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Updated: June 28, 2025
Sometimes the vein also is injured and an arterio-venous aneurysm established. Owing to the laxity of the tissues, it increases rapidly, and it may soon attain a large size, filling up the axilla, and displacing the clavicle upwards. This renders compression of the third part of the subclavian difficult or impossible.
The progress of natural cure is indicated by the aneurysm becoming smaller, firmer, less expansile, and less compressible; the murmur and thrill diminish and the pressure effects become less marked. While these changes are taking place the collateral arteries become enlarged, and an anastomotic circulation is established.
While any of the large branches in the abdomen may be affected, the most common seats are in the aorta itself, just above the origin of the cœliac artery and at the bifurcation. The clinical features vary with the site of the aneurysm and with its rapidity and direction of growth. A smooth, rounded swelling, which exhibits expansile pulsation, forms, usually towards the left of the middle line.
A brief examination, to which he submitted with cheerful unconcern, showed that it was a solid growth, and I told him so. He knew some pathology and was, of course, an excellent anatomist, so there was no avoiding a detailed explanation. "Now, for my part," said he, buttoning up his waistcoat, "I'd sooner have had an aneurysm. There's a finality about an aneurysm.
The treatment is governed by the same principles as apply to the pathological varieties, but as the walls of the artery are not diseased, operative measures dealing with the sac and the adjacent segment of the affected artery are to be preferred. An abnormal communication between an artery and a vein constitutes an arterio-venous aneurysm.
It is less successful than the proximal ligature, and is therefore restricted to aneurysms so situated as not to be amenable to other methods; for example, in aneurysm of the common carotid near its origin, the artery may be ligated near its bifurcation, or in aneurysm of the innominate artery, the carotid and subclavian arteries are tied at the seat of election. Compression.
The organisation of this clot results in the healing of the wound in the vessel wall. In other cases the blood escapes beyond the sheath and collects in the surrounding tissues, and a traumatic aneurysm results. Secondary hæmorrhage may occur if the wound becomes infected.
This does not necessarily imply failure to cure, as the recurrent pulsation may only be temporary; the formation of laminated clot may ultimately take place and lead to consolidation of the aneurysm. The least desirable result of the Hunterian ligature is met with in cases where, owing to widespread arterial disease, the collateral circulation does not develop and gangrene of the limb supervenes.
You know, the first lady has received now almost a million letters from people all across America and from all walks of life. I'd like to share just one of them with you. Richard Anderson of Reno, Nevada, lost his job and, with it, his health insurance. Two weeks later, his wife, Judy, suffered a cerebral aneurysm. He rushed her to the hospital, where she stayed in intensive care for 21 days.
#Treatment.# In treating an aneurysm, the indications are to imitate Nature's method of cure by means of laminated clot.
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