The concept of peripheral artery aneurysm
When the weakened portion of a blood vesselexpanding a balloon, it is called an aneurysm. Most often affects the aorta aneurysm - the main artery of the body. The aorta carries blood from the heart to all the other organs and tissues. Part of the aorta, located in the chest, is the naming of the thoracic. Part of the aorta located in the abdomen is called an abdominal department.
Peripheral artery aneurysm affectsless than the aorta. The most common peripheral aneurysm affects the popliteal artery, which runs down the back of the knee. Less aneurysm affects the femoral artery in the groin, the carotid artery in the neck and sometimes on the upper extremity arteries. A special type of peripheral aneurysms that affect the kidney or intestinal artery, called visceral aneurysms.
Aortic aneurysms can cause seriouscomplications such as rupture or separation. Although peripheral arterial aneurysm rupture is rare. However, peripheral artery aneurysms often observed clot formation, which can cause clogging of the brain vessels, or limbs.
Aneurysms of peripheral arteries, especially in larger sizes, can compress the nerves passing near or vein and cause pain, numbness, or swelling.
The main symptoms of the disease
At the outset of the disease the patient may notfeel any signs of aneurysms, especially if it is small-sized. Two of the three patients with peripheral arterial aneurysm not noted any sign of disease.
Symptoms of peripheral aneurysm depends on the size and location of it. Possible signs of peripheral arterial aneurysms:
- feeling pulsatile
- pain or cramps in your arms or legs during exercise
- pain in the arm or leg alone
- painful sores or wounds in fingers or toes
- referred pain, or numbness in hands or feet, associated with compression of nerves
- gangrene (necrosis) of tissue as a result of blockage of the arteries
If involvement of the carotid arteries canthere are signs of transient ischemic attacks or stroke. It is written in detail in the section on diseases of the carotid arteries. If involvement of the intestinal arteries, mesenteric ischemia symptoms appear.
The causes of the disease
The cause of peripheral artery aneurysms mayhave an infection or damage the walls of arteries to any other cause. However, the main reason for the development of aneurysms remains yet unclear. Researchers believe the main reason for the development of atherosclerosis, aneurysms. The normal artery wall has a smooth and flat surface. It has a certain elasticity. Atherosclerosis of the arteries appear on the walls of special growths - atherosclerotic plaques, which consist of cholesterol, calcium and fibrotic tissue. Over time, the arteries are less elastic. Under the action of high blood pressure (such as in the aorta 120 mm Hg) arterial wall extends - aneurysm occurs.
Factors contributing to this process:
- high blood pressure
- high blood cholesterol
- hereditary factor
With age, the risk of developing peripheral arterial aneurysm increases.
Methods of diagnosis of peripheral artery aneurysms
First the doctor know the patient's complaints, their nature, and when they came with nothing connected. Then conducted glad instrumental studies. We list these methods:
- duplex ultrasound
- Magnetic resonance imaging
- CT scan
- Angiography - the most invasive method
It is known that many patients with aneurysmsin addition, suffer from heart disease. Therefore, before the surgical treatment of aneurysms should be evaluated cardiovascular system. This includes the electrocardiograms, cardiac ultrasound, and others.
The main directions of the treatment of the disease
Treatment of an aneurysm depends on its localization,sizes, the presence of symptoms and complications of the aneurysm thrombus. For example, an aneurysm of the popliteal artery is not an indication for surgery. In this case, the doctor may recommend the following:
- control the risk factors for atherosclerosis
- regular walks in order to maintain adequate blood flow to the leg
- Do not cross legs
- follow the hygiene toe and the emergence of ulcers on the fingers - a sign, it is a signal of circulatory disorders
Although popliteal artery aneurysm is raretorn, sometimes it can be thrombosed, resulting in disturbed blood flow in the leg. Such aneurysms can also serve as a source of blood clots and particles of atheromatous plaques, which also leads to violations of blood circulation in the lower leg. Ultimately, these phenomena lead to disastrous results - the need for amputation of the lower limbs (fingers, feet and above). Therefore, most often in aneurysms of the femoral or popliteal artery best option is only operative treatment. Aneurysms of the carotid arteries and the arteries of the upper limbs somewhat different clinic. But the treatment of the same, as well as all aneurysms.
Typically in the treatment of peripheral artery aneurysms vascular surgeons use either bypass surgery or prosthetics.
Bypass surgery is that the surgeonHe creates from the "donor" of the vessel (usually saphenous vein thigh) workaround for blood flow. Aneurysm is deleted. This operation is usually performed under local anesthesia, sometimes under general (it all depends on the severity and location of the aneurysm).
When the surgeon removes the portion of prostheticsartery aneurysm struck, and in its place is stitched synthetic prosthesis in the form of tubes. The material from which the vascular prosthesis is made on the properties and performance characteristics approaching the walls of arteries.
When thrombosis lumen artery aneurysmthe method of thrombolytic therapy comprising that virtually thrombus using a special catheter during angiography administered thrombolytic - substance dissolving thrombus. However, this method is effective only when the fresh blood clots.
There is another new methodEndovascular Surgery - stenting. The method consists in the fact that with a catheter, which is used for angiography into the artery to the aneurysm site, the stent is supplied - special design of cylindrical shape, which serves as a scaffold for the aneurysmal wall of the modified expanded artery. This method is used when the risk of conventional surgery is high.
In some cases, especially when inadequatethe treatment, the patient may develop gangrene - necrosis. The changes in the tissues is already irreversible. The only way to preserve the health of the patient, in this case - amputation.
Preventing the development of aneurysms is to eliminate the risk of their occurrence. About them already mentioned above.