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Aneurysm
What
is an aneurysm? An aneurysm
is a bulging of an artery caused by uncontrolled hypertension or injury or
weakness to the artery itself. The pressure from blood flow against the
arterial wall causes the aneurysm to slowly grow in size, giving it its
bulging characteristic. Typically, atherosclerotic disease (plaque buildup
within the arterial wall) is present. Aneurysms can
occur in any blood vessel in the body, but the most common type arises in the
largest artery in the body—the aorta. This condition affects over
200,000 Americans and is referred to as an abdominal aortic aneurysm (AAA). An AAA is a
very serious condition that claims the lives of 15,000 Americans every year.
As the aneurysm continues to grow, it has the potential to rupture or leak.
If this occurs, more than half of these individuals go into shock and die as
a result of massive internal bleeding. The key is to detect an AAA at its
earliest stage so it can be properly treated. What
are the warning signs and symptoms of an aneurysm? Abdominal
aortic aneurysms (AAAs) are referred to as “the silent killer”,
as the majority of people do not have symptoms. However, AAA can sometimes
present with the following:
If you have
one or more of the above risk factors, we recommend that you discuss with
your doctor certain tests that can detect an AAA early so it may be properly
treated. Sometimes,
people will experience symptoms that suggest the presence of AAA:
If you
experience any of the above symptoms, you should be evaluated by your doctor
immediately. Prompt action may prevent a life-threatening situation. How
is an aneurysm detected? Abdominal
aortic aneurysms are sometimes detected during a routine physical
examination. Your physician may hear pulsations in your abdomen (also called
bruits) with a stethoscope. However, they are usually difficult to detect
(especially in persons who are overweight). If your physician suspects that
you may have an aneurysm, either due to pulsations in the abdomen or other
risk factors such as family history, high blood pressure, high cholesterol,
old age, etc., he or she will likely perform any of the following imaging
studies to make the diagnosis:
What
are the treatment options for an aneurysm? Once an
aneurysm (including AAA) is diagnosed, your physician will determine the
appropriate treatment depending upon its size and location. If the aneurysm
is small, your physician will likely monitor its growth with repeated
ultrasound imaging. If it is large (greater than 5 centimeters), or is growing
rapidly and showing signs that it might rupture, an interventional
catheterization or surgery may be required. Open
Abdominal Surgery: This traditional approach is the surgical removal of the
aneurysm. During this surgery, you are asleep while the surgeon removes the
aneurysm and sews a synthetic graft in its place. Usually, you can expect to
stay in the hospital for about a week, and recuperation time is about six
weeks. Endovascular
Intervention: Some patients may be candidates for a minimally invasive alternative.
The endovascular approach requires small incisions in the groin. A graft
attached to a catheter is threaded through your arterial system until it
reaches the location of the aneurysm. The graft is left in place to prevent
the aneurysm from growing by keeping blood pressure away from the arterial
walls. Not all individuals are candidates for this minimally invasive
alternative. Further, while your hospital stay (about 2 days) and
recuperation time (about 1 – 2 weeks) is much less than traditional
surgery, the procedure still carries risk and will require follow-up
monitoring. Consult your
physician about which option is best for you. |
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