Home » Thoracic aortic aneurysm: what it is, what the causes are and how to treat it

Thoracic aortic aneurysm: what it is, what the causes are and how to treat it

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Thoracic aortic aneurysm: what it is, what the causes are and how to treat it

diAntonella Sparvoli

A thoracic aneurysm is an abnormal dilation of the aorta. It usually does not cause symptoms but can become a serious threat to health in the event of a blood vessel rupture

Thoracic aortic aneurysm is usually not felt, but its presence can be a serious threat to your health. If this permanent dilation of the aorta ruptures, often fatal internal bleeding occurs. When the risk of rupture is high, therefore, preventive surgical treatment must be taken into consideration, which can now also be performed with less invasive endovascular techniques compared to traditional open surgery.

What is a thoracic aneurysm and what causes it?

«The aorta is the largest artery in the human body. The thoracic aorta, in particular, is the section that originates from the left ventricle of the heart and reaches the diaphragm. Normally this artery has a diameter of two-three centimeters, however, for various reasons it can undergo, in one of its sections, a dilation: when this reaches four centimeters in diameter we begin to speak of an aneurysm – explains Roberto Chiesa, director of the Vascular Surgery Unit at the Irccs San Raffaele Hospital in Milan and former full professor of Vascular Surgery at the Vita-Salute San Raffaele University. The causes are not well defined, but the risk factors that can favor the weakening of the aorta wall and its dilation are known. These include family history, smoking, uncontrolled hypertension, high levels of fat in the blood and, more generally, anything that can promote atherosclerosis. In some cases, especially in young people, thoracic aneurysm is linked to particular genetic diseases of the connective tissue.”

What are the treatments for thoracic aneurysm?

«If the aneurysm is small in size with a low risk of rupture, it should be kept under control by performing a chest CT scan, annually or biannually, following the specialist’s instructions. Generally speaking, the risk of rupture is higher the larger the aneurysm and the faster its evolution. Repair surgery is usually considered when the aneurysm exceeds 5 and a half centimeters, certainly when it exceeds 6 and in the presence of symptoms. In patients with genetic diseases of the connective tissue, the surgical indication already exists for aneurysms above 5 centimeters”, concludes Chiesa.

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What type of surgery is performed, when indicated?

Until 20 years ago, thoracic aneurysm repair operations were performed only with an open chest, but over the years endovascular techniques have been introduced. «Open surgery is maintained for young patients and those with genetic diseases, while we prefer to use the new endovascular procedures above 65-70 years of age» reports Chiesa. «Endovascular treatment is burdened by fewer immediate complications. For some years, especially for thoraco-abdominal aneurysms, we have been able to use prostheses with ramifications that allow the aneurysm to be excluded, maintaining the vascularization of the various organs. These are operations performed only in a few centers and which often require the construction of tailor-made prostheses” points out Professor Andrea Kahlberg, coordinator of the Vascular Emergency Area of ​​the Vascular Surgery Unit of the San Raffaele in Milan.

February 28, 2024 (modified February 28, 2024 | 11:28)

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