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Aneurysms
An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus (starting point) for clot formation (thrombosis) and embolization. As an aneurysm increases in size, the risk of rupture, which leads to uncontrolled bleeding, increases. Although they may occur in any blood vessel, particularly lethal examples include aneurysms of the Circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can arise in the heart itself following a heart attack, including both ventricular and atrial septal aneurysms. There are congenital atrial septal aneurysms, a rare heart defect. Etymology The word is from Greek: ἀνεύρυσμα, aneurysma, "dilation", from ἀνευρύνειν, aneurynein, "to dilate". Classification Aneurysms are classified by typ ...
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Arterial Aneurysm
An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus (starting point) for clot formation (thrombosis) and embolization. As an aneurysm increases in size, the risk of rupture, which leads to uncontrolled bleeding, increases. Although they may occur in any blood vessel, particularly lethal examples include aneurysms of the Circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can arise in the heart itself following a heart attack, including both ventricular and atrial septal aneurysms. There are congenital atrial septal aneurysms, a rare heart defect. Etymology The word is from Greek: ἀνεύρυσμα, aneurysma, "dilation", from ἀνευρύνειν, aneurynein, "to dilate". Classification Aneurysms are classified by type ...
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Aortic Aneurysm
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be abdominal, back, or leg pain. The prevalence of abdominal aortic aneurysm ("AAA") has been reported to range from 2 to 12% and is found in about 8% of men more than 65 years of age. The mortality rate attributable to AAA is about 15,000 per year in the United States and 6,000 to 8,000 per year in the United Kingdom and Ireland. Between 2001 and 2006, there were approximately 230,000 AAA surgical repairs performed on Medicare patients in the United States. The etiology remains the topic of continued investigation. Known causes include trauma, infection, and inflammatory disorders. Risk factors include cigarette smoking, advanced age, dyslipidemia, hypertension, and coronary artery disease. The pathophysiology of the disease is related to an initial arterial insult causing a cascade of inflammation and ...
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Abdominal Aortic Aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, back, or leg pain may occur. Large aneurysms can sometimes be felt by pushing on the abdomen. Rupture may result in pain in the abdomen or back, low blood pressure, or loss of consciousness, and often results in death. AAAs occur most commonly in those over 50 years old, in men, and among those with a family history. Additional risk factors include smoking, high blood pressure, and other heart or blood vessel diseases. Genetic conditions with an increased risk include Marfan syndrome and Ehlers–Danlos syndrome. AAAs are the most common form of aortic aneurysm. About 85% occur below the kidneys with the rest either at the level of or above the kidneys. In the United States, screening with abdominal ultrasound is recommended for mal ...
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Endovascular Coiling
Endovascular coiling is an endovascular treatment for intracranial aneurysms and bleeding throughout the body. The procedure reduces blood circulation to the aneurysm through the use of microsurgical detachable platinum wires, with the clinician inserting one or more into the aneurysm until it is determined that blood flow is no longer occurring within the space. It is one of two main treatments for cerebral aneurysms, the other being surgical clipping. Clipping is an alternative to stenting for bleeding. Medical uses Endovascular coiling is used to treat cerebral aneurysms. The main goal is prevention of rupture in unruptured aneurysms, and prevention of rebleeding in ruptured aneurysms by limiting blood circulation to the aneurysm space. Clinically, packing density is recommended to be 20-30% or more of the aneurysm's volume, typically requiring deployment of multiple wires. Higher volumes may be difficult due to the delicate nature of the aneurysm; intraoperative rupture rate ...
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Vascular Surgery
Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolved from general and cardiac surgery and includes treatment of the body's other major and essential veins and arteries. Open surgery techniques, as well as endovascular techniques are used to treat vascular diseases. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system excluding the coronaries and intracranial vasculature. Vascular surgeons often assist other physicians to address traumatic vascular injury, hemorrhage control, and safe exposure of vascular structures. History Early leaders of the field included Russian surgeon Nikolai Korotkov, noted for developing early surgical techniques, American interventional radiologist Charles Theodore Dotter who is credite ...
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Pseudoaneurysm
A pseudoaneurysm, also known as a false aneurysm, is a locally contained hematoma outside an artery or heart due to damage to the vessel wall. The injury goes through all the three layers of the arterial wall causing a leak, which is contained by a new weak wall formed by the products of the clotting cascade. Hence, a pseudoaneurysm does not contain any layer of the vessel wall. This differentiates it from a true aneurysm, which has all the three layers of the vessel wall and dissecting aneurysm where there is breach in the innermost layer (tunica intima) and subsequent dissection/separation between tunica intima and tunica media. Pseudoaneurysm being close to the vessel, can be pulsatile, and be mistaken for a true aneurysm or dissecting aneurysm or vice versa. The most common presentation of pseudoaneurysm is Femoral pseudoaneurysm following access for endovascular procedure and it may complicate up to 8% of vascular interventional procedures. Small pseudoaneurysms can spon ...
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Ventricular Aneurysm
Ventricular aneurysms are one of the many complications that may occur after a heart attack. The word aneurysm refers to a bulge or 'pocketing' of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum, or within the aorta. In the heart, they usually arise from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. This, in turn, may block the passageways leading out of the heart, leading to severely constricted blood flow to the body. Ventricular aneurysms can be fatal. They are usually non-rupturing because they are lined by scar tissue. A left ventricular aneurysm can be associated with ST elevation. Signs and symptoms Ventricular aneurysms usually grow at a very slow pace, but can still pose problems. Usually, this type of aneurysm grows in the left ventricle. This bubble has the potential to block blood flow to the rest of the body, and thus limit the patient's stamina. In other cases, a si ...
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Ventricular Aneurysm
Ventricular aneurysms are one of the many complications that may occur after a heart attack. The word aneurysm refers to a bulge or 'pocketing' of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum, or within the aorta. In the heart, they usually arise from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. This, in turn, may block the passageways leading out of the heart, leading to severely constricted blood flow to the body. Ventricular aneurysms can be fatal. They are usually non-rupturing because they are lined by scar tissue. A left ventricular aneurysm can be associated with ST elevation. Signs and symptoms Ventricular aneurysms usually grow at a very slow pace, but can still pose problems. Usually, this type of aneurysm grows in the left ventricle. This bubble has the potential to block blood flow to the rest of the body, and thus limit the patient's stamina. In other cases, a si ...
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Circle Of Willis
The circle of Willis (also called Willis' circle, loop of Willis, cerebral arterial circle, and Willis polygon) is a circulatory anastomosis that supplies blood to the brain and surrounding structures in reptiles, birds and mammals, including humans. It is named after Thomas Willis (1621–1675), an English physician. Structure The circle of Willis is a part of the cerebral circulation and is composed of the following arteries: * Anterior cerebral artery (left and right) * Anterior communicating artery * Internal carotid artery (left and right) * Posterior cerebral artery (left and right) * Posterior communicating artery (left and right) The middle cerebral arteries, supplying the brain, are not considered part of the circle of Willis. Origin of arteries The left and right internal carotid arteries arise from the left and right common carotid arteries. The posterior communicating artery is given off as a branch of the internal carotid artery just before it divides into i ...
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Aortic Arch
The aortic arch, arch of the aorta, or transverse aortic arch () is the part of the aorta between the ascending and descending aorta. The arch travels backward, so that it ultimately runs to the left of the trachea. Structure The aorta begins at the level of the upper border of the second/third sternocostal articulation of the right side, behind the ventricular outflow tract and pulmonary trunk. The right atrial appendage overlaps it. The first few centimeters of the ascending aorta and pulmonary trunk lies in the same pericardial sheath. and runs at first upward, arches over the pulmonary trunk, right pulmonary artery, and right main bronchus to lie behind the right second coastal cartilage. The right lung and sternum lies anterior to the aorta at this point. The aorta then passes posteriorly and to the left, anterior to the trachea, and arches over left main bronchus and left pulmonary artery, and reaches to the left side of the T4 vertebral body. Apart from T4 verte ...
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Abdominal Aorta
In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). Structure The abdominal aorta begins at the level of the diaphragm, crossing it via the aortic hiatus, technically behind the diaphragm, at the vertebral level of T12. It travels down the posterior wall of the abdomen, anterior to the vertebral column. It thus follows the curvature of the lumbar vertebrae, that is, convex anteriorly. The peak of this convexity is at the level of the third lumbar vertebra (L3). It runs parallel to the inferior vena cava, which is located just to the right of the abdominal aorta, and becomes smaller in diameter as it gives off branches. This is thought to be due to the large size of its principal branches. At the 11th rib, the diameter is 122mm long and 55mm wide and this is because of the constant pressure. The abdominal aorta is clinically divided into 2 segments: ...
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Common Iliac Artery
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates into the external and internal iliac arteries. Structure The common iliac artery are about 4 cm long in adults and more than a centimeter in diameter. It begins as a branch of the aorta. This is at the level of the 4th lumbar vertebra. It runs inferolaterally, along the medial border of the psoas muscles. It bifurcates into the external iliac artery and the internal iliac artery at the pelvic brim, in front of the sacroiliac joints. The common iliac artery, and all of its branches, exist as paired structures (that is to say, there is one on the left side and one on the right). The distribution of the common iliac artery is basically the pelvis and lower limb (as the femoral artery) on the corresponding side. Relations Both co ...
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