Treatment for aortic aneurysms that are small (usually less than 4.5 cm in diameter) consists of controlling associated risk factors (elevated cholesterol, smoking and high blood pressure). These small aneurysms should be monitored frequently to note any changes in size. The treatment for aortic aneurysms that reach a certain size (usually > 5 cm) or are enlarging over time is surgical repair. The surgeon replaces the damaged part of the aorta with a tube of synthetic material. Most candidates for aneurysm surgery have extensive cardiovascular disease, therefore there is about a 4% risk of heart complications, double the risk for most other kinds of surgery. For this reason, doctors usually wait until the aneurysm is 4.5 cm in diameter before operating, or if there is evidence of expansion or symptoms.A new treatment involves inserting a synthetic tube, called a stent, inside the aorta, at the point of disease. This procedure repairs aortic aneurysms without the trauma of surgery. All of the pressure in the blood pushes against the walls of the tube, and not against the weakened natural walls of the aorta, reducing the chance of rupture.
