Aneurysms are dilations in the arteries that can swell up and rupture, causing bleeding within the body and potentially leading to death. As aneurysms can occur on any part of the body, there are various treatments available that take into account the location of the aneurysm and the size of the swelling. Whether or not the aneurysm has already ruptured will also affect the aggressiveness of treatment. Potential aneurysm treatments commonly include some mixture of surgery and medication.
Although there are various types of aneurysms that can occur, they commonly occur in the aorta, the largest artery in the body, which extends through the chest and abdomen. Aortic aneurysms are classified into two main types depending on their location in the aorta. An ascending aneurysm, also known as a thoracic aortic aneurysm (TAA), occurs within the area that ascends upward from the heart. The majority of aortic aneurysms, however, are abdominal aortic aneurysms (AAA), those that occur in the aortic area around the abdomen.
Aneurysm treatments for TAA and AAA will usually depend on whether they are causing symptoms. Often, the condition is painless and only begins to cause symptoms when the aorta has grown large, is leaking, or has ruptured. In fact, the condition is often only diagnosed after the patient receives a computed tomography (CT) scan for an unrelated reason.
If no symptoms are present with a TAA or AAA and the size of the aneurysm is small, doctors may recommend regular monitoring as the main aneurysm treatments. If so, patients will typically need to have regular exams and imaging tests. Medications are also likely to be prescribed to slow the growth rate of the aneurysm and prevent it from bursting. Specifically for those with high blood pressure, beta blockers may be given to lower blood pressure, while patients with high cholesterol will likely be given statins. Lifestyle changes including stopping smoking, getting to a healthy body weight, and consuming a heart-healthy diet will also likely be recommended.
When aortic aneurysms are fast growing or have already burst, open abdominal or open heart surgery is often the standard aneurysm treatment. This treatment involves cutting into the skin and tissue to get direct access to the dilation. Then the damaged aorta is removed, and a synthetic tube will be sewed in as a replacement. Instead of major surgery, however, endovascular surgery may also be done. An endovascular surgery involves making a small incision into the groin and then inserting a stent graft into the damaged aorta. The graft will repair the rupture by eliminating the pressure and allowing normal blood flow to resume.
When aneurysms occur in arteries of the brain, they are called cerebral aneurysms. If brain aneurysms rupture, the complications can be quite severe, including a stroke, coma, or death. As it is seldom simple to determine if a cerebral aneurysm will rupture, surgical aneurysm treatments for brain aneurysms often occur on ruptured and intact cerebral aneurysms.
The primary surgical treatment for a cerebral ruptured aneurysm is mirovascular clipping, which requires removing a piece of the skull to insert a metal clip within the main blood vessel that feeds the aneurysm to close it off. If the aneurysm is in an inoperable area of the brain, endovascular coiling may be done instead. Endovascular coiling is a less invasive procedure that involves threading a catheter up through the leg and into the site of the aneurysm. A wire is inserted into the rupture, which coils up and causes the blood to clot, sealing off the rupture from the blood circulation system.
If the ruptured aneurysm has caused brain damage or if symptoms persist, additional aneurysm treatments may be done. For instance, if excess fluid is in the brain, a drainage device can be inserted to relive the pressure. Additionally, non-surgical treatment options such as the use of rehabilitative and speech therapy may be done to cope with brain changes caused by the hemorrhage or the surgery.
When aneurysms occur in an area other the brain or major aorta in the body, they are called peripheral aneurysms. Although not as likely to rupture, they can form blood clots that can break away and block blood flow to the brain or a limb. They can also compress a nerve, causing pain and swelling in the affected region. Aneurysm treatments for peripheral aneurysms commonly depend on whether blood flow is blocked. If blood flow is blocked, a bypass can be done to reroute blood flow around the blockage.
