Is an aneurysm a death sentence?

Aneurysm is an expansion of the vessel, more than twice its normal diameter. More than 60% of all aneurysms are located in the abdominal aorta. This pathology arises more often in people suffering from rheumatism, aortoarteritis, syphilis, atherosclerosis, tuberculosis. A common cause of an aneurysm is a trauma to the abdomen, operations on the aorta.

The mechanism of occurrence

The onset of enlargement is associated with degenerative changes in the elastic aortic framework. With increasing resistance in the distal parts of the arteries, the pressure in the abdominal aorta increases. In the absence of a vessel's ability to withstand increased pressure, its expansion occurs at a particular location. Aneurysm - an aorta site with turbulent blood flow, in which thrombi are often formed.

Clinic

With a small diameter of the aneurysm (less than 20% of cases), asymptomatic flow is possible. In other cases, all clinical signs of an aneurysm are divided into typical and indirect. Typical: pulsating abdominal formation, pain, noise during cardiac contraction over the aneurysm. Pain can resemble a hepatic or renal colic, localized to the left of the navel, can radiate into the back or waist.

Indirect signs

• Abdominal syndrome: nausea, vomiting, lack of appetite, weight loss.
• Urologic syndrome: hematuria, dysuric disorders.
• Ishioradicular syndrome: back pain, motor and sensitive disorders in the legs.
• Chronic leg ischemia syndrome: intermittent claudication, trophic changes.

Aneurysm is a constantly progressive disease. More than half of the patients die within 2 years after the diagnosis of the complications that have arisen.

Diagnostics

Ultrasonic examination allows to establish localization and the sizes of education. On the aneurysm monitor is a rounded expansion of the vessel with clear contours, near-wall overlays and slowed turbulent blood flow. With angiography, the aorta is enlarged. On the overview radiographic image of the abdominal cavity organs , the enlarged contours of the aorta with calcification deposits are visible, often accompanied by impressions on the vertebrae - by usuras. With CT, a rounded formation with clear contours, thin walls, parietal thrombi and calcifications is determined.

Treatment

Aneurysm is a disease in which, in the vast majority of cases, surgical intervention is performed, which is associated with a high probability of complications. The operation is contraindicated for patients who have suffered acute myocardial infarction, have a history of circulatory insufficiency, stroke.

Operative intervention

There are various options for surgical treatment:

• Removal of an aneurysm along with an aneurysmal sac, aortic prosthetics or bypass surgery;
• Removal of aneurysm without a bag with intramuscular prosthetics.

Prosthetics are often accompanied by aortic prosthesis. Mortality after the intervention does not exceed 10%. If the risk of surgery is high, aortic stenting is carried out: carrying a self-expanding prosthesis through the femoral artery .

Complicated aneurysm

The consequences of an aneurysm directly depend on its size: the larger it is, the greater the probability of its dissection or rupture.