Thoracoabdominal aortic aneurysm treatment in 522 Vascular surgery clinics worldwide

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522 clinics specializing in Vascular surgery providing treatment of Thoracoabdominal aortic aneurysm A thoracoabdominal aortic aneurysm is a life-threatening condition characterized by the abnormal dilation of the aorta's segment spanning the chest and abdomen, increasing the risk of rupture, leading to severe internal bleeding and potential mortality.
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disease worldwide.

Africa · 7
Americas · 100
Asia · 182
Europe · 212
Oceania · 21
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Africa · 7 Americas · 100 Asia · 182 Europe · 212 Oceania · 21
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Prices for popular procedures:
  1. Abdominal aortic aneurysm repair
    $13,981
  2. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $13,833
  3. Carotid endarterectomy (CEA)
    $3,814
  4. Arteriovenous (AV) fistula surgery
    ≈ $1,847
  5. Endovascular thrombectomy
    ≈ $3,488
  6. Catheter-directed sclerotherapy (CDS) (Unilateral)
    $158
  7. Unilateral varicose veins surgery
    $1,237
  8. Surgical thrombectomy
    ≈ $9,848
  9. Reconstructive surgery for peripheral artery disease (PAD)
    ≈ $7,052
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Tallinn, Estonia
Specializations: Cardiac surgery, Vascular surgery, Oncology
Languages: English, Estonian, Russian
The Hospital of Reconstructive Surgerywas founded at Keila Hospital initially under the name of Keila Cardiac Clinic in October 1993. Due to focusing on reconstructive read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $14,594
  2. Aortography
    ≈ $900
  3. Aortic arch replacement
    ≈ $6,839
  4. Thoracic aortic aneurysm surgery
    ≈ $8,270
  5. Abdominal aortic aneurysm repair
    ≈ $10,958
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $10,872
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $10,278
  8. Aortic reconstruction
    ≈ $5,407
  9. Carotid endarterectomy (CEA)
    ≈ $3,084
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Bratislava, Slovakia
Specializations: Cardiac surgery, Vascular surgery
The National Institute of Heart and Vascular Diseases is one of the most modern and best-equipped Slovak hospitals, the top institution of cardiovascular medicine in read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $23,505
  2. Aortography
    ≈ $1,043
  3. Aortic arch replacement
    ≈ $8,945
  4. Thoracic aortic aneurysm surgery
    ≈ $11,039
  5. Abdominal aortic aneurysm repair
    ≈ $11,667
  6. Aortic reconstruction
    ≈ $5,487
  7. Carotid endarterectomy (CEA)
    ≈ $925
  8. Foam sclerotherapy (Unilateral)
    ≈ $422
  9. Peripheral artery angioplasty and stent placement
    ≈ $3,884
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Budapest, Hungary
Specializations: Cardiac surgery, Vascular surgery
The task of the György Gottsegen National Cardiovascular Institute is the complex cardiovascular examination and non-invasive, invasive therapy of the entire spectrum of cardiovascular diseases read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $23,505
  2. Aortography
    ≈ $1,043
  3. Aortic arch replacement
    ≈ $8,945
  4. Thoracic aortic aneurysm surgery
    ≈ $11,039
  5. Abdominal aortic aneurysm repair
    ≈ $11,667
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $12,938
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $12,975
  8. Aortic reconstruction
    ≈ $5,487
  9. Arteriovenous (AV) fistula surgery
    ≈ $1,393
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Budapest, Hungary
Specializations: Cardiac surgery, Vascular surgery
Languages: English, German
The Heart and Vascular Clinic of Semmelweis University in Városmajor is a center where patients with cardiology, heart surgery and vascular surgery profiles are cared read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $22,735
  2. Aortography
    ≈ $1,244
  3. Aortic arch replacement
    ≈ $9,886
  4. Thoracic aortic aneurysm surgery
    ≈ $11,701
  5. Abdominal aortic aneurysm repair
    ≈ $10,769
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $13,795
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $12,534
  8. Aortic reconstruction
    ≈ $6,536
  9. Bentall surgery
    ≈ $10,475
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Mumbai, India
Specializations: Cardiac surgery, Vascular surgery
Asian Heart Institute (AHI), India's No. 1 Heart Care Hospital, has been set up with an aim to provide world-class cardiac care in India. In read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $66,332
  2. Aortography
    ≈ $3,251
  3. Aortic arch replacement
    ≈ $22,867
  4. Thoracic aortic aneurysm surgery
    ≈ $32,320
  5. Abdominal aortic aneurysm repair
    ≈ $25,019
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $49,562
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $52,960
  8. Aortic reconstruction
    ≈ $13,734
  9. Peripheral artery angioplasty and stent placement
    ≈ $11,198
photo
Ottawa, Canada
Specializations: Cardiac surgery, Vascular surgery
Languages: English, French
The University of Ottawa Heart Institute has flourished into one of Canada’s most distinguished heart health centres for the unparalleled care it provides to its read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $66,332
  2. Aortography
    ≈ $3,251
  3. Aortic arch replacement
    ≈ $22,867
  4. Thoracic aortic aneurysm surgery
    ≈ $32,320
  5. Abdominal aortic aneurysm repair
    ≈ $25,019
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $49,562
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $52,960
  8. Aortic reconstruction
    ≈ $13,734
  9. Bentall surgery
    ≈ $44,794
photo
Saint John, Canada
Specializations: Cardiac surgery, Vascular surgery
Languages: English, French
As New Brunswick’s only tertiary cardiac care centre, we provide close to a million Atlantic Canadians with the treatments they need and the care they read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $4,486
  2. Aortography
    ≈ $363
  3. Aortic arch replacement
    ≈ $2,652
  4. Thoracic aortic aneurysm surgery
    ≈ $2,715
  5. Abdominal aortic aneurysm repair
    ≈ $4,084
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $1,634
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $4,072
  8. Aortic reconstruction
    ≈ $1,969
  9. Peripheral artery angioplasty and stent placement
    ≈ $1,228
photo
Kyiv, Ukraine
Specializations: Cardiac surgery, Vascular surgery
The Heart Institute is the flagship of Ukrainian cardiology and cardiac surgery, equipped with the latest technology, where the most experienced doctors daily fight for read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $6,752
  2. Aortography
    ≈ $483
  3. Aortic arch replacement
    ≈ $3,864
  4. Thoracic aortic aneurysm surgery
    ≈ $4,080
  5. Abdominal aortic aneurysm repair
    $8,165 - $8,750
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $7,342
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $7,628
  8. Aortic reconstruction
    ≈ $2,935
  9. Foam sclerotherapy (Unilateral)
    ≈ $183
photo
Minsk, Belarus
Specializations: Cardiac surgery, Vascular surgery
State Institution "Republican Scientific and Practical Center" Cardiology "is the leading scientific, medical, organizational, methodological and educational institution. The center provides a full range of read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $93,114
  2. Aortography
    ≈ $6,456
  3. Aortic arch replacement
    ≈ $51,223
  4. Thoracic aortic aneurysm surgery
    ≈ $55,004
  5. Abdominal aortic aneurysm repair
    ≈ $56,073
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $73,857
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $64,451
  8. Aortic reconstruction
    ≈ $34,687
  9. Arteriovenous (AV) fistula surgery
    ≈ $7,394
photo
Berlin, Germany
Specializations: Cardiac surgery, Vascular surgery
Languages: Arabic, Chinese, English, French, German, Russian, Spanish; Castilian
Helping people with heart disease by providing the best possible medical care using the very latest technology – that’s the mission of the medical and read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $93,114
  2. Aortography
    ≈ $6,456
  3. Aortic arch replacement
    ≈ $51,223
  4. Thoracic aortic aneurysm surgery
    ≈ $55,004
  5. Abdominal aortic aneurysm repair
    ≈ $56,073
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $73,857
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $64,451
  8. Aortic reconstruction
    ≈ $34,687
  9. Peripheral artery angioplasty and stent placement
    ≈ $19,931
photo
Munich, Germany
Specializations: Cardiac surgery, Vascular surgery
The German Heart Center Munich - clinic at the Technical University of Munich - is a specialist hospital for heart and circulatory diseases. For over read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $82,506
  2. Aortography
    ≈ $3,004
  3. Aortic arch replacement
    ≈ $27,378
  4. Thoracic aortic aneurysm surgery
    ≈ $36,525
  5. Abdominal aortic aneurysm repair
    ≈ $30,226
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $23,797
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $23,797
  8. Aortic reconstruction
    ≈ $12,629
  9. Peripheral artery angioplasty and stent placement
    ≈ $10,614
photo
Okayama, Japan
Specializations: Cardiac surgery, Vascular surgery
Languages: English, Japanese
The Sakakibara Heart Institute of Okayama is one of the most prestigious cardiovascular institutes in Japan, and was established in 1932 by Dr Toru Sakakibara. read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $9,983
  2. Aortography
    ≈ $501
  3. Aortic arch replacement
    ≈ $6,817
  4. Thoracic aortic aneurysm surgery
    ≈ $7,841
  5. Abdominal aortic aneurysm repair
    ≈ $6,049
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $13,570
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $12,145
  8. Aortic reconstruction
    ≈ $4,200
  9. Uterine artery embolization (UAE)
    ≈ $2,455
photo
Almaty, Kazakhstan
Specializations: Cardiac surgery, Vascular surgery
Languages: English, Kazakh, Russian
Kazakh Scientific Research Institute of Cardiology was organized in November 1977. according to the decision of the Central Committee of the Communist Party of Kazakhstan read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $57,438
  2. Aortography
    ≈ $2,521
  3. Aortic arch replacement
    ≈ $22,902
  4. Thoracic aortic aneurysm surgery
    ≈ $37,347
  5. Abdominal aortic aneurysm repair
    ≈ $21,757
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $24,278
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $20,255
  8. Aortic reconstruction
    ≈ $6,119
  9. Foam sclerotherapy (Unilateral)
    ≈ $1,130
photo
Saint-Denis, France
Specializations: Cardiac surgery, Vascular surgery
The CCN is a medico-surgical establishment specializing in the management of cardiovascular pathologies. With its team of specialists and the use of innovative techniques, the read more
Prices for popular procedures:
  1. Complex aortic surgery
    by request
  2. Aortography
    by request
  3. Aortic arch replacement
    by request
  4. Thoracic aortic aneurysm surgery
    by request
  5. Abdominal aortic aneurysm repair
    by request
  6. Abdominal endovascular aneurysm repair (EVAR)
    by request
  7. Thoracic endovascular aneurysm repair (TEVAR)
    by request
  8. Aortic reconstruction
    by request
  9. Implantable cardioverter-defibrillator implantation (ICD)
    by request
photo
Lima, Peru
Specializations: Cardiac surgery, Vascular surgery
The National Cardiovascular Institute "Carlos Alberto Peschiera Carrillo" - INCOR is a specialized reference center of EsSalud, with management autonomy, belonging to level III - read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $23,505
  2. Aortography
    ≈ $1,043
  3. Aortic arch replacement
    ≈ $8,945
  4. Thoracic aortic aneurysm surgery
    ≈ $11,039
  5. Abdominal aortic aneurysm repair
    ≈ $11,667
  6. Aortic reconstruction
    ≈ $5,487
  7. Carotid endarterectomy (CEA)
    ≈ $925
  8. Foam sclerotherapy (Unilateral)
    ≈ $422
  9. Arteriovenous (AV) fistula surgery
    ≈ $1,393
photo
Debrecen, Hungary
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Orthopedic surgery, Oncology
The Clinical Center provides the high quality implementation of patient care in University of Debrecen. In the Clinical Center of University of Debrecen more than read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $72,146
  2. Aortography
    ≈ $2,283
  3. Aortic arch replacement
    ≈ $23,240
  4. Thoracic aortic aneurysm surgery
    ≈ $32,634
  5. Abdominal aortic aneurysm repair
    ≈ $27,853
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $27,835
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $26,857
  8. Aortic reconstruction
    ≈ $9,813
  9. Foam sclerotherapy (Unilateral)
    ≈ $1,515
photo
New Plymouth, New Zealand
Specializations: Cardiac surgery, Vascular surgery, Orthopedic surgery, Oncology
Established in 1983, and the only private surgical hospital in the city, it provides services to around 4000 patients each year. Our team provides services read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $35,816
  2. Aortography
    ≈ $1,426
  3. Aortic arch replacement
    ≈ $12,091
  4. Thoracic aortic aneurysm surgery
    ≈ $17,502
  5. Abdominal aortic aneurysm repair
    ≈ $15,072
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $14,736
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $12,026
  8. Aortic reconstruction
    ≈ $4,643
  9. Carotid endarterectomy (CEA)
    ≈ $5,886
photo
Bogota, Colombia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Orthopedic surgery, Oncology
"Méderi is a University Hospital that has an agreement with the Universidad del Rosario and other university institutions in the country, for which it bases read more
Prices for popular procedures:
  1. Complex aortic surgery
    ≈ $41,388
  2. Aortography
    ≈ $1,628
  3. Aortic arch replacement
    ≈ $14,253
  4. Thoracic aortic aneurysm surgery
    ≈ $18,102
  5. Abdominal aortic aneurysm repair
    ≈ $15,736
  6. Abdominal endovascular aneurysm repair (EVAR)
    ≈ $18,238
  7. Thoracic endovascular aneurysm repair (TEVAR)
    ≈ $17,463
  8. Aortic reconstruction
    ≈ $7,263
  9. Foam sclerotherapy (Unilateral)
    ≈ $775
photo
Tijuana, Mexico
Specializations: Cardiac surgery, Vascular surgery, Orthopedic surgery
At Hospital Excel, your health and safety are our main priority, so we have additional security measures to keep you and your family, as well read more
Prices for popular procedures:
  1. Abdominal endovascular aneurysm repair (EVAR)
    from $1,654
  2. Thoracic endovascular aneurysm repair (TEVAR)
    from $1,535
  3. Carotid endarterectomy (CEA)
    from $591
  4. Peripheral artery angioplasty and stent placement
    from $886
  5. Arteriovenous (AV) fistula surgery
    ≈ $873
  6. Endovascular thrombectomy
    from $472
  7. Carotid angioplasty and stenting
    from $1,063
  8. Uterine artery embolization (UAE)
    from $1,181
  9. Inferior vena cava (IVC) filter placement
    $591
photo
Moscow, Russia
Specializations: Cardiac surgery, Vascular surgery, Thoracic surgery, Orthopedic surgery, Oncology
In "SM-Clinic" on the street. Senezhskaya is based in the Center for Weight Correction, which has collected almost all the possibilities to help people with read more

Clinics grouping by rating

Clinic with the highest rating of 5 — Clinical Hospital Lapino in Moscow, Russia and 5 more, clinic with the most reviews number of 35757 — Aster CMI hospital in Bengaluru, India.

With rating 4.0 and over — 172 clinics .

Countries with the highest number of clinics treating the diseases:

Thoracoabdominal aortic aneurysm:

Related procedures:

Thoracoabdominal aortic aneurysm: Overview and Treatment Options

Introduction

A thoracoabdominal aortic aneurysm is a pathologic local expansion of a section of the main artery throughout its entire length due to the weakness of its walls. Depending on the localization, an aortic aneurysm may manifest with pain in the chest or abdomen, the presence of a pulsating tumor-like mass, and symptoms of compression of adjacent organs: dyspnea, cough, dysphonia, dysphagia, swelling, and cyanosis of the face and neck. The basis of aortic aneurysm diagnosis consists of radiological (chest and abdominal radiography, aortography) and ultrasound methods (duplex scanning of the thoracic/abdominal aorta). Surgical treatment of the aneurysm involves its resection with aortic prosthesis or closed endoluminal prosthesis of the aneurysm with a special endoprosthesis.

General information

Aortic aneurysm is characterized by irreversible dilation of the lumen of the arterial trunk in a limited area. The ratio of aortic aneurysms of different localization is approximately as follows: abdominal aortic aneurysms account for 37% of cases, ascending aorta - 23%, aortic arch - 19%, descending thoracic aorta - 19.5%. Thus, thoracic aortic aneurysms in cardiology account for almost 2/3 of all pathology. Thoracic aortic aneurysms are often combined with other aortic malformations - aortic insufficiency and coarctation of the aorta.

Causes

By etiology, all aortic aneurysms can be divided into congenital and acquired. The formation of congenital aneurysms is associated with hereditary diseases of the aortic wall:

  • Marfan syndrome
  • fibrous dysplasia
  • Ehlers-Danlos syndrome.
  • Erdheim's syndrome
  • hereditary elastin deficiency, etc.

Acquired aortic aneurysms can have inflammatory and non-inflammatory etiologies:

  1. Postinflammatory aneurysms result from specific and nonspecific aortitis in fungal lesions of the aorta, syphilis, and postoperative infections.
  2. Non-inflammatory degenerative aneurysms are due to atherosclerosis, defects in suture material, and aortic prostheses.
  3. Hemodynamic-post stenotic and traumatic aneurysms are associated with mechanical injury to the aorta.
  4. Idiopathic aneurysms develop in aortic medionecrosis.

Older age, male gender, arterial hypertension, tobacco smoking and alcohol abuse, and hereditary aggravation are considered risk factors for the formation of aortic aneurysms.

Pathogenesis

In addition to aortic wall defects, mechanical and hemodynamic factors are involved in aneurysm formation. Aneurysms are more likely to occur in functionally stressed areas under increased stress due to high blood flow velocity, steepness of the pulse wave, and its shape. Chronic traumatization of the aorta and increased activity of proteolytic enzymes destroy the elastic framework and cause nonspecific degenerative changes in the vessel wall.

A formed aortic aneurysm progressively increases in size as the stress on its walls increases in proportion to the expansion of its diameter. Blood flow in the aneurysmal sac slows down and becomes turbulent. Only about 45% of the blood volume in the aneurysm enters the distal arterial bed. This is because blood rushes along the walls when entering the aneurysmal cavity, and the turbulence mechanism and the presence of thrombotic masses in the aneurysm restrain the central flow. Thrombus in the aneurysm cavity is a risk factor for thromboembolism of distal aortic branches.

Classification

Several classifications of aortic aneurysms have been proposed in vascular surgery, considering their localization by segments, shape, wall structure, and etiology. In accordance with the segmental classification, the following are distinguished

  • aneurysm of Valsalva sinuses
  • ascending aortic aneurysm
  • aortic arch aneurysm
  • descending aortic aneurysm
  • abdominal aortic aneurysm
  • aneurysm of combined localization - thoracoabdominal aneurysm.

Evaluation of the morphologic structure of aortic aneurysms allows us to subdivide them into true and false (pseudoaneurysms):

  1. A true aneurysm is characterized by thinning and bulging outward of all aorta layers. The etiology of true aortic aneurysms is usually atherosclerotic or syphilitic.
  2. Pseudoaneurysm. The wall of a false aneurysm is represented by connective tissue formed due to the organization of a pulsating hematoma; the native aortic walls are not involved in forming a false aneurysm. By origin, they are more often traumatic and postoperative.

Considering the clinical course, uncomplicated, complicated, and dissecting aortic aneurysms are distinguished. Specific complications of aortic aneurysms include ruptures of the aneurysmal sac accompanied by massive internal bleeding and hematoma formation, aneurysm thrombosis and arterial thromboembolism, and phlegmons of the surrounding tissues due to infection of the aneurysm.

A particular type is a dissecting aortic aneurysm, when, through a rupture of the inner membrane, blood penetrates between the layers of the arterial wall and spreads under pressure along the course of the vessel, gradually dissecting it.

Symptoms of an aortic aneurysm

Clinical manifestations of aortic aneurysms are variable and determined by the localization, size of the aneurysmal sac, extent, and etiology of the disease. Aneurysms may be asymptomatic or accompanied by scanty symptomatology and detected during preventive examinations. The leading manifestation is pain due to the lesion of the aortic wall, its stretching or compression syndrome.

Abdominal aortic aneurysm

The clinic of abdominal aortic aneurysm is manifested by transient or persistent diffuse pain, abdominal discomfort, belching, heaviness in the epigastrium, sensation of gastric overflow, nausea, vomiting, bowel dysfunction, and weight loss. Symptomatology may be associated with compression of the cardiac section of the stomach, the duodenum, and the involvement of visceral arteries. Often, patients independently determine the presence of increased pulsation in the abdomen. On palpation, a tense, dense, painful pulsating mass is detected.

Thoracic aortic aneurysm

Aortic aneurysm of the ascending aorta is characterized by pain in the heart region or behind the sternum due to compression or stenosis of the coronary arteries. Patients with aortic insufficiency are bothered by dyspnea, tachycardia, and dizziness. Large aneurysms cause the development of superior vena cava syndrome, which includes headaches and swelling of the face and upper half of the trunk.

Aortic arch aneurysm leads to esophageal compression with dysphagia; in case of compression of the recurrent nerve, there is voice hoarseness (dysphonia), dry cough; vagus nerve involvement is accompanied by bradycardia and salivation. In compression of the trachea and bronchi, dyspnea and stridor breathing develop; in compression of the lung root - congestion and frequent pneumonia.

Pain in the left arm and scapula occurs when a descending aortic aneurysm irritates the periaortic sympathetic plexus. If the intercostal arteries are involved, spinal cord ischemia, paraparesis, and paraplegia may develop.

Thoracoabdominal aortic aneurysm

This type of aortic aneurysm is characterized by a combination of abdominal and thoracic symptoms, so the clinical presentation is usually more varied. In addition, this type of aneurysm increases the likelihood of life-threatening complications such as rupture or dissection of the aneurysm.

Complications

A rupture with massive bleeding, collapse, shock, and acute heart failure may complicate aortic aneurysms. Aneurysm rupture can occur in the superior vena cava system, pericardial and pleural cavity, esophagus, and abdominal cavity. This leads to severe, sometimes fatal conditions - superior vena cava syndrome, hemopericardium, cardiac tamponade, hemothorax, and pulmonary, gastrointestinal, or intra-abdominal bleeding.

When thrombotic masses detach from the aneurysmal cavity, a picture of acute occlusion of the limb vessels develops cyanosis, pain in the toes, and intermittent claudication. Renovascular arterial hypertension and renal failure occur in renal artery thrombosis; stroke occurs in cerebral artery lesions.

Diagnosis

Diagnostic search for aortic aneurysm includes assessment of subjective and objective data, radiologic, ultrasound, and tomographic studies. An auscultatory sign of aneurysm is the presence of a systolic murmur in the projection of aortic dilation. Abdominal aortic aneurysms are detected by palpation of the abdomen in the form of a tumor-like pulsating formation. Following diagnostic tests are usually used:

  1. Radiography. The plan of radiological examination of patients with thoracic or abdominal aortic aneurysm includes fluoroscopy and chest radiography, review radiography of the abdominal cavity, and radiography of the esophagus and stomach. At the final stage of the examination, aortography is performed to clarify the localization, size, and extent of the aortic aneurysm and its relation to adjacent anatomical structures.
  2. Ultrasound. Echocardiography recognizes ascending aortic aneurysms; otherwise, a duplex scan of the thoracic/abdominal aorta is performed.
  3. Computed tomography (CT) of the thoracic and abdominal aorta allows the accurate and clear visualization of aneurysmal dilation, detection of dissection and thrombotic masses, para-aortic hematoma, and foci of calcinosis.

A comprehensive instrumental examination determines the indications for surgical treatment. Thoracic aortic aneurysms should be differentiated from lung and mediastinal tumors, and abdominal aortic aneurysms should be differentiated from abdominal cavity masses, mesenteric lymph node lesions, and retroperitoneal tumors.

Treatment of aortic aneurysm

An asymptomatic, non-progressive course of aortic aneurysm is limited to dynamic observation by a vascular surgeon and radiologic control. To reduce the risk of possible complications, hypotensive and anticoagulant therapy and cholesterol reduction are performed.

Surgical intervention is indicated in abdominal aortic aneurysms with a diameter greater than 4 cm, thoracic aortic aneurysms with a diameter of 5.5-6.0 cm, or in case of enlargement of smaller aneurysms by more than 0.5 cm in six months. In case of aortic aneurysm rupture, the indications for emergency surgery are absolute.

The surgical treatment of an aortic aneurysm consists of excision of the aneurysm, suturing of the defect, or its replacement with a vascular prosthesis. Taking into account the anatomical localization, aneurysms of the abdominal aorta, thoracic aorta, aortic arch, thoracoabdominal part of the aorta, and infrarenal aorta are resected.

In hemodynamically significant aortic insufficiency, resection of the ascending thoracic aorta is combined with aortic valve prosthesis. Endovascular prosthesis of aortic aneurysm with stent placement is an alternative to open vascular intervention.

Prognosis and prevention

The prognosis of aortic aneurysm is mainly determined by its size and concomitant atherosclerotic lesion of the cardiovascular system. In general, the natural course of aneurysms is unfavorable and is associated with a high risk of death from aortic rupture or thromboembolic complications. Aortic aneurysms with a diameter of 6 cm or more have a 50% annual probability of rupture, and smaller diameters have a 20% annual probability of rupture. Early detection and planned surgical treatment of aortic aneurysms is justified by low intraoperative (5%) mortality and good long-term results.

Preventive recommendations include controlling BP, organizing a proper lifestyle, regular follow-ups with a cardiologist and cardiac surgeon, and drug therapy for concomitant pathology. People at risk of developing aortic aneurysms should undergo a screening ultrasound examination.

  • Isabella Gonzalez, M.D.
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