What differentiates an aneurysm from a thrombosis?

Aneurysm and thrombosis are two conditions of the cardiovascular system that can cause serious disturbance in blood circulation but what are they etiologically very different. The treatment of both is also different, as are the risk factors and preventive guidelines.

Briefly, an aneurysm is a permanent swelling in the wall of a blood vessel. It usually resembles the shape of a balloon and can appear on one or both sides of the blood vessel, modifying blood flow. Blood pressure exerts pressure on the aneurysm, modifying it until it eventually ruptures. Thrombosis is the formation of a thrombus or clot of fibrin and platelets that is blocked in a blood vessel.

What is an aneurysm?

An aneurysm is defined as a permanent swelling in a blood vessel, usually balloon-shaped, that fills with blood. Aneurysm is a consequence of a weakening of the vascular wall from various causes, both genetic and acquired.

Aneurysms can theoretically occur in any blood vessel, but they are more common in arteries than in veins. Some of the most dangerous, due to their location, are aneurysms, cerebral arteries, especially the cerebral arterial circle, and aortic aneurysms. Other relatively common aneurysms appear in the femoral and popliteal arteries, both in the legs, in the splenic artery (supplies the spleen and part of the stomach), and in the mesenteric arteries that supply the intestine and other organs of the digestive system.

As the aneurysm fills and swells with blood, the risk of rupturing is increasing, and the consequences can be severe internal bleeding and even death. Aneurysms are also a nest for thrombus formation, since the alteration of the vascular wall and the eddies that are created in the blood flow favor the formation of clots.

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True and false aneurysms

Aneurysms can be classified according to several criteria, such as the degree of vascular wall involvement, the morphology of the dilatation, or its location. Among the main types of aneurysms, we find:

True aneurysm: The layers of connective tissue and muscle that form the vascular wall appear dilated but intact. Among the most common are atherosclerotic aneurysms, congenital aneurysms, and ventricular aneurysms (may appear in the heart after myocardial infarction). False aneurysm or pseudoaneurysm: the vascular wall presents a rupture that does not affect the connective tissue that covers the vessel. Blood escapes from the vascular lumen and accumulates between the vessel and surrounding tissue, forming a hematoma. The hematoma tends to clot as a natural mechanism to stop blood leakage. Saccular aneurysm: Vascular dilatation takes the form of an approximately spherical bag or balloon. It is common for them to be completely or partially filled with thrombi. fusiform aneurysm: The dilatation is fusiform with variable diameter and length. Arterial dissection: Arterial dissection occurs when the vascular wall is torn and blood accumulates between some of the vascular layers, forcing them apart.

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types of aneurysms basilar aneurysm

What is a thrombosis?

Thrombosis is the process of formation of a thrombus or clot within a blood vessel. The clot is formed by the same physiological clotting mechanism that prevents bleeding, but the problem is that it is triggered inside the vessel.

The clot normally remains attached to the vascular wall where it grows and hinders blood flow. A fragment (plunger) can also break and cause an embolism; the plunger travels through the bloodstream until it finds a small-caliber vessel and blocks it.

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Thrombus formation can be initiated by damage to vascular walls, rupture of a vessel, alteration of blood components, presence of atherosclerotic plaques, or changes in blood flow (eg, in changes that form a vortex flow). . These factors stimulate the chemical cascade that converts prothrombin to thrombin, an enzyme that catalyzes the transformation of fibrin to fibrinogen. The fibrinogen protein forms a mesh that serves as a network to adhere platelets and form the thrombus.

Main differences

Both aneurysm and thrombosis are conditions of the circulatory system and can eventually block or significantly impede blood circulation, but their pathophysiology is very different.

Aneurysm is a permanent dilation of blood vessels, thrombosis is the formation of a clot inside the blood vessels. the aneurysm is always a pathological process; thrombi can respond to completely physiological mechanisms and become pathological only in some situations. The aneurysm forms in the vascular wall, the thrombus forms in the blood, although it can adhere to the wall. The main risk of an aneurysm is its rupture and consequent internal bleeding. The main risk of thrombosis is embolism or blockage of blood circulation. The aneurysm, by affecting the blood circulation and the vessel wall, can be a risk factor for the formation of thrombi. Aneurysms can form slowly, while thrombi usually form much more quickly. The most frequent treatment of thrombosis includes the use of anticoagulant drugs. The most common aneurysm treatment is surgical interventions to fix the dilatation or implantation of stents that circumvent the deformation of the blood vessel.

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