The cold winter has just passed, and the earth radiates a hint of warmth of spring. In this season full of hope, the ward of vascular surgery, however, admitted several patients whose hearts are as cold as winter, in their eyes, the world is gray, life is short and painful, and what torments them physically and mentally is the criminal we are going to complain about – the aneurysm family. If bombs are not enough to scare people, the unscheduled bombs that grow on the body are enough to destroy anyone’s will, and when such bombs explode, they are enough to destroy anyone’s physical strength and even life, and the bombs here are the aneurysm family, as we often say. Since the aneurysm group is so dangerous, let’s get to know the source of these criminals and at the same time study the way to eliminate them. The big guy in the aneurysm group is the abdominal aortic aneurysm, which lives in the human abdominal cavity and gets its nutrition from the human diet high in oil, fat and alcohol. The elderly are the target of its bullying, and once humans get older, their tissues loosen up and their metabolism slows down, it becomes even more rampant and grows up immediately. When humans are in a state of chronic mental stress and their resistance is reduced, abdominal aortic aneurysms will seize this opportunity to expand their power. When it grows to a certain extent and humans try to restrain it, this untimely bomb will end human life by an explosion. In fact, abdominal aortic aneurysm is an expansion of the aorta, which forms for many reasons, not only some of the above factors, and it harms middle-aged and elderly people on earth regardless of race, class or gender. In addition to the explosion, it has some other bad traits, such as compression of the abdominal viscera causing difficulties in eating and drinking, difficulties in urination, compression of other blood vessels, causing a variety of ischemic manifestations. Don’t look at its size, humans are not easy to find it, because it grows quietly in the stomach, and only when it forms a certain climate, it gives humans some signals, such as abdominal pain, abdominal pulsating masses. Of course, humans do not allow such criminals to go unpunished and have taken certain measures. But fighting with such bad criminals is a big risk to take and a big price to pay. As an example, Mr. Wang was in a meeting abroad in 2000 and suddenly had severe abdominal pain, and when he went to the hospital, it was an abdominal aortic aneurysm, which was treated in a local specialist hospital. The doctors adopted a heavy-handed strategy and tried to open the abdomen to remove the aneurysm, but because the enemy was very strong, we could only first jam its supply line method and adopted the tactic of artificial vessel bypass to spare the abdominal aortic aneurysm, and a bad battle made our supply A bad battle made our supply seriously insufficient, and the patient bled heavily, so we could only temporarily adjourn and terminate the operation. This time, with the arrival of Mr. Wang, we developed a method to dismantle the enemy from the inside after in-depth study, which is to use intracavitary isolation of abdominal aortic aneurysm to infiltrate our elite soldiers into the enemy’s interior, cut off the pressure fuse and blood supply line, and let the aneurysm fail in its own nest, atrophy and die. The executioner among aneurysms is the aortic coarctation aneurysm, which appears to do most often to detonate the thoracic aorta, releasing all the blood into the thoracic or abdominal cavity and killing the person immediately. The only lives our side was able to save were those of those whose executioners did not do so for the time being. The timing of the appearance of a coarctation aneurysm is often similar to that of an abdominal aortic aneurysm. In addition, congenital disorders (such as Marfan’s syndrome and syphilitic aorta) and trauma can also cause it to present itself. Why the entrapment is called the executioner is because it is so inhumane that it harms humans on average 10 years younger than those with abdominal aortic aneurysms and favors pregnant women in particular. It administers malaria by tearing the aortic wall so hard that the aortic wall is so weak that it ruptures immediately or causes untimely rupture under the impact of high pressure blood flow. In addition this executioner causes human suffering not only the pain of sleepless nights, but also the compression of the various branch arteries of the aorta, causing ischemia of the head, upper limbs, internal organs and lower limbs, resulting in a decrease in function in minor cases and the abolition of limbs and destruction of internal organs in major cases. For such an enemy, our strategy is to focus on screening, paying special attention to humans with congenital diseases and severe atherosclerosis, to look for the first signs of the emergence of entrapment with regular checkups, and to unite various professional forces to rescue them as soon as there is wind, and to adopt different strategies according to its characteristics for those who have already been found executioners, if it is a type A entrapment, please ask your fellow thoracic and cardiac surgeons to do solve, if it is a B-type entrapment, it can be solved by our side. Specific tactics are also used for internal differentiation, cutting off the pressure fuse and blood supply line, allowing thrombus formation in the entrapment, defusing the bomb and increasing the strength of the defense. The little plankton of aneurysms is the visceral aneurysm, which is the brother of the abdominal aortic aneurysm. Why do I say it is a gangster because there is no one place where it appears, but once it does, it is quasi-ungood. For example, various branch vessels in the abdominal cavity, such as the hepatic artery, splenic artery, renal artery, celiac artery, and mesenteric artery, are covered with its bad traces. The reasons for the appearance of the little plankton cannot be separated from atherosclerosis, infection and trauma. Its greatest danger, too, is the untimely explosion that causes massive bleeding in the abdominal cavity threatening human life. After years of tracing the bad traces of visceral aneurysms, it was found that it particularly likes to appear on the splenic artery, with an incidence of 60% of visceral aneurysms. What’s more, besides appearing in its real face, it sometimes shows itself in a false face, which is called a pseudoaneurysm, without a complete vessel wall, formed by the rupture of the vessel and wrapped by the surrounding tissue. When it appears with a false face, because the first explosion did not succeed, revenge psychology is particularly strong, the wind will prompt it to throw a tantrum, causing the aneurysm to explode and rupture. For such a small gangster, our attitude is resolute and tactics are flexible. Generally, we use imaging to test its bottom first, and once we know where its harm lies, we can consider eliminating it immediately, using methods such as landfill with steel ring, cutting off pressure fuse with membrane stent, and cutting off its blood supply line from the source. Sometimes the aneurysm can be detected by imaging, but if it cannot be dealt with by these methods, consider directly terminating the aneurysm with a fossa to re-establish a new blood flow channel. Ms. Yang, who is now in the ward, had vague pain in the upper abdomen without any cause a month ago, and it gradually worsened. The surgery used one side of the carotid artery as the access, and the catheter guidewire went in and soon reached the abdominal aorta and soon entered the aneurysm, but it was found that the conditions for placing the stent with membrane were not suitable, so the plan was changed at that time, and it was decided to put all the steel coils into the aneurysm cavity, and because of the huge cavity, more than 50 coils were put in total, which finally filled the cavity and eliminated the risk of aneurysm rupture. The destruction madness in aneurysm is N aneurysm, because it belongs to limb aneurysm and there are many tendons and fascias bound around it, so its bleeding after rupture can be controlled in time and it is not easy to cause fatal danger. Therefore it changes the means of doing bad things and is famous for compressing nerves and veins, occluding arteries by thrombosis and destroying the function of the lower leg. Mr. Liu in the ward, a lump suddenly appeared in the left N fossa 2 weeks ago with a pulsation consistent with the pulse. Recently, the lump gradually increased in size and the skin around it gradually darkened, and the toes also felt numb, and the active toes were no longer as flexible as before, and the temperature of the foot gradually decreased and was cold to the touch. After MRI, we easily identified it as a pseudoaneurysm of the N artery with a diameter of 10 cm or more. Most N artery aneurysms are caused by atherosclerosis, but also by infection and trauma, and the main target is the elderly. Due to its proximity to the skin surface, N aneurysm is relatively easy to detect. Based on its special destructive effects caused not only by rupture but also by compression of surrounding blood vessels and nerves, we believe that defusing the bomb is as important as relieving the compression. Our side adopts the traditional method of combat plan of finding one and removing one, replacing the removed lesion site with an autologous vein, which eliminates the risk of rupture and relieves the compression, while also establishing an arterial homologation. Mr. Liu’s aneurysm was still growing in the last few days, and the pain and compression symptoms were gradually increasing. We had decided to take immediate action to completely eliminate this destructive maniac, and since the aneurysm was large and extended to the middle of the thigh, we decided to control the femoral artery at the root of the thigh first, so that the upstream artery supplying blood to the aneurysm was under control. The rupture of the N artery pseudoaneurysm was repaired with an artificial vascular patch. After the surgery, the bleeding and compression problems were solved, and the movement of the lower leg returned to normal. The family of aneurysms, the untimely bombs around us that try to destroy the mental and physical plans of human beings, has long been recognized by vascular surgeons, who have adopted targeted treatment plans according to their characteristics and hope that human beings can better understand the causes of these diseases and be able to prevent aneurysms from the root cause and nip these evil things in the bud. This is the duty of a vascular surgeon.