Aneurysm –  is a bulge or ballooning in a blood vessel caused by weakness in the vessel wall. Aneurysms can occur in any blood vessel, but they are most commonly seen in the aorta which is the largest artery in the body.

There are two main types of aneurysms.

1. Abdominal aortic aneurysms (AAA’s) these occur in the abdominal section of the aorta.
2. Cerebral aneurysms – these occur in the brain.

Aneurysms can be asymptomatic and may go undetected, but they can also be life threatening if they rupture causing severe bleeding and potential fatal complications.  Risk of rupture depends on the size and location of the aneurysm.  Risk factors for developing an aneurysms include smoking, high blood pressure, atherosclerosis, and a family history of aneurysms.

The commonest manifestation of the condition is where the wall of the main artery in the abdomen thins and the artery balloons out leading to a dilated sac. This does not cause any symptoms and most patients are unaware that they have an aneurysm. Left untreated however, most aneurysms continue to enlarge and are more at risk of rupturing (often a fatal complication) the larger the size they reach. Aneurysms are more common in men, and can run in families, or be associated with hypertension and atherosclerosis without a family history.

There is now a national screening programme for 65-year-old men, but women and younger patients (where the incidence is much lower) are not covered by this. Some aneurysms are more complex and involve the thoracic aorta or the abdominal aorta at the level of the renal and mesenteric arteries (involving the blood supply to the kidneys and guts). These aneurysms require a more specialised treatment plan and often need custom stents or sophisticated surgical procedures only available at larger specialist vascular centres. The Lindo Wing, St Mary’s Hospital has one of the largest experiences of such cases in the UK.

The Lindo Wing, St Mary’s Hospital was the site of the world’s first installation of endovascular robotics system, and our team has pioneered its development. We performed the worlds’ first robotic endovascular repair and now have the largest series of robotic cases in the world.

• Open surgery for all aneurysms
• Endovascular aortic repair
• Complex custom made stent grafting techniques
• Robotic endovascular aneurysm repair

Peripheral aneurysms – are less common and can affect the popliteal artery, (leg artery behind the knee) or femoral arteries, sometimes palpable as a pulsatile lump.  Although aneurysms here behave differently from aortic aneurysms, they often still need treatment to prevent them thrombosing (occluding), or embolising (fragment’s breaking off),  leading to ischaemia of the foot or leg,  these aneurysms can be diagnosed with a simple non-invasive duplex scan and can be treated with surgery or where appropriate, stenting.

• Open surgical bypass
• Endovascular stent graft repair
• Endovascular coiling and occlusion