Frequently asked questions about aortic aneurysms

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Am I ticking time bomb?

The risk of complications associated with small aneurysms (< 4–4.5 cm) is generally very low and they may remain stable without the need for surgery or grow at a very slow rate over years.

With respect to medium sized aneurysms (4.5–5.5 cm), it is hard to predict the risk of mid- to long-term complications, so each case must be assessed by a surgeon specialising in aneurysms.

Preventive surgery is usually indicated for aneurysms of more than 5.5–6 cm in diameter because the risk of complications derived from the aneurysm is greater than the risk associated with the intervention. Despite this, it is important to know that emergency/urgent surgery is not normally necessary except in complex cases (ruptured or symptomatic aneurysms, dissections) or if the aneurysm is very large.

I have an aneurysm and they say it could get worse. So why don’t I undergo the operation now?

Every patient is different, and we can only make partial predictions about how each aneurysm will progress. The decision to operate is made when the risks of preventive surgery are no longer greater than the risk of the aneurysm developing into a short-term complication.

When is surgery necessary if I do not have any symptoms?

This depends on the location of the aneurysm, its size and the surgical risk for each patient. Aortic aneurysms measuring 5–6 cm generally require assessment and potentially surgical treatment.

Can I do anything to reduce the size of the aneurysm?

Unfortunately, the damaged section of aorta does not grow smaller over time. There is no medical treatment or lifestyle changes that can reduce aortic aneurysms to a normal size.

What can I do to stop the aneurysm from progressing or developing complications?

Maintaining control over your blood pressure, cardiovascular risk factors and stress are essential to reduce or contain the rate at which the disease progresses. Similarly, it is important that you attend check-ups as regularly as recommended by your healthcare professionals.

How often do I need to have imaging tests to monitor an asymptomatic aneurysm?

If the aneurysm is still far from being large enough to start considering an intervention, annual ultrasound or CT check-ups are usually sufficient. However, when the aorta dilates to a size close to the diameter recommended for surgery, check-ups tend to be carried out more frequently.

I have an aneurysm and the doctors have told me that both endovascular and open surgery are possible – which option is better?

The best option is always selected on an individual basis and adapted to the needs of each patient and each aneurysm. Given that several techniques are sometimes possible for a single case, you should pay close attention to the advice from the specialists skilled in the treatment of this type of disease and at centres that can offer all possible treatment options.

How long will I need to recover if I undergo open surgery?

The postoperative recovery period depends on the size and location of the aneurysm. Most patients spend approximately 1 week in hospital and the first 24–48 hours in intensive care. You may require around 3 months to recover in function of your evolution.

How can aortic aneurysms be prevented?

The best preventive measures are to follow a healthy lifestyle with a low-fat diet, exercise regularly, avoid stress and control any cardiovascular risk factors such as smoking, high cholesterol, high blood pressure and diabetes.

Substantiated information by:

Eduardo Quintana Obrador
Xavier Yugueros

Published: 10 March 2020
Updated: 10 March 2020

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