2. INTRODUCTION:
• An aneurysm is an abnormal bulge or ballooning in the wall of an
artery. Aneurysms can form in arteries of all sizes. It occurs when
the pressure of blood passing through part of a weakened artery
forces the vessel to bulge outward, forming what you might think of
as a blister.
• Most aneurysms occur in the aorta, but they can also occur in other
arteries in the brain, heart, intestines, neck, spleen, back of the
knees and thighs, or elsewhere in the body. If an aneurysm in the
brain bursts, it can cause a stroke.
5. CLASSIFICATION OF ANEURYSM:
(A)According to Size;
1. Fusiform Aneurysm: It is a diffuse dilation that involves the
entire circumstances of the arterial segment. i.e., whole
artery.
2. Saccular Aneurysm: It is a distention of a vessel projecting
from one side. It is a distinct, localized out pouching of the
arterial wall.
3. Dissecting Aneurysm: Haemorrhage or intramural hematoma,
separating the layers of an arterial wall. It commonly involves
Arch of aorta.
6.
7. • (B) According to cause;
1. True Aneurysm: It is a result of the slow weakening of
the arterial wall caused by long term diseases such as
hypertension, atherosclerosis, etc.
2. False Aneurysm: Pseudoaneurysm is caused by traumatic
break in the arterial wall.
8.
9. TYPES OF ANEURYSM:
• Types of aneurysm include thoracic and abdominal aortic
aneurysms, cerebral aneurysms and peripheral aneurysms.
1. Aortic aneurysm: Most aneurysms occur in the aorta. The
aorta is the main artery that carries blood from the heart
to the rest of the body. The aorta comes out from the left
ventricle (main pumping area) of the heart and travels
through the chest and abdomen.
10. THORACIC AORTIC
ANEURYSM:
• An aortic aneurysm that occurs
in the part of aorta running
through the thorax (chest) is
called a thoracic aortic
aneurysm (TAA). One in four
aortic aneurysms is a TAA. The
most common feature of the
Thoracic aortic aneurysm is
severe pain, constant, in supine
posture.
11. ABDOMINAL AORTIC
ANEURYSM
• An aortic aneurysm that
occurs in the part of the
aorta running through the
abdomen is called an
abdominal aortic aneurysm.
Three out of four aortic
aneurysms are AAAs.
Abdominal aortic aneurysm
most commonly occurs at
infra-renal part of aorta.
12. 2. CEREBRAL ANEURYSM:
• Aneurysms that occur in an artery in the brain are called cerebral
aneurysms. They are sometimes called berry aneurysms because they
are often the size of a small berry. Most cerebral aneurysms produce
no symptoms until they become large, begin to leak blood, or rupture.
• A ruptured cerebral aneurysm causes a stroke. Signs and symptoms
can include a sudden, extremely severe headache, nausea and
vomiting, stiff neck, sudden weakness in area of the body, sudden
difficulty in speaking and even loss of consciousness, coma or death.
Sometimes a cerebral aneurysm will leak a small amount in what is
called a sentinel bleed. This causes a bad headache that gets better,
followed a few days later by the true rupture.
13.
14. 3. PERIPHERAL ANEURYSM
• Aneurysms that occur in arteries other than the aorta (and
not in the brain) are called peripheral aneurysms. Common
locations for peripheral aneurysms include the popliteal
artery that runs down the back the thigh behind the knee;
the femoral artery, which is the main artery in the groin;
and the carotid artery, which is the main artery in the
neck.
15.
16. • Peripheral aneurysms are not as likely to rupture as aortic
aneurysms, but blood clots can form in peripheral
aneurysms. If a blood clot breaks away from the aneurysm,
it can travel to another part of the artery and block blood
flow through the artery. If a peripheral aneurysm is large,
it can press on a nearby nerve or vein causing pain,
numbness or swelling.
17. CAUSES AND RISK FACTORS:
Factors that increase the risk for aneurysm include:
A congenital abnormality
A defective gene
Atherosclerosis (hardening and narrowing of the inside of arteries)
Severe and persistent high blood pressure inside an artery
Smoking- Smokers are eight times more likely to develop an
aneurysm than non-smokers
Overweight or obesity
Family history of aortic aneurysm, heart disease, or other diseases
of artery
Inflammation of the blood vessels, such as vasculitis
18. Trauma such as a blow to the chest in a car accident
Stimulant drugs like cocaine
Deep wounds, injuries, or infections of the blood vessels
Certain diseases that can weaken the wall of the aorta,
such as: Marfan syndrome, an inherited disease in which
tissues don’t develop normally, untreated syphilis,
polycystic kidney disease and Tuberculosis
21. DIAGNOSTIC EVALUATION
An aneurysm may be diagnosed by chance during a routine
physical exam;
• Chest x-ray
• Ultrasound
• Echocardiography
• Computed tomography
• Magnetic resonance imaging (MRI)
• Angiography
• Aortogram
25. SURGICAL MANAGEMENT
• Surgery may be recommended if an aneurysm is
large and likely to rupture. Enlarging thoracic
aneurysms should be considered for surgery. Two
main types of surgery to repair aortic aneurysms
are Open abdominal or Open chest repair and
Endovascular repair.
26. OPEN REPAIR:
• The traditional and most common type of surgery for aortic aneurysms is
open abdominal or open chest repair. It involves a major incision in the
abdomen or chest. General anaesthesia is needed with this procedure.
The aneurysm is removed and the section of aorta is replaced with an
artificial graft made of material such as Dacron or Teflon.
• The surgery takes three to six hours, and the patient remains in the
hospital for five to eight days. It often takes a month to recover from
open abdominal or open chest surgery and return to full activity. Open
abdominal and chest surgeries have been performed for 50 years. More
than 90% of patients make a full recovery.
27.
28. ENDOVASCULAR REPAIR
• In this, the aneurysm is not removed, but a graft is
inserted into the aorta to strengthen it. This type of
surgery is performed through catheters inserted into the
arteries; it does not require surgically opening the chest or
abdomen.
31. NURSING DIAGNOSIS:
1. Altered tissue perfusion related to aneurysm.
2. Risk for infection related to surgery.
3. Pain related to pressure of aneurysm on nerves
and postoperatively.
4. Knowledge deficit related to an aneurysm and its
treatment.
