Why does the aneurysm occur particularly in the abdominal cavity? | Aortic aneurysm

Why does the aneurysm occur particularly in the abdominal cavity?

An aortic aneurysm most often occurs in the abdominal cavity. In 90% of cases it forms below the renal artery. The exact cause of this is not yet fully understood. It could be because the structures and organs surrounding the aorta are conducive to a bulging of the aortic wall at this location, or because the pressure in the vessel becomes particularly high here due to certain factors. Another reason is probably processes that occur at the cellular level, but which have not yet been fully understood.

Are you allowed to do sports with an aortic aneurysm and which one?

In principle, sport is possible with an aortic aneurysm. However, the diameter of the aneurysm and the causative disease are very important. It must therefore be decided individually for each patient.

In general, it can be said that sports where the blood pressure rises sharply should be avoided in the case of an aortic aneurysm. An example of this is weight training. A rise in blood pressure increases the pressure on the aortic wall and thus promotes a life-threatening rupture. Aerobic endurance sports such as Nordic walking are recommended.

Epidemiology

Men are predominantly affected by aortic aneurysm (ratio to women 6:1). The age peak lies between 65 and 75 years of age. Since there is no preventive examination in the sense of an aortic aneurysm, a relatively high number of unreported cases can be assumed, even among younger patients. In 10% of older patients suffering from high blood pressure, an aortic aneurysm can be detected.

MRI of the aorta

For the planning of aortic aneurysm therapy, it is important to have an imaging procedure to assess the aneurysm and the vessel wall. For this purpose either CT or MRI with contrast medium is used. MRI is superior to CT because it can better depict the nature of the vessel wall and there is no radiation exposure for the patient, but it is not applicable in emergencies due to the greater time required. Since magnetic radiation is used in MRI, it cannot be used in patients with pacemakers or metallic stents.

Summary

An aneurysm is a bulging of the vessel wall. A distinction is made between the aneurysm verum (real aneurysm), in which the entire vessel wall is bulged, the aneurysm dissecans, in which there is bleeding between the two layers of the vessel, and the aneurysm spurium, in which there is a rupture of all wall layers with simultaneous bleeding into surrounding tissue. In this type of aneurysm, a sheath later forms around the bleeding, which in turn can exert pressure and functional disorders on surrounding organs.

If the aortic aneurysm (rupture) of an aneurysm diameter of more than 5 cm tears, urgent surgery is indicated. This involves opening the thorax, disconnecting the aorta from the bloodstream and either suturing the open area after the aneurysm has been removed or inserting a plastic-coated tube (stent). All aortic aneurysms smaller than 4 cm that do not cause symptoms should be closely monitored by ultrasound.

An increase in size should not exceed 0.4 cm per year. If this is the case, surgery is also indicated. Without therapy, 50% of asymptomatic aneurysms rupture within the next 10 years.

Symptomatic aneurysms rupture on average after 1-2 years (90%). With planned surgery 4-7% of patients die, with emergency surgery up to 50-90%. Aortic aneurysm is a serious clinical picture, the chances of recovery have increased considerably in recent years due to better materials and surgical procedures.