Vascular Surgery: Aneurysms

An aneurysm is a bulging or ballooning of a blood vessel that is more than 150% of vessel’s normal size. This occurs because of damage to the vessel wall. The diameter of the artery is bigger in an aneurysm while it is smaller in atherosclerosis. The most common artery to develop an aneurysm is the aorta, followed by the iliac artery, femoral artery and popliteal artery. If an aneurysm ruptures it causes internal bleeding, which can be fatal.

Aneurysm Risk Factors

The exact causes of aneurysms are still unknown, but we do know of several things that can increase your risk of an aneurysm. Aneurysms develop when there is damage to the arterial walls. People with atherosclerosis are at risk of developing aneurysms as the plaque lining the arterials walls hardens and damages the walls.

High blood pressure is another risk factor. The heart needs to work harder to pump blood throughout the body, which puts more pressure on the arterial walls. This can weaken and damage the blood vessels.

Smoking, a high cholesterol diet, obesity, a family history of heart disease, and other factors that increase risk factors for high blood pressure and atherosclerosis will also increase risk of aneurysm. Be sure to discuss these factors with your primary care physician so they can advise you on appropriate prevention steps.

Common Symptoms

More often than not, aneurysms do not have any noticeable symptoms. It is up to you to discuss your aneurysm risk factors with your doctor so that they can perform screenings when necessary. That said, some patients with aneurysms have noticed symptoms before it ruptured. These include:

  • A dizzy, lightheaded feeling
  • Increased heart rate
  • Nausea and vomiting
  • Pain
  • Drowsiness
  • Blurry vision
  • Headaches
  • Dilated pupils

Treatment for Aneurysms

Treating an aneurysm will depend on where the aneurysm developed. Treatment usually takes place after the aneurysm has ruptured as lifestyle changes can often be used to prevent the aneurysm from rupturing.

Aneurysm interventional procedures:

  • Endovascular coiling – A minimally invasive procedure where small coils attached to a catheter are inserted into an aneurysm. The coils stop blood flowing from the aneurysm, stopping the internal bleeding.
  • Surgical clipping – A small section of the skull is temporarily removed so the surgeon can gain access to the aneurysm and place a clip on it to stop blood flow.
  • Endovascular grafting – Another minimally procedure, this procedure replaces the weakened arterial walls with an artificial tube called a graft. This procedure can also be used to treat an aneurysm at risk of bursting.
  • Flow divert surgery – If the aneurysm is particularly large, the surgeon will forego trying to repair it altogether, opting instead to divert blood flow away from the aneurysm using a stent to prevent internal bleeding.

Recovering From Surgery

Minimally invasive aneurysm surgeries are fairly simple and patients can usually return home the same day. In cases of open surgery, patients typically spend a week in the hospital while their body heals. During this time, patients often receive diuretics to help prevent fluid buildup. Blood thinning medication may also be prescribed to prevent blood clots while your body adjusts to the change.

The risk of developing another aneurysm increases after one has formed. Many patients will require cardiac rehabilitation after their surgery to control aneurysm risk factors like high blood pressure and atherosclerosis. Some lifestyle changes include quitting smoking, dietary changes, and heart-healthy exercise routines.