An aneurysm is a local bulge in an artery wall in any part of the body. Aneurysms are a direct threat to life. However, in most cases, early diagnosis and treatment increase the chances of survival. What are the types, causes and symptoms of aneurysms?

Aneurysmis a local bulge in an artery wall in any part of the body. Due to the place of occurrence, the following are distinguished:

  • aortic aneurysm,
  • heart aneurysm,
  • brain aneurysm (cerebral artery aneurysm),
  • femoral artery aneurysm,
  • popliteal aneurysm,
  • renal artery aneurysm.

Taking into account the symptoms, there are asymptomatic, symptomatic and ruptured aneurysms.

However, the structure of the wall allows to distinguishreal aneurysmsandpseudo-aneurysms . A true aneurysm can be seen when a baggy widening of the vessel's lumen is observed, with the continuity of its walls maintained. Pseudoaneurysm, on the other hand, is caused by a break in the continuity of an artery wall tightly surrounded by muscles, fascia or connective tissue.

Aneurysms are distinguished due to their shape:

  • baggy- may appear in the form of a bag coming out of a small part of the vessel wall
  • fusiform- the convexity may refer to the full circumference of the vessel wall along its section
  • miliary (microaneurysms)are microscopic protrusions of small (50-250 nm in diameter) artery branches

The groupaneurysmsalso includes delaminating aneurysms, which in fact are intramural hematomas.

Aneurysm of the abdominal / thoracic aorta

Aorta is the largest artery in the human body. It begins in the left ventricle of the heart and then runs through the chest down to the abdominal cavity where it splits into two common iliac arteries. Aortic aneurysm means its enlargement, exceeding its average size by at least 50%.

It stands out:

  • thoracic aortic aneurysm - in the thoracic part there is an ascending part, arch and descending part, hence aortic arch aneurysm, ascending and descending aortic aneurysm
  • abdominal aortic aneurysm
  • thoracoabdominal aortic aneurysm

Most, about 90%, of aortic aneurysms are aortic aneurysmsabdominal.

Causes of abdominal aortic aneurysm : atherosclerosis, arterial hypertension, injuries, chronic inflammation, congenital defects in the structure of the vessel.

Symptoms of an abdominal aortic aneurysm : depend on its location and whether the aneurysm is ruptured or not. The symptoms of thoracic aortic aneurysm are chest pain, cough, hoarseness. On the other hand, patients with abdominal aortic aneurysm complain of crushing abdominal pain (less often in the lumbosacral region), pulsation in the abdominal cavity, feeling of fullness after eating a meal. In turn, aortic aneurysm rupture causes sudden, severe pain, a feeling of weakness, and loss of consciousness.

Treatment of an abdominal aortic aneurysm : when the aneurysm is small, your doctor may want to observe it through periodic check-ups. The purpose of the observation is to find out if and to what extent the aneurysm is enlarging. Your doctor may also prescribe medications to lower your blood pressure to reduce the pressure on the aneurysm. However, if an aneurysm is enlarging, especially at a rapid pace, there is a greater risk of it rupturing.

If the doctor thinks there is a risk of the aneurysm rupturing, then surgery is performed. During this procedure, the aorta is repaired by replacing the section containing the aneurysm with a fabric tube called a vascular prosthesis.

To achieve the same effect, a physician may perform an endovascular repair procedure. Instead of opening the chest, the doctor makes a small incision near the hip through which a plastic tube (sheath) containing the graft is inserted and inserted into the aorta. The graft stent is released in the aorta and disconnected from the sheath. The graft stent cuts the aneurysm and creates a new path for blood flow.

Post-infarction aneurysm

Causes of post-infarction aneurysm:Post-infarction aneurysm is most often a complication of extensive heart attacks, usually left ventricular anterior wall infarctions. If the free wall of the ventricle is ruptured, the blood extravasates into the pericardial sac, leading to a tamponade or to the formation of a pseudoaneurysm. Post-infarction left ventricular aneurysm gives poor prognosis. The greatest risk of the patient's death is if the aneurysm develops within 48 hours. from heart attack.

Symptoms of post-infarction aneurysm:is most often asymptomatic.

Treatment of post-infarction aneurysm:consists in surgical removal of the aneurysm (this procedure is called aneurismectomy) and wall clots. The edges of the gate are sewn together or a Dacron patch is sewn onto the resulting opening (this operation is called the Dora method).

See what an aneurysm looks like

See the gallery of 6 photos

Brain aneurysm

A brain aneurysm is an intracranial aneurysm or an aneurysm of the cerebral vessels. When one of the layers that makes up an artery weakens at one point, the blood flowing under pressure pushes the weakened part of the artery outwards. Then a bulge is formed, which increases with time and may break. A brain aneurysm can develop at any age.

Causes of brain aneurysms:The most important cause of brain aneurysms is a congenital defect in the structure of the vessel.

Symptoms of a brain aneurysm:Until the aneurysm ruptures and a hemorrhagic stroke occurs, there are usually no symptoms. Sometimes a large brain aneurysm may compress adjacent structures and cause related symptoms. For example, if the aneurysm is near the nerves innervating the eye, pain behind the eye, drooping of the eyelid, and pupil dilation may occur. You may experience a sudden, severe headache that is completely different from the pain that occurs with a migraine, for example.

Brain aneurysm treatment:an operation is performed which consists in removing the aneurysm and putting a titanium clip in its place.

Brain aneurysm surgery

Pulmonary Aneurysm

Pulmonary aneurysm, more specifically pulmonary trunk aneurysm, is a very rare type of aneurysm.

Causes of pulmonary artery aneurysm:These are mainly pulmonary vascular diseases, which lead to an increase in pulmonary vascular resistance and to hypertension in the pulmonary artery, and thus to its widening. Other, less common causes of a pulmonary aneurysm include acquired heart defects - usually mitral stenosis, lung cancer, tuberculosis infection.

Pulmonary aneurysm symptoms:initially pulmonary aneurysm may not cause any symptoms. However, as the walls of the pulmonary artery expand, poor exercise tolerance, exercise dyspnea, general weakness, coughing and sometimes hemoptysis appear.

Treatment of pulmonary aneurysm:involves excision of the aneurysm and implantation of a plastic prosthesis.

Aneurysm of the femoral artery

Causes of the femoral artery aneurysm:Degenerative changes in the wall of the femoral artery, reconstructive surgery (when the suture line of the artery is broken) or trauma to the femoral artery (e.g. during puncture for insertion) catheter).

Symptoms of femoral artery aneurysm:manifested by local pain or as a tumor.

Treatment of an aneurysm of the femoral artery:the doctor may recommend observation andmonitoring consisting in performing an ultrasound once a year or performing a repair procedure. Antiplatelet therapy may be necessary.

Popliteal Aneurysm

This aneurysm rarely ruptures, but more often leads to embolism, resulting in peripheral thrombosis.

Causes of popliteal artery aneurysm:incl. microtrauma, infectious background and congenital collagen defects.

Symptoms of popliteal artery aneurysm:often the first noticeable symptom of the disease is deep vein thrombosis. Swelling of the lower leg and foot appears. In the popliteal region, you can feel a tumor with your finger or a wide ripple in the popliteal fossa. Sometimes there is pain when the tumor is touched. Some patients experience cooling down and turning pale on the skin of the lower leg and feet, and in advanced cases, gangrene of the toes.

Treatment of popliteal artery aneurysm:if there is an embolism, the first thing to do is to open the vessels. A drug is administered topically through a catheter inserted into the femoral artery to dissolve the thrombotic lesions. Only after restoration is performed, surgery is possible, consisting in excision of the changed artery and implanting an insert in it, or performing a bypass anastomosis.

Aneurysms of visceral and renal arteries

Aneurysms of visceral and renal arteries, although rarely recognized, pose a serious threat to life (mortality rate: 10-25%). Visceral aneurysms are most often located on the splenic artery. The second most frequent location is the hepatic artery. They can also occur on the gastroduodenal artery and pancreatic branches.

The causes of both visceral and renal aneurysms are not fully understood, but many diseases and factors predispose to their occurrence.Most visceral aneurysms are caused by degenerative changes in the vessels - damage to the middle membrane of the artery.

Other causes of visceral aneurysms include: atherosclerosis, hypertension, fibro-muscular dysplasia and connective tissue diseases. Renal aneurysms, on the other hand, are most often detected in the course of fibromuscular dysplasia, degenerative wall changes and vasculitis.

Symptoms of visceral and renal artery aneurysms:usually do not give any specific symptoms or remain completely asymptomatic. Often the first symptom of their occurrence is a rupture and the associated symptoms of hypovolemic shock.

In turn, renal artery aneurysm causes symptoms such as hypertension in most casesarterial, haematuria, abdominal and lumbar pain and less common kidney infarctions caused by embolic material (thrombus) very rarely rupture aneurysms of the renal arteries.

Treatment of visceral and renal artery aneurysms:the doctor can choose the classic treatment technique (with opening the patient) and endovascular treatment. Aneurysms can be closed using various endovascular techniques, metal spirals, stent grafts.

  • Pulmonary embolism (pulmonary embolism) - symptoms, causes, prevention
  • Reverse Arterial Perfusion Syndrome (TRAP)
  • Gerstmann's syndrome (angular artery syndrome): causes, symptoms, treatment
About the authorMonika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.

Category:

Cardiology