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What Is An Aneurysm? What Causes Aneurysm?

no bigger than 1.6 inches (about 4cm) in diameter, and there are no symptoms, it may be best to tack the approach of watching-and-waiting, instead of surgery. This is also known as "watchful waiting". In most cases the risks caused by surgery are greater than the likely risks caused by a small aneurysm. Watchful waiting usually involves an ultrasound scan every 6 to 12 months. The patient will be asked to be alert for any signs or symptoms of dissection or rupture. Small observational studies have suggested that statins can significantly reduce the growth rate of small abdominal aortic aneurysms, Janet T. Powell, M.D., Ph.D., Professor at Imperial College and Honorary Consultant for United Healthcare in London revealed. *If the aneurysm is medium-sized - a medium-sized aneurysm is no bigger than 2.2 inches (5.5 cm) in diameter and bigger than 1.6 inches (4 cm). It is more difficult now to weigh up the risks of surgery against the risks of a medium-sized aneurysm. The chances of both patient and doctor deciding on one or the other are pretty even. *Large-sized or rapidly-growing aneurysm - a large aneurysm is larger than 2.2 inches (5.5 cm) in diameter, while a rapidly growing one is expanding at more than 0.5 cm every six months. In most cases the patient will require surgery. The damaged section of the aorta will be removed and replaced with a graft (synthetic tube) which is sewn into place. This is major surgery - open-abdominal or open-chest surgery. The patient will take several months to recover completely. Endovascular surgery - this is a less invasive procedure to repair an aneurysm. A graft is attached to the end of the catheter which is inserted through an artery and threaded up into the aorta. The graft - consisting of a woven tube covered by a metal mesh support - is placed at the site of the aneurysm and stuck there will pins or small hooks. This graft strengthens the weakened section of the aorta and prevents the aneurysm from rupturing. Patients recover much faster with this procedure, and seem to have fewer complications. Long-term survival for patients undergoing surgical repair of intact abdominal aortic aneurysms has improved in recent decades, according to a Swedish study. Thoracic aortic aneurysm treatment: Surgery is usually required as soon as the aneurysm reaches a diameter of 2.2 inches (5.5 cm). Patients with Marfan syndrome, as well as those with close relative who had an aortic dissection may undergo surgery if the aneurysm is smaller. Beta blockers have been shown to slow down the growth of thoracic aortic aneurysms for patients with Marfan syndrome. Cerebral (brain) aneurysm treatment: Ruptured cerebral aneurysm treatment Patients with brain aneurysms have two options if the aneurysm has ruptured: 1. Surgical clipping. 2. Endovascular coiling. *Surgical clipping - the aneurysm is closed off. The surgeon removes a section of the skull to get to the aneurysm and finds the blood vessel that feeds it. A tiny metal clip is placed on the neck of the aneurysm to block off the blood flow to it. *Endovascular coiling - a catheter is inserted, usually in the groin, and is threaded through the body to the brain where the aneurysm is located. A guide wire is used to push a soft platinum wire through the catheter and into the aneurysm. The wire coils up inside the aneurysm and disrupts the blood flow, making it clot. The clotting of the blood effectively seals off the aneurysm from the artery. *Endovascular, noninvasive thoracic aortic aneurysm repair (TEVAR) is safer than open aneurysm repair (OAR) as it is associated with fewer cardiac, respiratory, and hemorrhagic complications, as well as a shorter hospital stay, this study revealed. Patients whose aneurysms are coiled instead of clipped have a better survival rate over five years, according to a long-term study of the International Subarachnoid Aneurysm Trial (ISAT). However, another study found that over time outcomes are similar. Smokers who undergo coil embolization are at a high risk of having another aneurism elsewhere later on, this study revealed . The following cerebral aneurysm treatments help relieve symptoms as well as managing complications: *Painkillers - usually for headaches. *Calcium channel blockers - these stop calcium for entering cells of the blood vessel walls. They reduce the amount of widening and narrowing of blood vessels; often a complication of a ruptured aneurysm. *A vassopressor - this is an injected drug which raises blood pressure; widens blood vessels which have remained stubbornly narrowed. The aim is to prevent stroke. *Anti-seizure drugs - seizures may occur after an aneurysm has ruptures. Examples include levetiracetam (Keppra), phenytoin (Dilantin, Phenytek, others) and valproic acid (Depakene). *A ventricular catheter - this can reduce the pressure on the brain caused by hydrocephalus (excess cerebrospinal fluid). The catheter, which is placed in the spaces filled with fluid inside the brain, drains the excess liquid into an external bag. It may be necessary to place a shunt system - a shunt (flexible silicone rubber tube) and a valve. The shunt system is a drainage channel that starts in the brain and ends in the patient"s abdominal cavity. *Rehabilitation therapy - sometimes a subarachnoid hemorrhage causes brain damage, resulting in impaired speech and bodily movements. Rehabilitation therapy helps the patient relearn vital skills. Unruptured cerebral aneurysm treatment The unruptured cerebral aneurysm can be sealed off with surgical clipping or endovascular coiling. Deciding on this is not easy as the risks are often equal, and sometimes higher than the potential benefits. The following will help the surgeon determine what to do: *Exactly where the aneurysm is. *How big the aneurysm is. *The patient"s age. *The patient"s general state of health *Whether the patient has a family history of ruptured aneurysms. *Whether the patient has any congenital conditions which may raise the risk of the aneurysm rupturing. Patients with hypertension (high blood pressure) need to have their condition carefully monitored - proper control of hypertension significantly reduces the likelihood of a rupture. Complications A ruptured aneurysm is a major problem. An abdominal aneurysm rupture will cause mass bleeding leading to shock, and even death. A cerebral aneurysm rupture causes serious bleeding into the fluid surrounding the brain. The patient will have an extremely painful headache, which is usually followed by loss of consciousness. A cerebral aneurysm rupture is a life threatening emergency. Occasionally, a piece from inside an aneurysm may become dislodged and travel into the artery - the clot is known as a thrombosis. If it lodges into a small artery it will block blood flow. The blocked blood flow can be very serious, especially if it happens in an artery to a major organ, such as the heart, lungs or brain. Prevention A large percentage of aneurysms are caused by arteriosclerosis - a vascular disease. The following steps will help prevent the development of arteriosclerosis and aneurysms: *Quit smoking *Keep your blood pressure under control *Keep your blood cholesterol levels under control *Eat a healthy, well balanced diet, rich in fruit and vegetables, unrefined carbohydrates, dietary fiber, good quality fats, and lean protein *Keep your bodyweight within the ideal limits for your height *Get at least 7 hours of good quality sleep each night *Keep yourself physically active (check with your doctor that this is OK for you) Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

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