Aneurysms

Diagnosis of Aneurysms

An aneurysm is a bulge or weakening in a blood vessel wall, which can occur in arteries such as the aorta, brain arteries, or peripheral vessels. Diagnosis involves:

Medical history and physical exam

• Your healthcare provider will review risk factors, including family history, high blood pressure, smoking, or connective tissue disorders.

• Physical examination may detect a pulsating mass, especially in abdominal aneurysms.

Imaging tests

• Ultrasound: Commonly used for screening abdominal aortic aneurysms.

• CT scan or CT angiography: Provides detailed images of the blood vessels and aneurysm size.

• MRI or MR angiography: Used to assess aneurysms in the brain or other vessels.

• Cerebral angiography: Specialized test to examine aneurysms in the brain.

Additional tests

• Blood tests may be done to check for conditions contributing to aneurysm formation, such as high cholesterol or connective tissue disorders.

• Screening for aneurysms may be recommended for individuals with family history or risk factors.

Treatment of Aneurysms

Treatment depends on the size, location, and risk of rupture:

Monitoring (Watchful waiting)

• Small aneurysms often do not require immediate surgery.

• Regular imaging is performed to track growth and rupture risk.

Medications

• Blood pressure control with beta-blockers or other antihypertensives can reduce stress on the artery wall.

• Cholesterol-lowering drugs may be prescribed to reduce atherosclerosis-related risk.

Surgical treatments

• Open surgical repair: The aneurysm is removed and replaced with a synthetic graft.

• Endovascular repair (EVAR): A minimally invasive procedure using a stent graft inserted through a blood vessel to reinforce the aneurysm wall.

Emergency treatment

• Ruptured aneurysms require immediate surgery to prevent life-threatening bleeding.

Key Takeaways

• Aneurysms can develop silently; early detection through imaging is crucial.

• Small aneurysms may only require monitoring and lifestyle management.

• Large or symptomatic aneurysms often need surgical repair to prevent rupture.

• Controlling blood pressure, cholesterol, and other risk factors is important for prevention.