Click Here

Wednesday, March 19, 2008

Aneurysm

An Aneurysm (or aneurism) is a localized, blood-filled dilation (balloon-like bulge) of a blood vessel caused by disease or weakening of the vessel wall. Aneurysms most commonly occur in arteries at the base of the brain (the circle of Willis) and in the aorta (the main artery coming out of the heart), a so-called aortic aneurysm. The bulge in a blood vessel can burst and lead to death at any time. The larger an aneurysm becomes, the more likely it is to burst.

Formation:
Most frequent site of occurrence is in the anterior cerebral artery from the circle of Willis. The occurrence and expansion of an aneurysm in a given segment of the arterial tree involves local hemodynamic factors and factors intrinsic to the arterial segment itself.

The human aorta is a relatively low-resistance circuit for circulating blood. The lower extremities have higher arterial resistance, and the repeated trauma of a reflected arterial wave on the distal aorta may injure a weakened aortic wall and contribute to aneurysmal degeneration. Systemic hypertension compounds the injury, accelerates the expansion of known aneurysms, and may contribute to their formation.

Aneurysm formation is probably the result of multiple factors affecting that arterial segment and its local environment.

Treatment:
Historically, the treatment of arterial aneurysms has been surgical intervention, or watchful waiting in combination with control of blood pressure. Recently, endovascular or minimally invasive techniques have been developed for many types of aneurysms.
Brain Aneurysm-Currently there are two treatment options for brain aneurysms: surgical clipping or endovascular coiling.
Aortic & Peripheral Aneurysm-For aortic aneurysms or aneurysms that happen in the vessels that supply blood to the arms, legs, and head (the peripheral vessels), surgery involves replacing the weakened section of the vessel with an artificial tube, called a graft that is sutured at vascular stumps. Instead of sewing, the graft tube ends, made rigid and expandable by nitinol wireframe, can be much more simply and quickly inserted into the vascular stumps and there permanently fixed by external ligature. Less invasive endovascular techniques allow covered metallic stent grafts to be inserted through the arteries of the leg and deployed across the aneurysm.

No comments: