An aneurysm is a ballooning or weakening of an artery wall. The process is usually caused by plaque on the inner lining of the wall. Aneurysms may also be caused by trauma or heredity. Most people are unaware that they have an aneurysm until it is found incidentally during other testing. Aneurysms usually occur in the thoracic (chest) or abdominal (belly) aorta, the main blood vessel in the body. Aneurysms can occur in other blood vessels as well.
Aneurysms are usually without symptoms. A small percentage of patients experience symptoms including back pain, abdominal pain, and chest pain.
Abdominal Ultrasound: A probe will be placed on your abdomen and then sound waves are sent through the skin to form a picture of the aorta on the screen.
CT Scan: A computer uses X-rays to produce pictures of the structures inside the body. Patients may need to drink a barium solution. Patients must fast for this test.
CT Angiogram: This is the most precise test for defining the anatomy of the aneurysm, including the size, diameter and proximity of the aneurysm to the kidney arteries. Images are enhanced by injecting the patient with contrast. Patients must fast for this test.
Invasive Arterial Testing
Angiogram: An angiogram is an X-ray of your arteries. The test is done to determine the exact location of disease in the arteries, including the size and shape of the aneurysm. Blood work is drawn before the test to check the kidney function and ability of the blood to clot.
During the test an intravenous catheter is inserted into a vein in your arm. You will be given intravenous fluids and medicine to relax you.
A needle will be inserted to numb the area of the artery and then a catheter will be placed in the artery (usually the groin or arm). Dye will be injected into the artery. The procedure takes approximately one hour. After the procedure you will need to lie flat for several hours with pressure at the puncture site to prevent bleeding.
The treatment for aneurysms involves surgical repair of the artery. This is accomplished by one of two techniques; open surgical repair or endovascular repair.
Although aneurysms may be hereditary it is also believed that atherosclerosis plays a role in the development of aneurysms. Treatment that is strongly recommended would be changes in lifestyle, especially ones that can begin at home. Many risk factors with include: age, smoking, high blood pressure, high cholesterol, diabetes, obesity, a sedentary lifestyle, and a family history. While family history and age cannot be controlled, taking control of your lifestyle can make a difference
Minimally Invasive Treatment
The Endovascular Repair (Contemporary) is minimally invasive surgery. Using this technique a stent graft, which is a woven polyester tube, is placed inside the diseased vessel without opening the surrounding tissue or the blood vessel. This excludes the aneurysm from normal blood flow. An incision will be made in both groins. A catheter with the endograft is advanced up the artery in your groin and put in place to exclude the aneurysm sac. The surgery takes approximately two hours. The patient is recovered in the post anaesthesia care area. The patient is then transferred to the vascular nursing floor; this is a regular surgical floor. The surgery generally does not require a stay in the intensive care unit. The patient is usually discharged within 1-2 days.
The Open Repair (Traditional) is major surgery. The aneurysm is opened and the contents (thrombus) within it are removed. A piece of synthetic tube graft is sewn in place where the aneurysm was to reinforce the blood vessel walls. The surgery takes approximately 3 hours, requires general anaesthesia, and a large incision in is made on your left side. The patient will be placed on a ventilator or breathing machine and the patient may be in the intensive care unit for 1-2 days. The patient is then transferred to the vascular surgery floor and usually discharged within 3-5 days.