aneurysm

2. 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

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

4. THE LAYERS OF VESSEL WALL
INVOLVED
TRUE ANEURYSM

PSEUDO ANEURYSM

5. 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.

6. 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.

10.  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.

11. 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.

12. SYPHILITIC ANEURYSM
 Syphilitic Aneurysms arise during tertiary syphilis due to chronic inflammation inthe
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.

13. AORTIC ANEURYSM

14. 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%.

15. COMPLICATION OF THORACIC ANEURYSM

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

17. 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.

18. COMMON CAUSES FOR
ANEURYSM ETIOLOGY/ RISK
FACTORS
 Atherosclerosis may contribute to weakening of blood vessel
 Infection which affect the arterial wall
 Syphilis
 Marfan syndrome( Inherited disorder that changes the protienthat helps to
make healthy connective tissue. It affects connective tissue, heart, eyes, blood
vessels and bone. Tall and thin with long arms,legs,fingers and toes)
 Penetrating or blunt trauma
 High blood pressure it may enlarge or weaken the blood vessel
 Older age(greater than 60)
 Male sex
 Smoking

19. GENERAL PATHOPHYSIOLOGY

20. DIAGNOSIS

21. PHYSICAL EXAMINATION

26. MANAGEMENT OF ANEURYSM

27. 27

28. 28

29. INDICATION OF SURGERY FOR AORTIC
ANEURYSM

30. ENDO VASCULAR GRAFT
PROCEDURE
 It is an alternative to conventional surgical repair ofAAA.
 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.

31. 31

32. BENEFIT V/S COMPLICATIONS OF
ENDOVASCULAR REPAIR
BENEFITS COMPLICATIONS

33. SURGICAL MANAGEMENT

34. CLIPPING THE ANEURYSM

35. WRAPPING THE ANEURYSM
.

36. 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.

37. INTERPOSITION TECHNIQUE
• Aneurysmal tissue is excised and replaced with a
prosthetic tube graft interpose between two aortic
remnants.

38. ROSS PROCEDURE
• Removes the abdominal aortic valve. The surgeon then
replace it with the patient’s own pulmonary valve. The
surgeon used a valve from cadaver donor to replace
the pulmonary valve

39. BENTALL PROCEDURE
• It is a surgery to replace part of the aorta and the aortic
valve of the heart because of a bulge in the aorta.

41. CABROL PROCEDURE
• The ascending aorta replacement with a
composite graft and direct re-implantation of
coronary arteries into an inter position graft,
which is anastomosed side-side to the aortic
graft. Blood flows (arrows) from the aorta into the
right and left coronary limbs and, eventually, the
coronary arteries.

43. NURSING DIAGNOSIS AND INTERVENTION
Monitor vital signs,
Obtain information regarding back or abdominalpain
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 weeksafter
surgery
. Teach the client about the importance of wound care.