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Understanding Aneurysms: Diagnosis, Treatment, and Outcomes

Understanding Aneurysms: Diagnosis, Treatment, and Outcomes

An aneurysm can be a life-threatening occurrence. Fortunately, it is a condition that is well understood and has benefited from recent advances in treatment. Patients can reduce the fear that may surround this diagnosis by learning exactly what an aneurysm is, complications that may arise, and what treatment options exist.

To listen to an in-depth conversation on this topic with Dr. Andreas Sakopoulos, cardiothoracic surgeon at Salinas Valley Memorial Healthcare System (SVMH), click here.

What Is an Aneurysm?

Dr. Andreas Sakopoulos, a cardiothoracic surgeon at Salinas Valley Memorial Healthcare System (SVMHS), explains it best. “An aneurysm is a localized dilation of an artery. A portion of it is grown and swelling more than the other parts of the artery. It is the localized swelling of any artery, and it can affect any artery of the body.”

The aorta is a large artery that connects blood flow through the body, like a blood superhighway. “It comes out of the heart, up towards the neck, and gives off branches that go to the arms, into the brain arteries, then takes a big U-turn around the neck and goes down the spine, explains Dr. Sakopoulos. “When it hits the belly button, it splits into two. One goes to the left leg. One goes to the right leg”.

The split in the stomach area has higher propensity of aneurysms than other areas. Aneurysms also occur in brain arteries and in other areas of the body. “Any artery of the body is potentially prone to develop this aneurysmal dilation or this swelling,” notes Dr. Sakopoulos. “One can envision that if an artery continues to get bigger and bigger and bigger, it could potentially get so big that it bursts. What should be flowing in this tube will actually instead emanate out of the artery and bleed. That is a potentially life-threatening situation.”

Aneurysm Complications

In addition to the potential bursting of the aneurysm, there is also risk of clotting. When clots develop, they could break apart and plug up arteries in other areas of the body. These blockages are called embolisms. “An aneurysm does not give you any symptoms until it becomes complicated, until it’s developing one of those complications,” warns Dr. Sakopoulos.

Arterial thickness varies throughout the body, but specific factors weaken these arteries. Some factors cannot be altered, like family history and male gender. However, smokers and those with high blood pressure can take action to reduce their risk of aneurysm. Smoking may directly harm the lining of the arteries, and high blood pressure may expand the artery and weaken its walls. Those with high risk factors should be screened regularly.

“Generally speaking, if you start developing pain, it means that the aneurysm is either rupturing or dissecting or embolizing. There is a complication occurring,” says Dr. Sakopoulos. “The key would be to try to discover who has an aneurysm before it develops a complication.”

Treatment Options

With the advancement of aneurysms treatment over the last several years, there are two main treatment options. First is the removal of the area where the aneurysm exists; replacing that spot of artery with a graft. This is a common treatment.

Another technique is to place a stent graph within the artery. “We place a sleeve inside the aneurysm and fix it above the aneurysm and then downstream from the aneurysm,” explains Dr. Sakopoulos. “Imagine you have a normal-looking vessel, then a dilated portion of the vessel, and then it gets normal again. As long as you can put a sleeve a tube that will fit inside and attach it snugly upstream and downstream from the aneurysm, the aneurysm will still be there but the blood will be flowing in.” It essentially creates an internal bypass.

Although an aneurysm can be fatal, it doesn’t have to be. Knowing your risk factors and getting screened can put you on the path to treatment. “Things are very safe at our hospital. Please do not hesitate to come and visit, and please do not delay medical care. All precautions are taken in the hospital for prevention of COVID-19. We have an excellent emergency room department. Please don’t hesitate to come,” urges Dr. Sakopoulos.