An aneurysm is a bulge in the wall of a blood vessel. Fatty deposits can build up in the vessel wall and damage the inner layer of the vessel. This can sometimes cause the vessel to weaken and become thin. This can lead to the formation of an aneurysm.
Aneurysms can also develop for other reasons. Patients can inherit diseases that prevent the blood vessels from forming properly. The walls may lose their elasticity and become weak and fragile. Occasionally, aneurysms develop as a result of infection or trauma.
Aneurysms can develop in any artery of the body. Aneurysms in the lower aorta are called abdominal aortic aneurysms. Thoracic aortic aneurysms are higher up in the chest. Aneurysm can also affect the blood vessels of the brain (called cerebral vessels). A rupture of a cerebral blood vessel can cause a stroke.
The most serious complication of an aneurysm is a rupture or tear. The largest artery in the body is the aorta. All of the blood that is pumped from the heart travels through the aorta. An individual can bleed to death very quickly if an aneurysm in the aorta ruptures. Emergency surgery would be needed to save the patient's life. The surgeon would need to temporarily clamp off all the blood flow to the aorta until the bleeding is controlled. Blood loss and the need to clamp off the bleeding vessel can deprive surrounding organs of oxygen. Patients who survive emergency surgery for a bleeding aneurysm are at high risk for many different complications. For example, both the kidney and the bowel are at very high risk for damage after emergency aneurysm repair.
There are many different ways to repair an aneurysm. The surgeon will choose a method based on the size and location of the aneurysm, the general health of the patient and the urgency required. It is always preferable to repair an aneurysm before it bleeds. Surgery that is not urgent is called "elective".
Some aneurysms are best repaired through an incision that allows the surgeon to visualize the bood vessel and replace the damaged area with a piece of "graft" material. This is called an "open repair". Other aneurysms can be repaired from inside by inserting a "new liner" or stent into the vessel. This is called an "endovascular repair".
Stents are positioned through a catheter that is inserted into a blood vessel. Small aneurysms that are difficult to access can sometimes be packed with very thin platinum wires. This procedure is called coiling. Other aneurysms can be treated by injecting material that cuts off the blood supply to the area. These types of treatments are performed in the Xray department by a radiologist with specialized skills (called an interventional radiologist).
A surgeon who specializes in the repair of blood vessels is called a Vascular Surgeon. Blood vessels in the brain are repaired by Neurosurgeons and blood vessels around the heart are repaired by Cardiovascular Surgeons.
Image 1 : Atherosclerosis is one cause for aneurysm formation.
Image 2 : Atherosclerosis is one cause for aneurysm formation.