Aortic aneurysms and aortic dissections are serious conditions that affect the body’s largest blood vessel, the aorta. The aorta carries blood from the heart to the rest of the body, so when it becomes weakened or torn, it can quickly become life-threatening if not treated. 

Fortunately, treatment has advanced significantly. Many patients can be treated with a minimally invasive procedure that uses a stent which is placed inside the aorta. In some cases, the stent is custom-made to match a patient’s unique anatomy for a safer, more precise repair. In this comprehensive guide, we’ll break down what aortic aneurysms and dissections are, what symptoms to watch for, how minimally invasive endovascular stent repair works, and what patients can expect during recovery.

Quick Answer: How Are Aortic Aneurysms Treated?

Aortic aneurysms are commonly treated in a minimally invasive manner using a stent graft, which is a mesh tube with fabric along the perimeter.  The stent is placed inside the aorta so blood flows within it as opposed to along the aneurysm where the wall is weakened. This approach, called EVAR, TEVAR, or FEVAR, excludes the aneurysm from blood flow thereby preventing rupture. Treatment depends on the aneurysm’s size, location, and the patient’s overall health.

What Is an Aortic Aneurysm?

An aortic aneurysm is when part of the aortic wall weakens and bulges outward. Over time, this bulge can enlarge, making the vessel wall weaker and more prone to rupture, which is a medical emergency. There are three main types of aortic aneurysms, depending on where they occur in the body:

• Abdominal Aortic Aneurysm (AAA): Refers to aneurysms in the lower portion of the aorta as it passes through the abdomen. AAAs, which are the most common type of aneurysm, are often found incidentally during imaging tests, since they often do not cause symptoms until they become larger and/or rupture.
• Thoracic Aortic Aneurysm (TAA): Refers to aneurysms that arise in the upper portion of the aorta as it passes through the chest. Like AAAs, these aneurysms typically do not cause symptoms unless they become very large and so they are mainly discovered incidentally when imaging is obtained for other reasons.
• Thoracoabdominal Aortic Aneurysm (TAAA): Refers to aneurysms that involve the aorta as it passes from the chest into the abdomen. These are the most complicated aneurysms to treat due to several important arteries that branch off the aorta in this area to feed the intestines and kidneys.

What Is an Aortic Dissection?

The aortic wall is made of three layers of tissue.  An aortic dissection occurs when a tear develops in the innermost layer of the aorta. Blood then flows between the layers of the vessel wall, causing them to separate. This is often a medical emergency because it can quickly disrupt blood flow to vital organs. Unlike aneurysms, dissections typically cause sudden and severe symptoms such as intense chest or back pain.

Aortic Aneurysm Symptoms

Most aortic aneurysms develop without noticeable symptoms. When symptoms do appear, they often indicate that emergency care is needed:

• Chest Or Back Pain: A lingering discomfort from pressure on nearby structures
• Abdominal Pulsing Sensation: A noticeable heartbeat-like feeling in the abdomen
• Hoarseness Or Swallowing Difficulty: Caused by pressure on nearby nerves or structures in the chest when aneurysms become large

Aortic Dissection Symptoms

Aortic dissections usually cause sudden, severe symptoms that require emergency care:

• Sudden Severe Chest Or Back Pain: Often described as tearing or ripping pain
• Pain That Spreads: May move to the neck, jaw, abdomen, or back
• Shortness Of Breath: Due to strain on the heart
• Fainting Or Dizziness: From sudden changes in blood flow or pressure
• Weak Pulse Or Blood Pressure Differences: One arm may feel weaker or lower in pressure

Who Is at Risk for Aortic Aneurysms and Dissections?

Several factors can increase the risk of developing aortic disease, including:

• Long-term high blood pressure
• Smoking history
• Older age
• Family history of aortic conditions
• Connective tissue disorders

For high-risk individuals, doctors may recommend screening with imaging such as ultrasound or CT scans to detect problems early.

How Minimally Invasive Endovascular Aortic Stent Repair Works

Endovascular aortic repair is performed through small puncture sites or incisions, typically in the groin. A thin catheter is guided through the blood vessels to the affected area of the aorta. A stent graft is then placed inside the vessel to reinforce the weakened or damaged section of the aorta while permitting normal blood flow to the rest of the body.

In more complex cases, surgeons may use custom-made stent grafts designed from detailed CT imaging. These devices are tailored to the patient’s exact anatomy and allow for ongoing blood flow to the intestines and kidneys, which standard devices do not permit.

What Is Recovery Like After Aortic Stent Repair?

Recovery varies depending on the type of repair performed and each patient’s overall health. Most patients can expect a structured recovery plan with close follow-up care:

• Hospital Recovery Period: Patients are closely monitored after the procedure to ensure stable blood flow and proper healing before discharge.
• Return To Activity: Walking and regular activity is encouraged early, with a step-by-step return to normal daily activities over time.
• Incision Care And Healing: If groin access sites are used, patients receive instructions on keeping the area clean and watching for signs of irritation or infection.
• Follow-Up Imaging Appointments: Routine scans are scheduled to confirm the stent is working properly and the aorta remains stable.
• Ongoing Lifestyle And Medical Management: Blood pressure control, medications, and healthy lifestyle habits are often important for long-term protection of the aorta.

Advanced Aortic Care at Florida Medical Clinic Orlando Health

At Florida Medical Clinic Orlando Health, patients with aortic aneurysms and dissections are evaluated and treated by experienced vascular surgeons who specialize in complex aortic disease. Advanced imaging is used to carefully assess the aorta and determine the most appropriate treatment approach for each patient. When appropriate, patients may be candidates for minimally invasive endovascular stent repair, including custom-made devices designed for complex anatomy. Care is focused on early detection, precise treatment, and long-term follow-up to support better outcomes. With several convenient locations across the region, patients can access specialized vascular care without having to travel far from home.

Meet Dr. Dean Arnaoutakis

Dr. Dean Arnaoutakis is a board-certified vascular surgeon specializing in advanced vascular and endovascular procedures, including complex aortic aneurysms, aortic dissections, carotid artery disease, and peripheral arterial disease. He completed his medical training at Weill Cornell Medical College, residency at Johns Hopkins Hospital, and fellowship at Harvard University/Brigham and Women’s Hospital. Dr. Arnaoutakis did additional training in France focusing on complex endovascular aortic surgery. He offers both open and minimally invasive/endovascular treatment options for aortic disease, including custom-made stents. Dr. Arnaoutakis is committed to helping patients clearly understand their condition and treatment options.