What is an aneurysm?

An aneurysm is a bulging, weak area in the wall of a blood vessel. It may occur in any blood vessel, but most often develops in an artery rather than a vein. An aneurysm can be characterized by its location, shape, and cause. 

An aneurysm may be found in many areas of the body, such as the brain (cerebral aneurysm), the aorta (the largest artery in the body), the neck, the intestines, the kidney, the spleen, and the vessels in the legs (iliac, femoral, and popliteal aneurysms). The most common location of an aneurysm is the aorta, which carries oxygenated blood from the heart to the body. A thoracic aortic aneurysm is one that occurs in the chest cavity. An abdominal aortic aneurysm occurs in the abdomen. 

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What causes an aneurysm to form?

An aneurysm may be caused by factors that result in the break down of the artery wall. The exact cause isn't fully known. Atherosclerosis (hardening of the arteries) is thought to play an important role. Risk factors associated with atherosclerosis include:

Risk factors you can’t control:

  • Older age
  • Male
  • Family history
  • Genetic factors

Risk factors you can control:

  • High cholesterol
  • High blood pressure
  • Smoking
  • Diabetes
  • Obesity

Other specific causes of aneurysms are related to the location of the aneurysm.

What are the symptoms of an aneurysm?

Aneurysms may have no symptoms. If symptoms are present, they will depend on the location of the aneurysm in the body. Pain is the most common symptom regardless of the aneurysm location. The symptoms of an aneurysm may look like other medical conditions or problems. Always see your doctor for more information.

How are aneurysms diagnosed?

What tests you’ll need depends on the location of the aneurysm. Along with a complete medical history and physical exam, tests for an aneurysm may include:

  • Computed tomography (CT or CAT) scan. This imaging test uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
  • Magnetic resonance imaging (MRI). An MRI uses large magnets, radio frequency energy, and a computer to make detailed images of organs and structures in the body.
    Echocardiogram (echo). This procedure evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that makes a moving picture of the heart and heart valves.
  • Arteriogram (angiogram). This is an X-ray image of the blood vessels used to evaluate various conditions, such as aneurysm, stenosis (narrowing of the blood vessel), or blockages. A dye (contrast) will be injected through a thin flexible tube placed in an artery. This dye will make the blood vessels visible on the X-ray.
  • Ultrasound. An ultrasound uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. An ultrasound is used to view internal organs as they function, and to assess blood flow through various vessels.

What is the treatment for aneurysms?

Treatment options for an aneurysm may include:

  • Monitoring. Your doctor may monitor the size and rate of growth of your aneurysm with ultrasounds every 6 months to 12 months. This is part of a "watchful waiting" approach for smaller aneurysms. 
  • Managing risk factors. Steps such as quitting smoking, controlling blood sugar if you have diabetes, losing weight if overweight, and controlling dietary fat intake may help to control the progression of the aneurysm. 
  • Medicine. Medicine can help control factors such as high cholesterol and high blood pressure. 
  • Surgical repair. Surgical repair of the aneurysm can be done with large incisions and grafts or with smaller incisions, X-ray images and a stent-graft combination.

What are the complications of aneurysms?

The biggest complication of an aneurysm is that it may tear (dissect) or rupture. Because an aneurysm may continue to increase in size, along with progressive weakening of the artery wall, treatment is required to prevent rupture of an aneurysm. The larger an aneurysm becomes, the greater the risk for rupture (bursting). Rupture can cause life-threatening bleeding and possibly death. Loss of blood flow to the area the artery provides circulation to can cause organ and tissue death, which may lead to amputation of the dead tissue.

Living with an aneurysm

Until your aneurysm reaches the point where it needs to be repaired, it’s very important to follow your healthcare provider’s recommendations closely.

  • Have ultrasound screenings done as often as recommended
  • Follow recommendations regarding diet, exercise and physical activity, and weight management
  • Take medicine as prescribed

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, notify your healthcare provider. Get immediate medical attention if you have a sudden, severe pain in the area of the aneurysm. This could be a sign that the aneurysm has ruptured.

Key points about aneurysm

  • Aneurysms are bulging, weak areas of an artery wall and can occur anywhere in the body.
  • The most common symptom is pain in the area of the aneurysm.
  • Aneurysms are repaired once they reach a certain size to prevent rupture of the blood vessel.
  • Treatment of aneurysms also includes controlling risk factors such as blood pressures, cholesterol, diabetes, and stopping smoking, which may require changes in lifestyle and medicine.