What are the Types of Aneurysms?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Aneurysms?
The ballooning or bulging of the wall of a blood vessel, which is usually an artery, due to weakening is known as an aneurysm. The bulge is known as an aneurysm when the dilation of the blood vessel is at least 50% more than the normally expected diameter of the blood vessel. An aneurysm is normally asymptomatic, but the sudden bursting of the aneurysm can cause life-threatening bleeding. In this article, we will be discussing in detail the various type of aneurysms.
- What is the different type of Aneurysms?
- What are the causes of Aneurysms?
- What are the risk factors of Aneurysms?
- What are the symptoms of Aneurysms?
- How to diagnose Aneurysms?
- What is the treatment for Aneurysms?
- What are the risks of Aneurysms?
- How to prevent Aneurysms?
What is the different type of Aneurysms?
Aneurysms can be classified based on their location in the body as follows:
Aortic aneurysm:
- This type of aneurysm is located in the aorta, which is the main blood vessel of the heart that carries blood from the heart to the other organs of the body.
- The normal diameter of the aorta is 2 to 3 centimeters in diameter, and the aortic aneurysm can bulge to 5 centimeters or more.
- Aortic aneurysms can further be of the following two types:
Abdominal aortic aneurysm: This type of aneurysms is seen in the section of the aorta passing through the abdomen or stomach area.
Thoracic aortic aneurysm: This type of aneurysm is seen in that section of the aorta that passes through the chest region.
Cerebral or brain aneurysm:
- This type of aneurysm occurs in the blood vessels that supply blood to the brain.
Peripheral aneurysm:
- This type of aneurysm is seen in the blood supplying the other parts of the body, like the groin, legs, or neck.
- The different types of peripheral aneurysm are:
Femoral artery aneurysm: This type of aneurysms occurs in the femoral artery in the groin region.
Carotid artery aneurysm: This type of aneurysms is seen in the carotid artery in the neck area.
Popliteal aneurysm: This is the most common type of peripheral aneurysm, that is seen behind the knees.
Mesenteric artery aneurysm: This type of aneurysm is seen in the artery that transports blood to the intestines.
Splenic artery aneurysm: This type of aneurysm occurs in the splenic artery that supplies blood to the spleen.
Visceral aneurysm: This type of aneurysms occurs in the arteries supplying blood to the kidneys or bowel.
Aneurysms can also be classified according to the shape of the bulge in the artery, as follows:
- Fusiform aneurysms: This type of aneurysm shows bulging on all the sides of a blood vessel.
- Berry aneurysm: This type of aneurysm shows bulging that looks like a berry on a narrow stem. This is the most common form of cerebral aneurysm.
- Saccular aneurysm: This type of aneurysm shows bulging only on one side of the vessel.
- False aneurysm or pseudoaneurysm: A breach in the vessel wall layers leads to the leaking of blood within. The leakage is then contained by the perivascular tissue of the blood vessel or the surrounding soft tissue to create a pseudoaneurysm. A hole in the wall of the blood vessel acts as a means of direct communication of blood flow between the blood vessel and aneurysm. False aneurysms have a higher risk of rupture and therefore require immediate treatment.
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What are the causes of Aneurysms?
The various causes of aneurysms may include:
- High blood pressure causing damage and weakening of the blood vessels
- Congenital aneurysm (weakness in the wall of a blood vessel present from birth)
- Atherosclerosis (deposit of fat and cholesterol in the blood vessel wall)
- Injury or trauma
- Inherited diseases resulting in weaker walls of the blood vessels
- Sexually transmitted diseases like syphilis
- Kidney disorders, like polycystic kidney disease (cluster of fluid-filled sacs, known as cysts, are formed in the kidneys) that increases the risk of cerebral aneurysm
- Infection
- Unknown cause
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What are the risk factors of Aneurysms?
Certain factors increase the risk of developing aneurysms and may include:
- Age above 65 years
- Family history of aneurysm
- Abdominal aortic aneurysms are more commonly seen in men, whereas, brain aneurysms are more commonly seen in women
- Obesity
- Hypertension (high blood pressure)
- Smoking
- Poor diet
- Sedentary lifestyle
( Know more about- What is Hypertension? )
What are the symptoms of Aneurysms?
In the initial stages, aneurysms are usually asymptomatic. They usually turn symptomatic on rupturing. The symptoms, when present, depending on the location of the aneurysm and may include:
Abdominal aortic aneurysm: This condition is usually difficult to detect as it is slow-growing and asymptomatic. The aneurysm may or may not rupture, and an enlarged aneurysm may have the following symptoms:
- Back pain
- Constant, deep pain in the abdomen (stomach region) or on the side of the abdomen
- Pulsation felt near the belly button
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Thoracic aortic aneurysm:
- Difficulty in breathing
- Difficulty in swallowing
- Persistent cough
- Hoarseness of voice
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- Shortness of breath
- Pain in the chest, jaw, and upper back region
Unruptured cerebral aneurysm:
- Numbness on side of the face
- Double or blurred vision
- Pain behind and above one eye
- Dilated pupil
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Ruptured aneurysm:
- Confusion
- Double or blurred vision
- Loss of consciousness
- Drooping eyelid
- Nausea
- Vomiting
- Seizure
- Stiff neck
- Sensitivity to light
- Sudden, severe headache
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How to diagnose Aneurysms?
- Physical examination: The doctor will check the physical symptoms of the patient. The patient’s medical history and family history are also noted.
- CT scan: It is an imaging test that helps in obtaining clear pictures of the heart or brain, and the blood vessels inside.
- MRI scan: Magnets, radio waves, and a computer are used to obtain detailed images of the heart or brain, and check for any abnormalities in the blood vessels.
- Vascular ultrasound: Sound waves are used to check for abnormalities like blockages and blood clots in the blood vessels.
- Chest x-ray: It helps in obtaining the images of the organs inside the chest, like the heart, lungs, and blood vessels. Abnormalities in the heart or blood vessels can be detected using x-ray images.
- Angiogram: A long, flexible tube, known as a catheter, is inserted into a blood vessel through the neck, arm, or groin region. The catheter is then threaded to the heart and a dye is injected into the catheter. The dye travels to the brain or heart, and x-rays are then taken and checked for any abnormalities in the blood vessels.
( Know more about- What is Angiography? )
- Lumbar puncture or spinal tap: It is a procedure done for extracting and examining a small amount of cerebrospinal fluid (CSF) to check if there is any blood present, which could be indicative of a ruptured or leaking aneurysm.
- Electrocardiogram (ECG): This test helps in measuring the electrical activity of the heart and checking for any irregularities in the heart.
- Electroencephalogram (EEG): This test helps in measuring the electrical activity of the brain and checking for any irregularities in the brain.
- Echocardiography: Sound waves are used to obtain moving images of the heart, and to check if the chambers and valves of the heart are working properly.
- Stress test: This test helps in checking if the heart is working well under physical stress.
( Know more about- What is Echocardiography? )
What is the treatment for Aneurysms?
The type of treatment done for an aneurysm depends on the size of the aneurysm and how fast it is growing. The different treatment options include:
Medical monitoring:
- This treatment is recommended in cases of small abdominal aortic aneurysm, which is asymptomatic.
- Regular checkups and imaging tests are recommended to check the growth of the aneurysm.
- In cases of an unruptured aneurysm, blood pressure control by medications, and quitting smoking is recommended.
Surgery:
- Surgery is recommended in cases of large aneurysms, which are rapidly growing and are symptomatic.
- Surgical repair options include:
( Know more about- What are the types of Aneurysm Surgeries ? )
- Open abdominal surgery: The surgeon makes a large incision (cut) in the abdomen where the aneurysm exists. The damaged area of the aorta is then separated and replaced by a synthetic graft, and sutured (stitched) into place. The procedure is performed under general anesthesia (patient is asleep during the procedure) and takes 3 to 4 hours to complete. The patient usually stays in the hospital for 7 to 10 days after the procedure.
- Endovascular repair: A stent graft is placed by the surgeon in the damaged area of the aorta to separate the aneurysm from the normal flow of blood. This is a minimally-invasive procedure done without opening the aorta surgically. The patient stays in the hospital for 2 to 4 days after the procedure.
- Emergency surgery in case of a ruptured aneurysm: A ruptured aneurysm or an aneurysm with an increased risk of rupture requires emergency surgery.
- Surgical clipping for cerebral aneurysm: A part of the skull is removed by the surgeon by a craniotomy procedure to locate and access the aneurysm. A metal clip is then placed on the neck of the aneurysm to obliterate the blood flow
- Endovascular therapy or coiling for brain aneurysm: This is a minimally-invasive procedure, in which a catheter or a hollow tube is inserted through a small cut made in the groin region. A guidewire is then passed through the catheter, and a soft platinum wire is pushed into the aneurysm. The blood flow to the aneurysm is cut off by a coiling wire around the base of the artery, where it supplies blood to the aneurysm.
- Flow diverters for brain aneurysm: Flow diverters are stent-like, tubular implants that divert the blood away from the aneurysm sac. The body is then stimulated for healing the site and reconstruction of the patent artery.
Treatment options for peripheral aneurysms:
- The various treatment options for peripheral aneurysms are similar to aortic aneurysm and include:
- Monitoring and observation for a small aneurysm.
- Surgical repair (bypass) procedure
- Endovascular repair
( Know more about- What is Brain Aneurysm Surgery? )
What are the risks of Aneurysms?
The various complications of aneurysms include:
- Thromboembolism (obstruction of blood flow to the adjacent organs and tissues, leading to the formation of masses of blood, known as blood clots)
- Stroke (the blood flow to the brain is interrupted)
- Severe pain in the chest region
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- Severe pain in the back
- Hydrocephalus (the collection of fluid in the brain)
- Angina pectoris (sudden pain in the chest area that may lead to a heart attack)
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- Subarachnoid hemorrhage (rupture of aneurysm causing bleeding in the space that surrounds the brain)
- Vasospasm (constriction of the blood vessels)
- Brain damage
- Kidney failure
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- Damage to the nearby nerves
- Coma (a prolonged state of unconsciousness
How to prevent Aneurysms?
Certain lifestyle changes can help in preventing aneurysms and may include:
- Eat a healthy diet
- Quit smoking
- Exercise regularly
- Manage stress
- Maintain a healthy weight
- Treatment of conditions like diabetes, high cholesterol, high blood pressure
- Screening tests for abdominal aortic aneurysm after the age of 65
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We hope that we could answer all your questions regarding the type of aneurysms through this article.
If you need more information about the different type of aneurysms, you can contact a Cardio-Vascular and Thoracic Surgeon.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give the best advice and correct treatment plan.
