Thoracoabdominal Aortic Aneurysm in Nice
Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes
Treatment of Thoracoabdominal Aortic Aneurysm
Dr. Ilya Khantalin in Nice
Thoracoabdominal aortic aneurysm is a serious condition requiring specialized management in a dedicated center due to the significant risks it entails.
Today, arterial diseases are treated using modern techniques validated by the Haute Autorité de Santé (French National Authority for Health), with an approach that emphasizes innovation and compliance with recognized surgical protocols.
As a vascular surgeon, Dr. Ilya Khantalin, based at the Arnault Tzanck Institute in Saint-Laurent-du-Var near Nice, assists you in understanding, treating, and monitoring this condition.
Here you will find essential information about thoracoabdominal aortic aneurysm, its treatments, surgical indications, and the necessary follow-up.
Vascular diseases are recognized as Long-Term Illnesses (Affections de Longue Durée – ALD), allowing for 100% coverage by French Social Security.
What Is a Thoracoabdominal Aortic Aneurysm?
Vascular Surgeon in Saint-Laurent-du-Var
A thoracoabdominal aortic aneurysm is an abnormal dilation of the wall of the aorta—the main artery of the human body that supplies blood to various vital organs. This type of aneurysm extends through a portion of the aorta that lies in both the thoracic and abdominal regions. This location distinguishes it from purely abdominal or thoracic aortic aneurysms, which involve more limited segments.
The aneurysm typically forms due to weakening of the aortic walls, caused by various risk factors, including high blood pressure, smoking, hypercholesterolemia, and certain hereditary factors. Over time, the aneurysm may enlarge, thereby increasing the risk of rupture, which can be fatal.
Symptoms and Treatment of Thoracoabdominal Aortic Aneurysm
Vascular Surgery Specialist in Saint-Laurent-du-Var
Symptoms of Thoracoabdominal Aortic Aneurysm
The presence of a thoracoabdominal aortic aneurysm is often asymptomatic, especially in the early stages.
However, when the aneurysm begins to compress surrounding structures or grows significantly, symptoms may appear, including:
- Persistent abdominal or chest pain
- Back pain, potentially radiating to the legs
- A pulsating sensation in the abdomen, sometimes palpable
- Difficulty breathing and shortness of breath
- Digestive or urinary issues due to compression of nearby organs
In case of such symptoms, early screening can enable timely diagnosis, thus minimizing the risk of complications.
Treatment of Thoracoabdominal Aortic Aneurysm
Treatment depends primarily on the size of the aneurysm, its progression, and the associated risks for the patient.
Active Surveillance
For small aneurysms (generally less than 5 cm in diameter), close monitoring is often recommended. This non-invasive approach involves regular imaging exams—such as CT angiography or ultrasound—to assess the aneurysm’s progression and determine the appropriate timing for surgical intervention.
Surgical Treatment: Endograft and Open Surgery
When the aneurysm reaches a critical size (typically greater than 5.5 cm in high-risk patients) or shows rapid growth, surgery is advised. Two primary surgical techniques are available:
- Fenestrated Endograft (Endovascular Repair):
This minimally invasive approach involves inserting a graft into the dilated segment of the aorta through an incision in the femoral artery. The endograft reinforces the aortic wall and restores normal blood flow, preventing rupture. This technique is often favored in patients with comorbidities that make open surgery risky. - Open Surgery:
This procedure involves making a large incision across both abdominal and thoracic regions to access the aorta and replace the dilated segment with a synthetic graft, followed by reimplantation of the digestive arteries. Though more invasive and requiring longer recovery, open surgery offers durable results and is often preferred for complex aneurysms or in younger, physically fit patients.
Treatment Indications and Decision Criteria
Treatment indications for thoracoabdominal aortic aneurysm are based on several criteria:
- Aneurysm Size: In general, a diameter greater than 5–5.5 cm is an indication for surgery.
- Growth Rate: Rapid expansion (more than 0.5 cm per year) warrants urgent intervention.
- Associated Symptoms: The onset of pain or signs of compression necessitates prompt treatment.
- Overall Health Status: Comorbidities (hypertension, diabetes, kidney failure, etc.) influence the choice between open surgery and endograft.
Postoperative Follow-Up of Thoracoabdominal Aortic Aneurysm
After treatment, rigorous follow-up is essential to prevent recurrence and monitor the vascular prosthesis if one has been implanted.
- Imaging Follow-Up: Regular imaging exams—usually CT angiography or ultrasound—are performed to assess the condition of the graft, aortic patency, and the absence of postoperative complications.
- General Medical Follow-Up: Patients are encouraged to adopt a healthy lifestyle. Blood pressure control, cholesterol management, and smoking cessation are critical measures to reduce complications and prolong graft life.
- Routine Consultations: Depending on the associated risks and type of procedure, regular consultations with the vascular surgeon are scheduled.
Thoracoabdominal aortic aneurysm is a condition requiring specialized care in a dedicated surgical center. Dr. Ilya Khantalin, vascular surgeon, offers personalized treatment and thorough follow-up for each patient. Thanks to advances in vascular surgery, current treatments significantly reduce the risks associated with this condition.
Early screening and regular monitoring remain the most effective ways to prevent severe complications related to thoracoabdominal aortic aneurysm.
For more information about managing this condition or to schedule a consultation, please contact Dr. Khantalin.