What are three major causes of an aneurysm?
Types of AneurysmsAn aneurysm can occur in any blood vessel in the body, but those that occur in the brain, chest, and abdomen are the most serious, says Kimberly Brown, MD, MPH, an emergency room physician at the Baptist Memorial Health Care in Memphis, Tennessee. Show
Abdominal Aortic AneurysmsThe aorta is the main artery in the body that supplies oxygen to the brain, muscles, and cells in the body. An abdominal aortic aneurysm develops in the portion of the aorta located in the abdomen. Abdominal aortic aneurysms affect 4 to 8 percent of people, past research estimates. (2) Thoracic Aortic AneurysmsA thoracic aortic aneurysm forms in the portion of the aorta in the chest above the diaphragm. Only 50 percent of people who develop a thoracic aortic aneurysm notice symptoms, according to the National Heart, Lung, and Blood Institute (NHLBI). (3) As a 2015 review published in Open Heart notes, thoracic aortic aneurysms occur in about 10 in 100,000 people. (4) Cerebral AneurysmA cerebral aneurysm is in the arteries of the brain. Sometimes, these aneurysms are called brain or intracranial aneurysms. About 30,000 people a year will be affected by ruptured cerebral aneurysms and most are between ages 30 and 60, according to the National Institute of Neurological Disorders and Stroke. (5) Peripheral AneurysmPeripheral aneurysms affect areas of the body other than the aorta or the brain. These aneurysms can occur in the popliteal artery located behind the knees, the femoral arteries, or the main arteries in the groin and the carotid arteries in the neck, according to Beth Israel Lahey Health. (6) According to the Society for Vascular Surgery, peripheral aneurysms in the abdomen, also known as splenic aneurysms, are rare and affect 0.7 percent of the population. (7) Those in the legs are also uncommon, and affect 0.007 percent of men and fewer women. About 70 percent of peripheral arterial aneurysms are popliteal aneurysms and 20 percent are iliofemoral aneurysms, located in the hip joint. These types of aneurysm are usually accompanied by abdominal aortic aneurysms and more than 50 percent occur on both sides, notes the Merck Manual. (8) Mycotic and Dissecting AneurysmsMycotic and dissecting aneurysms are disease processes by which aneurysms can form, rather than individual types of aneurysm. For example, someone can be diagnosed with a mycotic cerebral aneurysm or a dissecting carotid aneurysm, which affects the carotid artery that carries blood to the head and brain, per the Mayo Clinic.(9) Mycotic Aneurysm Mycotic aneurysms are caused by a bacterial infection, usually one that originated in the heart, such as endocarditis, and cause the arterial wall to become infected and dilate, notes past research. (10) Mycotic aneurysms are rare, and represent 0.6 percent of all aortic aneurysms, per an article published in 2018 in the journal Clinical Medicine Insights: Cardiology. (11) Dissecting Aneurysm An aneurysm can also grow and dissect in both the brain and the aorta. “Blood dissects or travels underneath a tear in the innermost layer called the intima,” Teitelbaum says. “It lifts up the intima and causes a ‘bleb’ or an aneurysmal outpouching of the blood vessel,” he says. Aortic dissection is uncommon and occurs in 5 to 30 cases per one million people each year, notes Stat Pearls. (12) Learn More About Types of Aneurysms How Is an Aneurysm Diagnosed?Along with symptoms, several screening and diagnostic tools are used by doctors to diagnose an aneurysm. Aortic AneurysmFor abdominal and thoracic aortic aneurysms, a computerized tomography (CT) angiogram can help doctors see the extent of the aneurysm and if there is also clot in it, Teitelbaum says. Magnetic resonance imaging (MRI) may also be used. An abdominal ultrasound is recommended to screen men for aortic aneurysms. If an aneurysm smaller than 5.5 centimeters (cm) in diameter is found, your doctor will repeat the ultrasound every 6 to 12 months to make sure it doesn’t grow. Abdominal aortic aneurysms are the easiest to detect and follow, Brown says. Because symptoms can be vague and look different in women than in men, it’s important to know all the warning signs to look for. In 2019, the U.S. Preventive Services Task Force also updated their screening guidelines for abdominal aortic aneurysm for people who do not have signs or symptoms, according to an article published in the Journal of the American Medical Association. (19) According to the new recommendations, men between the ages of 65 to 75 who have never smoked should have a one-time ultrasound screening instead of routine screening of all men in the age group. Furthermore, the task force recommends against routine screening for abdominal aortic aneurysm in women who have never smoked and have no family history of the condition. Cerebral AneurysmSymptoms of a cerebral aneurysm can help your doctor make a diagnosis, but not everyone will have symptoms. “About 2 to 5 percent of Americans are walking around right now with a brain aneurysm and most don’t know it, since most of the time the first sign of an aneurysm is when it ruptures,” Teitelbaum says. A CT scan uses X-ray images to detect a cerebral aneurysm. But if the scans don’t detect anything, your doctor may use angiography, a test that uses dyes and X-rays to better visualize blood vessels and arteries, Teitelbaum says. Aneurysms that slightly bleed, known as sentinel hemorrhage, may not be detected on a CT scan, and in this case, a spinal tap will be done, Teitelbaum says. Peripheral AneurysmPeripheral aneurysms are diagnosed in physical exam. If one is suspected, duplex ultrasound and computerized tomography (CT) scans will be ordered to confirm the diagnosis. (7) Mycotic AneurysmMycotic aneurysms are diagnosed based on four different criteria: symptoms, laboratory results, CT or MRI results, or findings during surgery, yet there isn’t a consensus on how to diagnose them. (11) Dissecting AneurysmA dissecting aneurysm is diagnosed with a chest X-ray, however 10 to 20 percent of patients with a dissecting aneurysm have a normal scan. Other tests, such as MRI, CT scan, electrocardiogram, and transesophageal echocardiography (TEE), may be used, notes past research. (20) Aneurysm PrognosisThe outcomes and chance of recovery for aneurysm depend on the type. Abdominal Aortic AneurysmsAbdominal aortic aneurysms that are between 3 and 3.5 centimeters (cm) in diameter are considered a normal size, while those that are greater than 3.5 cm carry a higher risk for rupture. Those larger than 7 cm in diameter carry the highest risk of rupture, with between 20 and 40 percent of abdominal aneurysms of this size rupturing, according to Merck Manual. (21) About 50 percent of those with a ruptured abdominal aortic aneurysm make it to the hospital alive. Of those who do, up to 50 percent do not survive the repair, past research notes. (22) Meanwhile, those who have an elective operation have between 1 and 5 percent risk, per research. (23) “Since there is that death rate of elective treatment of abdominal aortic aneurysms, that’s why surgeons want to wait until they’re definitely in the range of a higher risk of rupture,” Teitelbaum says. In 2014, aortic aneurysms in general were the primary cause of nearly 10,000 deaths and a contributing cause of 17,215 deaths in the United States in 2009, according to the Centers for Disease Control and Prevention (CDC) and past research, respectively. (24,25) Overall, abdominal aortic aneurysms are estimated to cause 4 to 5 percent of sudden deaths, notes past research. (26) Thoracic Aortic AneurysmsThe risk of rupture is directly correlated to the diameter of a thoracic aortic aneurysm, per previous research. (27) According to a September 2015 study in the journal Circulation, people with aortic diameters of 50, 55, and 60 mm had an aortic event within one year at a rate of 5.5 percent, 7.2 percent, and 9.3 percent, respectively. (28) Overall, between 50 and 80 percent of people who suffer a thoracic aortic rupture do not survive, according to the SVS. (29) Among patients with a thoracic aortic aneurysm who have elective surgery, the five-year survival rate is 85 percent, while those you undergo emergency surgery have a five-year survival rate of 37 percent. (30) Cerebral AneurysmsCerebral aneurysms that are less than 10 millimeters (mm) in diameter are considered small, those between 10 and 25 mm are large, and those that are greater than 25 mm are “giant.” “These are the aneurysms that do the worst. They tend to recur and they cause the greatest number of deaths,” Teitelbaum says. About 25 percent of people who have a ruptured cerebral aneurysm do not survive the first 24 hours. Twenty-five percent die from complications within six months. (5) Overall, about 40 percent of cases of brain aneurysms that rupture are fatal, per BAF. (17) In recent years, however, the prognosis among people with unruptured cerebral aneurysms has improved, according to 2006–2016 data from a study published in August 2020 in the Journal of NeuroInterventional Surgery. (31) Peripheral AneurysmThe risk of rupture of peripheral aneurysms is low. Less than 5 percent are popliteal aneurysms, or those located in the back of the knee, and between 1 and 14 percent of iliofemoral aneurysms, located in the hip joint are at risk of rupture, according to the Merck Manual. (8) Still, blood clots can form, break away, and prevent blood flow through the artery. (3) What’s more, a large peripheral aneurysm can press on a nearby nerve or vein and cause pain, numbness, or swelling. (3) Mycotic AneurysmNearly all untreated mycotic aneurysms lead to rupture and can be fatal, which is why timely diagnosis and treatment are key, per previous research. (10) Dissecting AneurysmThese types of aneurysms can rupture and cause bleeding, cut off the blood flow to the small vessels that come out of the main artery or to larger branches, cause stroke, and organ and cell damage that may be fatal (called necrosis). Thoracic aortic aneurysms less than 6 cm have between 31 and 43 percent risk of rupture depending on location. Between 2.5 and 8 percent of surgeries will be fatal, notes past research. (32) Treatment and Medication Options for AneurysmTreatment for an aneurysm depends on its cause, size, location, the factors that put you at risk, and whether the aneurysm has ruptured or is at risk for rupture, according to the NHLBI. (35) Your doctor may decide on a wait-and-watch approach, medication, surgery, or a combination of treatments. Wait and WatchAll types of aneurysms that are small and asymptomatic may only require close and careful monitoring, with imaging studies (X-rays, ultrasound, CT scan, or MRI) performed periodically. The size and how fast it grows, however, will determine how frequently it should be checked. Medication OptionsBlood pressure medicines such as calcium channel blockers and beta-blockers may be prescribed to control blood pressure because hypertension can further weaken an aneurysm and increase the risk for leaking or rupture. Statins such as Lipitor (atorvastatin) may also be used to prevent vasospasm, a condition in which the arteries in the brain narrow after a brain aneurysm rupture. Antiplatelet medication may also be prescribed in patients who undergo surgery to repair cerebral aneurysm, according to MedStar Georgetown University Hospital. (36) Surgery Options and ProceduresAbdominal Aortic Aneurysms and Thoracic Aortic Aneurysms For large, leaking, or ruptured aortic aneurysms, two types of treatments are available: open repair and endovascular stenting, Teitelbaum says. During open repair, the surgeon removes the aneurysm and a portion of the aorta. The section of the aorta is then replaced with a graft made from material such as Dacron or Teflon, according to Michigan Medicine. (37) With endovascular stenting, the surgeon threads a catheter into the aneurysm, uses an X-ray to visualize the artery, and inserts a collapsed stent into the aneurysm. The stent graft allows blood flow through the aorta instead of the aneurysm and reinforces the weakened section to the aorta to prevent a rupture. Cerebral Aneurysm Brain aneurysms that have burst will require emergency surgery for the aneurysm itself and to evacuate blood from the skull, or to drain excess fluid from the brain. If an aneurysm is growing or at risk of rupture or dissection, there are two options for a ruptured brain aneurysm: open repair (or microvascular clipping) and endovascular embolization (or EVAR repair). Open repair is a treatment in which a small titanium clip is placed across the neck of the aneurysm to prevent blood flow. Once the aneurysm appears to have disappeared, the odds of recurrence are very small, Teitelbaum says. Meanwhile, endovascular embolization is a treatment in which coils are inserted into the aneurysm to stabilize it and prevent blood flow. The wire causes a blood clot and destroys the aneurysm, notes Johns Hopkins Medicine. (38) For large or wide aneurysms where your doctor doesn’t advise a watch-and-wait approach, flow diversion treatment will be used. The treatment uses a device made of fine metal wires that guide blood flow through the artery and past the aneurysm, resulting in closure of the aneurysm. Unlike other treatments, it’s the only one that doesn’t have the risk for recurrence, Teitelbaum says. In July 2018, the FDA approved the Surpass Streamline Flow Diverter, a stent for the treatment of wide-neck and fusiform intracranial aneurysms. (39) Additionally, in December 2018, the FDA approved the WEB (Woven EndoBridge) Device, a self-expanding mesh ball that is meant to reduce blood flow to cerebral aneurysms. (40) The device is navigated through catheters from blood vessels in the legs into the brain. It conforms to the shape of the aneurysm and prevents blood flow and the risk of rupture, notes Yale Medicine. (41) Peripheral Aneurysm The treatment for a peripheral aneurysm depends on its location, the condition of the surrounding blood vessels, and other medical issues. (7) Bypass surgery is one option. The blood flow is redirected around the aneurysm, and then the aneurysm is removed or tied off to prevent blood from filling it up again. A stent graft, which is placed inside the vein to seal off the aneurysm, is another type of treatment. A splenic aneurysm may be treated with embolization of the aneurysm or by removing the spleen. Mycotic Aneurysm Mycotic aneurysms are treated with a combination of antibiotics and open repair surgery or endovascular aneurysm repair (EVAR). (42) Dissecting Aneurysm Beta-blockers may be prescribed to lower blood pressure and heart rate to a normal range. (12) In some patients, surgery may be performed to prevent aortic rupture and other issues with the heart. Treatment for an aneurysm is individual and based on several factors. Because all types of surgery carry risks, and recovery times vary, it’s important to compare the options with your doctor. Onyx A liquid embolic agent, Onyx is an FDA-approved treatment for intracranial, saccular, sidewall aneurysms that have a wide
neck. (43) Onyx is a liquid polymer that is injected through a microcatheter into the aneurysm. The substance solidifies, sealing off blood flow to the aneurysm in order to reduce pressure and risk of rupture, notes CathLab Digest. (44) The treatment is used in place of, or in combination with, endovascular embolization with coils. Learn More About Treatment for Aneurysm: Medication, Alternative and Complementary Therapies, Surgery Options and More Prevention of AneurysmBecause aneurysms can cause lifelong health complications or be fatal, it’s important to know the risk factors and your family history. “Make sure you have a family doctor that you trust that really knows you and knows your family history and can monitor your symptoms if you start having headaches, chest pain, or abdominal pain,” Brown says. Additionally, there are certain diet and lifestyle changes you can make to prevent an aneurysm. Eat HealthfullyAvoid foods high in calories, saturated fat, trans fat, and sodium when you can. Instead, focus on whole foods, including plenty of fruits and vegetables, lean protein such as boneless and skinless chicken breast, whole grains, and healthy fats like avocado and nut butter. If you have high cholesterol, eat foods rich in omega-3 fatty acids like fatty fish, nuts and seeds, to help get your levels in a healthy range, recommends the American Heart Association (AHA). (45) Manage HypertensionIf you have high blood pressure, work with your doctor to manage it. Use an at-home blood pressure monitor every day, eat a low-sodium diet, maintain your weight, exercise regularly, and find ways to reduce stress, per the AHA. (46) Exercise RegularlyA regular fitness regimen can lower your blood pressure and triglycerides, raise good cholesterol, and, in combination with a healthy diet, help you lose weight, notes Medline Plus. (47) But if you have been diagnosed with an aneurysm, it’s important to work with your doctor on finding low-impact workouts. Quit SmokingStudies show smoking significantly increases your chances of aneurysm. According to a July 2018 study in the Journal of Neurology, Neurosurgery & Psychiatry Women, women between 30 and 60 years old who were smokers had a fourfold increased risk for an unruptured intracranial aneurysm. (48) Over-the-counter smoking cessation aids, prescription medication, and support groups can all help you kick the habit. Talk to your doctor about which options he or she thinks would work best for you. Seek Treatment for DepressionWhile studies suggest depression is associated with cardiovascular disease, less is known about aneurysm risk among people with this
mental illness. Yet according to an October 2019 study published in the Journal of the American Heart Association, individuals with symptoms of depression have a 30 percent increased risk of abdominal aortic aneurysms. (49) Learn More About How to Help Prevent Aneurysms Resources We LoveFavorite Orgs for Essential Aneurysm InfoNational Heart, Lung, and Blood Institute An aneurysm is a complex and often confusing condition, so having a resource on hand that makes it easier to understand can be a game changer. We particularly appreciate this resource from the National Heart, Lung, and Blood Institute for its discussion on the basics you need to know about aneurysm. Bookmark this site for critical 101 info on aneurysm causes, risk factors, symptoms, treatment options, and more. American Heart Association For a more succinct breakdown on aneurysms, check out this overview page from the American Heart Association. Here you can learn about the different types and symptoms of aneurysm. Bonus: You’ll even learn how to help reduce your risk of aneurysm, which may be especially important if this condition runs in your family, or if you’ve had a history of lifestyle habits that might otherwise increase your risk of developing an aneurysm. Favorite Aneurysm Support NetworksMayo Clinic If an aneurysm has affected you or a loved one, we recommend checking out this support group from the renowned Mayo Clinic. Located at the Mayo Clinic’s St. Mary’s campus in Rochester, Minnesota, the group meets during the evenings on the first Thursday of every month and a registered nurse facilitates discussions. If you’re nowhere near Rochester, why not check out this resource for inspiration on starting an aneurysm support group in your hometown? Brain Aneurysm Foundation While mental health professionals generally recommend in-person support groups, these get-togethers may not be convenient for you. This is where online support groups like this one from the Brain Aneurysm Foundation can be helpful. You can even post a blog about your experiences on the community website as a way to cope and inspire others. Favorite Sites for Aneurysm Diet AdviceAmerican College of Cardiology Your doctor may have told you that it’s important to reduce your blood pressure to prevent an aneurysm from getting worse. But where do you start? Aside from stress management, your diet can play a key role in reducing your blood pressure, and this resource from the American College of Cardiology provides a few tips on how to get started. Mayo Clinic The DASH (Dietary Approaches to Stop Hypertension) diet is one way you can help support your health while dealing with an aneurysm. The Mayo Clinic outlines the DASH diet in this handy resource on dietary tips for hypertension. We recommend bookmarking this resource for diet and other tips, such as stress management strategies and exercise ideas. Favorite Aneurysm AppsBrain Aneurysm Foundation If you’re looking for a free app related to brain aneurysms, we recommend downloading this one from the Brain Aneurysm Foundation. The app lays out a treasure trove of free educational articles, videos, and webinars to answer your pressing questions about brain aneurysms. Plus, via their community feature, you can connect with others like you, along with caregivers and loved ones of people with aneurysms. Get it on Google Play or on the App Store. Favorite Aneurysm ConferencesSociety for Vascular Surgery Researchers are actively studying aneurysms to improve how they’re diagnosed, managed, and treated. For some of the latest info on aneurysm studies, check out this resource’s conference. If you can’t attend the next meeting, download and print a copy of the conference agenda to take to your next doctor’s appointment or support group session. Favorite Clinical Trial OutreachNational Institutes of Health You may be interested in furthering related research rather than just reading about it. In that case, you may consider participating in a clinical trial. Bookmark this resource from the National Institutes of Health to be on the lookout for clinical trials in your area, and if you spot one you’re interested in joining, be sure to chat with your healthcare team first. Brain Aneurysm Foundation Likewise, if you’re on the hunt for clinical trials related to brain aneurysms only, take a look this page from the Brain Aneurysm Foundation. The overall focus of most of the listed clinical trials are related to genes and how certain markers may contribute to the formation of brain aneurysms. Additional reporting by Rosalyn Carson-DeWitt, MD, and Beth W. Orenstein. Editorial Sources and Fact-Checking
What is the most common cause of an aneurysm?The most common culprits are atherosclerosis and high blood pressure. Deep wounds and infections can also lead to an aneurysm. Or you may be born with weakness in one of your artery walls.
What factors can trigger aneurysm?Risk factors include:. Smoking. Smoking is linked to both the development and rupture of cerebral aneurysms. ... . High blood pressure. ... . Size. ... . Location. ... . Growth. ... . Family history. ... . The greatest risk occurs in individuals with multiple aneurysms who have already suffered a previous rupture or sentinel bleed.. What is the main cause of brain aneurysm?Brain aneurysms are caused by a weakness in the walls of blood vessels in the brain.
Can you get an aneurysm from stress?Strong emotions, such as being upset or angry, can raise blood pressure and can subsequently cause aneurysms to rupture.
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