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Aortic Aneurysm Treatment Singapore

Aortic Disease

aortic aneurysm

These conditions primarily affect the arteries, which are blood vessels responsible for transporting oxygenated blood from the heart to the rest of the body. The aorta, the body’s main and largest artery, can be afflicted by various conditions that compromise its function and structural integrity. These conditions can manifest in various ways, from minor symptoms to life-threatening events. Early diagnosis and treatment are crucial to prevent life-threatening complications.

What is the Aorta?

The aorta is the largest artery in the body, acting as the main blood vessel that transports oxygen-rich blood from the heart to the rest of the body. It starts from the heart, extends through the chest (thoracic aorta), continues down the abdomen (abdominal aorta), and into the pelvis, supplying blood to the legs. Along its course, the aorta branches out to supply vital organs such as the lungs, stomach, liver, intestines, and kidneys.

What is an Aortic Aneurysm?

An aortic aneurysm (AA) is an abnormal bulge or ballooning in the wall of the aorta where it has weakened. This condition can develop in various parts of the aorta:

  • Thoracic Aortic Aneurysm (TAA): Develops in the part of the aorta that runs through the chest, potentially leading to severe chest or back pain, and complications such as aortic dissection or rupture.
  • Abdominal Aortic Aneurysm (AAA): Develops in the part of the aorta that runs through the abdomen. Symptoms may include a pulsating feeling above the navel, deep, constant pain in the abdomen or on the side of the abdomen, or even back pain.
  • Thoracoabdominal Aortic Aneurysm (TAAA): Involves both the thoracic and abdominal segments of the aorta, causing severe pain in both areas and carrying a high risk of rupture.

Who is Affected?

Aortic aneurysms can affect anyone but are more common in men over the age of 65. Risk factors include:

  • Atherosclerosis: Buildup of fat and cholesterol weakens arterial walls.
  • Family History: A family history of aortic aneurysms increases risk.
  • Genetic Conditions: Syndromes like Marfan, Ehlers-Danlos, and Loeys-Dietz increase susceptibility.
  • Tobacco Use: Smoking accelerates atherosclerosis and damages arterial walls.
  • High Blood Pressure: Chronic hypertension weakens arterial walls.
  • Age: Risk increases with age.
  • Gender: Men are more likely to develop aortic aneurysms than women.

Why is it Dangerous?

In its early stages, an aortic aneurysm may not pose an immediate health risk if it is smaller than scientifically established threshold diameters or shapes. However, as it grows, the aneurysm walls stretch and thin, compromising the aorta’s ability to withstand blood pressure. This increases the risk of rupture, which leads to severe internal bleeding and can be fatal without prompt medical intervention.

Diagnosis and Treatment

Early diagnosis and treatment of aortic aneurysms are crucial to prevent life-threatening complications. Regular screening, especially for individuals with risk factors, can help detect aneurysms before they become critical. Treatment options vary based on the size and location of the aneurysm and may include:

  • Monitoring: Regular imaging tests to track the aneurysm’s size and growth.
  • Medication: Managing risk factors such as high blood pressure and cholesterol.
  • Surgery: Repairing the aneurysm through procedures such as open surgical repair, endovascular aneurysm repair (EVAR), or thoracic endovascular aneurysm repair (TEVAR).

Understanding aortic aneurysms and their potential risks underscores the importance of early detection and management to maintain cardiovascular health.

abdominal aortic aneurysm
This refers to an abnormal bulge or ballooning in the wall of the aorta as it passes through the abdomen.

  • Causes of Abdominal Aortic Aneurysm (AAA):

    • Atherosclerosis: The buildup of fat and cholesterol narrows and weakens the arterial walls.
    • Genetics: Individuals with a family history are at a higher risk.
    • Tobacco Use: Smoking accelerates atherosclerosis and damages the arterial wall.
    • High Blood Pressure: Chronic hypertension can weaken the arterial wall over time.

  • Symptoms of Abdominal Aortic Aneurysm (AAA):

    • Many AAAs are silent and asymptomatic and are discovered during routine medical exams.
    • A pulsating feeling near the navel.
    • Deep, constant pain in the abdomen or lower back.

  • Abdominal Aortic Aneurysm (AAA) Treatment Options:

    • Observation: Regular monitoring for smaller aneurysms.
    • Endovascular Repair: A less invasive procedure where an endo-graft is inserted to exclude the aneurysm.
    • Open Repair: A more traditional surgery where the aneurysm is replaced with a graft.
thoracic aortic aneurysm
This involves a bulging or enlargement in the upper part of the aorta that runs through the chest.

  • Causes of Thoracic Aortic Aneurysm:

    • Genetics: Syndromes like Marfans, Ehlers-Danlos and Loeys-Dietz predispose individual to increased risk.
    • High Blood Pressure: Chronic hypertension stresses the arterial wall.
    • Atherosclerosis: Hardening of the arteries with weakening of the arterial walls.

  • Symptoms of Thoracic Aortic Aneurysm:

    • Often silent until it's severe.
    • Chest pain or tightness.
    • Back pain.
    • Shortness of breath or trouble breathing.

  • Thoracic Aortic Aneurysm Treatment Options:

    • Observation: Monitoring for smaller aneurysms.
    • Endovascular Repair: A minimally invasive procedure using a stent-graft.
    • Open Repair: Traditional surgery which is no longer commonly used due to significant risk of problems and death.
aortic dissection

A serious condition where the inner layers of the aorta separate due to a tear, allowing blood to flow between them.

  • Causes of Aortic Dissections:

    • High Blood Pressure: Chronic hypertension is the most common cause.
    • Traumatic Injury: Accidents or injuries can lead to a tear.
    • Genetic Conditions: Syndromes like Marfans, Ehlers-Danlos and Loeys-Dietz predispose individual to increased risk.

  • Symptoms of Aortic Dissections:

    • Sudden, severe chest or upper back pain, often described as a tearing sensation.
    • Shortness of breath or difficulty breathing.
    • Fainting or dizziness.
    • Loss of consciousness

  • Aortic Dissections Treatment Options:

    • Medications: To rapidly lower blood pressure and reduce heart rate.
    • Endovascular Repair: Inserting a stent-graft to repair the dissection and promote aortic remodeling
    • Open Repair: Traditional surgery which is no longer commonly used due to significant risk of problems and death.
iliac aortic aneurysm
An enlargement in the iliac section of the aorta, which branches out to supply blood to the lower body.

  • Causes of Iliac Aortic Aneurysm:

    • Atherosclerosis: Hardening of the arteries with weaked arterial walls.
    • Genetics: A family history can increase risk.
    • Tobacco Use: Smoking or chewing tobacco accelerates atherosclerosis.

  • Symptoms of Iliac Aortic Aneurysm:

    • Often silent and discovered during routine exams.
    • Pelvic or lower back pain.
    • Leg pain, numbness, or weakness.

  • Iliac Aortic Aneurysm Treatment Options:

    • Endovascular Repair: A minimally invasive procedure using a stent-graft.
    • Open Repair: Traditional surgery to replace the affected segment.

Seek Expert Aortic Aneurysm Treatment in Singapore

Aortic diseases can have severe implications if left untreated. If you or a loved one is experiencing any of the symptoms mentioned above, it is crucial to seek expert care immediately. Our team offers comprehensive diagnostic and treatment services tailored to individual needs.

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Frequently Asked Questions About Aortic Aneurysm

An aortic aneurysm is an abnormal enlargement or ballooning of the aorta, the largest artery in the body that carries oxygen-rich blood from the heart to the rest of the body. It occurs when the wall of the aorta weakens and bulges outwards.
Aortic aneurysms primarily affect adults aged 65 and above, with men being more commonly affected. Risk factors include smoking, high blood pressure, atherosclerosis, genetic conditions, and family history.
  • Thoracic Aortic Aneurysm (TAA): Occurs in the chest portion of the aorta.
  • Abdominal Aortic Aneurysm (AAA): Occurs in the abdominal portion of the aorta.
  • Thoracoabdominal Aortic Aneurysm (TAAA): Spans both the thoracic and abdominal areas of the aorta.
In the early stages, small aortic aneurysms may not pose an immediate risk but should be monitored by a vascular surgeon. Larger aneurysms (>5cm in diameter) have a higher risk of rupture, leading to severe internal bleeding and potentially death. The risk of rupture increases with the aneurysm’s size.
Aortic aneurysms often develop without symptoms until they grow significantly or rupture. Common symptoms include a pulsating mass in the abdomen and severe, persistent pain in the abdomen, back, or chest. Immediate medical attention is required if these symptoms occur due to the high risk of rupture. Other symptoms include indigestion, blood clots, and fever if the aneurysm becomes infected.
Aortic aneurysms are typically diagnosed through imaging tests. An ultrasound scan of the aorta is often used for initial screening. A detailed CT scan with contrast provides comprehensive information about the aneurysm’s size, shape, and relation to surrounding arteries and organs.

Treatment is recommended when:

  • The aneurysm’s diameter exceeds 5cm for AAA and 5.5cm for TAA.
  • The aneurysm grows rapidly (more than 5mm every six months).
  • Symptoms such as pain develop.
  • Complications like distal embolization occur.
  • The aneurysm starts to leak or ruptures.
  • Endovascular Aortic Stent Graft Repair (EVAR or TEVAR): A minimally invasive procedure where a stent graft is inserted through the groin vessels to exclude the aneurysm from blood pressure, thereby preventing rupture.
  • Open Surgical Repair: A major operation where the aneurysm is replaced with a graft through an abdominal or chest incision.
Recovery depends on the type of surgery. Endovascular stent graft repair typically involves a shorter hospital stay of 24 to 48 hours. Open surgical repair requires ICU stay and hospital recovery for up to ten days. Post-surgery, regular CT or ultrasound scans are needed to monitor the aneurysm and the effectiveness of the treatment.
Minimally invasive endovascular repair (EVAR & TEVAR) generally have lower risks of complications compared to open surgery and are typically recommended unless other considerations apply.

Close management of chronic medical conditions such as hypertension and cholesterol with medications is crucial. Maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking can also help prevent aortic aneurysms.

For more information about aortic aneurysms, or to schedule a consultation with a vascular surgeon in Singapore, contact our clinic today. Our experienced team is dedicated to providing comprehensive vascular care and advanced treatment options to ensure your health and well-being.

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