Aneurysms

Aneurysms are blood vessels that have increased in size, usually more than double their normal diameter. These channels, called arteries, carry blood from the heart to the major organs and tissues around the body. Growth can occur due to a weakness in the wall of the blood vessel and with time, they become thin and like a balloon, increase the risk of rupture and bleeding.

The most common place for aneurysms to occur is the aorta, the largest artery in the body. Abdominal Aortic Aneurysms (AAA) are the most common, followed by aneurysms of the pelvis, lower limbs, chest and rarely major organs.

Aneurysms can occur due to hereditary defects in the layer that strengthens the blood vessel wall. Other risk factors include high blood pressure, heart disease, smoking and increasing age.

If there is a family history of aneurysms, it is recommended that you get screened for aneurysms, particularly men over 40 years of age and smokers.

Arterial aneurysms grow with time and many go unnoticed until they rupture and cause life-threatening internal bleeding. This risk dramatically increases with the size of the aneurysm. If found in their early stages when small, it may not cause any immediate danger but will need to be regularly monitored. Larger aneurysms may require surgery to prevent them from bleeding.

Most aneurysms do not cause any symptoms. Those that do, can cause pain in the abdomen, back or chest. Some are found during medical examination or felt as a pulsating mass. Many are found during scans for other conditions.

If you have been diagnosed with an aneurysm and experience pain or become unwell, please present to the closest Emergency Department immediately.

With technology improving, scans are regularly performed to diagnose many medical conditions. It is often during these scans that aneurysms are diagnosed.

Ultrasound is a safe and reliable technique to assess arterial aneurysms in the abdomen or limbs. It uses sound echoes and does not require radiation or contrast dye. For aneurysms of the chest, a CT scan will be used to more accurately assess aneurysms of the aorta and deep arteries.

Depending on the size and location of the aneurysm, Dr Bullen will discuss a specific management plan. The type of treatment offered will depend on your age, health issues and anatomy to successfully fix the problem safely with the shortest recovery time.

When small, it may involve regular monitoring and medication. If there is a risk, surgery may be recommended. There are two main types, minimally invasive stenting or open surgical repair.

• Endovascular (keyhole) treatment involves inserting a stent (metal tube with material lining) to block off flow into the bulge and prevent bleeding while maintaining flow through the stent to the organ or limb. This is usually performed using Angiograms (specialised X-ray with contrast dye) via a small incision in the groin.

• Open surgical treatment involves going through the body and directly exposing the aneurysm. The flow through the abnormal blood vessel is then clamped off and the artery repaired using material and sutures.