What is a thoracic aortic aneurysms and how is it treated?

In January, a study in the Journal of Vascular Surgery found that women are more likely than men to suffer complications, including death, from a minimally invasive vascular surgical procedure to repair thoracic aortic aneurysms. The reason: surgical devices too large for women’s anatomy.

Below is information about thoracic aneurysms and how they are treated. Read the press release on this study here.

What is the aorta?
The aorta is the body’s largest artery, which circulates oxygen-rich blood from the heart throughout the body. The aorta starts in the heart and extends to the abdomen.

What is a thoracic aortic aneurysm?
When the aorta weakens and stretches out, it can bulge, causing a life-threatening condition called an aortic aneurysm. A thoracic aortic aneurysm is a bulging of the aorta in the chest area, under the rib cage. 

Who treats thoracic aortic aneurysms?
Vascular surgeons have advanced training in diseases of arteries and veins. They are the only doctors trained in all the possible ways of treating vascular disease, including medical treatment, noninvasive testing, minimally invasive surgery, and open surgery. Patients can locate a vascular surgeon at the Society for Vascular Surgery's website.

What is TEVAR?
Thoracic endovascular aortic repair (TEVAR) is a minimally invasive way to treat a thoracic aneurysm. TEVAR is the standard of care for patients with thoracic aneurysms as long as their anatomy allows treatment. Patients undergoing TEVAR have fewer complications than patients undergoing open surgery and are often discharged from the hospital within 48 hours. 

What is an iliac artery?
At the abdomen, the aorta branches off into two smaller arteries known as the common iliac arteries. Vascular surgeons use the iliac artery in TEVAR. Generally, these arteries are smaller in women than in men, which contributes to higher complication rates in women for TEVAR.

Who is at risk for a thoracic aortic aneurysm?
Thoracic aneurysms affect 15,000 Americans annually. The risk factors are:

  • Age, 65 and older
  • History of smoking or chewing tobacco 
  • High blood pressure
  • Arteries damaged by plaque build-up, also known as atherosclerosis
  • Family history 
  • Connective tissue disorder, such as Marfan Syndrome

What are the symptoms?
Most patients do not have any symptoms. Some patients may experience:

  • Pain in the jaw, neck, and upper back
  • Chest or back pain
  • Coughing, hoarseness, or difficulty breathing

Who should be screened?
People who fit either category should discuss a screening with their doctor.

  • Family history (parent, child or sibling) of thoracic aortic aneurysm 
  • Connective tissue diseases 

How is it diagnosed?
Thoracic aneurysms are diagnosed primarily by CT scans or MRI.  Because this aneurysm is within the chest, it is impossible for a doctor to detect during a physical examination.