Aneurysm

Definition & Types

• An aneurysm is an abnormal dilation or weakening of a blood vessel wall.

• Can occur in the aorta (abdominal or thoracic), peripheral arteries, cerebral arteries, etc.

Risks & Consequences

• Risk of rupture, which can cause massive internal bleeding and death.

• Pressure on neighboring structures (e.g. nerves or organs).

• Thrombus formation inside the aneurysm, embolization.

Diagnosis

• Imaging: ultrasound (for abdominal), CT angiography, MR angiography.

• Monitoring size and growth rate.

Treatment

• Conservative management for small aneurysms (monitoring, blood pressure control).

• Surgical repair if aneurysm is large or symptomatic:
    – Open repair: excision and grafting
    – Endovascular repair (stent grafts) – less invasive, faster recovery.

Aneurysms — more nuance

• Growth rate & rupture risk: Decisions on when to intervene depend on size thresholds (e.g. abdominal aortic aneurysms > 5.5 cm in many guidelines) and growth rates.

• Endovascular vs open repair trade-offs: Endovascular repair (EVAR) is less invasive, with quicker recovery but has risks of endoleaks (persistent blood flow into aneurysm sac).

• Surveillance strategies: After repair, periodic imaging is required to ensure graft integrity, detect leaks or expansion.

• Genetic & connective tissue links: Some aneurysms are associated with genetic conditions (Marfan’s, Ehlers–Danlos), which may affect management.