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Aneurysms

An aneurysm is a balloon-like bulge in a weakened section of an artery wall. These serious vascular conditions can be caused by certain medical problems, accidents and genetic conditions. Aneurysms are dangerous because if they go undetected and untreated, they can burst, resulting in life-threatening internal bleeding.

 

Types of Aneurysms

Although they can develop in arteries anywhere in the body, these are the most common places aneurysms occur:

  • Brain aneurysm: A bulge in a weakened section of the wall of an artery in the brain, also known as a cerebral or intracranial aneurysm
  • Abdominal aortic aneurysm: A bulge in a weakened section of the wall of the aorta, the large blood vessel that supplies blood to the legs and abdomen
  • Thoracic endovascular aneurysm: A bulge in a weakened section of the wall of the aorta, the large blood vessel that runs down the body through the chest
  • Peripheral aneurysm: A peripheral aneurysm (PA) occurs in an artery other than the aorta—although it can be an indicator of aortic aneurysm. Peripheral aneurysms in the legs are most common in the popliteal artery, which runs down the back of the lower thigh to the knee, but can also occur in the femoral artery, which is in the groin area. If you have a peripheral aneurysm in one leg, it’s likely you have one in the other.

 

Symptoms of and Risk Factors for Aneurysms

Aneurysms can form and grow for years without causing any signs or symptoms until they burst (rupture), obstruct blood flow or grow so large that they put pressure on nearby structures.

For people whose aneurysms do cause symptoms, the symptoms vary, depending on the type, severity and location of the aneurysm. Signs and symptoms also depend on whether the aneurysm has ruptured or is impacting other parts of the body.

  • An abdominal aortic aneurysm may cause deep pain in your back or the side of your abdomen, a throbbing sensation in the abdomen, or a gnawing pain in your abdomen that can last for hours or days.
  • Someone with a thoracic aortic aneurysm may have symptoms that include pain in the jaw, neck, back or chest, shortness of breath, coughing, hoarseness, difficulty swallowing or trouble breathing.

  • An aneurysm in the brain can cause symptoms such as a severe localized headache, dilated pupils, pain behind eye, blurred or double vision, weakness and numbness.
  • Peripheral aneurysms can cause a painful, throbbing lump or cramping near the site of the aneurysm. Two out of three PA patients do not experience any symptoms.

If you are experiencing symptoms of an aneurysm, contact your doctor promptly.

Risk factors for aneurysms include:

  • Increasing age: People 65 and older are more likely to develop abdominal aortic aneurysms.
  • Gender: Men are at higher risk for aortic aneurysms than women are.
  • High blood pressure
  • Atherosclerosis
  • Smoking
  • Family history of aneurysms
  • Trauma – such as in a violent vehicle accident – can injure the arteries and increase aneurysm risk.

 

Diagnosing Aneurysms

Aneurysms can be diagnosed using imaging technologies such as:

  • Ultrasound imaging: High-frequency sound waves produce dynamic visual images of organs, tissue and blood flow inside the body.
  • Echocardiogram ("echo") tests: Echocardiography is a type of cardiac imaging that uses sound waves to create moving pictures of the heart and its blood vessels at rest and during exercise. Echocardiogram images may be used to diagnose, evaluate and monitor aneurysms. Types of echo tests include:

    • Transthoracic 2-D echocardiography (TTE): This common, non-invasive echo study is performed externally, outside of the chest. TTE can be performed using bubbles (to identify problems with cardiac blood flow) or DEFINITY® contrast (to further clarify imaging).
    • Transesophageal echocardiography (TEE): This minimally invasive study can help cardiologists get a closer look at cardiovascular structures if more information is needed after a TTE study.
  • Computed tomography (CT) and magnetic resonance imaging (MRI), and when appropriate, cardiac CT and MRI: These sophisticated non-invasive technologies provide doctors with highly detailed images of the inside of the body.
  • Diagnostic cerebral angiography: This minimally invasive imaging technology gives doctors a detailed view of the inside of the brain’s blood vessels.

 

Treating Aneurysms

The treatment for an aneurysm depends upon where in the body it is located, its severity, the overall health of the patient and whether or not it has ruptured (which is a medical emergency). Specialized vascular surgeons and neurovascular surgeons perform surgery if necessary. Treatments include:

  • Aneurysm coiling: Coiling is a newer, minimally invasive procedure that uses tiny catheters to insert small coils directly into an aneurysm and fill it from inside the vessel. Coiling also can be used to treat bleeding in the brain and other parts of the body. Learn more about what to expect from aneurysm coiling.
  • Endovascular aneurysm repair (EVAR): Endovascular techniques may be used to treat peripheral dissections (when the inner wall of an artery tears) and bypass techniques to perform arteriovenous graft surgery (connecting an artery to a vein) to make possible life-saving hemodialysis treatment for patients with kidney failure.
  • Bypass surgery: Bypass surgery may be used to treat aneurysms in the legs. Physicians make an incision near the affected area and attach a vein from another part of the body above and below the blockage, bypassing the aneurysm and restoring blood flow.
  • Abdominal aortic aneurysm repair: Depending on the severity and location of the aneurysm, it may be repaired with either traditional open surgery or a minimally invasive endoluminal procedure.
  • Thoracic endovascular aneurysm repair: This surgery is performed inside the aorta, using long tubes and imaging guidance to insert a stent graft that diverts blood away from the aneurysm. Learn more about what to expect from thoracic endovascular aneurysm repair.
  • Proximal aortic surgery

 

Make an Appointment

If you or someone you know has the signs or symptoms of an aneurysm, please make an appointment today with one of WakeMed’s experienced vascular specialists.