Definition and cause
An artery enlargement, also called aaneurysm, Is an abnormal udposning on an artery (an artery). This is happening against the background of a weakening of the muscles in åren.
The background to the development of aneurysm is not completely clear, but there are certain factors that may play a role:
- Atherosclerosis. As the deposited fat and calcium in karvæggen, reduced wall resilience, and especially by simultaneously high blood pressure is a risk that the artery yields and expanded. Atherosclerosis is by far the leading cause of aneurismedannelse.
- Hereditary malformation of arterievæggens muscle. Some genetic diseases (eg. Marfans syndrome) can cause serious deterioration in karvæggene. It is seen often in hovedpulsåren, aorta.
It is seen that people have innate udposninger in arteries, most often in the brain. Udposningen is ærteformet, and can not be labeled. Polycystic kidney disease also gives an increased risk of aneurismedannelse in the brain.
- Inflammation in karvæggenwas previously a frequent cause of the aneurysm. It was due to syphilis, disease widespread. With antibiotics, this disease was very rare, and therefore no big problems anymore. Diseases such as bacterial endokarditis and polyarteritis nodosa is now responsible for most of the inflammation triggered aneurysm.
- Direct damage. Often seen after previous surgery on an artery. The wall formed to arvæv, which is not so resilient and strong as the natural tissue. It can give aneurysm. Injecting drug use can also give aneurysm.
Udposning may have varying appearance. They are often congenital ærteformede. They later acquired can go far with a tub and can be very large.
A condition that sometimes referred to under aneurysm, is known dissekerende aorta (sometimes mistakenly calleddissekerendeaortaaneurisme). It is a condition in which the innermost layer of blood vessel in hovedpulsåren burst, and blood runs into karvæggen and working (these may) along karvæggen.
Aneurysm found most frequently in the brain and the aorta, but can also be seen in other arteries, for example. in knæhasen or groin.
The great danger by an aneurysm is that the wall will burst and a single arterieblødning.
Symptoms of the artery extension
An aneurysm makes no symptoms in themselves. If it grows so large that it hit the other structures that can be seen from these symptoms. A burst aneurysm is a very serious condition. The symptoms depend on the location:
Aorta and heart: The vast majority aortaaneurismer sit in the abdomen, while about 10% sits in the chest. The first symptom is often a sense of pulsation in the abdomen. It may also be uncomfortable, loss of appetite and weight loss due to a pressure of the gastrointestinal tract structures. By udposning back can cause pressure on the nerve roots that can give pain. A aortaaneurisme are not as rare as a chance at an ultrasound scan of the abdomen for any other reason.
A dissekerende aorta often occurs in breast part and is indicated by sudden chest pain, which can resemble those seen by a heart attack. The pains occur when the innermost layer in the tank to rupture and the pain shifted as the blood works its way into karvæggen (this may). Those facing the blood back to the heart, can cause aortainsufficiens and heart failure.
Deficits an aneurysm, or a dissekeret aorta, it is a very acute condition, and it often leads to death.
Brain: There may prove a headache, feel and / or visual disturbances when an aneurysm in the brain becomes so large that it pressed its surroundings. Deficits an aneurysm in the brain gives it a subaraknoidal stroke. Many are seeing this as a smæld in the head, and there is a sudden headache, nausea and sensitivity to light. The condition is very serious and often fatal.
Because blood flow in the artery to an aneurysm, a highly increased risk of developing blood clots (thrombotic), who can tear themselves loose and give embolism. They can become lodged in benets arteries and in adverse placate treated cases, dry gangræn.
In the kidney, it can lead to acute kidney failure.
Serious complications of brain and aortaaneurismer mentioned in symptoms.
Precautions and diagnosis
The most important precaution is to avoid the development of arteriosclerosis and high blood pressure (see more below those). Smoking will aneurysm to grow faster and thus increase the risk of failure.
The diagnosis can be made by various imaging studies. The abdomen may show an ultrasound examination aortaaneurisme, and the method could also be used in arteries in the legs. CT or MRI can detect aneurysm elsewhere.
Treatment of artery extension
Treatment depends on where the aneurysm is located. It will in all cases dealing with a high blood pressure and possible. factors that dispose of arteriosclerosis (see the prevention of arteriosclerosis).
The ærteformede hjerneaneurismer can, if properly evaluated, treated with a small clip on udposningen, or by so-called coiling (see below subaraknoidalblødning treatment. However, this is usually only arises in connection with a flaw tion.
A burst aortaaneurisme be treated with surgery right away.
Patients with a aortaaneurisme that do not give genes will be closely monitored and growing expansion to a certain size, will also be offered operative treatment. You go in and remove the enlarged or ruptured part of the tank and replace it with a prosthesis made of plastic. In the chest, it is somewhat harder to operate, why are only offered surgery by symptoms.
The dissekerende aorta treated with acute blood pressure and relieve pain resources. Depending on whether it threatens the heart, you will make surgery or waiting.
Aneurysm in the legs, giving symptoms can also be treated with a plastic prosthesis.
Prognosis and course
A burst aneurysm in the brain or aorta can cause death very quickly. In the brain of bleeding prognosis depends on size and treatment (see more below subaraknoidalblødning).
Aortaaneurismer have different prognosis depending on where it sits.
Aortaaneurisme belly:At the flaw is, mortality is around. 90%, and many do not reach the hospital. If an enlargement size (approximately 5.5 cm in diameter), where the operation is recommended, the risk without treatment between 10 and 20 percent annually for the burst.
The preventive surgery is associated with some mortality (around 5%). It is linked to the scale of operation, but can also partly be seen in the light of the patients basic condition and age.
Aortaaneurisme in the chest region: The prognosis of operation for enlargement of the breast is worse than the expansion of the stomach (10-20% mortality).
Dissekerende aorta:The mortality rate of operation is between 10% and 30%, and the dissection of the heart, there is a risk for heart failure and shock.
For successful operation of aortaaneurisme the life expectancy only slightly below normal elsewhere.