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Aneurysms of peripheral arteries: causes, symptoms, diagnosis, treatment

 
, medical expert
Last reviewed: 23.04.2024
 
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Peripheral arterial aneurysms - pathological expansions of peripheral arteries, caused by the weakening of the arterial wall.

Approximately 70% of peripheral arterial aneurysms are popliteal; 20% are iliac-femoral. Aneurysms of these localizations often combine with aneurysms of the abdominal part of the aorta and more than 50% of cases are bilateral. The rupture is relatively rare, but these aneurysms can lead to thromboembolism. They are much more common in men than in women (the ratio is more than 20: 1); the average age of detection is 65 years. Aneurysms in the arteries of the hands are relatively rare. They can cause limb ischemia, distal embolism and stroke.

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Causes of aneurysms of peripheral arteries

Infectious (mycotic) aneurysms can occur in any artery, but the femoral artery usually suffers. They usually develop because of infections caused by salmonella, staphylococci, or pale treponema (syphilis).

Common causes include atherosclerosis, infarction of the popliteal artery, and infected emboli.

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Symptoms of aneurysms of peripheral arteries

Peripheral arterial aneurysms usually exist asymptomatically. However, tenderness in palpation, chillness and pallor of the limbs, paresthesia or lack of pulse due to thromboembolism or (rarely) rupture of aneurysm may develop. Infectious aneurysms can cause local pain, fever, malaise and weight loss.

Diagnosis of aneurysms of peripheral arteries

The diagnosis is established using ultrasound, angiography, MRI or CT. Suspicion of popliteal aneurysms occurs when physical examination reveals an enlarged pulsating artery; The diagnosis is confirmed by visualization studies.

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Treatment of aneurysms of peripheral arteries

The risk of rupture of limb aneurysms is low (<5% for popliteal and 1% for orofemoral aneurysms). With an aneurysm of the arteries of the legs, surgical treatment is often chosen. It is resorted to when the arteries are enlarged 2 times compared to the norm or clinical symptoms appear. However, surgical treatment is prescribed for all aneurysms of the arteries of the hand, because the risk of serious complications (for example, thromboembolism) is high. The damaged segment of the artery is excised and replaced with a transplant. The limb can be preserved after surgical repair in 90-98% with asymptomatic aneurysms and in 70-80% in the presence of clinical manifestations.

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