An aortic aneurysm is a bulge in the wall of the aorta, the body's main artery. About 200,000 people in the US are diagnosed each year. Treatment depends on size and location: small aneurysms are watched, larger ones may need surgery or a stent placed through the leg.
What's actually going on in research
Trials are testing medications that might slow aneurysm growth, new stent devices that work for complex anatomy, and ways to predict which small aneurysms will grow quickly. Researchers are also studying inflammation markers that may guide treatment timing and examining genetic factors that raise risk.
Medications to slow growth
Drugs targeting inflammation and blood vessel remodeling are being tested to see if they can prevent small aneurysms from enlarging. The goal is to delay or avoid surgery in people who are poor surgical candidates.
Complex stent devices
New branched and fenestrated stents allow repair of aneurysms near major branch arteries, areas that previously required open surgery. These devices are expanding the number of people who can have minimally invasive repair.
Imaging and prediction tools
Studies are testing CT and ultrasound methods that measure wall stress and material properties, not just diameter. Better prediction could help decide who needs early repair and who can safely wait.
What to know before you search
Eligibility typically depends on aneurysm size, location, anatomy, prior treatments, and whether the person is healthy enough for surgery or a stent procedure.
What types of trials are currently open
- Device trials — Testing new stent grafts for complex aneurysms, including those involving branch arteries near the kidneys or head. Some compare different device designs.
- Medication trials — Testing drugs that may slow aneurysm growth, often in people with small aneurysms being watched. These include blood pressure medications and drugs targeting inflammation.
- Imaging studies — Testing new CT or ultrasound methods to predict which aneurysms will grow or rupture, beyond simple size measurements.
- Surgical technique trials — Comparing different approaches to open repair or different ways to manage complications during stent placement.
- Natural history studies — Following people with small aneurysms over time to learn which factors predict growth and rupture risk.
Recently added Aortic Aneurysm trials
Receive aortic repair surgery with a tested flushing technique
FlushTEVAR is a non-profit, interventional, randomized, controlled, single-blind, national multicenter study promoted by the University of Bologna and coordinated by the Vascular Surgery Unit of IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, under the direction of Prof. Mauro Gargiulo, who also serves as Principal Investigator. The study aims to develop and evaluate a pre-implant thoracic endograft flushing technique using carbon dioxide (CO₂) to reduce periprocedural embolic events and cerebral infarctions in patients undergoing Thoracic Endovascular Aortic Repair (TEVAR). TEVAR is currently the treatment of choice for acute aortic syndromes and aneurysms involving the descending thoracic aorta. Despite its widespread use, TEVAR remains associated with significant neurological complications, with an incidence ranging from 3% to 8% in standard procedures and reaching up to 16% in more complex endovascular interventions. Cerebral embolization caused by solid and gaseous particles is considered the main cause of perioperative stroke and silent brain infarction (SBI), the latter being defined as ischemic brain injury detected by neuroradiological imaging in the absence of immediate clinical symptoms. During TEVAR, approximately 90% of microembolic signals detected in the middle cerebral artery are caused by gaseous emboli, with the highest number occurring during endograft deployment. This phenomenon is associated with the manufacturing and sterilization processes of endografts, during which gas microparticles become trapped between the endograft and its delivery system and are subsequently released into the bloodstream when the device is deployed at the intended aortic site. The primary objective of the study is to assess the difference in the incidence of major neurological events, including stroke and transient ischemic attack (TIA), as well as silent brain infarctions, between patients whose endografts undergo a standardized pre-implant flushing protocol with CO₂ followed by conventional saline flushing, and patients receiving standard saline flushing alone. Major neurological events will be assessed clinically, while silent brain infarctions will be evaluated using study-specific diffusion-weighted magnetic resonance imaging (DW-MRI) of the brain performed within 72 hours after the procedure. A total of 90 patients will be enrolled across four participating centers and randomized in a 1:1 ratio after providing informed consent. Forty-five patients will be allocated to the experimental arm and treated with CO₂ flushing before the standard saline flushing procedure during TEVAR, while forty-five patients will be allocated to the control arm and will receive standard saline flushing only. Eligible patients must be at least 18 years of age and present with type B acute aortic syndrome in the acute, subacute, or chronic phase, or thoracic and thoracoabdominal aneurysms with Crawford extent I, II, III, or IV. Written informed consent is required for participation. Patients will be excluded if the procedure is performed using CO₂ angiography, if endografts without a sheath are used, if emergency endovascular treatment is required, if they have experienced a stroke or TIA within the previous six months, if the proximal sealing zone is 0 or 1, if any contraindication to DW-MRI is present, or in cases of pregnancy or breastfeeding. At study completion, the two treatment groups will be compared on the basis of diffusion-weighted brain MRI findings. The primary endpoint is the number of silent brain infarctions and the determination of whether a statistically significant difference exists between the CO₂ flushing group and the saline flushing group. The safety of the procedure will be evaluated through both technical and clinical success. The planned study duration is three years, and postoperative rates of SBI and TIA/stroke will be compared between groups using Fisher's and Pearson's chi-square tests.
Donate tissue samples to help researchers understand aortic aneurysm development
Ascending aortic aneurysms (AAAs) are serious conditions that can lead to aortic dissections or ruptures, carrying a high risk of mortality. Their pathophysiology is based on complex mechanisms involving inflammatory and metabolic processes, as well as alterations in mitochondrial function. The presence of a bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) significantly influences the progression and severity of aneurysms. Bicuspid aortic valve (BAV) patients often develop aortic aneurysms earlier, as early as age 40-50, whereas tricuspid aortic valve (TAV) patients generally present with a degenerative condition that appears later (after age 50). The objective of this study is to compare the inflammatory, metabolic, and transcriptomic signatures of myeloid cells and total aortic tissue between BAV and TAV patients. These analyses will help identify specific molecular mechanisms, potential biomarkers, and therapeutic targets. To ensure pathophysiological homogeneity, patients with aneurysms of genetic origin (Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, etc.) will be excluded.
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