According to American heart association an aneurysm occurs when part
of an artery wall weakness, allowing it to widen abnormally or balloon
out.
An aneurysm is a localized sac or dilation formed at a weak point in the
wall of the aorta
Because of the high pressure in the arterial system, aneurysms can
enlarge, producing complications by compressing surrounding structures
Aneurysm is the second most frequent disease of the aorta after
atherosclerosis

CLASSIFICATION CAN BE
BASED ON
True aneurysm
False aneurysm
Saccular aneurysm
Fusiform aneurysm
Berry aneurysm
Secondary to atherosclerotic,
Syphilis.

THE LAYERS OF VESSEL WALL
INVOLVED
TRUE ANEURYSM

PSEUDO ANEURYSM

MORPHOLOGICAL FEATURES
( SHAPE AND SIZE OF ANEURYSM)
SACCULAR ANEURYSM
They are spherical in shape and involve only a portion of the vessel
wall, they very in size and are often filled either partially or
fully by a thrombus.
FUSIFORM ANEURYSM
A localized dilation of an artery in which the entire circumference
of the vessel is distended. The result is an elongated, tubular,
or spindle like swelling.

BERRY ANEURYSM
A berry aneurysm, which looks like a berry on a narrow stem, is
the most common type of brain aneurysm. They make up 90
percent of all brain aneurysms, according to Stanford Health
Care. Berry aneurysms tend to appear at the base of the brain
where the major blood vessels meet, also known as the Circle of
Willis.
When a berry aneurysm ruptures, blood from the
artery moves into the brain causing subarachnoid haemorrhage.

 The aneurysm ruptures it can lead to haemorrhage stroke.
 A raptured aneurysm quickly become life threatening and requires prompt
medical treatment.
 According to the meta analysis done by Boogaarts ‘etal’ in the year 2015
they found that aneurysmal rupture prior to treatment is a major cause of
death and morbidity in aneurysmal subarachnoid haemorrhage.
They also found that aneurysm size is an important risk factor for
aneurysmal bleeding.

ATHEROSCLEROTIC ANEURYSM
 Atherosclerotic Aneurysms are aneurysms caused by atherosclerosis and typically
occur in the abdominal aorta.
 Inflammation associated with atherosclerosis leads to destruction, thinning and thus
weakening of vascular wall, specifically the tunica media, which leads to aneurysmal
dilation of the vessel.

SYPHILITIC ANEURYSM
 Syphilitic Aneurysms arise during tertiary syphilis due to chronic inflammation in the
tunica adventitia of large elastic arteries, particularly the aorta. Ischemia of the tunica
media, combined with further syphilitic invasion into the tunica media itself, results
in medial destruction and weakening, ultimately causing dilation and aneurysm-
formation.

AORTIC ANEURYSM

THORACIC AORTIC ANEURYSM
 It is primarily in the thorax.
 It is the ballooning of the upper aspect of aorta, above the diaphragm.
 The principal causes of death due to thoracic aneurysmal disease are dissection
and rupture.
 Once rupture occurs the mortality rate is 50 to 80%.

COMPLICATION OF THORACIC
ANEURYSM

SIGNS AND SYMPTOMS OF TAA
 Compression of Superior venacava may produce congestion of head,
neck and upper extremities.
 Pulse and BP differences
 Chest pain
 Abnormal pulsation apparent on chest
 Shortness of breath
 Cough
 Hoarseness
 Dysphagia

ABDOMINAL AORTIC ANEURYSM
Vast majority of aneurysm are asymptomatic unless raptured. Rupture may
result in pain in the abdomen or back, low blood pressure and often result in
death.

COMMON CAUSES FOR ANEURYSM
ETIOLOGY/ RISK FACTORS
 Atherosclerosis may contribute to weakening of blood vessel
 Infection which affect the arterial wall
 Syphilis
 Marfan syndrome
 Penetrating or blunt trauma
 High blood pressure it may enlarge or weaken the blood vessel
 Older age(greater than 60)
 Male sex
 Smoking
 Family history of aneurysmal disease

GENERAL PATHOPHYSIOLOGY

DIAGNOSIS

PHYSICAL EXAMINATION

MANAGEMENT OF ANEURYSM

INDICATION OF SURGERY FOR
AORTIC ANEURYSM

ENDO VASCULAR GRAFT
PROCEDURE
 It is an alternative to conventional surgical repair of AAA.
 This techniques involves the placement of a suture less aortic graft into the
abdominal aorta inside the aneurysm via femoral artery cut down
 After the graft is delivered to the predetermined point , the graft is pressed
or implanted against the vessel wall by balloon inflation
 The blood then flows through the vascular graft, thus preventing the
expansion of the aneurysm due to pressure, and the aneurysmal wall begin
to shrink over time because the blood is now being diverted through the
endograft.

OPEN SURGICAL REPAIR
– Longer Recovery Time
Longer Hospital Stay
– 90% Long Term Success
– Younger patients typically.
EVAR
– Shorter length of stay
– Reduction in blood loss
– ICU utilization reduced
– Reduce morbidity/mortality rate
– Older patients typically
– Needs long-term follow-up
– May need secondary procedures
for end leaks.

BENEFIT V/S COMPLICATIONS OF
ENDOVASCULAR REPAIR
BENEFITS COMPLICATIONS

SURGICAL MANAGEMENT

CLIPPING THE ANEURYSM

WRAPPING THE ANEURYSM
.

COILING OF ANEURYSM
A catheter is introduced in to the femoral artery and threaded up to the
cerebral blood vessel
Platinum coils attached to a thin wire are inserted into the catheter and then
placed in the aneurysm until the aneurysm is filled with the coil.
So it packing prevents the blood from circulating through the aneurysm and
reduce the risk of rupture.

NURSING DIAGNOSIS AND INTERVENTION
Monitor vital signs,
Obtain information regarding back or abdominal pain
Explain all procedures in simple words
Reduce unnecessary external stimuli
Instruct the patient not to lift any heavy objects(beyond 2.5 kg) for about 6 to 12 weeks after
surgery
. Teach the client about the importance of wound care.

CONCLUSION

BIBLIOGRAPHY