aneurysm (ănˈyŏrĭzəm) [key], localized dilatation of a blood vessel, particularly an artery, or the heart. Dilatation of an artery, and therefore weakness of that portion of the arterial wall, may be rarely congenital, or it may be caused by syphilis, hypertension (high blood pressure), arteriosclerosis, bacterial and fungal infections, or penetrating injury as from a bullet or knife. An aneurysm may be asymptomatic or it may cause varying symptoms, depending upon its location and size and on whether the expanding mass is pressing on adjacent nerves or vital organs. The weakened arterial walls of an aneurysm are always in danger of sudden rupture, with resulting hemorrhage and death.
Aneurysms occur most commonly in the large arteries; the aorta, the largest vessel in the body, is the one most often affected. Ventricular aneurysms of the heart often occur after myocardial infarctions. Aneurysms also occur in the arteries within the skull and in other areas of the body.
Aneurysms can be detected by echocardiogram, spin echo magnetic resonance imaging scans, coronary arteriograms, and biplane ventriculograms. Treatment, where feasible, may involve surgery to remove the aneurysm or the insertion of coiled wire to close it off. Coiled wire can only be used on aneurysms that are connected to the blood vessel by a narrowed neck. The coiling fills the aneurysm, obstructing the flow of blood into the dilatation, and blood clots form around the wire, preventing the aneurysm from bursting. Surgical excision of the dilated saclike portion of the affected artery sometimes requires the replacement of that portion by a synthetic graft, a section of vessel (made of polymer fiber) that is similar in size.
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