Aortic aneurysm

Aortic aneurysms can appear in any area throughout their entire course, being more frequent in the abdominal aorta (80%) than in the thoracic aorta (20%). An aneurysm is considered when the widening, that is, the diameter of the artery is 1.5 times larger than usual.

How is it produced?

The aorta is the main and largest artery of the organismor. It leaves the left ventricle and distributes blood throughout the body, making its way through the chest (thoracic aorta) and the abdomen (abdominal aorta) where it bifurcates into the iliac arteries that will supply the extremities.

The aneurysm appears due to a progressive weakness of the layers that make up the wall of the artery. The most common cause is atherosclerosis, especially in abdominal aneurysms. La is a disease of the arteries in which there is a narrowing of their caliber and a hardening of the wall, which can dilate, leading to an aneurysm.

Other causes of aneurysm They can be infections, trauma, hypertension, diabetes and inflammatory diseases that affect the large blood vessels.

Symptoms

In most cases the aneurysm is totally asymptomatic and it is usually an accidental finding when the patient undergoes a test (for example a CT scan) for another reason. When they give symptoms depend on location and size of the aneurysm, presenting highly variable symptoms.

• In the thoracic aneurysms Symptoms may appear due to compression of the organs near the aorta or due to the rupture of the aneurysm. The patient may present with chest pain, emission of blood from the mouth (hemoptysis), feeling short of breath, cough, difficulty swallowing, nausea, vomiting, loss of consciousness and heart failure, among others.
• In the abdominal aneurysms Abdominal or lumbar pain, constipation, or a 'throbbing' mass may appear on physical examination.

The breaking off An aneurysm is the most serious complication and can cause immediate death of the patient. The risk of rupture is related to the size of the aneurysm.

Diagnosing an aneurysm

The diagnosis is often accidental when performing a radiological test to the sick for another cause. Besides of physical examination and complete medical history, the procedures to diagnose an aortic aneurysm is performed by imaging techniques that allow a detailed view of the aorta and the existence of a dilation.

• Computed tomography (CT): it is generally the most used technique.
• Magnetic resonance imaging (MRI).
• (transthoracic and abdominal).
• Arteriography Invasive procedure in which a contrast agent is injected through a catheter placed in an artery that allows the blood vessels to be seen in the X-ray image. It is usually performed before surgery to assess in detail the involvement of the vessels that come out of the the aorta.

Treatment

The treatment depends on size and location of the aneurysm and the presence or not of symptoms. If the size of the aneurysm it is small and there are no symptoms the aneurysm is monitored by performing controls with periodic ultrasound and CT, generally every 6-12 months.

• The treatment surgicalIn other words, aneurysm repair is indicated in aneurysms that show symptoms, with risk of rupture due to their diameter or that have a rapid growth rate (more than half a centimeter per year). Consists of the removal of the aneurysm segment of the aorta that is replaced by an arterial segment of synthetic material (prosthesis) and restores normal circulation. Aneurysm surgery has serious risks and complications that can affect (depending on their location) the brain, heart, kidney or abdomen mainly.
• It also can place a stent, that is, a metallic expandable prosthesis that is placed inside the weakened vessel wall and keeps it open. The aneurysm will remain, but the blood will circulate inside the prosthesis.

In all patients with aneurysm, strict control of blood pressure must be carried out, so they are given antihypertensive drugs.

Prevention

Lead healthy lifestyle habits: not smoking, cholesterol, hypertension and diabetes control reduces the risk of vascular diseases.