Aneurysm

                                          Aneurysm

Aneurysm is defined as a permanent localized dilation , stretching and ballooning of an artery or blood vessels to around 50% increases in the size.

Etiology :-

The exact cause is unknown.

Risk factor :-

• Atherosclerosis 
• congenital defect is arterial wall
• Genetically weakness of wall
• Hypertension
• Trauma or injury
• Micro-tic infection
• Elevated cholesterol level
• Impaired nutrition

Classification :-

1. According to location :- they are described according to specific vessels in which they develop. Example: Aortic aneurysm , iliac aneurysm , thoracic aneurysm , lastly more preciously according to the area of vessels they affect.
2. According to Etiological factor :- Aneurysm is classified according to cause such as atherosclerotic aneurysm,microtic, aneurysm, hypertension aneurysm, traumatic aneurysm.
3. According to Appearance :- Classification of aneurysm is sometime based on shape and anatomic feature or size.
4. Sacular Aneurysm :- Sacular aneurysm involves all three layers of artery. A out pouching of an artery at point where the media is thin.
5. Fusiform Aneurysm :- Fusiform aneurysm involves the entire circumference of the vessels. It is localized uniform dilation of an artery.
6. Dissecting Aneurysm :- In disecting aneurysm hematoma is present in the arterial wall that separates the layers of arterial wall.
7. False Aneurysm :- False aneurysm results from the development of a sac around a hematoma that maintain a communication with the leumen of an artery where wall has been ruptured or penetrated.

Pathophysiology :-

Abdominal aortic aneurysm four types more often then the thorasic aneurysm. the Natural cause of untreated aneurysm is to expand or rupture.The aorta is under greater stress then the rest of the arterial system because of its large diameter and its exposure to high pressure during each systolic ejection of blood.

Clinical Manifestation :-

• Awareness of pulsation mask in the abdomen.
• Abdominal pain and back pain
• Pain in lower abdomen , groin, and genitalia
• Decrease hemoglobin
• Sign of hemorrhage
• Shock
• Abdominal Distension

Diagnostic Evaluation :-

• Physical Examination
• USG
• CT Scan
• Abdominal Aortography

Complication :-

• Coronary artery disease
• Pulmonary obstructive disease
• Pre-renal failure
• Spinal cord ischemia
• Change in sexual function
• Severe bleeding

Management :-

1. Surgical Management :-  Surgery is usually not perform on clients with a less symptomatic abdominal aortic aneurysm smaller then 4-5cm. In Every six month a USG is indicated to determine whether any change in the size occurred.

• Endovascular Procedure :- It is a newer method for lower emergency treatment to repair abdominal aneurysm. small incision are made in the groin and a vascular into the aorta. deflated balloon and tightly wrapped polyester cloth graft is placed , when properly position the graft is securely place by inflation the balloon and opening the graft of the diameter needed to prevent blood clot in the aneurysm then the balloon is deflated and remove along with the catheter at the each end of the graft hooks are present that help secure it to the inner walls of aorta.
• Aneurysm Repair :- Surgical repair is usually recommended for all aneurysm greater then 6cm. find