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Aneurysm Prevention Program Recommended

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 39 in the May 5, 2010 issue
Reprinted on page 24 in the September 8, 2010 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.

Aneurysm comes from the Greek word for dilation. It most commonly refers to a dilation of a blood vessel due to a weakening of the arterial wall. Aneurysms look like a bulging tire tube and sometimes they can burst or leak. This can be troublesome if it occurs in a sensitive area of the brain, or involves the main blood supplier called the aortic artery.

Sometimes, aneurysms are due to conditions we are born with, but many aneurysms are linked to atherosclerosis and high blood pressure. Build up of plaque on the artery walls can cause them to get rigid and weak.

The most common sites for an aneurysm are in the main aorta and also in the small arteries at the base of the brain. The bigger the aneurysm, the weaker the wall and there is an increased risk of rupture. Rupture will result in bleeding or hemorrhage in the brain which will result in stroke-like symptoms. Rupturing an aneurysm on your main artery can be quite fatal.

Many older people have Abdominal Aortic Aneurysms (AAA) often present as pulsing masses in patients with lean abdomens. For some reason, Caucasian men are most prone to aneurysm development but it is rarely a problem before age 55.

If abdominal aneurysms begin to leak, the symptoms may mimic a heart attack or back pain or simply an "unwell" feeling. Simple ultrasound examinations are used to identify these aneurysms. Abdominal aneurysms which reach over 5 cm in size can be surgically repaired, but the procedure can be risky, depending on other health problems. Once they rupture, surgery can rarely occur fast enough to save the patient, but is sometimes attempted.

Berry aneurysms are smaller and occur within the cerebral circulatory vessels of the brain. When these aneurysms swell, severe headaches, visual problems and uncontrolled eye movements may give some warning. When they rupture and bleed, we refer to this as a hemorrhagic stroke. They are diagnosed using CAT scan and MRI technology. Surgery can be performed and clips are used to stop the bleeding. There are some less invasive procedures that use special coil devices via catheters introduced through the neck region.

There are two other types of aneurysms. A mycotic aneurysm is the result of a fungal infection that tends to begin in the wall of a damaged artery. As it grows, it weakens the wall further causing aneurismal enlargement. Treatment involves destroying the fungal colony and then repairing the artery. Vascular surgeons are specially trained to perform these procedures. Atherosclerotic aneurysms are linked to the build up of fatty deposits on the walls of our arteries.

Risk factors for the development of aneurysms include: smoking, obesity, high blood pressure, elevated cholesterol, a poor immune system, sedentary life style, and genetics. Many aneurysms can be tracked clinically, and there is no pressing need for surgery. Start your prevention program right now with a brisk walk!


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