Four Key Questions About Aneurysm

What is an aortic aneurysm?

The aorta is the body’s main conduit, the one that carries blood from the heart to the rest of the body. It can suffer a process called aneurysm, or aneurysmal degeneration, which consists of dilation of its walls, so that it can rupture and cause internal bleeding. These situations can be very serious, of course, and the most important thing is early detection.

What are the causes of an aneurysm and what are the symptoms?

Most of the time aneurysms are caused by smoking, high blood pressure, or a family history of aortic problems or aneurysm problems. Among its symptoms, most of the time they are asymptomatic, i.e., the patient lives a normal life and because, today, because we do diagnostic tests, scans, MRI, ultrasound, for any other reason, they are found by chance in most cases. That is, a patient may have an aneurysm, even a large one, and not have any symptoms. What happens is that symptoms do occur when it becomes complicated, i.e. when it ruptures or when it suffers internal bleeding due to rupture.

What types of aneurysm are there?

Aneurysms are classified based on the criteria of their etiology, their location, because they can be thoracic or abdominal, thoracoabdominal… And also based on the type of morphology they have. The most important thing is to distinguish the most common, which are abdominal aortic aneurysms, which occur in the abdominal area of the aorta and thoracic aneurysms. And the patients, or perhaps the most dangerous types of aneurysms, are those that occur in areas of the aorta where vital branches of the body arise.

For example, if an aneurysm occurs in the arch area of the aorta, where the carotid arteries and the arteries that irrigate the brain leave, or if a thoracoabdominal aneurysm occurs, as we call it, which is right in the area where the arteries leave for the kidneys, for the intestine… those are the most dangerous, because in order to treat it we have to keep in mind to maintain the vascularization of the territories of the arteries that leave the area. All this has evolved a great deal in recent years, and numerous techniques have been developed, both open and endovascular, to be able to treat cases that not so many years ago we thought were inoperable.

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How can aneurysms be treated?

Regarding the treatment of aneurysms, it logically depends on their location. Aneurysms of the ascending aorta or aortic arch usually require open surgery and the use of extracorporeal circulation. Those of descending thoracic or abdominal aneurysms are increasingly performed with techniques that we call endovascular, they are minimally invasive techniques, with prostheses made to measure almost for each patient and are interventions that are usually done through the groin with small incisions and introducing prostheses that cover the aneurysm inside, from the groin or from the femoral, from the inside, making it unnecessary to open the cavities to reach the aneurysm itself.

In any case, there are cases in which there are better results with open surgery rather than endovascular, and of course each case is special and requires a completely thorough study to decide for each patient and for each type of aneurysm which is the best treatment indicated. The important thing is to be treated by professionals who do it on a daily basis and that all treatment options are available, both open and endovascular, so that, objectively, you can recommend to a patient what is the best treatment for your case.