AORTIC ANEURYSM Etiology Symptoms with Treatment
- Aneurysm is a pathological dilatation of a segment of vessel.
- An aneurysm affecting any part of the aorta from the aortic valve to the iliac arteries.
- True aneurysm involves all 3 layers of an artery or vein or heart.
- Pseudo aneurysm is a breakage of intima and media of the blood vessels, sometimes containing a clot, and lined by adventitial layer.
- A fusiform aneurysm is a diffusely dilated aneurysm.
- A saccular aneurysm is a bulging of the vessel
Aneurysm may be abdominal or thoracic.
- Cystic medial necrosis -as in Marfan syndrome, Ehlers-Danlos syndrome etc.
- Thoracic aneurysms occur most commonly in the sixth and seventh decade of life.
- Hypertension is an important risk factor, being present in over 60 percent of patients
- Mycotic aneurysm (An aneurysm dU~jo_staphylococcal,~treP-tococcal or salmonella infection qf the aorta gn a plaque~ .
- these are infected saccu[ar aneurysl1Js).
- Takayasu disease Trauma Congenital Vasculitis.
- Thoracoabdominal aneurysms — 10 %
- Descending aortic aneurysms distal to the left subclavian artery — 40%
- Ascending aortic aneurysms arise anywhere from the aortic valve to the innominate artery — 60%
- Aortic arch aneurysms include any thoracic aneurysm that involves the brachiocephalic vessels — 10 %
THORACIC AORTIC ANEURYSM
Usually asymptomatic Symptoms
- Chest pain
- Superior vena cava
- X-ray chest
- – 2D echocardiography
- – TEE – trans esophageal
- – CT
- – MRI
- – Aortography .
- Beta blockers
- Prosthetic grafts
- Other surgeries.
ABDOMINAL AORTIC ANEURYSM
- aneurysm is a focal dilation of a blood vessel with respect to the original or adjacent artery
- More common in elderly males
- Abdominal aortic aneurysm occurs four to five times more commonly in men than women ,
- The aneurysm is usually below the level of renal arteries
- Peripheral embolization is common due to atherosclerosis
- Abdominal aortic aneurysm in more common in patients with atherosclerosis
- Usually asymptomatic.
- X-ray abdomen –
- – CT, MRI
- – Aortography.
- Operative repair if diameter of aneurysm more than 5.5 em.
- Prosthetic graft, endovascular stents.