Aneurisma: cos’è, tutti i tipi e le cause

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Che cosa è un aneurisma? Con questo termine medico che deriva dal Greco antico ( ἀνεύρυσμα – aneurysma “dilatazione”) si indica la dilatazione di un’arteria (vaso sanguigno che porta in circolo l’ossigeno). Pensiamo ad un palloncino. Approssimativamente il concetto è il medesimo. Il rischio non è di per se stesso il rigonfiamento, ma il fatto che se diventa eccessivo il tessuto si rompe: la rottura di un’arteria porta con se conseguenze drammatiche, fatali, spesso talmente rapide da non offrire possibilità di intervento. La diagnosi precoce e la conoscenza dei fattori di rischio, possono dunque salvare la vita.

aneurisma tipi e cause

 


Tipi di aneurisma

La maggior parte degli aneurismi si verificano sull’aorta, l’arteria principale che trasporta il sangue ricco di ossigeno dal cuore al resto dell’organismo. L’aorta passa attraverso il torace e dell’addome.

L’aneurisma aortico addominale è il più frequente ed è anche quello che offre una possibilità di salvezza laddove si raggiunga prontamente una struttura sanitaria provvista di pronto soccorso e cardiochirurgia.

Più rari e più pericolosi gli aneurismi dell’aorta toracica ( tra cui l’aneurisma dell’aorta ascendente o discendente, sempre a seconda della posizione).
Esistono poi gli aneurismi cerebrali, che sono quelli che colpiscono le arterie del cervello. Questi sono noti anche come aneurismi a bacca per le dimensioni e la forma che li caratterizzano. In genere sono asintomatici, fino lla rottura che può dare origine ad un ictus.
Meno pericolosi, ma non per questo da trascurare i cosiddetti aneurismi periferici, ovvero quelli che colpiscono altre arterie. Tra questi troviamo l’aneurisma popliteo (dietro le cosce e le ginocchia), quello femorale ed il carotideo. Tali dilatazioni non sono suscettibili a rottura, tuttavia possono dar origine a coaguli di sangue che staccandosi comportano un rischio di occlusione (embolia). Se un aneurisma periferico è grande, può premere su un nervo o vena vicino e causare dolore, intorpidimento, o gonfiore.

Aneurisma, le cause

La forza del sangue che fluisce spinge contro le pareti di un’arteria. Fisiologicamente questi vasi sanguigni sono strutturati per rimanere indenni, ma talune condizioni possono indebolirli. L’invecchiamento, il fumo, ma soprattutto l’ipertensione sul lungo termine e l’aterosclerosi possono alterarne la qualità contenitiva. Aneurismi aortici possono raramente essere causati da una sifilide non trattata o da vasculite. Più spesso si riscontra una certa familiarità con il problema.  Anzi, esistono anche delle malattie genetiche che possono provocare aneurisma dell’aorta toracico, come la sindrome di Marfan, quella di Loeys-Dietz, di Ehlers-Danlos (tipo vascolare), e la sindrome di Turner.

Queste condizioni genetiche possono indebolire i tessuti connettivi del corpo e danneggiare l’aorta. Le persone che hanno questi problemi tendono a sviluppare aneurismi in età più giovane rispetto alle altre. Sono anche a maggior rischio di rottura e la dissezione.

Infine, ovviamente, anche un trauma può danneggiare la parete dell’aorta o di un’altra qualunque arteria.

Fattori di rischio

In questo contesto è quindi possibile identificare alcuni fattori di rischio (specie in riferimento all’aneurisma aortico) e sono:

  • Genere maschile. Gli uomini hanno più probabilità rispetto alle donne di avere aneurismi aortici.
  • Età. Il rischio per aneurismi dell’aorta addominale aumenta man mano che si invecchia. Questi aneurismi è più probabile che si verifichino in persone dai 65 anni in su.
  • Il fumo può danneggiare e indebolire le pareti dell’aorta.
  • Una storia familiare di aneurismi aortici. Le persone che hanno storie familiari di aneurismi aortici sono a più alto rischio per la condizione, e possono avere aneurismi prima dei 65 anni.
  • Una storia di aneurismi nelle arterie delle gambe.
  • Alcune malattie e condizioni che indeboliscono le pareti dell’aorta. Gli esempi includono pressione alta ed aterosclerosi.
  • Avere una valvola aortica bicuspide può aumentare il rischio di avere un aneurisma aortico toracico. Una valvola aortica bicuspide ha due foglioline invece della tipica tre.

 

Se si dispone di uno qualsiasi di questi fattori di rischio, è importante parlarne con il proprio medico, per effettuare indagini diagnostiche di screening.

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