU) after surgery. […] Our expert team uses the most advanced techniques to treat thoracic aortic aneurysms. […] When you go to U of U Health for thoracic aortic aneurysm treatment, you are choosing the most experienced, specialized team by surgery volume and physician training in the Mountain West region.

• #3 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #3 Thoracic Aortic Aneurysm: Symptoms, Causes, Treatment, More

  https://www.healthline.com/health/thoracic-aortic-aneurysm

  TAAs require prompt treatment to minimize your risk of a life threatening rupture. Depending on how large an aneurysm is, a doctor may recommend: […] Medications can help lower pressure around your aneurysm and reduce the chances of it rupturing. […] Emergency surgery is vital for a ruptured aneurysm. A doctor may recommend preventive surgery if an aneurysm is at risk of rupturing in the future. […] The American College of Cardiology and American Heart Association recommend preventive surgery if the aneurysm is in the ascending aorta and greater than 5.5 centimeters (cm), or 2.17 inches (in), across. Or, if its in the descending aorta and greater than 6.0 cm (2.4 in) across. […] Three types of surgery are used to treat TAAs: […] Treating a TAA early before it requires emergency surgery gives you the best chance of having a positive outcome. […] The 5-year survival rate for those who have preventive surgery is about 85%, but its only about 37% in people who have emergency surgery.

• #3 A New Treatment Approach for Deadly Aneurysms > News > Yale Medicine

  https://www.yalemedicine.org/news/abdominal-aortic-aneurysm-treatment

  One direction is to study ways to decrease inflammation around the aorta with medicines, says Dr. Guzman. […] The most obvious way to prevent aortic aneurysms is to get people to stop smoking, he says, adding that tobacco smoking accounts for about 75% of all abdominal aortic aneurysms, and its also a risk factor for thoracic aneurysms.

• #4 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  The need for prophylactic intervention is based on aneurysm size, location, growth, and other associated conditions and risk factors in the individual patient. Management strategies include surgery, which is mandatory in the acute setting and in cases of challenging anatomy, and endovascular techniques. Regular imaging surveillance is critical after diagnosis and after aneurysm interventions. […] Guidelines are available regarding surveillance and indications for intervention. […] The main determinants include aneurysm dimensions, rate of expansion, and associated conditions. […] Surgical evaluation is necessary when there are symptoms thought to be related to the TAA, irrespective of other factors. […] TAA size is the strongest predictor of acute aortic syndromes. […] In patients who have no other conditions, the guidelines recommend surgery when the aortic root, ascending aorta, or aortic arch reaches 5.5 cm and when the descending aorta reaches 6.0 cm.

• #4 Thoracic aortic aneurysm – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/care-at-mayo-clinic/mac-20350197

  Mayo Clinic doctors trained in blood vessel conditions (vascular specialists), blood vessel surgery (vascular surgeons), heart and blood vessel surgery (cardiovascular surgeons), chest surgery (thoracic surgeons), heart and blood vessel conditions (cardiologists), imaging (radiologists), and other healthcare professionals have experience evaluating and treating thoracic aortic aneurysms and other types of aortic aneurysms. […] Mayo Clinic’s thoracic surgeons are experienced in thoracic aortic aneurysm repair. […] Surgeons treat thoracic aortic aneurysms using endovascular surgery, open-chest surgery, aortic root surgery and other treatments. Mayo doctors have experience performing surgery to treat a thoracic aortic aneurysm located anywhere in the thoracic aorta. […] At Mayo Clinic, experienced healthcare professionals evaluate and interpret test results. Mayo Clinic has state-of-the-art laboratory and imaging facilities. Healthcare professionals at Mayo use advanced technology to accurately diagnose thoracic and abdominal aortic aneurysms and determine the type of surgery needed, if any.

• #4 Treatment of thoracic aortic aneurysm

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5879515/

  The diameter of thoracic aortic aneurysm (AA) is at least 1.5 times that of a normal thoracic aorta (1). […] Persons with thoracic AA must be counseled about smoking cessation and referred to a smoking cessation program with either use of nicotine replacement, varenicline, or bupropion (3). […] Dyslipidemia must be treated. Atorvastatin 40 to 80 mg daily or rosuvastatin 20 to 40 mg daily should be administered to persons with thoracic AA (4). […] Hypertension must be controlled to decrease myocardial infarction, stroke, heart failure, death from cardiovascular causes, and aortic dissection (3,7-12). The blood pressure in persons with thoracic AA should be lowered to less than 130/80 mmHg. A beta blocker plus an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker should be administered to these persons (3,7).

• #4 A New Treatment Approach for Deadly Aneurysms > News > Yale Medicine

  https://www.yalemedicine.org/news/abdominal-aortic-aneurysm-treatment

  One direction is to study ways to decrease inflammation around the aorta with medicines, says Dr. Guzman. […] The most obvious way to prevent aortic aneurysms is to get people to stop smoking, he says, adding that tobacco smoking accounts for about 75% of all abdominal aortic aneurysms, and its also a risk factor for thoracic aneurysms.

• #4 Thoracic Aortic Aneurysm: Symptoms, Causes, Treatment, More

  https://www.healthline.com/health/thoracic-aortic-aneurysm

  TAAs require prompt treatment to minimize your risk of a life threatening rupture. Depending on how large an aneurysm is, a doctor may recommend: […] Medications can help lower pressure around your aneurysm and reduce the chances of it rupturing. […] Emergency surgery is vital for a ruptured aneurysm. A doctor may recommend preventive surgery if an aneurysm is at risk of rupturing in the future. […] The American College of Cardiology and American Heart Association recommend preventive surgery if the aneurysm is in the ascending aorta and greater than 5.5 centimeters (cm), or 2.17 inches (in), across. Or, if its in the descending aorta and greater than 6.0 cm (2.4 in) across. […] Three types of surgery are used to treat TAAs: […] Treating a TAA early before it requires emergency surgery gives you the best chance of having a positive outcome. […] The 5-year survival rate for those who have preventive surgery is about 85%, but its only about 37% in people who have emergency surgery.

• #4 Thoracic Aortic Disease – Treatment Options – Atlantic Health System

  https://ahs.atlantichealth.org/conditions-treatments/heart-care/treatment-services/thoracic-aortic-disease/treatment-options.html

  The multi-disciplinary team of specialists at The Aortic Center have a variety of treatment options available to successfully treat most thoracic aortic conditions with minimal discomfort or inconvenience to the patient. […] Medications – Often diseases of the thoracic aorta dont require surgery but do require medications to control high blood pressure (hypertension). Our team of expert cardiologists will work with you to make sure that your blood pressure is well-controlled, which can prevent aneurysms from developing or progressing. […] Cardiac surgery – Treatment of thoracic aneurysm disease may require conventional open-heart surgery. Our team of expert heart surgeons can discuss surgical options for treatment of your aortic disease. Some of the surgical procedures we offer include aortic valve repair or replacement, valve-sparing aortic root replacement (where the patients own valve tissues are preserved while the diseased tissue around the valve is removed), aortic root replacement with either a bioprosthetic (tissue) valve or mechanical (metal) valve, ascending aortic replacement, and partial or total aortic arch replacement.

• #4 Thoracic Aortic Aneurysm and Aortic Dissection

  https://www.massgeneral.org/condition/thoracic-aortic-aneurysm

  Thoracic endovascular aortic repair (TEVAR). TEVAR needs only small cuts in the groin. The surgeon uses X-ray guidance and special tools. Then they can fix the aneurysm by inserting a metal mesh coil (stent-graft) inside the aorta. Not all thoracic aneurysms can be fixed with TEVAR. […] If the aneurysm is causing symptoms or is large, your provider may advise surgery. […] When a diagnosis of aortic dissection is confirmed, surgery or stenting is often done right away. Talk with your healthcare provider about how you can manage your thoracic aortic aneurysm and reduce your risk for complications. […] Treatment may include medicine, making lifestyle changes, keeping track with CT or MRI, echocardiogram, and surgery.

• #4 Aortic Aneurysm

  https://www.uabmedicine.org/specialties/aortic-aneurysm/

  Endovascular aneurysm repairs are typically performed by vascular surgeons, and these repairs depend heavily on the anatomy of the blood vessels and the cause of the aneurysm. […] Compared to open surgery, the minimally invasive procedure normally results in less pain and a faster recovery for the patient, but it cannot be used in all cases. […] Repairing this type of aneurysm typically requires open surgery, which is most commonly performed by a cardiac surgeon. […] Aneurysms in the aortic arch traditionally have been repaired with open methods, but newer endovascular methods are currently in development that allow for minimally invasive treatment of some of these aneurysms. […] Aneurysms in the descending thoracic aorta are most commonly treated with endovascular methods, but arterial anatomy and cause of the aneurysm may prevent a minimally invasive treatment from being used.

• #4 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment may be summarized as follows: Increased aortic size, Rapid aortic growth, Symptomatic aneurysm, Traumatic aortic rupture, Acute type B aortic dissection with associated rupture, leak, distal ischemia, Pseudoaneurysm, Large saccular aneurysm, Mycotic aneurysm, Aortic coarctation, Bronchial compression by aneurysm, Aortobronchial or aortoesophageal fistula. […] Aneurysm surgery has no strict contraindications. […] For patients with acute aortic dissection of the ascending aorta, emergency operation is required. […] Patients with acute dissection of the descending aorta do not necessitate surgical intervention unless complicated by rupture, malperfusion, progressive dissection, persistent recurrent pain, or failure of medical management. […] Most aneurysm repairs involve aortic replacement with a Dacron tube graft.

• #4 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  The use of CSF drainage is selective among most centers. […] Spinal cord ischemia is an uncommon complication following TEVAR, but its development can be identified by a preoperative renal insufficiency. […] Brain protection methods used during DHCA include intraoperative EEG monitoring, evoked somatosensory potential monitoring, hypothermia, and antegrade and retrograde cerebral perfusion. […] Patients who have undergone ascending aneurysm repairs are observed for signs of coronary ischemia, particularly if the coronary ostia were reimplanted, and for signs of aortic insufficiency when the aortic valve is repaired. […] Paraplegia is the main concern in patients who have had descending TAA or TAAA repairs. […] Acute postoperative renal dysfunction may be due to extended periods of ischemic cross-clamping or to hypothermic circulatory arrest.

• #4 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  In TEVAR, the rates of successfully placing the stent are as high as 99%. Thoracic aortic aneurysm open surgery is also a highly successful procedure. […] Thoracic aortic aneurysm surgery is a procedure to repair a balloon or bulge in your thoracic aorta. There are two types of thoracic aortic aneurysm surgery: open surgery and TEVAR. The type of surgery you have depends on multiple factors, including the size of the aneurysm and your overall health. Thoracic aortic aneurysm surgery is a lifesaving procedure for many people.

• #4 Research Shows New Procedure to Repair Complex Aortic Aneurysm Saves Lives.

  https://www.medstarhealth.org/blog/complex-aortic-aneurysm

  This minimally invasive graft procedure for aneurysms in the chest has proven very effective, demonstrating a 98% technical success rate. […] Therefore, the fenestrated and branched endovascular (F/B-EVAR) technology is being used for the high-risk patients through this trial to offer them a treatment tailored to their anatomy. […] There is no other commercially available technology that can repair complex aortic aneurysms in this way. […] The minimally invasive precision of this procedure allows us to treat patients we otherwise could not due to the high rate of complications from traditional surgery. […] Our study examines the safety and effectiveness of the PMEG device (FEVAR) to repair complex aortic aneurysms because we want this treatment to be available to everyone who could benefit.

• #4 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. Because the risk of rupture is proportional to the diameter of the aneurysm, aneurysmal size is the criterion for elective surgical repair. […] Elefteriades published the natural history of TAAs and recommended elective repair of ascending aneurysms at 5.5 cm and descending aneurysms at 6.5 cm for patients without any familial disorders such as Marfan syndrome. […] Patients with Marfan syndrome or familial aneurysms should undergo earlier repair, when the ascending aorta grows to 5.0 cm or the descending aorta grows to 6.0 cm. […] Rapid expansion is also a surgical indication. Growth rates average 0.07 cm/y in the ascending aorta and 0.19 cm/y in the descending aorta.

• #5 Thoracic Aortic Aneurysms – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/diseases-of-the-aorta-and-its-branches/thoracic-aortic-aneurysms

  Doctors try to repair aneurysms surgically before the aneurysm ruptures. […] People with a small thoracic aortic aneurysm are given CT examinations every 6 to 12 months so doctors can monitor the aneurysm and determine whether it is expanding. […] Patients are given a beta-blocker, calcium channel blocker, or another antihypertensive medication to reduce the rate at which the aneurysms grows and to reduce the risk that it might rupture. […] It is much better to treat a thoracic aortic aneurysm before it ruptures, so once it becomes 2 inches (5.5 to 6.0 centimeters) wide or larger, doctors will recommend repair. […] The choice of aneurysm repair technique depends on many factors, including the person’s age and general health and the anatomy of their aorta and aneurysm. […] In general, stent grafts are the first choice for thoracic aortic aneurysms because they are much less invasive, avoiding an open chest incision that is more painful and that requires longer recovery.

• #5 Thoracic aortic aneurysm – BHF

  https://www.bhf.org.uk/informationsupport/conditions/thoracic-aortic-aneurysm

  How is a thoracic aortic aneurysm treated? Treatment of a thoracic aortic aneurysm varies from regular health checks to emergency surgery. The type of treatment depends on the cause, size, location and growth rate of the thoracic aortic aneurysm. Your doctor will talk to you about the best option for you. If you have been diagnosed with a thoracic aneurysm, it is likely that you’ll be monitored with echocardiograms and CT scans every six or 12 months, to see if there are signs of changes in your aneurysm. How fast the aneurysm grows (if at all) will be different for everyone. […] Medicines may be prescribed to control risk factors such as high blood pressure and high cholesterol. These may include: angiotensin receptor blocker, beta blockers, statins. […] Other treatments include: Endovascular aortic aneurysm repair (EVAR). This involves tubes called stents put into your arteries to let blood flow freely. Your surgeon may recommend heart surgery (if your thoracic aneurysm has grown too much, causes symptoms, or if you have Marfan syndrome.) This involves removing the section of the aorta where the aneurysm is and replacing it with a new aorta made of synthetic (man-made) material, called a graft. Personalised external aortic root support (PEARS). This procedure can be offered to people with Marfan syndrome where the bottom of the aorta is very big. A special sleeve is made to put around the aorta to stop it getting bigger.

• #5 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Specific treatment will be determined by your physician based on: […] Surgical treatment options for thoracic aortic aneurysms […] Thoracic aortic aneurysm open repair […] Endovascular aneurysm repair (EVAR) […] Non-surgical treatment options for thoracic aortic aneurysms […] Controlling or modifying risk factors: Steps such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese, and controlling dietary fat intake may help to control the progression of the aneurysm […] Medication: To control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] The specific services available to your patients suffering from aortic diseases include: […] Use of endovascular stent grafts for the treatment of thoracic aortic aneurysms and aortic dissections

• #5 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. Because the risk of rupture is proportional to the diameter of the aneurysm, aneurysmal size is the criterion for elective surgical repair. […] Elefteriades published the natural history of TAAs and recommended elective repair of ascending aneurysms at 5.5 cm and descending aneurysms at 6.5 cm for patients without any familial disorders such as Marfan syndrome. […] Patients with Marfan syndrome or familial aneurysms should undergo earlier repair, when the ascending aorta grows to 5.0 cm or the descending aorta grows to 6.0 cm. […] Rapid expansion is also a surgical indication. Growth rates average 0.07 cm/y in the ascending aorta and 0.19 cm/y in the descending aorta.

• #5 Aortic Aneurysm – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/aortic-aneurysm/treatment

  Treatment for your aortic aneurysm will depend on its size, location, and the factors that put you at risk. Small aortic aneurysms may be managed with healthy lifestyle changes. The goal is to slow the growth of the aneurysm and lower the chance of rupture or dissection. Your healthcare provider may treat other medical conditions that raise your risk for rupture or dissection, such as high blood pressure, coronary heart disease, chronic kidney disease, and high blood cholesterol. Surgery may be recommended to repair large aneurysms. […] Depending on the cause or size of an aortic aneurysm or how quickly it is growing, your provider may recommend surgery to repair it. Rupture or dissection of an aneurysm may require emergency surgery. […] Open surgical repair is the most common type of surgery. You will be asleep during the procedure. Your doctor first makes a large cut in your stomach area or chest, depending on the location of the aneurysm. Then, the aneurysm is removed and a graft is sewn in its place. This graft is typically a tube made of leak-proof polyester. Recovery time for open surgical repair is about a month.

• #5 Aortic Aneurysm – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/aortic-aneurysm/treatment

  Endovascular aneurysm repair (EVAR) is done by cardiac catheterization and is less invasive than open surgical repair. This is because the cut is smaller, and you usually need less recovery time. EVAR is used to repair abdominal aortic aneurysms more often than thoracic aortic aneurysms. During the procedure, your surgical team makes a small cut, usually in the groin, then guides a stent graft a tube covered with fabric through your blood vessels up to the aorta. The stent graft then expands and attaches to the aortic walls. A seal forms between the stent graft and the vessel wall to prevent blood from entering the aortic aneurysm.

• #5 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  A growth rate of 1 cm/y or faster is an indication for elective surgical repair. […] Symptomatic patients should undergo aneurysm resection, regardless of aneurysm size. Acutely symptomatic patients require emergency operation. […] Patients who undergo surgery for symptomatic aortic insufficiency or stenosis with an associated enlarged aneurysmal aorta should have concomitant aortic replacement if the aorta reaches 5 cm in diameter. […] Concomitant aortic replacement should be considered for patients with bicuspid aortic valves with an aorta more than 4.5 cm in diameter. […] For descending TAAs, endovascular stent grafting is less invasive and is an ideal alternative to open repair for patients at high risk for complications of open repair. […] Stent grafts are also a reasonable alternative to open repair in patients who are not at high risk for complications.

• #5 Thoracic Aneurysm Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/761627-treatment

  Indications for surgical repair include the following: Rupture, acute dissection (ascending requires urgent intervention, whereas descending is managed medically or surgically, if vascular complications arise), symptomatic states, including pain, mediastinal organ compression, or aortic insufficiency severe enough to cause CHF or a dilated hypokinetic left ventricle, rapid aneurysm growth rate, absolute size (5.5 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm; in patients with Marfan syndrome, 5.0 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm). […] Surgical and other interventional options for TAA repair include the following: Open approaches using cardiopulmonary bypass, hypothermia, and grafting, endovascular stent grafting may be an option when TAA is limited to the descending aorta. […] Immediately consult with a cardiac surgeon (for ascending aorta or arch) or with a vascular surgeon (for descending aorta) for patients who are hemodynamically unstable or for patients with symptoms of a thoracic aneurysm.

• #5 Thoracic Aortic Aneurysm Repair | CTVS Central Texas – CTVS Texas

  https://ctvstexas.com/about-ctvs/our-services/cardiac-services/thoracic-aortic-aneurysm-repair/

  Your surgeon will use your state of health and the size and location of the aneurysm to determine which treatment option is best for you. […] Hospital stays for this procedure range from 1 to 3 days. You can expect to make a full recovery within 1 to 2 weeks. You will need a follow-up CT scan every 4 months for the first year after your procedure. After one year, you will require annual CT scans.

• #5 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #5 Research Shows New Procedure to Repair Complex Aortic Aneurysm Saves Lives.

  https://www.medstarhealth.org/blog/complex-aortic-aneurysm

  This minimally invasive graft procedure for aneurysms in the chest has proven very effective, demonstrating a 98% technical success rate. […] Therefore, the fenestrated and branched endovascular (F/B-EVAR) technology is being used for the high-risk patients through this trial to offer them a treatment tailored to their anatomy. […] There is no other commercially available technology that can repair complex aortic aneurysms in this way. […] The minimally invasive precision of this procedure allows us to treat patients we otherwise could not due to the high rate of complications from traditional surgery. […] Our study examines the safety and effectiveness of the PMEG device (FEVAR) to repair complex aortic aneurysms because we want this treatment to be available to everyone who could benefit.

• #5 Innovative Approaches to Aortic Aneurysm Treatment | Surgery | U of U School of Medicine

  https://medicine.utah.edu/surgery/cardiothoracic/news/2025/02/innovative-approaches-aortic-aneurysm-treatment

  A far less invasive option, developed about 30 years ago and performed regularly for about 15 years, is complex fenestrated endovascular aneurysm repair (FEVAR), which can treat aortic aneurysms in the belly and aneurysms that extend into the chest. During this procedure, a surgeon inserts sheaths into femoral arteries, uses wires and catheters through access points and into the aorta and its branch vessels, and places an endograft device made of metal and synthetic material to seal off the aneurysm. The main aortic graft has fenestrations and branches that connect to the visceral and renal vessels to maintain vital perfusion to the abdominal organs. Recovery time varies but the hospital stay can be as short as a day or two. […] U of U Health recently received the green light from the FDA to offer that different option. The agency has authorized Johnson and Droz to conduct a physician-sponsored investigational device exemption (PS-IDE) research trial for the FEVAR procedure called a Physician-Modified Endovascular Graft (PMEG). Rather than sending a CT scan to a manufacturer and waiting for them to build a custom endograft, Johnson and Droz use patients CT scans as a guide to modify stock endografts themselves.

• #5 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Lower thresholds for intervention are recommended when patients have associated conditions that increase the risk of dissection at smaller dimensions and increase the rate of growth. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] Blood pressure control is the cornerstone of medical management of TAA, as it makes pathophysiologic sense to reduce aortic wall shear stress and expansion. […] Interventions for TAA vary widely in complexity and are classified by location and by modality. Patients should be referred to a high-volume cardiac surgery center with aortic expertise for management to optimize outcomes. […] Aneurysm of the ascending aorta mandates surgical repair with median sternotomy, cardiopulmonary bypass, and circulatory arrest. […] On the other hand, aneurysm in the descending aorta can be addressed with endovascular repair using percutaneous access in suitable anatomy. […] Management of TAA is multidisciplinary, with many aspects beyond medications and interventions.

• #6 Thoracic Aortic Aneurysms – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/diseases-of-the-aorta-and-its-branches/thoracic-aortic-aneurysms

  Doctors try to repair aneurysms surgically before the aneurysm ruptures. […] People with a small thoracic aortic aneurysm are given CT examinations every 6 to 12 months so doctors can monitor the aneurysm and determine whether it is expanding. […] Patients are given a beta-blocker, calcium channel blocker, or another antihypertensive medication to reduce the rate at which the aneurysms grows and to reduce the risk that it might rupture. […] It is much better to treat a thoracic aortic aneurysm before it ruptures, so once it becomes 2 inches (5.5 to 6.0 centimeters) wide or larger, doctors will recommend repair. […] The choice of aneurysm repair technique depends on many factors, including the person’s age and general health and the anatomy of their aorta and aneurysm. […] In general, stent grafts are the first choice for thoracic aortic aneurysms because they are much less invasive, avoiding an open chest incision that is more painful and that requires longer recovery.

• #6 Aortic Aneurysms: Nonsurgical Treatments

  https://www.healthline.com/health/heart-health/aortic-aneurysm-treatment-without-surgery

  If you have an aortic aneurysm, a doctor will also recommend adopting lifestyle changes that promote heart health. […] Lifestyle changes for aortic aneurysm include quitting smoking, focusing on a heart-healthy diet, getting regular physical activity, and reducing stress. […] For small and some medium-sized aortic aneurysms, regular monitoring may be recommended. […] If your aneurysm is being monitored, a doctor may use nonsurgical treatments to improve your cardiovascular health and reduce the risk from your aneurysm. […] To date, there isn’t a nonsurgical treatment that can reliably shrink or slow the growth of aortic aneurysms. […] Nonsurgical treatments for aortic aneurysms include medications and lifestyle changes. But there currently aren’t any nonsurgical treatments that are guaranteed to slow the growth of aortic aneurysms. […] Surgery is still the main type of treatment for large aortic aneurysms or those that are growing quickly.

• #6 Thoracic Aortic Aneurysm | Vascular Center | UC Davis Health

  https://health.ucdavis.edu/vascular/diseases/thoracic_aortic_aneurysm.html

  Thoracic aortic aneurysms (TAAs) are considered high risk for rupture if they are located below the aortic arch and greater than 6.5 centimeters in diameter, about the size of a lemon, or if the aneurysm is rapidly increasing in diameter (greater than 1 centimeter per year). If the aneurysm is located in the arch or the ascending portion of the thoracic aorta, it is considered at risk for rupture at a diameter of 5.5 centimeter or larger. These numbers are not absolute. For example, surgeons treating patients with Marfans Syndrome may choose to repair smaller aneurysms. […] Slowly growing aneurysms should be closely monitored. Smoking cessation and medication to control blood pressure may help to slow the rate of enlargement of an intact aneurysm. Surgical repair of the aorta is the only definitive cure. However, risk of rupture must be weighed against the risks associated with surgery and to the patients pre-existing conditions.

• #6 Repair of a Thoracic Aortic Aneurysm | Society for Vascular Surgery

  https://vascular.org/your-vascular-health/your-care-journey/treatments/repair-thoracic-aortic-aneurysm

  Open surgery: You are put under general anesthesia and an incision is made, usually along the left side of your chest. The ribs are spread and the weakened area of the aorta is replaced with an artificial blood vessel (graft) made of cloth. Blood flow through the aorta must be stopped temporarily while the graft is sewn in place. Often, blood circulation to the body is maintained using mechanical pumps while the aorta is clamped.

• #6 Thoracic Aortic Aneurysm | Vascular Center | UC Davis Health

  https://health.ucdavis.edu/vascular/diseases/thoracic_aortic_aneurysm.html

  Repair of the aneurysm involves removing the distended portion of the aorta and replacing it with a tube called a graft. The cylinder-like graft, which is made of polyester fabric, is sewn in place. A hospital stay of between seven and 10 days is usually required if no complications occur. Complete recovery and return to a normal routine takes two to three months. […] Endovascular aneurysm repair (EVAR) is a less-invasive surgical treatment that involves a small incision in the groin and the insertion of a stent graft through a catheter placed in the femoral artery. Physicians use X-ray imaging to guide the stent graft to the diseased area. The graft is then expanded inside the aorta and held in place by metallic stents rather than stitches. Blood now flows through the stent graft, and blood-flow is excluded from the dilated segment of the aorta.

• #6 Thoracic Aortic Aneurysms – Clinical Features – Management – TeachMeSurgery

  https://teachmesurgery.com/vascular/arterial/thoracic-aorta-aneurysm/

  Patients with a confirmed thoracic aneurysm should be started on medical management. These patients are at increased cardiovascular risk, therefore should be initiated on statin and anti-platelet therapy to decrease the risk of myocardial infarction, blood pressure control optimise, and smoking cessation enforced (if appropriate). […] Surgical management is dependent on the location of the aneurysm, with the threshold for surgery varying dependent on patient factors. For example, patients suffering from Marfans syndrome or having a previous thoracic dissection have a greater risk of dissection and rupture, and threshold levels for intervention are often lower. […] A guide to thoracic aneurysm surgical interventions can be followed: Ascending Aorta – Treated when the diameter 5.5cm, the affected region of the aorta is excised and replaced with a dacron graft; if the aortic root is involved, a Bentall procedure is often performed, using a graft that also contains a prosthetic aortic valve. Aortic Arch – Once the aneurysm is over 5.5cm, surgery should be considered; the affected aorta is replaced with a multi-limbed graft, allowing for the branching of the great vessels (such procedures have a high risk of cerebral ischaemia from embolisation). Descending Aorta – Intervention is indicated when the diameter exceeds 6.0cm; these can be repaired open or with endovascular techniques, yet endovascular techniques have been shown to produce fewer post-operative complications and have a lower mortality.

• #6 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Lower thresholds for intervention are recommended when patients have associated conditions that increase the risk of dissection at smaller dimensions and increase the rate of growth. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] Blood pressure control is the cornerstone of medical management of TAA, as it makes pathophysiologic sense to reduce aortic wall shear stress and expansion. […] Interventions for TAA vary widely in complexity and are classified by location and by modality. Patients should be referred to a high-volume cardiac surgery center with aortic expertise for management to optimize outcomes. […] Aneurysm of the ascending aorta mandates surgical repair with median sternotomy, cardiopulmonary bypass, and circulatory arrest. […] On the other hand, aneurysm in the descending aorta can be addressed with endovascular repair using percutaneous access in suitable anatomy. […] Management of TAA is multidisciplinary, with many aspects beyond medications and interventions.

• #6 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #6 Endovascular Treatment of a Descending Thoracic Aortic Aneurysm | CTSNet

  https://www.ctsnet.org/article/endovascular-treatment-descending-thoracic-aortic-aneurysm

  Patients and surgeons are currently seeking safer and less-invasive approaches for the treatment of many surgical disorders. […] Initial data from a Phase II multicenter trial using the GORE TAG endoprosthesis suggests that endoluminal grafting for DTA aneurysms is associated with decreased length of stay, less blood transfusion and earlier return to a baseline activity lifestyle. […] Additional studies are needed to better compare these two different treatment modalities. […] DTA pathologies such as acute and chronic dissection, penetrating aortic ulcers and aortobronchial fistulas are also potentially amenable to endoluminal grafting. […] As this new technology evolves, associated training issues will become important.

• #6 Innovative Approaches to Aortic Aneurysm Treatment | Surgery | U of U School of Medicine

  https://medicine.utah.edu/surgery/cardiothoracic/news/2025/02/innovative-approaches-aortic-aneurysm-treatment

  A far less invasive option, developed about 30 years ago and performed regularly for about 15 years, is complex fenestrated endovascular aneurysm repair (FEVAR), which can treat aortic aneurysms in the belly and aneurysms that extend into the chest. During this procedure, a surgeon inserts sheaths into femoral arteries, uses wires and catheters through access points and into the aorta and its branch vessels, and places an endograft device made of metal and synthetic material to seal off the aneurysm. The main aortic graft has fenestrations and branches that connect to the visceral and renal vessels to maintain vital perfusion to the abdominal organs. Recovery time varies but the hospital stay can be as short as a day or two. […] U of U Health recently received the green light from the FDA to offer that different option. The agency has authorized Johnson and Droz to conduct a physician-sponsored investigational device exemption (PS-IDE) research trial for the FEVAR procedure called a Physician-Modified Endovascular Graft (PMEG). Rather than sending a CT scan to a manufacturer and waiting for them to build a custom endograft, Johnson and Droz use patients CT scans as a guide to modify stock endografts themselves.

• #6 Thoracic aortic aneurysm – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/drc-20350193

  The goals of treatment for a thoracic aortic aneurysm are to: […] Treatment for thoracic aortic aneurysm may include: […] Surgery is generally recommended for thoracic aortic aneurysms about 1.9 to 2.4 inches (about 5 to 6 centimeters) and larger. Surgery may be recommended for smaller aneurysms if you have a family history of aortic dissection or a condition linked to aortic aneurysm, such as Marfan syndrome. […] Types of surgeries and procedures for thoracic aortic aneurysms include: […] Open surgery to repair a thoracic aortic aneurysm involves removing the damaged part of the aorta. The damaged part is replaced with a synthetic tube, called a graft, which is sewn into place. […] In endovascular thoracic aortic aneurysm repair, the surgeon inserts a thin, flexible tube called a catheter through an artery in the groin area and guides it to the aorta. A metal mesh tube called a graft is placed at the aneurysm site. Small hooks or pins hold it in place. The graft strengthens the weakened part of the aorta to prevent rupture of the aneurysm. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #6 Thoracic Aortic Aneurysm: Types, Symptoms, & Treatment | AHN

  https://www.ahn.org/services/cardiovascular/conditions/thoracic-aortic-aneurysm

  Our team taps the expertise of doctors from different fields. We develop a treatment plan specific to your health condition and needs. AHN participates in clinical trials for carotid artery stenting and new therapies at the Cardiovascular Research Institute. […] Cardiovascular surgeons at (AHN) Cardiovascular Institute are leaders in performing thoracic endovascular aortic aneurysm repair (TEVAR) and have years of experience with procedures such as aortic arch, ascending trifurcated graft, valve-sparing aortic root, bicuspid aortic valve, elephant trunk, thoracoabdominal aneurysm repair, complicated Type B dissection management, and profound hypothermic circulatory arrest.

• #7 Treatment of thoracic aortic aneurysm

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5879515/

  The diameter of thoracic aortic aneurysm (AA) is at least 1.5 times that of a normal thoracic aorta (1). […] Persons with thoracic AA must be counseled about smoking cessation and referred to a smoking cessation program with either use of nicotine replacement, varenicline, or bupropion (3). […] Dyslipidemia must be treated. Atorvastatin 40 to 80 mg daily or rosuvastatin 20 to 40 mg daily should be administered to persons with thoracic AA (4). […] Hypertension must be controlled to decrease myocardial infarction, stroke, heart failure, death from cardiovascular causes, and aortic dissection (3,7-12). The blood pressure in persons with thoracic AA should be lowered to less than 130/80 mmHg. A beta blocker plus an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker should be administered to these persons (3,7).

• #7 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Specific treatment will be determined by your physician based on: […] Surgical treatment options for thoracic aortic aneurysms […] Thoracic aortic aneurysm open repair […] Endovascular aneurysm repair (EVAR) […] Non-surgical treatment options for thoracic aortic aneurysms […] Controlling or modifying risk factors: Steps such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese, and controlling dietary fat intake may help to control the progression of the aneurysm […] Medication: To control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] The specific services available to your patients suffering from aortic diseases include: […] Use of endovascular stent grafts for the treatment of thoracic aortic aneurysms and aortic dissections

• #7 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. Because the risk of rupture is proportional to the diameter of the aneurysm, aneurysmal size is the criterion for elective surgical repair. […] Elefteriades published the natural history of TAAs and recommended elective repair of ascending aneurysms at 5.5 cm and descending aneurysms at 6.5 cm for patients without any familial disorders such as Marfan syndrome. […] Patients with Marfan syndrome or familial aneurysms should undergo earlier repair, when the ascending aorta grows to 5.0 cm or the descending aorta grows to 6.0 cm. […] Rapid expansion is also a surgical indication. Growth rates average 0.07 cm/y in the ascending aorta and 0.19 cm/y in the descending aorta.

• #7 Thoracic Aortic Aneurysm and Aortic Dissection

  https://www.massgeneral.org/condition/thoracic-aortic-aneurysm

  Detailed information on thoracic aortic aneurysms, including description of a thoracic aortic aneurysm, causes, symptoms, diagnosis, treatment, and full-color anatomical illustrations […] Treatment may include surgery to fix or remove the aneurysm. Or a metal mesh coil (stent) may be inserted. This is to support the blood vessel and prevent rupture. […] Treatment may include: […] Surgery. […] Thoracic aortic aneurysm open repair. The type of surgery will depend on the location and type of aneurysm, and your overall health. For an aortic root, ascending aorta, or aortic arch aneurysm, 1 large cut (incision) may be made through the breastbone. The aneurysm is removed and a graft placed. If an ascending aneurysm involves damage to the aortic valve of the heart, the valve may be fixed or replaced during the procedure. For a thoracic descending aneurysm, 1 large cut may be made. It may go from the back under the shoulder blade, around the side of the rib cage, to just under the breast. This lets the surgeon see the aorta directly to fix the aneurysm.

• #7 Thoracic aortic aneurysm | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/thoracic-aortic-aneurysm?content_id=CON-20122020

  Types of surgeries and procedures for thoracic aortic aneurysms include: Open surgery. Most people with a thoracic aortic aneurysm have this major surgery. A surgeon removes part of the aorta damaged by the aneurysm. It’s replaced with a tube, called a graft, which is sewn into place. […] Endovascular aortic aneurysm repair (EVAR). This treatment is a less invasive option to open surgery. That means it uses small surgical cuts and may allow a faster recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and guides it to the aorta. A graft on the end of the catheter goes where the aneurysm is. Small hooks or pins hold the graft in place. The graft strengthens the weakened part of the aorta. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #7 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Surgical treatment of ascending aortic aneurysms depends on the extent of the aneurysm both proximally and distally. […] The choice of operation also depends on the underlying pathology of the disease, the patient’s life expectancy, the desired anticoagulation status, and the surgeon’s experience and preference. […] For elderly patients who cannot undergo a complex operation, another option is reduction aortoplasty. […] Descending TAAs may be repaired with open surgery or, if appropriate, with endovascular stent grafting techniques. […] Stent graft repair of descending TAAs should be performed if the predicted operative risk is lower than that of an open repair. […] Prevention of paraplegia is one of the principal concerns in the repair of descending TAAs and TAAAs. […] For endovascular stent grafting, CSF drainage and avoidance of hypotension are the primary mechanisms used to prevent paraplegia.

• #7 Thoracic aortic aneurysm – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/thoracic-aortic-aneurysm/

  Symptomatic TAAs involving the ascending aorta or the aortic arch […] Consider as an alternative in symptomatic TAAs involving the descending aorta […] Consider in asymptomatic TAAs. […] Thoracic endovascular aneurysm repair (TEVAR) […] Indications: Degenerative or traumatic descending aortic aneurysms […] Procedure: Under fluoroscopic guidance, an expandable stent graft is placed via the femoral or iliac arteries intraluminally at the site of the aneurysm. […] Requires lifelong postoperative surveillance […] All patients should receive conservative treatment to reduce the risk of further aneurysm expansion or rupture. Regular aneurysm surveillance via CT or MR is recommended for patients in whom the diameter of the aneurysm has not reached the threshold defined as the indication for repair. […] Follow-up frequency for surveillance of thoracic aortic aneurysm or dilatation via CT or MR

• #7 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  The use of CSF drainage is selective among most centers. […] Spinal cord ischemia is an uncommon complication following TEVAR, but its development can be identified by a preoperative renal insufficiency. […] Brain protection methods used during DHCA include intraoperative EEG monitoring, evoked somatosensory potential monitoring, hypothermia, and antegrade and retrograde cerebral perfusion. […] Patients who have undergone ascending aneurysm repairs are observed for signs of coronary ischemia, particularly if the coronary ostia were reimplanted, and for signs of aortic insufficiency when the aortic valve is repaired. […] Paraplegia is the main concern in patients who have had descending TAA or TAAA repairs. […] Acute postoperative renal dysfunction may be due to extended periods of ischemic cross-clamping or to hypothermic circulatory arrest.

• #7 Thoracic Aortic Aneurysms – Clinical Features – Management – TeachMeSurgery

  https://teachmesurgery.com/vascular/arterial/thoracic-aorta-aneurysm/

  Development of a second aneurysm is not uncommon in these patients post-intervention, so ongoing imaging studies as an outpatient are required following surgery, either with CT or MRI imaging. Recent studies demonstrate a perioperative mortality of between 2-17%, with arch aneurysms having the highest mortality at 25% mortality. Mortality is significantly lower in those undergoing endovascular repair.

• #7 Research Shows New Procedure to Repair Complex Aortic Aneurysm Saves Lives.

  https://www.medstarhealth.org/blog/complex-aortic-aneurysm

  This minimally invasive graft procedure for aneurysms in the chest has proven very effective, demonstrating a 98% technical success rate. […] Therefore, the fenestrated and branched endovascular (F/B-EVAR) technology is being used for the high-risk patients through this trial to offer them a treatment tailored to their anatomy. […] There is no other commercially available technology that can repair complex aortic aneurysms in this way. […] The minimally invasive precision of this procedure allows us to treat patients we otherwise could not due to the high rate of complications from traditional surgery. […] Our study examines the safety and effectiveness of the PMEG device (FEVAR) to repair complex aortic aneurysms because we want this treatment to be available to everyone who could benefit.

• #7 Management of thoracic aortic aneurysm in adults – UpToDate

  https://www.uptodate.com/contents/management-of-thoracic-aortic-aneurysm-in-adults

  Management of thoracic aortic aneurysm in adults […] Thoracic aortic aneurysm (TAA) can be due to degenerative, inflammatory, or genetically mediated etiologies. Among these, degenerative aneurysm related to hypertension is the most common. The natural history of TAA is one of progressive expansion, the rate of which depends upon the location of the aneurysm and its underlying cause. Although most TAAs produce no symptoms, patients who become symptomatic or have complications related to the aneurysm (eg, acute aortic regurgitation, dissection, aortic rupture, infection) should undergo repair. […] Conservative management of asymptomatic TAA aims to lessen stress on the aorta and limit further aortic expansion. Asymptomatic patients who do not meet the criteria for repair also require ongoing aneurysm surveillance. Any patient with additional clinical risk factors (eg, Marfanoid habitus, positive family history) should be evaluated for possible underlying genetic conditions known to be associated with thoracic aortic aneurysm and dissection (TAAD). Where expertise in the management of thoracic aortic disease is not available, the patient should be transferred to a high-volume cardiovascular center with a multidisciplinary aortic team to provide the best possible outcome.

• #8 Aortic Aneurysms: Nonsurgical Treatments

  https://www.healthline.com/health/heart-health/aortic-aneurysm-treatment-without-surgery

  Nonsurgical treatments for aortic aneurysms, such as medications and lifestyle changes, focus on reducing your risk of an aneurysm growing larger or bursting. […] Surgery is the main treatment for large aneurysms or those that are growing rapidly. Nonsurgical treatments may be an option for small and some medium-sized aortic aneurysms. […] Nonsurgical treatments for aortic aneurysms fall into two general categories: medications and lifestyle changes. […] Medications for aortic aneurysms aim to prevent the aneurysm from getting larger or bursting. […] Blood pressure medications lower the pressure that blood flow places on your artery walls. […] Statins lower your cholesterol levels, slowing the progress of atherosclerosis, an important risk factor for aortic aneurysms. […] Low-dose aspirin may also be used in people with aortic aneurysms that began with atherosclerosis.

• #8 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Specific treatment will be determined by your physician based on: […] Surgical treatment options for thoracic aortic aneurysms […] Thoracic aortic aneurysm open repair […] Endovascular aneurysm repair (EVAR) […] Non-surgical treatment options for thoracic aortic aneurysms […] Controlling or modifying risk factors: Steps such as quitting smoking, controlling blood sugar if diabetic, losing weight if overweight or obese, and controlling dietary fat intake may help to control the progression of the aneurysm […] Medication: To control factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] The specific services available to your patients suffering from aortic diseases include: […] Use of endovascular stent grafts for the treatment of thoracic aortic aneurysms and aortic dissections

• #8 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  Your provider may recommend thoracic aortic aneurysm surgery to lower your risk of an aneurysm rupture. TAAs dont always rupture. They are life-threatening if they do. […] Your provider uses imaging scans to decide if you need surgery for a thoracic aortic aneurysm. They often use CT scans to monitor the aneurysm size. Your provider may recommend surgery if the aneurysm is larger than 5.5 centimeters or has grown more than 0.5 centimeters in six months. […] Thoracic aortic aneurysm surgery significantly reduces your risk of an aneurysm rupture, which is a life-threatening emergency. Your healthcare provider typically recommends surgery when the risks of a rupture outweigh the risks of surgery. […] Most people are back to their usual routine within two to three months after thoracic aortic aneurysm surgery.

• #8 Thoracic Aortic Aneurysm and Aortic Dissection

  https://www.massgeneral.org/condition/thoracic-aortic-aneurysm

  Detailed information on thoracic aortic aneurysms, including description of a thoracic aortic aneurysm, causes, symptoms, diagnosis, treatment, and full-color anatomical illustrations […] Treatment may include surgery to fix or remove the aneurysm. Or a metal mesh coil (stent) may be inserted. This is to support the blood vessel and prevent rupture. […] Treatment may include: […] Surgery. […] Thoracic aortic aneurysm open repair. The type of surgery will depend on the location and type of aneurysm, and your overall health. For an aortic root, ascending aorta, or aortic arch aneurysm, 1 large cut (incision) may be made through the breastbone. The aneurysm is removed and a graft placed. If an ascending aneurysm involves damage to the aortic valve of the heart, the valve may be fixed or replaced during the procedure. For a thoracic descending aneurysm, 1 large cut may be made. It may go from the back under the shoulder blade, around the side of the rib cage, to just under the breast. This lets the surgeon see the aorta directly to fix the aneurysm.

• #8 Thoracic Aortic Aneurysms – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/diseases-of-the-aorta-and-its-branches/thoracic-aortic-aneurysms

  An endovascular stent graft is a hollow tube composed of fabric supported by a metal mesh that can be placed inside the aorta at the site of the aneurysm. […] The risk of death is low during stent graft repair of thoracic aortic aneurysms but is higher during a stent graft repair or surgery for a ruptured thoracic aneurysm. […] If syphilis or another infection is the cause of the aneurysm, doctors give antibiotics to treat the infection. Usually, the aneurysm must also be repaired.

• #8 New York Thoracic Aortic Aneurysm, Treatment for Chest Aneurysms | NYC

  https://www.drbenvenisty.com/thoracic-aortic-aneurysm-treatment-options/

  Proper diagnosis and treatment of aortic aneurysms require extensive knowledge and insight into the behavior of aneurysms. It is important to consider their size and the overall health of the patient as well as complications and risks associated with different methods of intervention. […] Treatment depends largely on the location of the aneurysm. To better understand, consider the three parts of the aorta—the ascending aorta (moves upward towards the head), the aortic arch (the curved middle section) and the descending aorta (moves downward, towards the feet). Typically, when an aneurysm is detected in the ascending or aortic arch and is larger than 5 centimeters, surgery is often suggested to replace the aorta. On the other hand, when an aneurysm is discovered on the descending thoracic aorta, surgical options vary and endovascular stenting may be recommended. Less invasive, endovascular stenting can be placed without a major incision. […] Options for the treatment of thoracic aortic aneurysms require careful consideration of an individual’s candidacy for specific methods, their overall health, pre-existing medical conditions and health history.

• #8 Thoracic Aortic Aneurysm

  https://www.uvmhealth.org/medcenter/conditions-and-treatments/thoracic-aortic-aneurysm

  Open Repair – With an open surgical repair, your surgeon makes an incision in your chest to remove the damaged part of the aorta. Then a synthetic tube-like device called a graft is sewn into place. The graft takes the place of the weakened part of the aorta and allows blood to pass easily. […] Recovery time for endovascular aneurysm repair is usually shorter than for open chest surgery. Long term follow-up care is needed to monitor the stent graft.

• #8 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #8 Thoracic Aortic Aneurysms – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/thoracic-aortic-aneurysms

  Surgery involves a median sternotomy (for ascending and aortic arch aneurysms) or left thoracotomy or thoracoretroperitoneal exposure (for descending and TAAs) and replacement with a synthetic graft. […] Elective surgery is indicated for aneurysms that are large, rapidly enlarging, causing bronchial compression, causing aortobronchial or aortoesophageal fistulas, symptomatic, traumatic, or mycotic. […] Treatment of mycotic aneurysms is aggressive antimicrobial therapy directed at the specific pathogen. Generally, these aneurysms must also be surgically repaired. […] Although open surgical repair of an intact TAA improves outcome, mortality rate may still exceed 7% at 30 days. […] Asymptomatic aneurysms that do not meet criteria for elective surgical or endovascular repair are treated with aggressive blood pressure control using a beta-blocker and other antihypertensives if necessary. […] Patients require frequent follow-ups to check for symptoms and serial CT or ultrasound every 6 to 12 months. Imaging frequency depends on aneurysm size.

• #8 Thoracic Aortic Aneurysm – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/heart-vascular/aortic-disease/thoracic-aortic-aneurysm

  Treatment options for an aortic aneurysm may include one or more of the following: […] Controlling or modifying risk factors: Quit smoking, control blood pressure, manage blood sugar is diabetic/pre-diabetic to help slow the progression of the aneurysm […] Observation: Routine CT scans to monitor the size and rate of growth of the aneurysm […] Medication: Decrease factors such as hyperlipidemia (elevated levels of fats in the blood) and/or high blood pressure […] Open Aneurysm Repair: Replacement of the diseased area of the aorta with a fabric graft […] Endovascular Aneurysm Repair: A minimally invasive alternative to the open repair […] Hybrid Aneurysm Repair: Combination of open surgery and endovascular to repair the aorta. […] Our NEXUS Aortic Arch Clinical Study is investigating the safety and effectiveness of the NEXUS aortic arch stent graft system treatment option.

• #8 Innovative Approaches to Aortic Aneurysm Treatment | Surgery | U of U School of Medicine

  https://medicine.utah.edu/surgery/cardiothoracic/news/2025/02/innovative-approaches-aortic-aneurysm-treatment

  Johnson says FEVAR is ideal for particularly fragile patients who are either too old or too sick to undergo open aneurysm repair. Prior to these minimally invasive FEVAR surgeries, these patients would have a big, old-fashioned open repair, but many would have complications that would send them to a nursing home or cause them to die in the hospital, she said. So, many of these patients were not offered anything. They were told, You have an aneurysm, but we cant fix it. Now, we have something to help them. […] At U of U Health, were willing to offer options to patients when other places have said, There’s nothing that we can do, Johnson said. The need to care for these patients is pushing surgery teams to be innovative.

• #8 Thoracic aortic aneurysm – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/care-at-mayo-clinic/mac-20350197

  Tests to diagnose aortic aneurysms may include echocardiography, computerized tomography angiography, magnetic resonance angiography and others. Genetic testing may be recommended if you have a family history of aneurysms or aneurysm rupture. […] Each year, more than 4,500 people with thoracic aortic aneurysm are seen at Mayo Clinic.

• #9 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Lower thresholds for intervention are recommended when patients have associated conditions that increase the risk of dissection at smaller dimensions and increase the rate of growth. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] Blood pressure control is the cornerstone of medical management of TAA, as it makes pathophysiologic sense to reduce aortic wall shear stress and expansion. […] Interventions for TAA vary widely in complexity and are classified by location and by modality. Patients should be referred to a high-volume cardiac surgery center with aortic expertise for management to optimize outcomes. […] Aneurysm of the ascending aorta mandates surgical repair with median sternotomy, cardiopulmonary bypass, and circulatory arrest. […] On the other hand, aneurysm in the descending aorta can be addressed with endovascular repair using percutaneous access in suitable anatomy. […] Management of TAA is multidisciplinary, with many aspects beyond medications and interventions.

• #9 Aortic Aneurysms: Nonsurgical Treatments

  https://www.healthline.com/health/heart-health/aortic-aneurysm-treatment-without-surgery

  If you have an aortic aneurysm, a doctor will also recommend adopting lifestyle changes that promote heart health. […] Lifestyle changes for aortic aneurysm include quitting smoking, focusing on a heart-healthy diet, getting regular physical activity, and reducing stress. […] For small and some medium-sized aortic aneurysms, regular monitoring may be recommended. […] If your aneurysm is being monitored, a doctor may use nonsurgical treatments to improve your cardiovascular health and reduce the risk from your aneurysm. […] To date, there isn’t a nonsurgical treatment that can reliably shrink or slow the growth of aortic aneurysms. […] Nonsurgical treatments for aortic aneurysms include medications and lifestyle changes. But there currently aren’t any nonsurgical treatments that are guaranteed to slow the growth of aortic aneurysms. […] Surgery is still the main type of treatment for large aortic aneurysms or those that are growing quickly.

• #9 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  A growth rate of 1 cm/y or faster is an indication for elective surgical repair. […] Symptomatic patients should undergo aneurysm resection, regardless of aneurysm size. Acutely symptomatic patients require emergency operation. […] Patients who undergo surgery for symptomatic aortic insufficiency or stenosis with an associated enlarged aneurysmal aorta should have concomitant aortic replacement if the aorta reaches 5 cm in diameter. […] Concomitant aortic replacement should be considered for patients with bicuspid aortic valves with an aorta more than 4.5 cm in diameter. […] For descending TAAs, endovascular stent grafting is less invasive and is an ideal alternative to open repair for patients at high risk for complications of open repair. […] Stent grafts are also a reasonable alternative to open repair in patients who are not at high risk for complications.

• #9 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Surgical treatment of ascending aortic aneurysms depends on the extent of the aneurysm both proximally and distally. […] The choice of operation also depends on the underlying pathology of the disease, the patient’s life expectancy, the desired anticoagulation status, and the surgeon’s experience and preference. […] For elderly patients who cannot undergo a complex operation, another option is reduction aortoplasty. […] Descending TAAs may be repaired with open surgery or, if appropriate, with endovascular stent grafting techniques. […] Stent graft repair of descending TAAs should be performed if the predicted operative risk is lower than that of an open repair. […] Prevention of paraplegia is one of the principal concerns in the repair of descending TAAs and TAAAs. […] For endovascular stent grafting, CSF drainage and avoidance of hypotension are the primary mechanisms used to prevent paraplegia.

• #9 Thoracic aortic aneurysm | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/thoracic-aortic-aneurysm?content_id=CON-20122020

  Types of surgeries and procedures for thoracic aortic aneurysms include: Open surgery. Most people with a thoracic aortic aneurysm have this major surgery. A surgeon removes part of the aorta damaged by the aneurysm. It’s replaced with a tube, called a graft, which is sewn into place. […] Endovascular aortic aneurysm repair (EVAR). This treatment is a less invasive option to open surgery. That means it uses small surgical cuts and may allow a faster recovery. The surgeon places a thin, flexible tube into a blood vessel, usually in the groin, and guides it to the aorta. A graft on the end of the catheter goes where the aneurysm is. Small hooks or pins hold the graft in place. The graft strengthens the weakened part of the aorta. […] Emergency surgery. A ruptured thoracic aortic aneurysm needs emergency surgery. This open-chest surgery is risky. There is a high chance of complications. That’s why it’s important to find and treat thoracic aortic aneurysms before they rupture.

• #9 Endovascular Treatment of a Descending Thoracic Aortic Aneurysm | CTSNet

  https://www.ctsnet.org/article/endovascular-treatment-descending-thoracic-aortic-aneurysm

  A 72 year old white male presented with a complaint of recent onset of upper mid-back pain. […] The patient was evaluated for open surgical repair of the aneurysm, but due to his significant co-morbidities, including COPD, CHF, ASA class IV status and severely depressed ejection fraction, he was felt not to be a surgical candidate. Therefore, he was offered endovascular repair of the aneurysm through an Investigator Device Exemption (IDE), Institutional Review Board-approved clinical protocol for the treatment of high-surgical risk patients with DTA pathologies. […] Despite recent advances in surgical technique with respect to open resection of DTA aneurysms, such as distal aortic perfusion, cerebrospinal fluid drainage and lumbar artery re-implantation, this approach is often associated with significant morbidity associated with the left posterolateral thoracotomy incision.

• #9 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #9 Thoracic Aortic Aneurysm Surgery

  https://my.clevelandclinic.org/health/treatments/17527-thoracic-aortic-aneurysm-surgery

  In TEVAR, the rates of successfully placing the stent are as high as 99%. Thoracic aortic aneurysm open surgery is also a highly successful procedure. […] Thoracic aortic aneurysm surgery is a procedure to repair a balloon or bulge in your thoracic aorta. There are two types of thoracic aortic aneurysm surgery: open surgery and TEVAR. The type of surgery you have depends on multiple factors, including the size of the aneurysm and your overall health. Thoracic aortic aneurysm surgery is a lifesaving procedure for many people.

• #9 Thoracic aortic aneurysm – BHF

  https://www.bhf.org.uk/informationsupport/conditions/thoracic-aortic-aneurysm

  How is a thoracic aortic aneurysm treated? Treatment of a thoracic aortic aneurysm varies from regular health checks to emergency surgery. The type of treatment depends on the cause, size, location and growth rate of the thoracic aortic aneurysm. Your doctor will talk to you about the best option for you. If you have been diagnosed with a thoracic aneurysm, it is likely that you’ll be monitored with echocardiograms and CT scans every six or 12 months, to see if there are signs of changes in your aneurysm. How fast the aneurysm grows (if at all) will be different for everyone. […] Medicines may be prescribed to control risk factors such as high blood pressure and high cholesterol. These may include: angiotensin receptor blocker, beta blockers, statins. […] Other treatments include: Endovascular aortic aneurysm repair (EVAR). This involves tubes called stents put into your arteries to let blood flow freely. Your surgeon may recommend heart surgery (if your thoracic aneurysm has grown too much, causes symptoms, or if you have Marfan syndrome.) This involves removing the section of the aorta where the aneurysm is and replacing it with a new aorta made of synthetic (man-made) material, called a graft. Personalised external aortic root support (PEARS). This procedure can be offered to people with Marfan syndrome where the bottom of the aorta is very big. A special sleeve is made to put around the aorta to stop it getting bigger.

• #9 Aortic Aneurysm Treatment at Emory Heart & Vascular

  https://www.emoryhealthcare.org/services/heart-vascular/treatments/aortic-aneurysm-treatment

  The cardiovascular experts at Emory Heart Vascular offer a wide range of treatments for aortic aneurysms. We will work with you to find the right therapy that meets your needs. […] Our specialists may first try to treat and control your aneurysm with medication. Medications to lower your blood pressure and cholesterol can help. But you still may need surgery. In those cases, our experts offer a variety of traditional, endovascular and minimally invasive procedures to fix your aortic aneurysm. These include: Aortic Root Surgery, Mechanical Composite Root Replacement, Reimplantation Valve Sparing Root Replacement, Tissue Valved Conduit Repair, Ross Procedure. […] Emory aortic surgeons perform more than 700 open and endovascular aortic procedures annually and perform more aortic dissections than any other medical center in Georgia. In addition to performing surgeries for a high volume of patients, our physicians also treat patients who simply need medical management alongside those who need more complex treatments. […] Our pioneering surgeons are also involved in many clinical trials that look at new aortic devices and treatments. This research gives you access to therapies that may not be available anywhere else.

• #10 Understanding Thoracic Aortic Aneurysm | Hull University Teaching Hospitals NHS Trust

  https://www.hey.nhs.uk/patient-leaflet/understanding-thoracic-aortic-aneurysm/

  Treatment options […] Treatment depends on many factors, such as the size and location of the aneurysm, your age and underlying health. It may include regular monitoring, medication, surgery when the aneurysm gets to a certain size, or endovascular treatment a less invasive repair where a stent is placed inside the aorta to repair the aneurysm. […] Regular monitoring, good blood pressure control, and lifestyle modifications are essential to manage the condition effectively.

• #10 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  A growth rate of 1 cm/y or faster is an indication for elective surgical repair. […] Symptomatic patients should undergo aneurysm resection, regardless of aneurysm size. Acutely symptomatic patients require emergency operation. […] Patients who undergo surgery for symptomatic aortic insufficiency or stenosis with an associated enlarged aneurysmal aorta should have concomitant aortic replacement if the aorta reaches 5 cm in diameter. […] Concomitant aortic replacement should be considered for patients with bicuspid aortic valves with an aorta more than 4.5 cm in diameter. […] For descending TAAs, endovascular stent grafting is less invasive and is an ideal alternative to open repair for patients at high risk for complications of open repair. […] Stent grafts are also a reasonable alternative to open repair in patients who are not at high risk for complications.

• #10 Treatment for Thoracic Aortic Aneurysm (TAA) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/thoracic-aortic-aneurysm/treatments.html

  Percutaneous endovascular stent graft repair of descending thoracic aortic aneurysms: A method of reinforcing an aneurysm in the aorta using a stent, which is a tube made of metal mesh or coil. The stent helps prevent the aneurysm from bursting […] For symptomatic aneurysms, immediate intervention is indicated.

• #10 Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure

  https://www.upmc.com/services/heart-vascular/services/procedures/tevar

  Endovascular repair is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery. […] TEVAR is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection in your chest without open surgery. […] You may be a candidate for TEVAR if you have a thoracic aortic aneurysm or aortic dissection in your chest that is large or growing. […] TEVAR is used to repair thoracic aortic aneurysms. […] TEVAR does involve some risk. […] Complications of TEVAR may include: Infection, Bleeding, Blood vessel injury, Aortic dissection, Aneurysm rupture, Stent failure or migration during deployment, Kidney damage from dye used during surgery to guide stent placement, Paralysis of the lower body. […] Treatment may involve either: Watchful waiting, Your doctor will monitor your condition with CT scans and control your blood pressure with drugs. […] Surgery, Your doctor will recommend TEVAR or an open chest aortic aneurysm repair. […] After TEVAR, many patients can live full, active lives with routine follow-up care. […] The TEVAR is a highly successful procedure for reducing the risk of aortic rupture.

• #10 Integrated Aortic Program | Thoracic Aneurysm Program

  https://www.valleyhealth.com/services/integrated-aortic-program

  Valleys Integrated Aortic Program offers regular follow-up and careful management to ensure you receive high quality care based on the latest evidence. […] Every patient in the Integrated Aortic Program receives an individualized treatment plan that includes managing risk factors such as high blood pressure and high cholesterol. […] For most patients, regular surveillance combined with risk factor management is enough treatment to safely manage their aneurysm. […] Treatment options include: Surgery, if needed, David procedure (valve-sparing aortic root replacement), Endovascular repairs or stents. […] If surgery is necessary, our cardiac and vascular surgeons are experienced in a wide variety of aneurysm procedures and techniques, with a focus on personalized treatment plans and the highest degree of care quality and patient safety. […] Valleys team uses advanced technology and genetic tools to tailor treatment to every patient. […] Through participating in and sharing research opportunities, we can provide our patients with the most innovative surgical and endovascular techniques and technologies.

• #10 Thoracic Aortic Aneurysms – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/thoracic-aortic-aneurysms

  Surgery involves a median sternotomy (for ascending and aortic arch aneurysms) or left thoracotomy or thoracoretroperitoneal exposure (for descending and TAAs) and replacement with a synthetic graft. […] Elective surgery is indicated for aneurysms that are large, rapidly enlarging, causing bronchial compression, causing aortobronchial or aortoesophageal fistulas, symptomatic, traumatic, or mycotic. […] Treatment of mycotic aneurysms is aggressive antimicrobial therapy directed at the specific pathogen. Generally, these aneurysms must also be surgically repaired. […] Although open surgical repair of an intact TAA improves outcome, mortality rate may still exceed 7% at 30 days. […] Asymptomatic aneurysms that do not meet criteria for elective surgical or endovascular repair are treated with aggressive blood pressure control using a beta-blocker and other antihypertensives if necessary. […] Patients require frequent follow-ups to check for symptoms and serial CT or ultrasound every 6 to 12 months. Imaging frequency depends on aneurysm size.

• #10 Thoracic Aortic Aneurysm: Types, Symptoms, & Treatment | AHN

  https://www.ahn.org/services/cardiovascular/conditions/thoracic-aortic-aneurysm

  Our team taps the expertise of doctors from different fields. We develop a treatment plan specific to your health condition and needs. AHN participates in clinical trials for carotid artery stenting and new therapies at the Cardiovascular Research Institute. […] Cardiovascular surgeons at (AHN) Cardiovascular Institute are leaders in performing thoracic endovascular aortic aneurysm repair (TEVAR) and have years of experience with procedures such as aortic arch, ascending trifurcated graft, valve-sparing aortic root, bicuspid aortic valve, elephant trunk, thoracoabdominal aneurysm repair, complicated Type B dissection management, and profound hypothermic circulatory arrest.

• #11 Thoracic Aortic Aneurysms: Causes and Treatment | Doctor

  https://patient.info/doctor/thoracic-aortic-aneurysms

  Thoracic aortic aneurysm treatment and management […] Thoracic aneurysms have been managed with treatment with -blockers and routine surveillance imaging, followed by surgical repair of the aneurysm when the risk of dissection exceeds the risk for repair. Therefore, there is a window to initiate therapies to slow aortic enlargement and delay or ideally prevent the need for surgical repair of the aneurysm to prevent a dissection. […] Who needs surgery? Immediate/urgent surgery is needed for: Ruptured TAA. Some types of aortic dissection. Acute symptoms (because these suggest expansion and impending rupture/dissection). […] Symptomatic TAAs merit surgery regardless of their size (because there is a higher risk that they will rupture or dissect). […] Asymptomatic TAAs are assessed to evaluate the relative risks/benefits of surgery. The risk of rupture depends on: Aneurysm diameter. This is the most important factor predicting rupture.

• #11 Thoracic Aortic Aneurysm Treatment | MedStar Health

  https://www.medstarhealth.org/services/thoracic-aneurysm-treatment

  At MedStar Health, our surgeons are now using stent-grafts to repair thoracic aortic aneurysms. This minimally invasive procedure uses a stent-graft devicea cloth-covered metal framethat is expanded within the aorta to alleviate pressure in the aneurysm sac and strengthen the artery wall. The procedure is performed through one small incision in the groin area, rather than large incisions in the chest or abdomen, and uses local anesthesia. This procedure generally requires a one-night hospital stay, compared to 7 to 14 days for major surgery, and has high success rates and less recovery time. […] MedStar Healths expertise with stent-graft repair of abdominal aortic and thoracic aortic aneurysms is unparalleled in the Mid-Atlantic region. We are one of the few FDA-designated research sites in the country, so you can take comfort in our experience and expertise.

• #11 Thoracic Aortic Aneurysm Sydney | Endovascular Aneurysm Repair Sydney

  https://www.sydneyvascularsurgery.com.au/thoracic-aortic-aneurysm.html

  This treatment is often reserved for cases not suitable for endovascular treatment (EVAR). […] In the event of suspected aneurysm rupture, you MUST present at your nearest hospital Emergency Department immediately. […] The risks of aneurysm treatment include: Cardiac complications, Respiratory complications, Kidney complications and damage, Bleeding at the site of repair and/or access, False aneurysm, Pain/Discomfort, Damage to blood vessels, Nerve effects (including those that can cause sexual dysfunction in males), Failure of technique and conversion to alternative approach, Blood clots (DVT/PE), Infection, Infection of the stent graft used for the aneurysm repair, Multiple organ failure (MOF), which can be fatal. […] While the risks of treatment are large, the risk of not treating the aneurysm can be worse.

• #11 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Lower thresholds for intervention are recommended when patients have associated conditions that increase the risk of dissection at smaller dimensions and increase the rate of growth. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] Blood pressure control is the cornerstone of medical management of TAA, as it makes pathophysiologic sense to reduce aortic wall shear stress and expansion. […] Interventions for TAA vary widely in complexity and are classified by location and by modality. Patients should be referred to a high-volume cardiac surgery center with aortic expertise for management to optimize outcomes. […] Aneurysm of the ascending aorta mandates surgical repair with median sternotomy, cardiopulmonary bypass, and circulatory arrest. […] On the other hand, aneurysm in the descending aorta can be addressed with endovascular repair using percutaneous access in suitable anatomy. […] Management of TAA is multidisciplinary, with many aspects beyond medications and interventions.

• #11 Aortic Aneurysm

  https://www.uabmedicine.org/specialties/aortic-aneurysm/

  Depending on arterial anatomy and cause of the aneurysm, thoracoabdominal aneurysms may be treated with endovascular, open, or hybrid techniques. […] Abdominal aortic aneurysms, often referred to as AAA, are the most common type of aortic aneurysm and develop in the section of the aorta below the diaphragm and within the abdomen. […] UAB Medicines vascular and cardiac specialists provide expert treatment of aortic aneurysms using minimally invasive endovascular procedures, open surgical reconstruction, or a combination of both techniques, depending on the location and cause of the aneurysms. […] Repair of complex aneurysms often requires a multidisciplinary approach involving both vascular and cardiac surgeons. […] We maintain an operating room designed specifically for vascular procedures, where we are able to perform hybrid aortic aneurysm repairs, combining both open surgery and minimally invasive endovascular techniques and maximizing the benefits of both. […] Our commitment to innovation and discovery often means that patients have access to advanced new treatments long before they are available to the general public.

• #12 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment may be summarized as follows: Increased aortic size, Rapid aortic growth, Symptomatic aneurysm, Traumatic aortic rupture, Acute type B aortic dissection with associated rupture, leak, distal ischemia, Pseudoaneurysm, Large saccular aneurysm, Mycotic aneurysm, Aortic coarctation, Bronchial compression by aneurysm, Aortobronchial or aortoesophageal fistula. […] Aneurysm surgery has no strict contraindications. […] For patients with acute aortic dissection of the ascending aorta, emergency operation is required. […] Patients with acute dissection of the descending aorta do not necessitate surgical intervention unless complicated by rupture, malperfusion, progressive dissection, persistent recurrent pain, or failure of medical management. […] Most aneurysm repairs involve aortic replacement with a Dacron tube graft.

• #12 Treatment for thoracic aortic aneurysm | Vascular Surgery, The University of Tokyo

  https://vascular-1su.jp/en/clinical/thoracic-aortic-aneurysm-stent-graft/

  Treatment for thoracic aortic aneurysm […] Thoracic aortic aneurysms are usually treated with open thoracic surgery or stent grafts. What makes the treatment difficult is the arterial branches toward the brain (brachiocephalic artery, carotid artery, and subclavian artery). If the aneurysm lesion includes the branches, bypass surgery should be done to preserve the blood flow to the brain. In open surgery, it is called branch reconstruction, and in stent graft treatment, it is called a debranch or hybrid. […] Thoracic endovascular aortic repair (TEVAR), which is a stent graft treatment for the thoracic aorta, basically uses a straight tube, unlike the bifurcated stent graft for the AAA; therefore, the operative procedure is simple. The operative time might be 1 h. However, because the devices are larger than those for abdominal aortic aneurysms, it is sometimes difficult to deliver the devices to the thoracic area through atherosclerotic and stenotic iliac arteries, which can cause vascular damage. In addition, new aortic dissection can occur during device delivery through the atherosclerotic- and dissection-based aorta. In addition, procedures around the orifices of aortic branches to the brain might cause stroke, and lengthy obstruction of the thoracic aorta might cause cerebral infarction and spinal cord paralysis. The TEVAR procedure carries a risk of such severe complications.

• #13 Thoracic Aneurysm Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/761627-treatment

  Indications for surgical repair include the following: Rupture, acute dissection (ascending requires urgent intervention, whereas descending is managed medically or surgically, if vascular complications arise), symptomatic states, including pain, mediastinal organ compression, or aortic insufficiency severe enough to cause CHF or a dilated hypokinetic left ventricle, rapid aneurysm growth rate, absolute size (5.5 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm; in patients with Marfan syndrome, 5.0 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm). […] Surgical and other interventional options for TAA repair include the following: Open approaches using cardiopulmonary bypass, hypothermia, and grafting, endovascular stent grafting may be an option when TAA is limited to the descending aorta. […] Immediately consult with a cardiac surgeon (for ascending aorta or arch) or with a vascular surgeon (for descending aorta) for patients who are hemodynamically unstable or for patients with symptoms of a thoracic aneurysm.

• #13 Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure

  https://www.upmc.com/services/heart-vascular/services/procedures/tevar

  Endovascular repair is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery. […] TEVAR is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection in your chest without open surgery. […] You may be a candidate for TEVAR if you have a thoracic aortic aneurysm or aortic dissection in your chest that is large or growing. […] TEVAR is used to repair thoracic aortic aneurysms. […] TEVAR does involve some risk. […] Complications of TEVAR may include: Infection, Bleeding, Blood vessel injury, Aortic dissection, Aneurysm rupture, Stent failure or migration during deployment, Kidney damage from dye used during surgery to guide stent placement, Paralysis of the lower body. […] Treatment may involve either: Watchful waiting, Your doctor will monitor your condition with CT scans and control your blood pressure with drugs. […] Surgery, Your doctor will recommend TEVAR or an open chest aortic aneurysm repair. […] After TEVAR, many patients can live full, active lives with routine follow-up care. […] The TEVAR is a highly successful procedure for reducing the risk of aortic rupture.

• #14 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment may be summarized as follows: Increased aortic size, Rapid aortic growth, Symptomatic aneurysm, Traumatic aortic rupture, Acute type B aortic dissection with associated rupture, leak, distal ischemia, Pseudoaneurysm, Large saccular aneurysm, Mycotic aneurysm, Aortic coarctation, Bronchial compression by aneurysm, Aortobronchial or aortoesophageal fistula. […] Aneurysm surgery has no strict contraindications. […] For patients with acute aortic dissection of the ascending aorta, emergency operation is required. […] Patients with acute dissection of the descending aorta do not necessitate surgical intervention unless complicated by rupture, malperfusion, progressive dissection, persistent recurrent pain, or failure of medical management. […] Most aneurysm repairs involve aortic replacement with a Dacron tube graft.

• #14 Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure

  https://www.upmc.com/services/heart-vascular/services/procedures/tevar

  Endovascular repair is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery. […] TEVAR is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection in your chest without open surgery. […] You may be a candidate for TEVAR if you have a thoracic aortic aneurysm or aortic dissection in your chest that is large or growing. […] TEVAR is used to repair thoracic aortic aneurysms. […] TEVAR does involve some risk. […] Complications of TEVAR may include: Infection, Bleeding, Blood vessel injury, Aortic dissection, Aneurysm rupture, Stent failure or migration during deployment, Kidney damage from dye used during surgery to guide stent placement, Paralysis of the lower body. […] Treatment may involve either: Watchful waiting, Your doctor will monitor your condition with CT scans and control your blood pressure with drugs. […] Surgery, Your doctor will recommend TEVAR or an open chest aortic aneurysm repair. […] After TEVAR, many patients can live full, active lives with routine follow-up care. […] The TEVAR is a highly successful procedure for reducing the risk of aortic rupture.

• #15 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  Indications for surgical treatment may be summarized as follows: Increased aortic size, Rapid aortic growth, Symptomatic aneurysm, Traumatic aortic rupture, Acute type B aortic dissection with associated rupture, leak, distal ischemia, Pseudoaneurysm, Large saccular aneurysm, Mycotic aneurysm, Aortic coarctation, Bronchial compression by aneurysm, Aortobronchial or aortoesophageal fistula. […] Aneurysm surgery has no strict contraindications. […] For patients with acute aortic dissection of the ascending aorta, emergency operation is required. […] Patients with acute dissection of the descending aorta do not necessitate surgical intervention unless complicated by rupture, malperfusion, progressive dissection, persistent recurrent pain, or failure of medical management. […] Most aneurysm repairs involve aortic replacement with a Dacron tube graft.

• #15 Treatment for thoracic aortic aneurysm | Vascular Surgery, The University of Tokyo

  https://vascular-1su.jp/en/clinical/thoracic-aortic-aneurysm-stent-graft/

  Treatment for thoracic aortic aneurysm […] Thoracic aortic aneurysms are usually treated with open thoracic surgery or stent grafts. What makes the treatment difficult is the arterial branches toward the brain (brachiocephalic artery, carotid artery, and subclavian artery). If the aneurysm lesion includes the branches, bypass surgery should be done to preserve the blood flow to the brain. In open surgery, it is called branch reconstruction, and in stent graft treatment, it is called a debranch or hybrid. […] Thoracic endovascular aortic repair (TEVAR), which is a stent graft treatment for the thoracic aorta, basically uses a straight tube, unlike the bifurcated stent graft for the AAA; therefore, the operative procedure is simple. The operative time might be 1 h. However, because the devices are larger than those for abdominal aortic aneurysms, it is sometimes difficult to deliver the devices to the thoracic area through atherosclerotic and stenotic iliac arteries, which can cause vascular damage. In addition, new aortic dissection can occur during device delivery through the atherosclerotic- and dissection-based aorta. In addition, procedures around the orifices of aortic branches to the brain might cause stroke, and lengthy obstruction of the thoracic aorta might cause cerebral infarction and spinal cord paralysis. The TEVAR procedure carries a risk of such severe complications.

• #16 Thoracic Aneurysm Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/761627-treatment

  Indications for surgical repair include the following: Rupture, acute dissection (ascending requires urgent intervention, whereas descending is managed medically or surgically, if vascular complications arise), symptomatic states, including pain, mediastinal organ compression, or aortic insufficiency severe enough to cause CHF or a dilated hypokinetic left ventricle, rapid aneurysm growth rate, absolute size (5.5 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm; in patients with Marfan syndrome, 5.0 cm for ascending aortic aneurysm, 6.0 cm for descending aortic aneurysm). […] Surgical and other interventional options for TAA repair include the following: Open approaches using cardiopulmonary bypass, hypothermia, and grafting, endovascular stent grafting may be an option when TAA is limited to the descending aorta. […] Immediately consult with a cardiac surgeon (for ascending aorta or arch) or with a vascular surgeon (for descending aorta) for patients who are hemodynamically unstable or for patients with symptoms of a thoracic aneurysm.

• #16 Treatment for thoracic aortic aneurysm | Vascular Surgery, The University of Tokyo

  https://vascular-1su.jp/en/clinical/thoracic-aortic-aneurysm-stent-graft/

  Treatment for thoracic aortic aneurysm […] Thoracic aortic aneurysms are usually treated with open thoracic surgery or stent grafts. What makes the treatment difficult is the arterial branches toward the brain (brachiocephalic artery, carotid artery, and subclavian artery). If the aneurysm lesion includes the branches, bypass surgery should be done to preserve the blood flow to the brain. In open surgery, it is called branch reconstruction, and in stent graft treatment, it is called a debranch or hybrid. […] Thoracic endovascular aortic repair (TEVAR), which is a stent graft treatment for the thoracic aorta, basically uses a straight tube, unlike the bifurcated stent graft for the AAA; therefore, the operative procedure is simple. The operative time might be 1 h. However, because the devices are larger than those for abdominal aortic aneurysms, it is sometimes difficult to deliver the devices to the thoracic area through atherosclerotic and stenotic iliac arteries, which can cause vascular damage. In addition, new aortic dissection can occur during device delivery through the atherosclerotic- and dissection-based aorta. In addition, procedures around the orifices of aortic branches to the brain might cause stroke, and lengthy obstruction of the thoracic aorta might cause cerebral infarction and spinal cord paralysis. The TEVAR procedure carries a risk of such severe complications.

• #17 Thoracic Endovascular Repair for Aortic Aneurysm (TEVAR) Procedure

  https://www.upmc.com/services/heart-vascular/services/procedures/tevar

  Endovascular repair is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection without open surgery. […] TEVAR is a minimally invasive surgery to fix an aortic aneurysm or an aortic dissection in your chest without open surgery. […] You may be a candidate for TEVAR if you have a thoracic aortic aneurysm or aortic dissection in your chest that is large or growing. […] TEVAR is used to repair thoracic aortic aneurysms. […] TEVAR does involve some risk. […] Complications of TEVAR may include: Infection, Bleeding, Blood vessel injury, Aortic dissection, Aneurysm rupture, Stent failure or migration during deployment, Kidney damage from dye used during surgery to guide stent placement, Paralysis of the lower body. […] Treatment may involve either: Watchful waiting, Your doctor will monitor your condition with CT scans and control your blood pressure with drugs. […] Surgery, Your doctor will recommend TEVAR or an open chest aortic aneurysm repair. […] After TEVAR, many patients can live full, active lives with routine follow-up care. […] The TEVAR is a highly successful procedure for reducing the risk of aortic rupture.

• #18 Thoracic Aortic Aneurysm Treatment & Management: Approach Considerations, Medical Therapy, Surgical Options

  https://emedicine.medscape.com/article/424904-treatment

  The use of CSF drainage is selective among most centers. […] Spinal cord ischemia is an uncommon complication following TEVAR, but its development can be identified by a preoperative renal insufficiency. […] Brain protection methods used during DHCA include intraoperative EEG monitoring, evoked somatosensory potential monitoring, hypothermia, and antegrade and retrograde cerebral perfusion. […] Patients who have undergone ascending aneurysm repairs are observed for signs of coronary ischemia, particularly if the coronary ostia were reimplanted, and for signs of aortic insufficiency when the aortic valve is repaired. […] Paraplegia is the main concern in patients who have had descending TAA or TAAA repairs. […] Acute postoperative renal dysfunction may be due to extended periods of ischemic cross-clamping or to hypothermic circulatory arrest.

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