Aortic Aneurysm
An aneurysm is where the blood vessel has become bigger than what it should be. The usual size is about 2-3cm in diameter.
The risk factors of developing an aneurysm include.
- Smoking
- Family history of aneurysms
- High blood pressure
Blood vessel in our body can rupture or tear (dissect) at any size. This can lead to death or major complications. The bigger the vessel the more likely this can happen. Intervention has also the risks. The guidelines on intervention intends to help mitigate the risks of rupture/dissection vs intervention.
A rupture is fatal in most cases. Dissection can also be fatal if not treated quickly.
Most patients with aneurysm do not have symptoms. Interventions aim to prolong life expectancy rather than improve symptoms.
Aneurysm affecting ascending and root preferably treated by open heart surgery. Arch, thoracic and abdominal aneurysm depending on fitness of patient and feasibility of stenting are further discussed. Open surgery vs stenting needs to be evaluated. It differs from patient to patient.
Most of patients with aneurysms who do not meet criteria for interventions are regularly followed with scans. These can be in the form of ultrasound, CT or MRI.
Patients with “stable” aneurysms for a number of years are usually offered MRI instead of CT for follow-up scans. This reduces radiation and requirement for injection of contrast which can impair kidneys. However, CT can be required in the event of abnormality or further assessment. For starters, MRI is more expensive than CT. Additional CT and visits add to the cost. Overall, MRI in these patients have benefits.