NCLEX/CGFNS Review Notes
by Lyle, RNDownloaded from
Types of Aortic Aneurysms
Aortic aneurysms are classified by shape, location along the aorta and the process that leads to their formation.The wall of the aorta is made up of three layers: a thin inner layer of smooth cells called the endothelium, a muscular middle layer whichhas elastic fibers, and a tough outer layer. When the walls of the aneurysm have all three layers, they are called true aneurysms. If the wall of the aneurysm has only the outer layer remaining, it is called a pseudoaneurysm. Pseudoaneurysms may occur as a result of trauma when the inner layers are torn apart.
Most fusiform aneurysms are true aneurysms. The weakness isoften along an extended section of the aorta and involves the entirecircumference of the aorta. The weakened portion appears as agenerally symmetrical bulge.
Saccular aneurysms appear like a small blister or bleb on the side of the aorta and are asymmetrical. Typically they arepseudoaneurysms caused either by trauma such as a car accident oras the result of a penetrating aortic ulcer.
Degenerative aneurysms are the most common. They occur as the result of breakdown of the connective tissue and muscularlayer. The cause could be cigarette smoking, high blood pressureand/or genetic conditions.
Dissecting aneurysms occur when a tear begins within the wall of the aorta causing the three layers to separate similar to whathappens to plywood that is left out in the weather. The dissection(separation of the layers) causes the wall of the aorta to weaken,and the aorta enlarges.Dissections may occur any place along the aorta and treatmentdepends upon the location. Frequently, dissections involving theascending aorta are treated with emergency surgery while thoseinvolving the descending thoracic aorta are treated withmedication. Although dissections are uncommon, they are the most common of the acute aortic syndromes. They are lethal if not treated. They should be treated only by surgeons who have special expertise.