The aorta is the main artery carrying blood from the heart to the rest of the body. As a vascular surgeon, I treat a whole range of conditions of the aorta. Probably the best known of these are aneurysms, or enlarged areas of the blood vessel, that can rupture if allowed to grow untreated — a life-threatening event.

The most commonly affected area is in the abdomen, at about the level of the navel. Aneurysms also can occur in the chest, which is called the thoracic aorta, and people with aortic aneurysms are also more likely to form aneurysms in the arteries of the pelvis and legs.

Typically, people do not have any symptoms of an aortic aneurysm until it is dangerously large and either ruptured or threatening to rupture. The good news about aneurysms is that if they are detected prior to this stage, they are very treatable. Often, aneurysms are detected during imaging, such as ultrasound, CT scan or MRI, performed for other reasons. In certain groups of people at increased risk for forming aneurysms, a simple screening ultrasound is recommended. Medicare recommends ultrasound for men ages 65 to 75 who have a history of smoking and for anyone with a family history of aneurysms. The Society for Vascular Surgery also supports screening of those older than 75 in relatively good health with a history of smoking.

Aneurysms of the aorta have been treated effectively by surgically replacing the enlarged section of aorta with a fabric graft since Dr. Michael DeBakey and others pioneered these operations in the 1950s. Today, one of the most exciting areas of vascular surgery is the incredible technical advances that have been made in the minimally invasive treatment of a wide range of conditions, including aneurysms. These days, the majority of aneurysms can be effectively treated with stents introduced through very small incisions in the groin, turning what used to be a three- to five-day day hospital stay into an overnight stay.

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Dr. Margaret C. Tracci is a vascular and endovascular surgeon at the University of Virginia Health System.

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