Aneurysm

An aneurysm is an abnormal bulge in the wall of an artery, an inflated balloon of blood. Aneurysms can occur in many parts of the body. They usually develop where pressure is strongest, that is, in areas where blood vessels divide and branch off. An aneurysm is extremely dangerous since it may result in rupture and subsequent hemorrhage or in the development of a serious clot.

Causes of an Aneurysm

There is no clearly recognized cause for the development of an aneurysm. Some aneurysms are congenital, already present at birth. Others may result from a slight defect in part of an arterial wall. Though there is no known cause of aneurysms, there are risk factors which make it more likely that a particular individual may develop one. These risk factors may include:

  • Poor elasticity of arterial walls
  • Plaque buildup on arterial walls
  • High blood pressure
  • High cholesterol
  • Smoking
  • Pregnancy
  • Infections of the blood

Types of Aneurysm

Aneurysms can occur in many different parts of the body. They are usually categorized according to the types which occur most frequently:

Aortic - Occur along the aorta, the major artery leaving the heart.

Cerebral - Occur in arteries supplying the brain.

Peripheral - Form in blood vessels in other parts of the body, including the leg, groin, neck or abdominal area.

Symptoms of an Aneurysm

Aneurysms within the body or brain often cause no symptoms. If an aneurysm occurs near the body's surface, however, a throbbing mass may be visible. Symptoms of aneurysms may include:

  • A pulsating lump
  • Cramps of arms or legs with exercise
  • Pain in arms or legs during rest
  • Painful sores or ulcerations of the toes or fingers
  • Radiating pain or numbness in the arm or leg
  • Gangrene, or tissue death

The rupture of an aneurysm is life-threatening. Symptoms may include:

  • Low blood pressure
  • Rapid heart rate
  • Lightheadedness

Diagnosis of an Aneurysm

Diagnosis of an aneurysm is done through a thorough physical examination and the use of diagnostic tests which may include a CT scan and an ultrasound.The health care provider will perform a physical exam.

Treatment of an Aneurysm

There are several ways to treat aneurysms depending on their location and severity. If an aneurysm is discovered in its early stages, the doctor can often keep it from rupturing with medication and regular checkups to see whether the aneurysm is enlarging. If surgery is necessary because the aneurysm has enlarged, is leaking or is believed to be in danger of rupturing, such surgery may be done in one of several ways. The doctor may make use of X-rays during the surgery to guide the stent to the proper location.The prognosis for successful surgery is usually excellent if the medical intervention is done in a timely fashion.

Surgery for an aneurysm involves replacing the weakened section of the affected blood vessel with an artificial tube, or graft. This procedure may be performed in one of two ways as:

Open surgery

During this repair procedure, the surgeon will make a large incision in the abdomen or chest in order to replace part of the artery.

Endovascular aneurysm repair (EVAR)

In this procedure, the surgeon uses a tiny tube, or stent, to prop open a blood vessel or to reinforce its wall. Since this procedure is minimally invasive, recovery time is shorter. Endovascular repair, however, is not appropriate for all patients and may require more follow-up maintenance than an open procedure.

Risks of an Aneurysm and Aneurysm Repair

Aneurysms are life-threatening in two basic ways. The patient may hemorrhage internally from a rupture, particularly of the aortic artery, or a clot may form and block blood flow leading to a stroke or heart attack.The surgical procedures performed to correct aneurysms also have inherent risks. These may include:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Damage to adjacent organs
  • Breathing problems
  • Hernia at the incision site

Recovery from an Aneurysm Repair

Following an open surgical aneurysm repair, the patient may stay in the hospital from five to ten days for monitoring. When a patient undergoes an endovascular repair, the patients' hospital stay may considerably shorter, perhaps two to three days. Generally, full recovery takes between six weeks and three months. In order to reduce the risk of another aneurysm, patients are instructed to maintain a healthy body weight, eat foods low in fat content, stop smoking and engage in some form of aerobic exercise

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