Once you are diagnosed with an aortic aneurysm, your doctor will evaluate:

• Whether you need surgery.
• Whether you will be able to withstand a major surgery.
• Whether you can avoid surgery, at least for the present.

Factors such as the shape and flexibility of the aorta and heart valves are also considered in deciding how to treat an aortic aneurysm.

When surgery is recommended

Aortic aneurysms that are causing symptoms or enlarging rapidly are considered at risk of rupturing. Surgery is usually recommended if either of these factors is present.

In men, surgery is also typically recommended for abdominal aortic aneurysms that are 5.5 cm or larger in diameter. In women, surgery may be recommended for smaller aneurysms. Some doctors perform surgery when the aneurysm is smaller, although the risk of rupture is considered low for aneurysms less than 5.5 cm in diameter.^{4, 5}

Surgery is also recommended when a small aortic aneurysm grows more than .5 cm within 6 months.

Surgical repair of thoracic aortic aneurysms is usually recommended when they reach 5.5 to 6 cm in diameter.

Surgical repair of aortic aneurysm

Both traditional surgery and endovascular aortic repair are used to treat aortic aneurysms. Talk to your doctor about which one is best for you.

If you have surgery, a doctor will make a large cut in your chest or belly. Then, your aneurysm will be removed and the damaged portion of your blood vessel will be replaced with a man-made graft.

Some aortic aneurysms can be repaired without traditional surgery, using endovascular aortic repair. A tube called a stent graft is inserted through an artery in the groin to "patch" your aorta. Although this procedure works well right away, experts do not know enough about its long-term effects. Because of this, you will need regular X-rays or CT scans for as long as you have the graft.

Medical treatment for aortic aneurysm

Smaller aneurysms (less than 5.5 cm in diameter) that are not at high risk of rupturing are generally treated with medication used to treat high blood pressure, such as a beta-blocker. Beta-blockers may decrease the rate at which aneurysms grow. In general, the risks of surgery to repair smaller aneurysms outweigh the possible benefits, because smaller aneurysms rarely rupture.

If surgery is not done to repair your aneurysm, you will have routine tests to monitor whether it is getting bigger.

You may need to take medication to treat high cholesterol and high blood pressure. While these measures have not been proven to slow aneurysm growth, they can improve your life in other ways. These measures reduce your risk of dying from heart attack and stroke, which kills most (66%) people with aneurysms.³ For more information, see the topics High Cholesterol and High Blood Pressure (Hypertension).