This article aims to enable nurses to provide
better and more informed care for patients with
abdominal aortic aneurysms. After reading this
article and completing the time out activities you The term aneurysm derives from the ancient Greek
word for ‘widening’ Aneurysms were first described by the 16th
century anatomist and physician Vesalius, who believed they were simply a widening of the
vessel (Collin et al 2009). Although the precise
pathophysiology of aneurysms remains
unclear, in 80% of cases it is associated with
atherosclerosis (Latessa 2002), which causes
weakening of the elastin fibres that form the
skeleton of the smooth muscle of the tunica
media (Sakalihasan et al 2005). This weakens
the muscle wall, and causes remodelling –
changes in shape of a structure, usually
associated with disease (Baxter 2004).
Remodelling associated with aortic aneurysms
causes the wall as well as the lumen of the aorta
to enlarge (Hands et al 2007). Generalised
atherosclerosis almost invariably causes
widespread ischaemia, often limiting the
functioning of vital organs, and is responsible
for co-morbidities, such as coronary artery
disease, that can complicate the care of patients
with aneurysms.
Aneurysms can occur in any part of the
aorta, and other vessels, but mostly occur
in the abdominal part of the aorta, usually
below the renal artery (Ridley and
Heinl-Green 2002). This article therefore
focuses on abdominal aortic aneurysms
(often called AAAs or triple As), although
much of the content is applicable to
aneurysms occurring elsewhere in the
vascular system. However, repair of the
thoracic aorta is complex and usually
confined to a few specialist cardiothoracic
centres, even though endovascular repair
is possible (Dolinger and Strider 2010).
In addition some patients may have
pseudoaneurysms, also called false
aneurysms, where an artery bleeds into a
haematoma that is outside the tunica externa.
Although false in the sense that the layers of
the arterial wall are not separated, by
definition the bleed into the haematoma
continues, necessitating similar vascular