It is called a silent killer.  You can't see it.  You can't feel it.  Generally, it gives you no warning.  And it can be deadly.  It is an aneurysm.

An aneurysm is an abnormal, balloon-like swelling on the wall of an artery.  Aneurysms form where arteries are weak.  Because the wall of the artery is weak and the pressure of the blood is high, a bubble or bulge forms.

This can occur in any artery, but is most common in the brain and the abdomen. In many instances, aneurysms are associated with other types of cardiovascular disease, especially hypertension (high blood pressure) and atherosclerosis, a condition in which fatty deposits form inside blood vessels and restrict blood flow.  

The incidence of aneurysms increases with age. Patients are generally between the ages of 60 and 85 years old. Traumatic injuries, infections and congenital (present from birth) disorders also may cause aneurysms.  Although aneurysms can occur in both men and women, they are much more common in men.  Other risk factors include tobacco use and a family history of aneurysms.  

The aorta is the largest blood vessel in the body and supplies blood to all areas of the body.  It rises from the heart and arches over and downward through the chest and abdomen.   Abdominal aneurysms commonly occur in the aorta at a point just below the arteries to the kidneys.  (This corresponds to a point even with the belly button.)  

A talented, young colleague of mine, Todd J. Neuberger, M.D., a vascular surgeon at the Vascular Institute of SSM St. Joseph's Health Center, told me more about this tricky medical problem. "Most aortic aneurysms produce no symptoms," Dr. Neuberger explained. "Often they are identified during a routine physical exam or by radiological tests such as ultrasound or CAT scans.  In about 20 percent of cases, an undiscovered abdominal aneurysm will rupture without warning, and the patient suddenly collapses and dies due to massive bleeding inside the abdomen."  

According to Dr. Neuberger, abdominal aneurysms traditionally have been treated by a surgical procedure which requires a large incision, a lengthy hospital stay and a total recovery time of four to eight weeks.

Recently, there has been a dramatic improvement in the way aneurysms are treated.  Many aortic aneurysms can now be treated successfully by inserting the graft through small incisions at the groin.  Dr. Neuberger explained, "To do this, the graft is loaded into a small tube.  This tube is inserted into the artery at the groin and advanced upward into the aorta.  Under x-ray guidance, the graft is released inside the aneurysm.  The graft is then attached above and below the aneurysm.  This is referred to as an 'endovascular repair,' meaning it was done from inside the artery.  Following the procedure, blood flow is through the graft, so that pressure is no longer being exerted on the aneurysm.  With this new procedure most patients are discharged home the following day and can quickly resume normal activities."

I was impressed not only with this new technology, but also that it is available so close to home. St. Joseph Health Center in St. Charles is one of just a few centers in the St. Louis metropolitan area in which the procedure is performed and the only such facility in St. Charles county.  

And I'm not the only one impressed.  Dr. Neuberger said, "The endovascular repair of aortic aneurysms is one of the greatest single surgical advancements ever introduced.  It is difficult to name another surgical development which has so profoundly changed the course of patient recovery from a life threatening disease."

Hank Clever, M.D., is a well-known pediatrician in the St. Charles community.  After retiring from private practice in 1998, Dr. Clever has continued to speak to community groups and organizations about a variety of health-related topics.  He can be reached for speaking engagements by calling SSM St. Joseph Health Center at 947-5621.

The Doctor Is In can be found in the St. Charles Post each Monday.  If you have questions you would like addressed by Dr. Clever, you can write him at SSM St. Joseph Health Center, 300 First Capitol Drive, St. Charles, MO  63301.

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