Aneurysms Pupuhi ā-ia tuku

An aneurysm is a bulge in your artery due to a weakness in the artery wall. Sometimes an aneurysm can burst (rupture). This is a medical emergency.

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Causes of an aneurysm

Arteries are large blood vessels found in every part of your body. Most carry blood away from your heart and deliver oxygen to the tissues around your body. An aneurysm can happen in any of the arteries in your body. 

Some people are born with a very narrow or weak artery, which increases their risk of an aneurysm.

An aneurysm can develop at any age. It is often not known what has caused it. Some possible causes include:

  • narrowing of the arteries (atherosclerosis)
  • family history of aneurysms
  • high blood pressure
  • injury to your aorta (largest artery).

Types and symptoms of aneurysms

There are different types and symptoms of aneurysms depending on which artery they happen in. If the aneurysm has not burst, there are often no symptoms.

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A brain aneurysm is where the wall of a blood vessel in your brain bulges.

If a brain aneurysm grows, it can cause:

  • headaches
  • problems with eyesight
  • numbness in an arm or leg.

A ruptured brain aneurysm causes bleeding around your brain (called a subarachnoid haemorrhage).

Symptoms may include:

  • a sudden severe headache
  • feeling sick and throwing up
  • drowsiness
  • loss of consciousness.

You have 2 carotid arteries — one on each side of your neck. They supply blood to your brain, neck and face. A carotid artery aneurysm happens when a weak part of the artery wall bulges.

Often you have no symptoms. If the aneurysm gets large, you may have:

  • difficulty swallowing
  • a swollen face
  • a hoarse voice.

If a blood clot breaks away from the carotid aneurysm, it can cause a transient ischaemic attack (TIA or mini stroke) or a stroke.

Transient ischaemic attacks

Strokes

Your aorta is the largest artery in your body. It goes from your heart, through your chest, to your abdomen (stomach) and supplies blood around your body.

An aortic aneurysm happens when an area of your aorta bulges. This makes your aorta's wall weaker, which can make it burst.

  • If the aneurysm is higher in your chest, it is called a thoracic aortic aneurysm.
  • If it is lower in your chest or in your abdomen, it is called an abdominal aortic aneurysm.

If the aneurysm is very large or leaking, it can cause abdominal or back pain.

As your aorta travels down your body, it divides into 2 arteries with one going to each leg. These are your iliac arteries.

You are more likely to get an iliac aneurysm if you have recently had:

  • an infection
  • hip or lower-back surgery.

These aneurysms often do not cause symptoms, but can cause leg, back or groin pain.

Your popliteal artery runs behind your knee and supplies blood to your knee joint, thigh and calf.

Having blood vessel surgery in one or both legs may increase the risk of having a popliteal aneurysm.

Symptoms can include pain behind your knee or foot, swelling in your lower leg and sometimes ulcers (sores) on your foot that do not heal. Some people have no symptoms.

Popliteal aneurysms usually do not rupture. But the aneurysm can cause a clot to form, which blocks the blood flow to your lower leg.

When to get immediate help

An aneurysm can burst and this is life-threatening. It often happens suddenly and without warning. A burst aneurysm can cause:

  • dizziness
  • sweaty skin
  • fast heart rate
  • shortness of breath
  • feeling faint
  • loss of consciousness
  • severe headache (if a brain aneurysm).

If you think you or someone near you is suffering from a burst aneurysm, phone 111 for an ambulance immediately.

Diagnosing an aneurysm

If your healthcare provider suspects you may have an aneurysm, they will examine you to see if they can feel:

  • the bulge caused by the aneurysm
  • its pulsations.

They may arrange tests such as an angiogram or a vascular ultrasound.

An angiogram is used to see the inside of your blood vessels and organs. A special dye is injected into a vein. Then a scanner is used to look at the blood flow through your arteries.

Duplex ultrasound is a safe and painless test that uses sound waves to look at blood vessels and blood flow. This can help identify an aneurysm. Types of vascular ultrasound tests include:

  • abdominal aortic ultrasound — looks at the aorta (the main artery leading away from your heart) and is used to check for abdominal aortic aneurysms
  • carotid arterial ultrasound — looks at the blood flow through the carotid arteries in your neck.

Tests for blood vessel problems

Treating an aneurysm

The treatment for an aneurysm depends on:

  • your general health
  • the size of the aneurysm
  • the location of the aneurysm
  • your symptoms.

Treatment options include medication, monitoring and surgery.

Taking medication

Your healthcare provider might prescribe medicines to:

  • lower cholesterol
  • control your blood pressure
  • control your blood glucose (sugar) if you have diabetes.

Monitoring

This is where your healthcare provider uses regular ultrasound scans to monitor the size and growth rate of your aneurysm.

Duplex ultrasound

Surgery

Sometimes you will need surgery. Types of surgery include:

  • endovascular repair — where the surgeon places a stent (a small plastic or metal tube) in your artery so your blood can flow through it instead of flowing through the aneurysm
  • open repair — where the surgeon makes a cut in your tummy or chest to get to your aorta and then puts an artificial graft over the aneurysm
  • arterial bypass surgery — where the surgeon redirects your blood flow around the aneurysm
  • endovascular coiling or surgical clipping — this is used to treat brain (cerebral) aneurysms
  • ligation — where the surgeon ties off your artery to stop the blood flowing and stop the aneurysm growing. This is used for popliteal aneurysms.

Preventing aneurysms

You cannot control all risk factors, but lifestyle changes can help you lower some risks. This means: