Locations of Arterial Aneurysms:

• • Most common in abdominal and thoracic aorta.

Types of Aneurysms:

1. Saccular aneurysm:
   • A sac-shaped bulge protruding from one side of the vessel wall.
2. Fusiform aneurysm:
   • A spindle-shaped dilation involving the entire circumference of the vessel, causing uniform ballooning.
3. Dissecting aneurysm:
   • Occurs when a tear develops in the tunica intima (inner layer).
   • Blood enters the tear and peels the tunica intima and media apart.
   • The wall becomes thinner and more prone to rupture.
   • Particularly dangerous due to the risk of rupture and hemorrhage.

Cause:

• • Atherosclerosis weakens the arterial wall, especially in the tunica media.
  • Other causes include trauma, infection (e.g., syphilis), and congenital defects.

Signs and Symptoms:

• • Bruit: A swishing sound heard with a stethoscope.
  • Palpable pulsation: Feeling a warm, pulsating mass.
  • Dysphagia: Difficulty swallowing if located near the esophagus.
  • Often asymptomatic until rupture.

Aortic Aneurysm Rupture:

• Usually fatal due to rapid hemorrhage.
• Signs of rupture:
  • Severe pain.
  • Shock.
  • Loss of pulse.
  • Organ failure due to blood loss.
• Blood loss can drown organs within one minute, risking death from hypovolemic shock.

Diagnostic Approaches:

• Imaging:
  • X-ray, ultrasound, CT scan, MRI are used to precisely locate and assess the size and shape of the aneurysm.
• Monitoring:
  • Regular imaging helps evaluate growth and risk of rupture.

Surgical Treatment:

• Graft placement:
  • Uses biocompatible materials like polystyrene (polyester), which are not rejected by the body.
  • Procedure options:
    • Endovascular grafting: Inserting a stent-graft via a catheter.
    • Open surgery: Excision of the affected segment and suturing in a graft.
  • The approach depends on aneurysm location and severity.

Prevention & Management:

• Treat underlying causes:
  • Control hypertension to prevent further weakening.
  • Avoid sudden exertion spikes.
• Lifestyle:
  • Maintain blood pressure within normal limits.
  • Regular monitoring in patients with known aneurysms or risk factors.

Summary:

Aneurysms are bulges or tears in blood vessel walls, with dissection being a dangerous form involving a tear and separation of vessel layers. Diagnosis relies on imaging, and surgical repair with grafts can restore vessel integrity. Managing blood pressure and avoiding stress are key preventive strategies.