What is an aneurysm?
An aneurysm is an abnormal, localised dilation of an artery, caused by weakening of the vessel wall. It can occur in several arteries of the body, and is most common in the aorta (the body's main artery).
Main types
- Abdominal aortic aneurysm: the most common, below the level of the kidneys
- Thoracic aortic aneurysm: in the upper part of the aorta
- Popliteal aneurysm: behind the knee (the most common of the peripheral ones)
- Carotid aneurysm
- Visceral artery aneurysm (renal, mesenteric, hepatic)
Risk factors
- Age over 65
- Smoking (the main modifiable factor)
- High blood pressure
- Atherosclerosis
- Family history of aneurysm
- Male sex (4–6 times more common)
- Connective tissue disorders (Marfan, Ehlers-Danlos)
Symptoms
Most aneurysms are asymptomatic and are found during routine imaging. When they grow large, they may cause:
- Abdominal or back pain (abdominal aorta)
- A pulsatile mass in the abdomen
- Chest or back pain (thoracic aorta)
- Pain, swelling and colour change in the leg (popliteal)
- In case of RUPTURE: sudden severe pain, low blood pressure, shock — EMERGENCY
Diagnosis
- Abdominal ultrasound: screening and follow-up
- Doppler ultrasound: for peripheral aneurysms
- Contrast-enhanced CT scan: detailed mapping
- Magnetic resonance imaging (MR angiography): a radiation-free alternative
Treatment
Treatment depends on the size, the location and how fast the aneurysm is growing:
- Small aneurysms (women <5 cm, men <5.5 cm): imaging follow-up every 6–12 months
- Strict risk-factor control: stop smoking, control blood pressure and cholesterol
- Endovascular repair (EVAR/TEVAR): minimally invasive technique with a stent graft
- Open surgery: replacement of the affected segment with a prosthesis
Coming from abroad? Read how treatment in Brazil works — the consultation, the imaging, the estimate and what to expect in São Paulo.