Arterial Aneurysms

An aneurysm is a localized, blood-filled balloon-like bulge of a blood vessel. Aneurysms most commonly occur in the abdominal aorta, which is the major artery in the lower half of the body that carries oxygenated blood from the heart to the rest of the body. When the size of an aneurysm increases, there is a significant risk of rupture, resulting in severe hemorrhage, other complications or even death.

Aneurysms also can occur in other blood vessels, particularly in the arteries of the leg. These aneurysms are dangerous because they generally contain blood clots. The blood clots can break off and block arteries that are further downstream. In other instances, the entire aneurysm can clot. Both of these situations can lead to decreased blood flow to the leg. Therefore, aneurysms found in the arteries of the leg are usually repaired as soon as possible once they are detected.

Aneurisms can be hereditary or caused by disease, both of which lead to the weakening of the blood vessels wall.

Risk factors for an aneurysm include:

  • Diabetes
  • Obesity
  • Hypertension
  • Smoking
  • Alcoholism
  • Copper deficiency
  • Old age

Many patients with aneurysms of the aorta have no symptoms, causing the condition to remain undiagnosed until the aneurysm ruptures. Other aneurysms are discovered during computed tomography (CT) or magnetic resonance imaging (MRI) scans that are performed for other health problems.

Some patients have mild symptoms of pain or discomfort in the area of the aneurysm. Severe abdominal, back or groin pain in a patient with an aneurysm could be due to a ruptured aneurysm and should be treated immediately.

Large aneurysms may require surgery while small ones are closely monitored with ultrasound and may never grow large enough to require surgery. Aneurysms of the aorta that are large enough to require repair are treated with one of the following:

  • Conventional Surgery — A synthetic graft is sewn inside the aneurysm to the artery above and below it to prevent the aneurysm from rupturing.
  • Endovascular Repair — A procedure that uses a catheter inserted in the groin to guide a self-expanding graft to the aneurysm. Endovascular repair does not require an abdominal incision and has a substantially shorter recovery. Not all aneurysms are suitable for endovascular repair.