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What are aneurysms?

Aneurysms are abnormal bulges in blood vessels. They can occur anywhere in the circulation, but are commonly found in the aorta: the main artery in the abdomen. These aneurysms are common in men over 60 years of age and may cause no symptoms whatsoever; being found incidentally during medical examinations or scans. On the other hand, back pain, discolouration of the toes, or sudden collapse are well recognised symptoms of this condition. Fortunately most men with back pain do not have an aneurysm! The larger the aneurysm the greater the risk of it rupturing (the image below shows the haematoma around the aneurysm). The result of rupture is certain death unless emergency repair is carried out.

Drawing showing the position of the aorta and the usual site of an aneurysm

Side-on view taken from a CT scan of an aneurysm. The bones are in white; the right kidney in brown and the aorta in red.

What causes aneurysms and can they be prevented?

The main risk factors for developing aortic aneurysms are hypertension (high blood pressure), smoking and a positive family history of aneurysms.

Much research has focussed on ways of preventing aneurysms growing or bursting. While some drugs with potential benefit have been identified we are a long way from being able to treat this condition without surgery.

What should be done about my aneurysm?

Small aneurysms can safely be monitored with regular ultrasound scans until they reach the size at which surgery is usually recommended (a diameter of 5.5 cm or so). Larger aneurysms can be repaired by conventional surgery or by the newer -and less invasive- endovascular surgery (stenting). Unfortunately the precise size and shape of an aneurysm does not always lend itself to stenting; and stenting has some potential long term problems.

Aneurysm surgery carries a significant mortality (5-10%) even if performed electively (non-emergency) and represents a major stress for the heart, lungs and kidneys. Therefore your Vascular Surgeon may suggest some tests to check that you heart and lungs are fit enough to withstand an operation.

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