Aneurysm Rupture
As the aneurysm grows a number of things can happen. The most serious complication of aneurysm disease is when the widened blood vessel bursts. This is known as a ruptured aneurysm. It most frequently occurs in the main vessel within the abdomen called the Abdominal Aorta and usually causes fairly instant death. In some circumstances there is a more controlled situation and treatment is possible. Even in the best cases, however, the chances of surviving a ruptured aneurysm is about 1 in 20. Those that do survive often have a long recovery and often have lasting problems relating to the major surgery involved. Preventing patients dying from Ruptured Abdominal Aortic Aneurysm is a major part of the work of the Vascular, Endovascular and Transplant team at the Christchurch Public Hosptial. We do this by treating aneurysms that have grown to a risky size before they rupture. For more about Treatment of Aortic Aneurysm, click here.
Aneurysm Dissection
Another complication of aneurysm is dissection (di-sect-shon), where the wall of the artery tears into layers like an onion skin. The main artery in the chest, the Thoracic (tho-ras-ik) Aorta, is most prone to dissection, particularly when there is very high blood pressure. It can cause problems with the heart or with blood flow to vital organs. In most cases strict blood pressure control is all that is required providing there is no further change in the aorta like enlargement of the weakened wall, and that there is no vital organ affected. Procedures to cover the tear with a stent or repair the vessel are reserved for the treatment of complicated dissection because of the risks involved in the treatments.
Aneurysm Thrombosis
Aneurysms of smaller vessels, particularly those in the limbs, tend to either block with a clot themselves or send multiple clots down the vessel into other arteries. This can cause the blood supply to that area to block completely and results in those tissues dying. If it is a slow process, the body can frequently adapt without there being a significant set of symptoms. If it is a sudden event then the body doen't have time and the tissues begin to die very quickly. It is vitally important that a patient with a thromboses aneurysm is treated in a timely manner. They frequently lose the use of their limb, and often that required removal through amputaion. An early sign of the presence of an aneurysm can be the development less significant areas of the body having blocked blood supply tyically the fingers or toes.
Embolisation
As the aneurysm gets wider, layers of clot can form at the edges. Over time these clots become stable but occasionally the stable surface becomes disrupted and bits of clot flow further along the artery with the blood as it flows to other parts of the body. Eventually the bit of clot, the embolus, gets lodged in a smaller vessel and this can block it completely. Whether this causes a problem at all depends on the rest of the blood supply to the same area and the type of tissues affected. It is a classical sign of aneurysm disease, for example, for the patient to develop a painful discloured 'blue' toe when the clot embolises to the small blood vessels of the great toe. Apart form the pain and discolouration it rarely causes a significant problem, the toe usually slowly recovers. If the clot embolises to a part of the gut however, there can be a bowel perforation and this can lead to very significant life-threatening illness. If there is evidence of embolus arising from an aneurysm, it is generally advisable to have the aneurysm treated irrespective of its size.
Infection/Inflammation
Stable layers of clot that build up can occasionally cause inflammation of the aorta. This is sometimes caused by bacterial infection. Pain is the predominant symptom, accompanied with general "unwellness" and, sometimes, a fever. Inflammatory aneurysms are dangerous and require urgent treatment. Depending on their size and position they would either be repaired by graft or stent insertion and the patient treated with both antiinflammatory drugs and high strength antibiotics for long periods.
Pressure effects
Rarely, the only complication or symptom that an aneurysm gives is one related to its size and its location. Occasionally there are symptoms of cough, difficulty swallowing, weight loss, feelings of fullness, numbness or weakness. These symptoms are often related to large aneurysms which can be easily identified by simple examination and investigations.
As the aneurysm grows a number of things can happen. The most serious complication of aneurysm disease is when the widened blood vessel bursts. This is known as a ruptured aneurysm. It most frequently occurs in the main vessel within the abdomen called the Abdominal Aorta and usually causes fairly instant death. In some circumstances there is a more controlled situation and treatment is possible. Even in the best cases, however, the chances of surviving a ruptured aneurysm is about 1 in 20. Those that do survive often have a long recovery and often have lasting problems relating to the major surgery involved. Preventing patients dying from Ruptured Abdominal Aortic Aneurysm is a major part of the work of the Vascular, Endovascular and Transplant team at the Christchurch Public Hosptial. We do this by treating aneurysms that have grown to a risky size before they rupture. For more about Treatment of Aortic Aneurysm, click here.
Aneurysm Dissection
Another complication of aneurysm is dissection (di-sect-shon), where the wall of the artery tears into layers like an onion skin. The main artery in the chest, the Thoracic (tho-ras-ik) Aorta, is most prone to dissection, particularly when there is very high blood pressure. It can cause problems with the heart or with blood flow to vital organs. In most cases strict blood pressure control is all that is required providing there is no further change in the aorta like enlargement of the weakened wall, and that there is no vital organ affected. Procedures to cover the tear with a stent or repair the vessel are reserved for the treatment of complicated dissection because of the risks involved in the treatments.
Aneurysm Thrombosis
Aneurysms of smaller vessels, particularly those in the limbs, tend to either block with a clot themselves or send multiple clots down the vessel into other arteries. This can cause the blood supply to that area to block completely and results in those tissues dying. If it is a slow process, the body can frequently adapt without there being a significant set of symptoms. If it is a sudden event then the body doen't have time and the tissues begin to die very quickly. It is vitally important that a patient with a thromboses aneurysm is treated in a timely manner. They frequently lose the use of their limb, and often that required removal through amputaion. An early sign of the presence of an aneurysm can be the development less significant areas of the body having blocked blood supply tyically the fingers or toes.
Embolisation
As the aneurysm gets wider, layers of clot can form at the edges. Over time these clots become stable but occasionally the stable surface becomes disrupted and bits of clot flow further along the artery with the blood as it flows to other parts of the body. Eventually the bit of clot, the embolus, gets lodged in a smaller vessel and this can block it completely. Whether this causes a problem at all depends on the rest of the blood supply to the same area and the type of tissues affected. It is a classical sign of aneurysm disease, for example, for the patient to develop a painful discloured 'blue' toe when the clot embolises to the small blood vessels of the great toe. Apart form the pain and discolouration it rarely causes a significant problem, the toe usually slowly recovers. If the clot embolises to a part of the gut however, there can be a bowel perforation and this can lead to very significant life-threatening illness. If there is evidence of embolus arising from an aneurysm, it is generally advisable to have the aneurysm treated irrespective of its size.
Infection/Inflammation
Stable layers of clot that build up can occasionally cause inflammation of the aorta. This is sometimes caused by bacterial infection. Pain is the predominant symptom, accompanied with general "unwellness" and, sometimes, a fever. Inflammatory aneurysms are dangerous and require urgent treatment. Depending on their size and position they would either be repaired by graft or stent insertion and the patient treated with both antiinflammatory drugs and high strength antibiotics for long periods.
Pressure effects
Rarely, the only complication or symptom that an aneurysm gives is one related to its size and its location. Occasionally there are symptoms of cough, difficulty swallowing, weight loss, feelings of fullness, numbness or weakness. These symptoms are often related to large aneurysms which can be easily identified by simple examination and investigations.
