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Aneurysm

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Definition

An aneurysm is an abnormal widening, bulge or ballooning of a part of a blood vessel due to weakness in the wall of the blood vessel. The bulge slowly enlarges and progressively increases in size.

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Types

  • Aneurysms are either:
    • Congenital (present before birth).
    • Acquired (develop due to a disease condition).
  • Depending on the location of the blood vessel involved, an aneurysm can be in the:
    • Aorta (the major artery from the heart)
      • Abdominal aortic aneurysms
      • Thoracic aortic aneurysms
    • Brain (cerebral aneurysm)
    • Leg (Popliteal artery aneurysm)
    • Intestine (Mesenteric artery aneurysm)
    • Splenic artery (an artery leading to the spleen) aneurysm

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Causes

  • It is not clear exactly what causes aneurysms.
  • Congenital or inherited weakness in an artery wall that makes them more susceptible to aneurysm e.g. people with Marfan syndrome.
  • Defects in some of the components of the artery wall may be responsible.
  • Hypertension (abdominal aortic aneurysms)
  • Smoking
  • Traumatic injury to the chest cage or abdomen.
  • Vasculitis - Inflammation of the internal lining of the blood vessel wall
  • Atherosclerotic disease (cholesterol buildup in arteries) may contribute to the formation of certain types of aneurysms.
  • Pregnancy is often associated with the formation and rupture of aneurysms of the splenic artery

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Symptoms

  • A pulsating or throbbing sensation in the middle of the abdomen, near your belly button.
  • Tenderness or pain in the abdomen
  • Localized bulge or swelling.
  • Dull pain in the back

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Implications

The most dangerous implications of aneurysm include rupture, infection, and compression of local structures. Rupture of an aneurysm can cause massive internal bleeding, which can be life threatening or often fatal. This is commonly seen with abdominal aortic aneurysms, mesenteric artery aneurysms, and splenic artery aneurysms. Rupture of aneurysms in the brain can cause stroke, disability and death. If the aneurysm ruptures during surgery and bleeding cannot be controlled, it ca result in death. Infection of the aneurysm, which may follow infection at other sites of the body, can lead to septicemia and rupture. In certain cases, aneurysms can compress neighboring structures such as nerves, leading to neurologic problems, such as weakness and numbness. This can occur with popliteal artery aneurysm. Clotting of the aneurysm occurs when blood stops moving inside the aneurysm, blocking further blood flow past the site of the aneurysm and depriving tissues of their blood supply beyond this point. This may result in sudden pain and sometimes a cold, numb sensation and loss of strength. If the blood flow is not restored quickly, part of your leg or foot may be permanently damaged or even require amputation. The blood clot may break loose and travel to the brain causing stroke or transient ischemic attack. The aneurysm may get dissected i.e. it tears along the wall of the blood vessel (most commonly abdominal aorta) and bleeding occurs into and along the aortic wall.

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What You Can Do

  • Prevention
    • Control of high blood pressure may help prevent some aneurysms.
    • Control of all risk factors associated with atherosclerotic disease (diet, exercise, cholesterol control) may help prevent aneurysms or their complications.
    • Scientists have discovered that you can add three and a half years to your life with regular exercise and your heart can benefit from simple exercises such as brisk walking for half-hour a day. A study found several walking routines can improve heart health: walking for 30 minutes three or four days a week, moderately or briskly, improved cardio-respiratory fitness. Fast-paced walking five days or more per week can lower cholesterol levels in the short-term.
    • Call your physician if you develop any new mass on your body, whether or not it is throbbing.
  • Treatment
    • Surgical excision is generally recommended. The timing and indications for surgery differ depending on the type of aneurysm.
      • Open abdominal or chest surgery - This operation repairs an aortic aneurysm. The damaged section of the blood vessel is replaced with a synthetic tube (graft), which is sewn into place. Although this surgery is generally successful, because it requires an incision in your abdomen or chest, the recovery time can be lengthy.
      • Endovascular surgery - Also called a stent-graft. In the procedure, a synthetic graft is attached to the end of a thin tube (catheter) and is inserted into your bloodstream, usually through an artery in your leg. Once in place, the graft is inflated and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

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Aneurysm