Surgical repair
Surgical repair requires a surgeon to open the chest cavity, clamp off the aorta and sew a fabric tube, called a graft, in place to prevent an aneurysm from rupturing. The surgery takes about 2 to 4 hours to complete. Patients usually stay overnight in the intensive care unit and stay another 7 to 10 days in the hospital. The overall recovery period can last up to 3 months.

Open surgical repairs carry high health risks for many older people, who may also suffer from other significant medical conditions such as heart disease, lung disease, diabetes or hypertension. Complications from surgery may include loss of leg function, irregular heartbeats, stroke, bleeding and kidney damage.

Observation
Many physicians place people who are ineligible for surgery under observation and monitor the progress of the aneurysm. Patients who are monitored are at risk of suffering a ruptured thoracic aortic aneurysm. An untreated ruptured thoracic aortic aneurysm can be fatal.

Endovascular repair
As a third and more recent alternative, researchers are currently studying endovascular repair of thoracic aortic aneurysms. Instead of making a large incision in the chest, the doctor makes a small incision near each hip to access the blood vessels. Through these small incisions, the endovascular graft is inserted into the arteries and positioned into the aorta. The graft seals off the aneurysm and makes a new path through which the blood flows. The graft remains inside the aorta permanently. Typically, endovascular repair takes 1 to 3 hours to complete, with a hospital stay of only a few days. The patient can usually return to normal activity within 4 to 6 weeks after the procedure.

Endovascular repair requires routine follow-up visits with the doctor. Tests will be done to evaluate the procedure and monitor success of the treatment. There is also a possibility that additional treatment or surgery may be required after the initial endovascular repair.

Several clinical trials are underway to determine the safety and effectiveness of endovascular treatment of thoracic aortic aneurysms. To find out more about one of these trials – the STARZ-TX2 trial – please click the forward arrow.