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Peripheral Aneurysmal Disease

Sydney Vascular Surgeon - Dr Mayo Theivendran

What is peripheral aneurysmal disease?

A potentially serious condition that can be successfully treated

Aneurysmal disease is a condition involving the weakening and enlargement of blood vessels.

These weakened areas can lead to various types of aneurysms (bulges), most commonly occurring in the abdominal aorta, known as an ‘abdominal aortic aneurysm (AAA)’, and in the popliteal artery in the legs, which supplies blood to the knee and lower leg. This is known as a ‘popliteal aneurysm’.

Popliteal aneurysm treatment Sydney

What causes aneurysmal disease?

The precise cause of aneurysmal disease is not always clear, but there are certain factors that contribute to its development. The primary causes include:

Aneurysmal disease - age risk factor

Age: As people age, their blood vessels can become less flexible and more prone to developing aneurysms.

Aneurysmal disease - gender risk factor

Gender: Men are more likely to develop aneurysms than women.

Aneurysmal disease - atherosclerosis risk factor

Atherosclerosis: This condition involves the build-up of fatty deposits (plaques) on the inner walls of blood vessels, leading to inflammation and weakening of the artery walls.

Aneurysmal disease - family history risk factor

Genetics: Family history plays a significant role in aneurysmal disease. If your close relatives have had aneurysms, you might be at a higher risk.

Aneurysmal disease - high blood pressure risk factor

High blood pressure: Uncontrolled high blood pressure can damage blood vessel walls, making them more susceptible to aneurysm formation.

Aneurysmal disease - smoking risk factor

Smoking: Smoking is a major risk factor for aneurysms as it promotes atherosclerosis and weakens artery walls.

Aneurysmal disease - pregnancy risk factor

Pregnancy: If you have an abdominal aneurysm and become pregnant, the aneurysm may grow rapidly and require repair.

What are the symptoms of an aneurysm?

Symptoms depend on the location of the aneurysm:

Abdominal aortic aneurysm

AAA - pain

Pain or discomfort in the abdomen or lower back

AAA - Pulsating sensation in the abdomen

Pulsating sensation in the abdomen

AAA - Sudden and severe pain if ruptures

Sudden and severe pain if the aneurysm ruptures (a vascular emergency)

Popliteal Aneurysm

AAA - pain

Leg pain or discomfort, especially when walking or exercising

AAA - Pulsating sensation in the abdomen

Swelling behind the knee or in the calf

AAA - Sudden and severe pain if ruptures

Sudden loss of function in leg associated with pain and sensation loss (a vascular emergency)

How is aneurysmal disease diagnosed?

Early diagnosis of aneurysmal disease is essential to assess the risks of complications. Several diagnostic methods are employed:

Ultrasound is used in the diagnosis of aneurysmal disease

Ultrasound

This is a non-invasive test using sound waves to create images of the blood vessels, providing information about the size and location of an aneurysm.

CT scans are used in the diagnosis of aneurysmal disease

Computed tomography (CT) scan

A CT scan produces detailed cross-sectional images that can help determine the size and shape of the aneurysm.

MRI scans are used in the diagnosis of aneurysmal disease

Magnetic resonance imaging (MRI)

An MRI scan uses magnetic fields and radio waves to create detailed images that are helpful in diagnosing aneurysms.

Angiography is used in the diagnosis of aneurysmal disease

Angiography

In this procedure, a contrast dye is injected into the blood vessels, and X-rays are taken to provide clear images of the arteries.

Do I have to get treatment for my aneurysm?

Whether you need to have your aneurysm repaired depends on its location and the likelihood of complications. Generally, if the aneurysm is more than 5cm in size, your doctor will recommend surgery.

A peripheral artery aneurysm is treated if there’s a risk it could cause a blockage or rupture.

What are the complications of aneurysmal disease?

If left untreated, aneurysmal disease can lead to severe complications, including:

Aneurysm rupture

The most critical complication is the rupture of the aneurysm. This can cause life-threatening internal bleeding and is considered a medical emergency.

Blood clots

Aneurysms can promote the formation of a blood clot, which affects blood flow to the limbs or vital organs.

Embolism

Embolisms are small pieces of a blood clot or plaque that break off and travel to other parts of your body, leading to complications, depending on where they end up.

How is aneurysmal disease treated?

The treatment approach for aneurysmal disease depends on the size and location of the aneurysm, as well as your overall health. There are two primary treatment options:

Medications

Medications are typically used to manage aneurysms and associated risk factors. These may include:

  • Blood pressure medications: Controlling high blood pressure is crucial to prevent further damage to the weakened blood vessel walls.

  • Cholesterol-lowering medications: Reducing cholesterol levels can help slow down the progression of atherosclerosis, which is often a contributing factor to aneurysms.

  • Antiplatelet medications: These blood-thinning medications can help prevent blood clots from forming within the aneurysm.

  • Beta-blockers: Your doctor my prescribe one of these blood pressure lowering drugs to reduce the risk of an aneurysm rupturing.

Surgical procedures for aneurysmal disease

For a slow-growing aneurysm, your doctor may recommend a ‘watch and wait’ protocol with or without with medication.

Elective surgery (at your convenience) may also be an option for a peripheral aneurysm.

Urgent surgical intervention may be necessary for a large or rapidly-growing aneurysm, if there's a high risk of rupture or blockage.

Endovascular aortic aneurysm repair (EVAR)

EVAR is a minimally invasive procedure used to treat an AAA. It involves the placement of a stent within the aneurysm to reinforce the artery wall and prevent further expansion.

Read more about endovascular aneurysm repair

This minimally invasive procedure can be used to open a narrowed carotid artery and place a stent to keep it open.

Mini-invasive access through patient groin

Open aneurysm repair

Open repair for an AAA is performed through an incision in the abdomen to directly repair the aneurysm.

Read more about open aneurysm repair  

This minimally invasive procedure can be used to open a narrowed carotid artery and place a stent to keep it open.

Incision made in the abdomen to repair the AAA

Thrombectomy (embolectomy)

If a blood clot has formed within the aneurysm, this procedure may be used to remove the clot and improve blood flow.

Read more about open thrombectomy  

Bypass of blocked aneurysm

If a blood clot has formed within the aneurysm, this procedure may be used to bypass the blockage.

Read more about deep vein thrombosis 

This minimally invasive procedure can be used to open a narrowed carotid artery and place a stent to keep it open.

  How Dr Theivendran can help

If you’ve been diagnosed with an arterial aneurysm and non-surgical treatments haven’t worked, ask your treating doctor for a referral to Dr Theivendran an experienced Vascular and Endovascular surgeon.

He will assess your condition and, if appropriate, discuss surgical options that can repair the aneurysm and bring peace of mind.

If you have any questions, please don't hesitate to contact our rooms on (02) 9066 6547

For appointments and enquiries:

Monday - Friday: 8:00am to 5:00pm
Fax: (02) 9182 7533

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