An aneurysm will most commonly involve an artery. Certain arterial segments are more prone to develop aneurysms, such as within the brain, the thoracic and abdominal aorta, and some of the leg arteries. An aneurysm is an abnormal expansion of the artery; why they develop is unclear, but loss of structural integrity within the vessel wall is a common feature. Smoking and high blood pressure seem to promote the development of certain aneurysms.

Aneurysms are of concern for two reasons: they can rupture or they can fill with blood clot. Rupture of an aneurysm is a very serious, often fatal condition. For this reason, repair is often indicated when an aneurysm gets to be a certain size. Aneurysms that occur in the legs are treated to prevent formation of clot: this clot can either cause complete cessation of blood flow or can break off and go into smaller arteries in the leg, often with significant symptoms.

An aneurysm may be discovered during routine physical exam or during evaluation for different medical conditions such as back problems. An aneurysm of the abdominal aorta is almost often asymptomatic. When suspected, diagnostic studies to evaluate for an aneurysm include ultrasound and CT scanning.

Repair of an aneurysm is recommended once it grows beyond a certain size. Once an abdominal aneurysm gets beyond five centimeters in diameter, repair will often be recommended. Small aneurysms have very little risk of rupture and for this reason, observation is often recommended. Surgical repair of an aneurysm is a very serious procedure and requires a thorough review of your medical problems with an idea toward the risks and benefits of operation.

Aneurysm repair has traditionally been through an open abdominal incision and replacement of the diseased segment of artery with a synthetic graft. While this has been a very good and durable procedure, it can be very stressful and typically requires a six to ten week recovery period. A newer method, endovascular repair, is currently performed by Hickory Surgical Clinic surgeons in conjunction with interventional radiologists. While this approach is not suitable for all aneurysms, it does enable this less stressful procedure to be used on higher risk patients. Whether or not your aneurysm would be appropriately treated through an endovascular means is something to discuss with your surgeon.

Aneurysm of the leg arteries are treated for different reasons. Clot can form inside the capacious space within an aneurysm and if the clot burden becomes large enough, the entire artery can close off. If a small piece of clot breaks off, it can proceed downstream into smaller arteries and block them. The arterial segments most prone to aneurysm formation are the common femoral, located in the groin, and the popliteal artery, located behind the knee. Aneurysms in these positions can often be felt on physical exam alone. Ultrasound is again a very appropriate means for diagnosis, while surgical repair will often require contrast arteriography.