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Aneurysms Information

  • An aneurysm (or aneurism) is localized, blood-filled dilation (bulge) of a blood vessel caused by disease or weakening of the vessel wall.[1] Aneurysms most commonly occur in arteries at the base of the brain (the circle of Willis) and in the aorta (the main artery coming out of the heart) - this is an aortic aneurysm. This bulge in a blood vessel can burst and lead to death at any time, much like a bulge in an over-inflated innertube. The larger an aneurysm becomes, the more likely it is to burst...
  • The layer of the artery that is in direct contact with the flow of blood is the tunica intima, commonly called the intima. This layer is made up of mainly endothelial cells. Adjacent to this layer is the tunica media, known as the media. This "middle layer" is made up of smooth muscle cells and elastic tissue. The outermost layer (farthest from the flow of blood) is known as the tunica adventitia or the adventitia. This layer is composed of connective tissue. Aneurysms can be treated.

    Aneurysms are also described according to size: Saccular or fusiform. A saccular aneurysm resembles a small sack; a fusiform aneurysm is shaped like a spindle.

    Aneurysms can be broken down into two groups: true aneurysms and false aneurysms. A true aneurysm involves an outpouching of all three layers of a blood vessel: the intima, the media, and the adventitia. True aneurysms can be due to congenital malformations, infections, or hypertension. A false aneurysm, also known as a pseudoaneurysm, involves an outpouching of only the adventitia. Pseudoaneurysms can be due to trauma involving the intima of the blood vessel, and are a known complication of percutaneous arterial procedures.

    Aneurysms can occur anywhere where there is a blood vessel, although they are most common in arteries. Most non-intracranial aneurysms (95%) arise distal to the origin of the renal arteries at the infrarenal abdominal aorta, a condition mostly caused by atherosclerosis. The thoracic aorta can also be involved. One common form of thoracic aortic aneurysm involves widening of the proximal aorta and the aortic root, which leads to aortic insufficiency. Aneurysms occur in the legs also, particularly in the deep vessels (e.g., the popliteal vessels in the knee). Arterial aneurysms are much more common, but venous aneurysms do happen (for example, the popliteal venous aneurysm).

    While most aneurysms occur in an isolated form, the occurrence of berry aneurysms of the anterior communicating artery of the circle of Willis is associated with autosomal dominant polycystic kidney disease (ADPKD).

    The third stage of syphilis also manifests as aneurysm of the aorta, which is due to loss of the vasa vasorum in the tunica adventitia.

    Most frequent site of occurrence is in the anterior cerebral artery from the circle of Willis. The occurrence and expansion of an aneurysm in a given segment of the arterial tree involves local hemodynamic factors and factors intrinsic to the arterial segment itself.

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