Patient
Information Series
What
is an Aneurysm?
It
is an abnormal swelling of the wall of an artery most commonly
caused by hardening of the arterial wall (atherosclerosis). The
main artery in the abdomen, the aorta, is most commonly affected.
Major risk factors include smoking, high blood pressure and diabetes.
Men over the age of 60 are mostly at risk.
How
is the diagnosis made?
With
increasing use of abdominal scans for the investigation of other
conditions most aneurysms are being discovered as incidental findings.
They usually cause no symptoms but can occasionally be felt as
a pulsatile swelling in the abdomen by your doctor. Sometimes
they cause back and abdominal pain by pressure. When suspected
the diagnosis is made with ultrasound or CT scan.
How
is it treated?
An
operation is usually recommended when they cause symptoms or otherwise
exceed a diameter of 5cm. Above this size the risk of rupture,
which carries a very high mortality, rises significantly. Smaller
aneurysms which are usually observed with regular scans may grow
to the critical size or expand at a rate where surgery becomes
advisable. Surgery involves replacing the aneurysm with a synthetic
material called Dacron through a long abdominal incision. The
operation and the risks involved are usually explained in detail
by the surgeon. A minimally invasive technique may be used especially
in an otherwise unfit patient by inserting the graft through a
groin artery(endoluminal repair).
Who
can develop an Aneurysm?
Those
at risk include:
- Men
above the age of 60
- Family
history of aneurysms especially brother or father
- History
of heart disease eg angina, myocardial infarction(heart attack),hypertension
or evidence of atheroclerosis.
- Smoking
is the most important avoidable risk factor.
Screening
by ultrasound scanning targeted at the high risk population remains
under debate.
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