Surgical repair of aneurysms is done by a couple of different methods. We typically do not hear about an aneurysm until it ruptures; this may make you think an aneurysm is a ruptured blood vessel. That is not the case. An aneurysm is an enlarged artery. It develops from a weakened area in the artery wall. The weakened area does not necessarily cause swelling, but it causes a bulge in the artery. Sometimes it causes symptoms, but in most cases it does not. Aneurysms may be monitored, but if they continue to grow, surgery must be done to repair them. If you do not get surgery, you are at risk of rupture. Surgery can be done in two separate methods. The doctor will determine which surgery is best for you depending on the factors of your health and the aneurysm.
Aneurysms alone are not as serious as the risk of rupture. When aneurysms rupture, it becomes life threatening. Aneurysms can occur in a lot of different areas of the body. The most common areas for an aneurysm include the aorta and brain. Aortic aneurysms may occur in the abdomen or thorax. A normal aorta is only about 0.8 inches in diameter. An aneurysm can grow up to about 2 inches in diameter before it ruptures. There is no real cause of an aneurysm, but there are several risk factors that may lead to the development of one.
Atherosclerosis and high blood pressure are two major risk factors for aneurysms. It is important to understand that arteries are elastic. They can expand and constrict based on blood flow. When the artery is constantly in a stretched state, it may not return to its normal state again. Atherosclerosis is the hardening of the arteries. When plaque builds up in the arteries, it can weaken the artery wall and create a bulge. High blood pressure may not seem like a problem initially, but over time, it leaves the walls of the artery stretched and creates an aneurysm. Heredity may also play a role in aneurysms. If aneurysms run in the family, you are at a higher risk for having one.
If you develop an aneurysm, you may have symptoms or you may not. With aortic aneurysms, you may have back pain or abdominal pain. Your blood pressure may fluctuate, and nerves can be affected. Most aneurysms do not cause any symptoms at all and are not diagnosed until they rupture. Treatment for aneurysms is dependent upon the size and location of an aneurysm. There are three types of surgical repair: Endovascular surgical repair, open surgery, and clipping.
Endovascular surgery is also known as an endovascular stent graft. This type of repair can be done in both the brain and aorta. The surgery is minimally invasive. The doctor first makes a small incision into the area of an aneurysm. The next incision is made into the artery. A catheter is placed through the incision. For aortic aneurysms, a stent is placed inside to strengthen the walls of the artery. Once the stent is in place, the catheter is removed and in most cases aneurysms are totally avoided. For brain aneurysms, the catheter releases contrast dye into the brain so they can see the blood vessels clearer. Instead of a stent, the catheter inserts metal wires that coil into a ball. The blood clots help to hold the coils in place. A stent may be used in conjunction with the coils to help hold those in place as well.
Open surgery relates to open abdominal surgery. This method is only useful for aortic aneurysms. The surgery is invasive and requires the opening of the abdominal cavity. The aorta is exposed and repaired that way. The doctor does the same thing as endovascular surgery by placing a stent inside in the artery wall. Instead of using a catheter, the doctor places the stent in with their hand. The surgery takes more time and has great risks. This could be the only option for aneurysms that are larger and are about to rupture.
The last method of treatment is clipping. Clipping is a form of treatment strictly for brain aneurysms. The brain is cut open; the scalp, skull, and all. The doctor places the clip on the base of an aneurysm to prevent it from bursting. This method of surgical repair is different from the rest. The other methods are only useful before aneurysm ruptures. This method is useful both before a rupture and after a rupture. It is typically the first method of treatment once a brain aneurysm burst.
All three surgical methods are life-saving. A ruptured aneurysm is a very serious problem and requires immediate attention. Several factors determine the method of surgical repair. If an aneurysm is too large, endovascular repair may not be the best method of treatment. The doctor has to weigh all the options and choose the method that will suit you best.
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