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Time is critical when an aneurysm ruptures

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The heart thumps 72 beats per minute, each beat pumps blood through arteries, distributing oxygen and vital nutrients that keep us alive. But if one of these arteries becomes weakened or cracked, the pressurized circulation of blood can turn fatal. This is called an aneurysm.

An aneurysm is a weakened blood vessel in the aorta — a vessel with the diameter of a garden hose that carries blood from the heart through the abdomen down into the legs.

When they are small, aneurysms are watched carefully,” says Constantine Andrew, MD, a Virtua vascular surgeon. “But if one continues to swell like an over inflated balloon, it can rupture or pop, causing severe internal bleeding. People who smoke and have high blood pressure are most at risk.”

Sam can attest to that. He had been living with high blood pressure for several years when he suddenly experienced severe abdominal and back pain. Not knowing what was wrong, his wife immediately drove him to the nearest emergency room (ER).

The ER physicians determined that Sam had a large aneurysm in his aorta that burst. Dr. Andrew says: “Patients must seek treatment immediately for severe abdominal
and back pain; they could be symptoms of a ruptured aneurysm, which can cause death in just minutes.”

A second chance
The Acute Vascular Emergency Service at Virtua Marlton is prepared for these dire emergencies, offering a multi-disciplinary medical team including both a vascular surgeon and an interventional radiologist who work together to repair the blood vessel.

Joshua Brodkin, MD, interventional radiologist at Virtua says: “If the rupture is contained, we can repair the vessel where the aneurysm burst and place a stent graft or slender tube so that blood can continue to flow in its place.

We now have minimally invasive ways of performing this procedure although we do continue to use traditional surgery when indicated.”

Sam was fortunate. Although the aneurysm burst, the surgeon and interventional radiologist controlled the bleeding and inserted the stent graft through the less invasive method. This procedure takes two hours, and patients usually stay in the hospital overnight, completely recovering within two to four weeks.

Busting blood clots
The team at the Acute Vascular Emergency Service are also proficient at treating other vascular conditions such as blood clots and peripheral arterial disease (PAD).

“Clots form when blood flows poorly through the body,” says Dr. Brodkin. “It eventually clumps and lodges itself in the vein or artery in the legs or arms. But it can travel upward into the lungs, heart, and brain, causing pulmonary conditions or stroke. Those who are obese, smoke and have cancer are most at risk.”

Symptoms of blood clots in the veins include pain, swelling and redness. Symptoms of blood clots in the arteries include pain, coldness, numbness and loss of motor
function. Frequently, physicians can dissolve clots by injecting blood thinners or clot busting medications.

Plaque attack
Most people equate plaque with a build-up that attacks the teeth and gums, but plaque can form in the arteries that supply blood to the legs and feet. This is called PAD.

“Plaque is a fatty material that can build up in the walls of the arteries,” says Dr. Andrew. “Once it hardens, it can decrease blood flow and injure nerves and tissues, which can result in a loss of a leg, a foot or even toes if not treated. People over age 50 are at higher risk if they have a history of:

• Diabetes
• Abnormal cholesterol
• Heart disease
• High blood pressure
• Kidney disease
• Smoking
• Stroke

PAD symptoms are pain, aching, fatigue, burning or discomfort in the muscles of your feet, calves or thighs. Physicians may prescribe medications which can keep plaque from forming in the arteries or enlarge the affected artery for improved blood flow. If the condition is severe, patients may need a stent or arterial bypass surgery.

“By exercising regularly, eating the right foods to control blood pressure and cholesterol, you can decrease your chances of developing blood clots and PAD,” says Dr. Andrew.