The word ‘Aneurysm’ basically means a widening of blood vessels causing a balloon-like bulge in the course of the vessel. An aneurysm can occur in a blood vessel that is weak or has a defect. Aneurysm is often associated with hardening of arteries (atherosclerosis). High blood pressure, heredity and injury to the blood vessels are also risk factors for aneurysms.
What are the types of aneurysms?
Aneurysms are most commonly encountered in the cerebral arteries (in the brain), the aorta of the heart (largest blood vessel of the heart), below the stomach and in close proximity with the kidneys and in the lungs (thoracic aneurysms).
- Aortic aneurysms: Aorta is the great artery whose job it is to carry blood from the heart through both the chest (thoracic aorta) and the abdomen (abdominal aorta). Hence aortic aneurysms can be of two types- i) Thoracic aortic aneurysms and ii) Abdominal aortic aneurysms.
- Brain Aneurysm: A ruptured aneurysm in the brain may cause strokes.
- Peripheral Aneurysms: If seen in arteries other than the aorta & the brain, they are called peripheral aneurysms. They can occur anywhere in the neck, in the groin, or even behind the knees.
What are the risk factors for aneurysms?
Diseases that injure and damage your heart and blood vessels also add to your risk for aneurysm. These diseases include the following.
- High blood pressure.
- High cholesterol levels in blood.
- Atherosclerosis (hardened arteries).
- Habits like Smoking.
Particular inherited connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome, can also up the risk for aortic aneurysm. Your family may possibly have a history of aortic aneurysms that increases risk.Unhealthy behaviors like tobacco use and smoking increase the risk of aneurysm.
Are aneurysms symptomatic?
No, most of the aneurysms are asymptomatic, until they start growing larger in size and are affecting the adjacent tissues or structures.
What are the symptoms of aneurysms ?
The symptoms of Aneurysms totally depend on the blood vessels and area affected by the aneurysm.
Signs and symptoms of thoracic aortic aneurysms.
- Sharp, sudden pain in the chest or upper back.
- Shortness of breath.
- Trouble breathing or swallowing.
Abdominal aortic aneurysms often are asymptomatic. If an individual does have symptoms, they can include the following.
- Throbbing or deep pain in your back or side.
- Pain in the buttocks, groin, or legs.
Signs and symptoms of brain aneurysms.
- Headache, nausea and vomiting
- Paralysis/ Weakness on one side of the body
- Vision/ Speech Problems
- Confusion, Sluggishness, Jerky Movements
- Black-outs
How are aneurysms diagnosed ?
Tools that accurately delineate aneurysms and associated defects include the below mentioned diagnostic procedures.
- CT Scans (Computerized Tomography)
- Arteriogram- Works to show size, location & shape of aneurysm. After administration of contrast dye, radiographs are taken to demonstrate the aneurismal defect.
- Magnetic Resonance Imaging
What is the treatment for aneurysms ?
An aneurysm is a ballooning or a bulge in a blood vessel which is caused due to the weakening of the wall of the blood vessel. An aneurysm can occur in the blood vessels of the brain, the lungs, the abdomen or the heart. An aneurysm needs urgent treatment when detected as it can be fatal.
Aneurysm is a condition which can lead to serious complications and hence detected it is most commonly treated with the help of a surgical repair. In certain cases, if the aneurysm is asymptomatic or is very small in size the doctors conduct a regular evaluation to see if there’s any increase in the size. The doctor may advise you to start certain medication to thin your blood to avoid clotting. If you are suffering from high blood pressure or any other conditions that require medical attention the consulting specialist will ask you to continue the required medication. The other restrictions may include not lifting of heavy weights and avoiding stress as they can contribute to the enlargement or rupture of the aneurysm.
If you are experiencing symptoms like chest pain, back pain, restlessness, high blood pressure and generalized weakness, or if on CT and MRI scan the size of the aneurysm is greater than 5 cm you should consult your specialist regarding a surgical aneurysmal repair. These are the major factors, minor factors may include overall health of the patient, age, gender (smaller aneurysmal repairs are more commonly done in women) and any associated medical problems.
The management of the aneurysms is largely dependent on where the aneurysm is and symptoms caused by the aneurysm. In majority of the cases, the aneurysm has to be treated by open surgery. It can either be occluded and by-passed or it can be treated by endovascular procedures (blocking the aneurysm from inside the blood vessel). The two common treatment options for aneurysms are as follows.
- Surgical clipping: It is a technique done to seal off an aneurysm. The surgeon first accesses the aneurysm and finds the feeding blood vessel to the aneurysm. Then he or she puts a minute metal clip right on the neck of the aneurysm to stop the blood flowing to it.
- Endovascular coiling: This is a less invasive procedure than surgical clipping and requires the surgeon to place a void plastic tube (catheter) into an artery, usually in your groin, and threads it up the arteries in your body to the aneurysm. A guide wire is then used to push a soft platinum wire via the catheter into the aneurysm. The wire then coils up after insertion into the aneurysm, disrupts the flow of blood and basically seals off the aneurysm from the artery.
Generally, the surgical repair of any aneurysm depends on the location of the aneurysm.
Thoracic aortic aneurysms occur above the diaphragm, hence most of the surgical incisions are given from the midline of the sternum (median sternotomy). Once the aorta is approached the damaged part of the vessel is replaced with the help of a graft material or an artificially manufactured stent. It is advised to ask your specialist about what kind of repair suits you the best. In case of an abdominal the surgical incision is made below the abdomen and the part of the damaged vessel is repaired. In patients affected with a brain aneurysm the standard procedure followed is open craniotomy or approach by drilling a hole in the skull and doing the repair. Other lesser invasive way of repairing a brain is the endovascular repair which utilizes a catheter to repair the damaged vessel. The injection of contrast material via the catheter helps the surgeon in visualizing the defect and the procedure is performed by using thin metal wires which coil into a mesh ball in the aneurysm and hence the procedure is called as coiling.
What happens before an aneurysm repair surgery ?
An aneurysmal repair is a major surgical procedure which requires highly skilled surgeons and operating team. The preoperative evaluation includes your overall general physical examination, monitoring of other health issues, detailed screening of the heart, lungs, abdomen and brain wherever the aneurysm is detected.
Is an aneurysm repair surgery performed under anesthesia?
Yes, an aneurysmal repair procedure is performed under the influence of general anesthesia.
What happens after the aneurysm repair surgery ?
Since aneurysmal repair is a major surgical procedure, after the procedure is completed the patient is monitored in the intensive care unit and is transferred to the wards once the condition is stable. The average length of stay in the hospital ranges form 4-7 days and the recovery after an aneurysmal repair can take about 3-6 months. During the doctor will advise you to visit for regular check-ups, continue the prescribed medication and avoid any strenuous exercise, sports or activities to aid in the recovery. Ask you healthcare specialist about the required precautions you need to take after an aneurysmal repair procedure.
What are the risks associated with an aneurysm repair surgery ?
The general complications related to administration of anesthesia may be nausea, vomiting, headache and abdominal upset. Since this is a major surgical procedure the chances of a seizure, a stroke, heart problems, infection and clotting are common. Behavioural changes like loss of balance, confusion, memory loss can be associated with the brain aneurysmal procedure.
What is the outcome of an aneurysm repair surgery ?
Occurrence of an aneurysm in the vessels always carries a major risk as it could be fatal. The treatment of aneurysm depends on timely diagnosis and treatment. Though some smaller aneurysms can be managed medically but most of the aneurysmal procedures are treated surgically to avoid any associated potential complications. Hence, the knowledge and information about the type of treatment for your condition plays a crucial role in the treatment of an aneurysm. It is advised to consult your treating specialist to explain you about the risks, benefits and outcome of the type of aneurysmal repair which is the best suited for you. The prognosis of an aneurysm is also dependant on the post-operative care, such as adapting a healthy lifestyle, quitting smoking, cardiac health monitoring and avoiding any kind of stress.
What are the lifestyle changes you can do to lower your risk ?
In case you have an unruptured aneurysm, you can definitely lower the risk of its rupture by making following lifestyle changes.
- Do not smoke or use recreational drugs. Speak with your doctor about strategies or a suitable treatment program to help you quit.
- Eat a healthy diet as well as exercise. This helps to keep a low blood pressure. Control your blood pressure if it is high. You should get the information.
How to find and reach aneurysm repair surgery specialists ?
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Find, reach and choose an aneurysm repair surgery specialist ( Aortic (Heart), Brain (Neurosurgery) & Peripheral Aneurysms (Vascular surgery) ) for aneurysm repair surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
