Rising Incidence of Aortic Aneurysms in India or Ballooning of the Major Blood Vessel

India

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New Delhi, June 20, 2023:

As the longevity increases the incidence of a major blood vessel (aortic) diseases in India is rising. It is thus important to raise awareness about the importance of early diagnosis and treatment.

An Aortic Aneurysm is the ballooning of the main artery in the body which runs through in the chest and abdomen. Whenever the diameter of these arteries increases to more than 1.5 times the normal diameter it forms an aneurysm. As the size of the aneurysm increases, it can rupture and bleed which can be fatal.

Dr. Rajiv Parakh, Chairman, Peripheral Vascular and Endovascular Sciences, Medanta  Mediclinic Defence Colony, New Delhi and Medanta – The Medicity, Gurugram said, uncontrolled high blood pressure, tobacco intake in any form, smoking, and high cholesterol are the common causes of aortic aneurysm which tends to run in families. Aortic Aneurysms are usually asymptomatic and grow slowly with time. Usually, the first symptom is a pain in the abdomen or back, indicating an increase in size which could be due to rupture or an impending rupture. Other symptoms could be because of the compression of adjoining organs due to the size, like hoarseness of voice, difficulty in swallowing, moving lump in the abdomen, and thumping pulsations in the chest or abdomen. Various guidelines have recommended periodic checkups for elderly and at high-risk patients”.A study published says that 10% of patients 10 years after having undergone any coronary interventions [stenting or bypass] are at risk of developing Aortic Aneurysm.

“Chest X-Ray and Ultrasound abdomen are able to pick up aneurysms in some of the cases. CT Angiography of the chest and abdomen is more confirmatory and is also helpful in sizing and planning the treatment. Depending on the location, existing disease, and general condition, the patient may be offered open surgical or an endovascular procedure” minimally invasive surgery or Keyhole surgery.

Open surgical procedure involves opening the chest or abdomen to expose the diseased aorta, and replacing it with a special tube (polymer-based graft). Though the surgical procedure is considered more durable in the long run, it has serious immediate postoperative complications, especially in elderly patients. The endovascular or minimally invasive procedure involves inserting a special stent graft to treat the aneurysm which allows the blood to flow from the normal aorta above to the healthy Aorta below through the special tube (polymer- based graft).

The Endovascular Repair of Abdominal or Thoracic Aorta (EVAR or TEVAR) is a safer and shorter procedure for treating aortic aneurysms. This procedure can be done either by small cuts in the groin or by needle holes in the groin, which reduces the overall complications and hospital stay of the patient. In case of more complex aneurysms with involvement of kidney or intestinal arteries in the aneurysm, the same can also be treated using special devices for Fenestrated or Chimney Aortic Aneurysm Repair (FEVAR or ChEVAR). Similar techniques are also used for treating complex aneurysm involving the proximal aorta, involving the arteries to the brain and upper limbs.

The safety of the endovascular repair helps in reducing the immediate postoperative complications, and hospital stay and allows the patient to return to work earlier.The surgical time for a standard EVAR or TEVAR procedure usually takes less than an hour and can be done under local anesthesia. The advent of newer stent grafts and structural improvements over the years has made this procedure safer and long-lasting.

Disclaimer: “Any and all the Information provided in the article are independent views expressed by Dr. Rajiv Parakh, Chairman – Peripheral Vascular and Endovascular Sciences, Medanta  Mediclinic Defence Colony, New Delhi, and Medanta – The Medicity, Gurugram is intended for a general overview and educational purposes only. This article is not to be treated as a medical advice. You are required to consult your registered medical practitioner for any clarification around this article”

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