Six years ago I got stents because of a leaking aneurysm in the aorta. Six months ago, an MRI scan found a new aneurysm with a diameter of 5.6 cm. Because of my age (77 years) and possible complications, it was not considered operable. Now I’ve had a duplex scan; according to the vascular surgeon, the aneurysm is only 4 cm. Can an aneurysm shrink just like that?
Joris Bartstra, journalist with a medical degree.
An aneurysm is a widening of the large body artery (aorta). There is a risk that it will tear one day. The chances of surviving this are slim, because the aorta is the ‘main line’ of the circulatory system. But surgery—to replace a piece of aorta or to reinforce it from the inside with a stent—is also risky. That is why aneurysms are regularly checked and the decision is made: to intervene or not? Action is taken in the event of rapid growth. An aneurysm never shrinks on its own. However, different studies can give different results. The duplex scan (a combination of ultrasound and doppler) mainly shows the blood flow. An MRI scan visualizes anatomical structures, but there are no clear agreements about exactly how an MRI should measure and what size belongs to which risk. An example: during a heartbeat, the circumference of the aorta is larger than in the resting phase. An MRI scan does show exactly what it looks like, so how you can repair it. To check if an aneurysm is growing, ultrasound (duplex scan) is the most common technique. According to European guidelines, an aneurysm between 4 and 5 cm should be checked annually.
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