Aortic Aneurysms: Nonsurgical Treatments (2024)

Nonsurgical treatments for aortic aneurysms, such as medications and lifestyle changes, focus on reducing your risk of an aneurysm growing larger or bursting.

An aneurysm happens when the wall of an artery weakens and begins to bulge out. Aortic aneurysms affect the aorta, the largest artery in your body.

If an aortic aneurysm bursts, it can cause potentially fatal bleeding in your body. According to the Centers for Disease Control and Prevention (CDC), 9,904 people died from aortic aneurysms in 2019.

Surgery is the main treatment for large aneurysms or those that are growing rapidly. Nonsurgical treatments may be an option for small and some medium-sized aortic aneurysms.

This article covers nonsurgical treatment of aortic aneurysms, who’s a candidate, and the outlook for those using nonsurgical approaches.

Nonsurgical treatments for aortic aneurysms fall into two general categories: medications and lifestyle changes.

Medications

Medications for aortic aneurysms aim to prevent the aneurysm from getting larger or bursting. They can also prevent cardiovascular events not related to the aneurysm, such as a heart attack, stroke, or heart failure.

Blood pressure medications lower the pressure that blood flow places on your artery walls. Medications that may be used for aortic aneurysms are:

• beta-blockers
• angiotensin-converting enzyme (ACE) inhibitors
• angiotensin receptor blockers (ARBs)

Statins lower your cholesterol levels, slowing the progress of atherosclerosis, an important risk factor for aortic aneurysms. Statins may also help by lowering inflammation, oxidative stress, and structural changes to your aorta.

Low-dose aspirin may also be used in people with aortic aneurysms that began with atherosclerosis (a buildup of plaque inside your arteries). These help to reduce the activity of platelets, which are involved in blood clotting. Platelets can make factors that contribute to structural changes in your aorta, increasing the risk from an aneurysm.

Lifestyle changes

If you have an aortic aneurysm, a doctor will also recommend adopting lifestyle changes that promote heart health. These changes can help lower the risk associated with aneurysms and improve your cardiovascular health.

Lifestyle changes for aortic aneurysm include:

• quitting smoking
• focusing on a heart-healthy diet
• getting regular physical activity
• reducing stress

For small and some medium-sized aortic aneurysms, regular monitoring may be recommended. This means that the size and growth rate of your aneurysm will be monitored periodically using ultrasounds.

If your aneurysm is being monitored, a doctor may use nonsurgical treatments to improve your cardiovascular health and reduce the risk from your aneurysm.

Additionally, the risks of surgery to repair an aneurysm may outweigh its benefits for some people. In this situation, nonsurgical approaches may also be used.

Treatment of aortic aneurysms focuses on surgical repair of large or fast-growing aneurysms in order to prevent them from bursting. This can be done using open surgery or a minimally invasive technique called endovascular aneurysm repair (EVAR).

To date, there isn’t a nonsurgical treatment that can reliably shrink or slow the growth of aortic aneurysms.

A 2019 review notes that while some clinical studies have found benefits for medications, larger controlled studies haven’t supported these findings.

Effective medical treatment of aortic aneurysms is still an unmet need. This is particularly true for small aortic aneurysms. No benefit has been observed for early treatment of small aortic aneurysms with open surgery or EVAR.

The outlook for people with aortic aneurysms that aren’t treated with surgery will depend on the size of their aneurysm. The rate their aneurysm is growing can also play a role.

Generally speaking, small aortic aneurysms have a very low risk of bursting. Your risk increases as the size of your aneurysm increases.

For example, a 2016 review notes that the 12-month risk of rupture for abdominal aortic aneurysms 4.0–4.9 centimeters (cm), or 1.5–1.9 inches (in), in diameter is just 1%. This increases to 11% when the aneurysm is 5.0–5.9 cm (1.9–2.3 in) in diameter.

It’s also important to take other factors into account when it comes to the outlook of someone with an aneurysm. For example, many people with aortic aneurysms are older adults who may have other underlying health conditions.

A 2016 study of nonsurgical management of large abdominal aortic aneurysms found that the individuals studied were more likely to die from nonaneurysm-related causes. Only a small percentage of people had an aneurysm that burst.

Nonsurgical treatments for aortic aneurysms include medications and lifestyle changes. But there currently aren’t any nonsurgical treatments that are guaranteed to slow the growth of aortic aneurysms.

Medications for aortic aneurysms include things like blood pressure medications and statins. These aim to reduce cardiovascular factors like high blood pressure or high cholesterol that may worsen an aneurysm. Lifestyle changes involve adopting heart-healthy behaviors.

Surgery is still the main type of treatment for large aortic aneurysms or those that are growing quickly. If you have an aortic aneurysm, a doctor will recommend a treatment that’s appropriate for your overall health and the risk of your aneurysm bursting.