Aneurysms

When it comes to evaluating and treating aneurysms – and providing effective minimally invasive approaches to their management – UT Southwestern Medical Center has one of the most experienced groups of neurosurgeons, vascular surgeons, and interventional radiologists in the U.S. 

Working together, our team coordinates complete care – from imaging evaluation to post-procedure follow-up – maintaining a high level of communication with patients throughout the process.

Expert Care for All Types of Aneurysms

An aneurysm is a bulging, weakened area of a blood vessel or an area where a blood vessel is dilated and larger than normal.

An aneurysm can be located in many areas of the body, such as the blood vessels of the brain, the aorta (the largest artery in the body), the intestines, the kidney, the spleen, and the vessels in the legs. The most common location of an aneurysm is the aorta, which carries oxygenated blood from the heart to the body. 

UT Southwestern’s multidisciplinary approach to treating aneurysms – involving interventional radiologists, vascular surgeons, and neurosurgeons, depending on the type of aneurysm – allows us to provide expert care for all types of aneurysms. 

Neurosurgeons in the Peter O’Donnell Jr. Brain Institute perform more pre-emptive surgeries to prevent aneurysm-induced stroke than any medical center in the region, having performed more than 2,500 of these surgeries over the past decade. 

Our interventional radiologists specialize in treating aneurysms and the areas of the body they affect. These specialists have advanced fellowship training in interventional radiology, plus extensive real-world experience. 

About Aneurysms

Aneurysms can accumulate into a blood clot, and this clot can break off and become lodged in smaller blood vessels downstream, causing damage to the organ. Larger aneurysms can rupture, which can be life-threatening. 

Aneurysms occur mostly in arteries that carry fast-flowing blood, and they result from the weakening of the blood vessel’s wall. This weakening can happen for many different reasons, such as genetic diseases, trauma, atherosclerosis, and infection. 

Types and Symptoms of Aneurysms

Symptoms associated with aneurysms depend on the location of the aneurysm in the body. The symptoms often resemble other medical conditions or problems.  

Symptoms that can occur with different types of aneurysms include: 

• Abdominal aortic aneurysm (AAA): Constant pain in abdomen, chest, lower back, or groin area
• Brain (cerebral) aneurysm: Sudden severe headache, nausea, vomiting, visual disturbance, or loss of consciousness
• Common iliac aneurysm: Lower abdominal, back, or groin pain
• Femoral and popliteal artery aneurysm: Easily felt pulsation of the artery located in the groin area (femoral artery) or on the back of the knee (popliteal artery)

Diagnosing Aneurysms

An aneurysm is usually discovered during an X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). It’s often found when doing one of these tests for other conditions. 

For patients who have been diagnosed with an aneurysm or show symptoms of having one, we might request one or a combination of the following diagnostic procedures, in addition to a complete medical history and physical examination:

• Arteriogram (angiogram): An X-ray image of the blood vessels is used to evaluate various conditions, such as aneurysm, stenosis (narrowing of the blood vessel), or blockages. A dye (contrast) will be injected through a thin flexible tube placed in an artery. This dye will make the blood vessels visible on the X-ray.
  
• Cerebrospinal fluid test: In this procedure for brain aneurysms, a specialist uses a needle to draw cerebrospinal fluid from the back to check for red blood cells (also known as a spinal tap or lumbar puncture).
• Computed tomography angiography (CTA): Combining a CT scan with injection of a special dye, this scan produces images of the blood vessels.
• Echocardiogram: Also called echo, this procedure evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor, which produces a moving picture of the heart and heart valves.
• Magnetic resonance imaging (MRI): An MRI uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
• Ultrasound: Through high-frequency sound waves and a computer, an ultrasound creates images of blood vessels, tissues, and organs. An ultrasound is used to view internal organs as they function and assess blood flow through various vessels.

Treatment for Aneurysm

UT Southwestern’s strong culture of surgical treatment of aneurysms spans more than 30 years. Our extensive experience is a reason why we are a major referral center for complex cases from Texas and many surrounding states. 

Treatment options for an aneurysm can include one or more of the following:

• Controlling or modifying risk factors, such as quitting smoking, controlling blood sugar (in patients with diabetes), and losing weight (if overweight or obese)
• Limiting dietary fat intake, which can help control the progression of the aneurysm
• Taking medication to control factors such as hyperlipidemia (high blood levels of cholesterol) or high blood pressure
• Having surgery, including minimally invasive approaches 

Different treatments have different strengths. We work with patients to determine which solution will achieve the most effective results for their case. 

Minimally Invasive Surgery

Whenever appropriate, we treat an aneurysm using minimally invasive endovascular surgery, which reduces recovery time and limits discomfort. 

In endovascular surgery, we use small catheters, placed inside the blood vessels, that can be guided up to the aneurysm. The aneurysm can then be blocked off by delivering tiny coils into the aneurysm or using a special covered tubular device called a stent graft. Either way, the goal is to block the aneurysm from any further blood flow into it.  

Traditional Surgical Treatments

For some patients, traditional open surgery is a more appropriate treatment. Because of the large number of referrals we receive, UT Southwestern surgeons maintain surgical expertise and continue to offer surgical treatments for patients who would benefit from open surgery (for example, in patients with aneurysms that are more likely to recur with coiling or those who are not able to take blood thinners).