Table of Contents

Aneurysm

An aneurysm or aneurism (from Greek: ἀνεύρυσμα, aneurusma, “dilation”, from ἀνευρύνειν, aneurunein, “to dilate”) is a localized, blood-filled balloon-like bulge in the wall of a blood vessel.

Aneurysms can occur in any blood vessel with examples including aneurysms of the circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can also occur within the heart itself.

Rupture

As an aneurysm increases in size, the risk of rupture increases.

A ruptured aneurysm can lead to bleeding and subsequent hypovolemic shock, leading to death. Aneurysms are a result of a weakened blood vessel wall, and can be a result of a hereditary condition or an acquired disease.

The most frequent location is the arterial bifurcation.

Classification

see Aneurysm classification

Parts

Dome

Pathogenesis

see Intracranial aneurysm pathogenesis.

Conditions associated with aneurysms

see Conditions associated with aneurysms

Treatment

Evolving endovascular technologies need to be integrated into the microsurgical management of aneurysms. Multimodality approaches are best used with complex aneurysms in which conventional therapy with a single modality has failed. Revascularization remains a unique surgical contribution to the overall management of aneurysms with which current endovascular techniques cannot be used. Multimodality management should be considered an elegant addition to the therapeutic armamentarium that, through simplification and increased safety, improves the treatment of complex aneurysms beyond what is achievable by performing clipping or coiling alone 1).

Aneurysm models

Aneurysm model

1)
Lawton MT, Quinones-Hinojosa A, Sanai N, Malek JY, Dowd CF. Combined microsurgical and endovascular management of complex intracranial aneurysms. Neurosurgery. 2008 Jun;62(6 Suppl 3):1503-15. doi: 10.1227/01.neu.0000333814.02649.a0. PubMed PMID: 18695569.