ABC of Vascular Disease
Aneurysmal Arterial Disease
1. What is aneurysmal arterial disease?
Aneurysmal arterial disease is a slow process through which arteries
throughout the body become progressively enlarged. Arterial aneurysms are
uncommon and do not normally cause symptoms until a complication occurs.
2. What causes aneurysmal arterial disease?
The arteries are not simply rubbery tubes that carry blood from the heart; they
are complex, living structures. The blood is pumped into the arteries at
pressure by the heart and the wall of the artery must be strong enough to
withstand this pressure and the artery must be durable to withstand the repeated
pulses for many years. The wall of an artery is a living structure that is
constantly being damaged and repaired. Even a small deficiency in this
process can, over many years, lead to a progressive change in the composition of
the artery wall. In aneurysm disease this repair process is not complete
and the wall of the artery loses its resilience and becomes less durable.
The outcome is that the wall of the artery stretches very slowly, driven by the
pressure of the blood inside, to form an aneurysm. At the same time as the
artery increases in diameter it also increases in length and this may cause the
artery to become bent and tortuous. The flow of blood in an aneurysm is
disturbed by the change in shape and causes clot to be deposited in the regions
where the blood is flowing very slowly. This clot has no strength and does
not protect the wall of the artery from the pressure of the blood. As the
artery gets larger the stress on the wall increases and the rate at which the
wall stretches also increases.
3. Does everyone get aneurysmal arterial disease?
No, it only seems to affect a proportion of people but there are some risk
factors which are associated with the development of arterial aneurysms:
|High blood pressure (hypertension)|
4. What are the symptoms of arterial aneurysmal disease?
Usually there are no symptoms at all until the condition is well advanced or
a complication occurs. The progressive stretching of the artery is very
slow, occurring over years, and is not painful. At the end stage of the
condition the artery may enlarge rapidly and this is sometimes painful.
5. What are the complications of arterial aneurysmal disease?
There are two serious complications of arterial aneurysms: rupture and
An aneurysm will rupture if it reaches such a size that the wall can no longer
withstand the stress generated by the blood pressure. If an aneurysm
ruptures the blood leaks out into the surrounding tissues causing a
haematoma. The artery that most commonly develops this complication is the
artery in the abdomen (aorta). Rupture of an aortic aneurysm is an
emergency and there is a very high risk of loss of life.
An aneurysm will occlude if the blood clot within it causes the blood to flow in
a tortuous path through it. A change in the shape of the blood clot can
then block the artery completely. The artery that most commonly develops
this complication is the artery just behind the knee (popliteal artery).
Occlusion of a popliteal aneurysm is an emergency and there is a high risk of
6. What can I do to prevent aneurysmal arterial disease from getting worse?
There is no evidence that restricting your lifestyle makes any difference.
It is important to seek medical advice regarding testing for the other treatable risk
factors, such as high blood pressure, and getting treatment if they are confirmed.
There are no drugs that can prevent or stop the development of arterial