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FOR IMMEDIATE RELEASE
Dick Cheney's aneurysm highlights overlooked health risks from blood vessel problems, U-M expert says
ANN ARBOR, Mich. - Vice President Dick Cheney will have surgery this weekend to
repair a bulging blood vessel behind one of his knees. It may sound like a minor
operation, but it brings to the nation's attention an often-overlooked and
sometimes life-threatening issue: the link between blood vessel problems and
heart disease.
Cheney's heart problems, including a history of heart attacks and heart rhythm
disturbances, are well known. But a University of Michigan blood vessel
specialist says many Americans don't make the connection between their heart's
health and the health of their arteries and veins.
And a lack of early diagnosis and treatment for problems with major blood
vessels could cost them their limbs - or their lives.
"The same things that harm the heart, such as smoking, high cholesterol,
obesity, high blood pressure, stress and genetic factors, harm the blood vessels
throughout your body," says Peter Henke, M.D., a vascular surgeon and medical
director of the Noninvasive Diagnostic Vascular Laboratory at the U-M
Cardiovascular Center.
"Vice President Cheney is like millions of Americans who have lived with all of
these risk factors for many years, and like many Americans, especially men, his
blood vessels are showing signs of wear and tear. Fortunately, he was diagnosed
and is being treated before something more serious happens," Henke adds.
Cheney's operation is for a condition called a popliteal aneurysm (POP-li-teel
ANN-yur-ism), which is a bulging, weakened spot in the main artery that travels
up the back of the leg. They're often diagnosed when a physical exam reveals a
bulge in the leg or a patient complains of leg pain and tiredness. Cheney's
spokespeople have said he has one of these aneurysms behind each knee; the
operation this weekend will fix one of them.
Popliteal aneurysms can encourage the formation of blood clots that can block
blood flow to the legs and can lead to amputation of a limb. Once a person
begins having symptoms from their popliteal aneurysm, they have a 1 in 5 chance
of losing a leg, and a 1 in 20 chance of dying, unless the problem is treated.
But even more seriously, the presence of popliteal aneurysms can mean that a
person has a high risk of having other aneurysms elsewhere in their body, says
Henke, an Associate Professor of Vascular Surgery who specializes in diagnosing
and repairing aneurysms and other blood vessel problems in the legs, neck and
trunk.
And those kinds of aneurysms carry even higher risks of death and disability.
The biggest threat, Henke explains, are aneurysms in the aorta, the giant artery
that brings blood out of the heart and branches off to feed the body.
Like popliteal aneurysms, aortic aneurysms are much more common among people who
have smoked, and who have had high cholesterol and high blood pressure for
years. Men, and people with a family history of aneurysms, have a much higher
risk. Risk also rises with a person's age.
With every beat of the heart, the high pressure of blood rushing through the
aorta presses on the blood vessel's muscular walls. "Hardened" artery walls,
made stiff by cholesterol deposits and the effects of smoking and high blood
pressure, can become weak in spots. At any of those spots, the force of the
blood can cause an aneurysm to bulge out, and to grow over time. Or, it can
cause the layers of the aorta wall to come apart, a condition called aortic
dissection that killed actor John Ritter.
If an aneurysm anywhere in the aorta ruptures, death can come within minutes or
hours as the body is starved of blood. Only about 20 percent of patients who
have a rupture of an aortic aneurysm in their abdomen survive, making it the
13th leading cause of death in the United States.
Like leg aneurysms, aortic aneurysms often go undetected, and are usually picked
up only in a thorough physical exam that includes a chest X-ray, says Henke. An
estimated 10 percent of all men over the age of 70, and a smaller percentage of
younger men and women, may have an aneurysm somewhere in their aorta that could
grow and rupture. But most don't know it.
In many cases, aortic aneurysms can be treated before they rupture, with surgery
that takes the strain off the bulging area by bypassing it with transplanted
blood vessel tissue or lining it with a device called a stent graft. The U-M
Section of Vascular Surgery has years of experience in both open-surgical and
minimally invasive surgery to repair aortic aneurysms, and is currently offering
patients the chance to take part in clinical trials of new options. U-M vascular
surgeons also study the reasons why aneurysms form, and the factors that affect
diagnosis, treatment and recovery.
But artery and vein problems throughout the body can include much more than
aneurysms, Henke emphasizes. Just like the blood vessels around the heart can
become clogged with cholesterol plaques and inflamed tissue, the blood vessels
in the legs and the neck can become partially or totally blocked. And that can
keep blood from getting to the limbs and brain.
When this occurs in the legs, Henke says, it's called PAD, for peripheral artery
disease. It can make a person's legs hurt, cramp up or feel tired when they walk
or even while they rest, because their leg muscles don't get enough oxygen due
to the lack of blood flow.
Often, people think the symptoms of PAD are just a sign of "getting old" - but
in fact they can be a danger sign for much more serious clogs in the blood
vessels of the heart. People with PAD are three times more likely to die of
heart attacks or strokes than people who don't have it.
When arteries in the neck, called the carotid arteries, become clogged, the
danger is even greater, Henke says. Carotid occlusion, the technical name for
this condition, can lead to dizziness, feeling faint, partial blindness, or numb
feelings. If a carotid artery becomes fully blocked, or if a blood clot breaks
off from the plaque and travels into the head, blood flow to part of the brain
stops. And that causes a stroke that can kill or leave someone permanently
disabled.
For more information:
Popliteal aneurysms and other peripheral aneurysms (Society for Vascular Surgery) Visit www.vascularweb.org, search for "peripheral aneurysm"
U-M Cardiovascular Center heart and blood vessel information:
www.med.umich.edu/cvc/learn
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