What is an Aortic Aneurysm?
An aortic aneurysm occurs when a weakened section of the aorta—the largest artery in your body—bulges outward, forming a balloon-like dilation. The aorta carries oxygen-rich blood from the heart to the rest of the body, running from the chest down through the abdomen. When the arterial wall weakens, the constant pressure of blood flow can cause it to expand well beyond its normal diameter.
Aortic aneurysms are classified by their location. An abdominal aortic aneurysm (AAA) develops in the portion of the aorta that passes through the abdomen, while a thoracic aortic aneurysm forms in the chest region. Abdominal aortic aneurysms are considerably more common and represent the type most frequently treated by vascular surgeons.
The primary danger of an aortic aneurysm is rupture. As the aneurysm grows, the arterial wall stretches thinner and becomes increasingly susceptible to tearing. A ruptured aortic aneurysm is a medical emergency with a high mortality rate. This is why early detection through screening and ongoing surveillance by a vascular specialist is so critical. At Vascular Surgical Associates, our team of board certified Vascular Surgeons. has extensive experience managing aortic aneurysms at every stage, from initial detection through surgical repair.
Signs & Symptoms
Most aortic aneurysms grow slowly and silently, producing no symptoms until they become large or rupture. Many are discovered incidentally during imaging studies performed for other reasons. When symptoms do appear, they may include:
Deep Abdominal Pain
A persistent, deep ache in the abdomen or on the side of the abdomen that may come and go or remain constant.
Back Pain
Steady, gnawing pain in the lower back that does not change with movement, often caused by the aneurysm pressing on the spine.
Pulsating Sensation Near the Navel
A noticeable throbbing or pulsating feeling in the abdomen, particularly near the belly button, caused by the enlarged artery.
Abdominal Tenderness
Tenderness or sensitivity when the abdominal area is touched, which may indicate the aneurysm is growing or at risk of complications.
Sudden, Severe Pain (Emergency)
Sudden onset of intense abdominal or back pain, dizziness, rapid pulse, or loss of consciousness may signal a rupture—call 911 immediately.
Risk Factors
Age 65 and Older
The risk of aortic aneurysm increases significantly with age as arterial walls naturally weaken and lose elasticity over time.
Tobacco Use
Smoking is the single strongest risk factor. It damages the aortic wall, accelerates plaque buildup, and significantly increases the rate of aneurysm growth.
High Blood Pressure
Chronic hypertension places ongoing stress on the aortic wall, increasing pressure that can contribute to the formation and expansion of an aneurysm.
Family History
Having a first-degree relative (parent or sibling) with an aortic aneurysm substantially increases your risk, suggesting a genetic component to arterial wall weakness.
Atherosclerosis
The buildup of fatty deposits (plaque) inside the arterial walls weakens the aorta and contributes to aneurysm development over time.
Male Gender
Men are significantly more likely to develop abdominal aortic aneurysms than women, though women who do develop them face a higher risk of rupture.
Diagnosis at VSA
At Vascular Surgical Associates, we use our ICAVL-accredited vascular laboratory to provide precise, reliable diagnostic imaging for aortic aneurysms. Our accreditation ensures that every study meets the highest national standards for accuracy and quality.
The most common initial screening tool is an abdominal ultrasound, a painless, non-invasive test that can accurately measure the diameter of the aorta. For patients who meet screening criteria—particularly men aged 65 to 75 with a history of smoking—this simple test can be lifesaving. When a more detailed evaluation is needed, we use CT angiography (CTA), which provides high-resolution, three-dimensional images of the aneurysm’s size, shape, and relationship to nearby arteries. CTA is essential for surgical planning and determining whether endovascular or open repair is most appropriate.
Our vascular surgeons also perform duplex ultrasound for ongoing surveillance of known aneurysms, allowing us to track growth over time and intervene at the optimal moment. Every diagnostic study is interpreted by our experienced vascular specialists, ensuring accurate results and a personalized treatment plan.
Treatment Options
Treatment for an aortic aneurysm depends on its size, rate of growth, location, and your overall health. Our vascular surgeons develop individualized treatment plans using the latest evidence-based guidelines and surgical techniques.
Surveillance & Monitoring
For small aneurysms (typically under 5.0 cm in men or 4.5 cm in women), regular imaging surveillance is the standard approach. We schedule periodic duplex ultrasound or CT scans to track the aneurysm’s growth, paired with blood pressure management and smoking cessation support to slow progression.
Endovascular Aneurysm Repair
Endovascular Aneurysm Repair is a minimally invasive procedure performed through small incisions in the groin. A stent graft is guided through the femoral arteries and deployed inside the aneurysm, creating a new channel for blood flow and relieving pressure on the weakened arterial wall. Endovascular Aneurysm Repair offers shorter hospital stays, faster recovery, and reduced surgical risk compared to open repair for eligible patients.
Open Surgical Repair
In open repair, the surgeon accesses the aorta through an abdominal incision, clamps the artery above and below the aneurysm, and replaces the diseased segment with a synthetic graft. While more invasive than Endovascular Aneurysm Repair, open repair is highly durable and may be the preferred option for certain aneurysm anatomies or younger patients who need a long-lasting solution.
Medication Management
Regardless of whether surgery is indicated, medications play a key role in managing aortic aneurysm risk. Beta-blockers and other antihypertensives help reduce blood pressure and the rate of aortic expansion. Statins may be prescribed to address underlying atherosclerosis and improve overall cardiovascular health.
Frequently Asked Questions
For most patients, surgical repair is recommended when an abdominal aortic aneurysm reaches 5.0 to 5.5 cm in diameter, or when it grows more than 0.5 cm over a six-month period. Women and patients with certain risk factors may be considered for repair at smaller sizes. Your vascular surgeon will discuss your individual threshold based on your anatomy, overall health, and the aneurysm’s characteristics.
Endovascular Aneurysm Repair is a minimally invasive approach that uses a stent graft inserted through small incisions in the groin. It typically involves a shorter hospital stay (one to two days) and faster recovery. Open repair involves a larger abdominal incision and direct replacement of the diseased aortic segment with a synthetic graft. Open repair generally requires a longer hospital stay and recovery period but offers excellent long-term durability. Our surgeons are highly experienced in both techniques and will recommend the best approach for your specific situation.
Current guidelines recommend a one-time abdominal ultrasound screening for men aged 65 to 75 who have ever smoked. Screening may also be recommended for individuals with a family history of aortic aneurysm, those with other vascular conditions, or anyone with risk factors such as long-standing hypertension. If you are unsure whether you should be screened, our team at Vascular Surgical Associates can help you evaluate your risk.
While lifestyle changes cannot reverse an existing aneurysm, they can significantly slow its growth and reduce the risk of rupture. Quitting smoking is the most impactful step you can take. Maintaining healthy blood pressure through diet, exercise, and medication is also essential. Your vascular surgeon will work with you to develop a comprehensive management plan that addresses all modifiable risk factors.
