Aortic Aneurysm
An aortic aneurysm is an abnormal enlargement of the aorta - the body's largest artery. Most are silent until they cause a problem. At MVM, we screen high-risk patients, follow known aneurysms with structured surveillance, and coordinate intervention when size or growth warrants it.
What is an aortic aneurysm?
The aorta is the largest artery in the body - it runs from the heart down through the chest and abdomen, supplying blood to almost every major organ. An aneurysm is an area where the wall of the aorta weakens and balloons outward. As the diameter grows, the wall thins and becomes more prone to rupture or dissection - both of which are life-threatening.
Aneurysms are named by location. Abdominal aortic aneurysms (AAA) are the most common, forming below the kidneys. Thoracic aortic aneurysms occur in the chest. The risk of rupture rises sharply once the aneurysm reaches a certain size - usually around 5.5 cm for abdominal aneurysms in most patients, though the exact threshold depends on the location, growth rate, and patient anatomy.
Most aneurysms are silent. They're often discovered incidentally on imaging done for other reasons. The right management depends on size, location, growth rate, and overall patient health - and ranges from medical management with surveillance to endovascular or surgical repair.
How MVM treats aortic aneurysm.
Patients and referring physicians choose MVM for aortic aneurysm because we run a true surveillance program - patients don't fall off the radar between scans - and we coordinate intervention timing carefully when growth indicates it's needed.
- Same-week consults. New aortic aneurysm patients are typically seen within 5 business days. Newly discovered large aneurysms are triaged for rapid evaluation.
- In-office abdominal ultrasound screening. One-time screening for at-risk patients (especially male former smokers age 65–75) performed in our office.
- Structured surveillance program. Scheduled follow-up imaging at appropriate intervals - patients don't get lost between scans.
- Blood-pressure and risk-factor management. The most important medical interventions for slowing aneurysm growth happen in the clinic, not the operating room.
- Coordinated EVAR and open repair. When repair is needed, we work with high-volume vascular surgery and endovascular teams and stay involved in your care.
- One specialist, full continuum. The doctor who diagnoses you also manages your medications and follow-up imaging.
Schedule an aortic aneurysm consultation.
Most patients are seen within a week. Bring any prior CT or ultrasound imaging, your medication list, and a written summary of your symptoms.
Schedule a consultationSend us an aortic aneurysm referral.
Same-week consults for newly discovered aneurysms, surveillance handoffs, or screening of high-risk patients. Closed-loop reporting back to your office within 48 hours.
Referral processCommon aortic aneurysm symptoms.
Most aortic aneurysms are silent. Symptoms - when they occur - often signal that the aneurysm has grown large, is leaking, or is at risk of rupture.
- Most patients have no symptoms - aneurysms are often found incidentally on imaging
- Deep, throbbing pain in the abdomen or lower back (abdominal aneurysm)
- Chest, upper back, or shoulder pain (thoracic aneurysm)
- A pulsating sensation near the navel
- Hoarseness or trouble swallowing with large thoracic aneurysms
- Cool, clammy skin and lightheadedness - possible signs of rupture (emergency)
- Sudden severe abdominal or back pain - possible rupture (emergency)
- Sudden tearing chest pain radiating to the back - possible aortic dissection (emergency)
Who is most at risk.
- Male sex and age over 65 - particularly high risk in men with a smoking history
- Smoking (current or past) - the single biggest modifiable risk factor for AAA
- Long-standing high blood pressure
- Family history of aortic aneurysm - first-degree relatives sharply raise risk
- Atherosclerosis, especially in patients with known PAD or coronary disease
- Connective tissue disorders (Marfan, Loeys-Dietz, Ehlers-Danlos) for thoracic aneurysms
- Bicuspid aortic valve for thoracic aortic aneurysms
- High cholesterol
How we diagnose aortic aneurysm at MVM.
Most patients leave their first visit with a clear assessment, a measurement, and a surveillance or intervention plan.
- Focused history and exam - including abdominal palpation for a pulsating mass
- Screening abdominal ultrasound - recommended one-time screening for men age 65–75 who have ever smoked
- Surveillance abdominal ultrasound - for known aneurysms below repair threshold
- CT angiography (CTA) - the most detailed imaging for size, shape, and planning intervention
- Transthoracic echocardiogram - for screening the aortic root and ascending aorta
- MR angiography (MRA) - alternative when CT contrast is contraindicated
Treatment options.
Most aortic aneurysms below the repair threshold are managed with surveillance and aggressive risk-factor control. Intervention is reserved for aneurysms that reach size criteria, grow rapidly, or become symptomatic.
Surveillance and medical management
For aneurysms below the threshold for repair, the right plan is structured imaging at defined intervals (every 6–12 months for moderate-size aneurysms) and aggressive medical therapy: blood-pressure control (particularly with beta-blockers when tolerated), statin therapy, smoking cessation (essential), and management of coexisting cardiovascular disease.
Repair options
When the aneurysm reaches size criteria or grows rapidly, repair is indicated. Modern options include:
- Endovascular aortic repair (EVAR) - a stent-graft placed through the femoral arteries to seal off the aneurysm from inside; for abdominal aneurysms with favorable anatomy
- Thoracic endovascular aortic repair (TEVAR) - the analogous procedure for thoracic aneurysms
- Open surgical repair - replaces the aneurysmal segment with a synthetic graft; reserved for cases where endovascular repair isn't anatomically suitable
We coordinate these interventions with high-volume vascular surgery and endovascular teams and stay involved in your pre- and post-procedural care.
Recovery and ongoing care
Recovery from EVAR is usually 1–2 weeks; open repair takes considerably longer. Lifelong imaging follow-up is required after any aortic repair to detect rare complications such as endoleak or graft migration. We see patients at defined intervals after repair and continue medical management indefinitely.
When to see a specialist.
- A newly discovered aortic aneurysm on imaging
- A known aneurysm without a recent surveillance scan
- Family history of aortic aneurysm or sudden cardiac death
- Male, age 65–75, with any smoking history - eligible for one-time screening
- A recommendation for aneurysm repair - second opinions welcome
Call 911 immediately for sudden severe abdominal, back, or chest pain - especially if described as tearing or accompanied by lightheadedness, sweating, or fainting. These can be signs of aneurysm rupture or aortic dissection - both immediate emergencies.
Aortic aneurysm FAQs.
How big is too big?
For most abdominal aortic aneurysms, repair is typically considered around 5.5 cm in men and 5.0 cm in women, though the exact threshold depends on shape, growth rate, and patient anatomy. Thoracic aneurysms have different thresholds. We review the criteria with you in detail.
How fast do aneurysms grow?
Most abdominal aortic aneurysms grow slowly - averaging a few millimeters per year. Growth is faster in larger aneurysms and in active smokers. Quitting smoking is the single biggest thing a patient can do to slow growth.
Are my children at risk if I have an aneurysm?
First-degree relatives of patients with aortic aneurysm have a significantly higher risk and may benefit from earlier screening - typically starting in their 50s, or sooner if there's a connective tissue disorder in the family. We can guide your family on appropriate screening.
What is EVAR, and how is it different from open surgery?
EVAR (endovascular aortic repair) places a stent-graft inside the aneurysm through small access points in the groin - avoiding open abdominal surgery. Recovery is much faster and complication rates are lower for suitable anatomy. Not every aneurysm is anatomically suitable for EVAR; we walk through what fits your specific case.
Will my aneurysm always need to be repaired?
Not necessarily. Many aneurysms remain below repair threshold for years - sometimes indefinitely. Surveillance imaging and medical management are how we make that judgment over time.
Schedule an aortic aneurysm consultation.
Most new patients are seen within a week. Bring any prior CT or ultrasound imaging, the medication list, and a written summary of your symptoms - we'll do the rest.