Aneurysm

Question 1

Definition

Answer 1

Dilation of artery more than 50%

Question 2

Causes

Answer 2

Atherosclerosis

Traumatic

Connective tissue disease

Male

Increasing age

Smoking

Question 3

Types

Answer 3

True- involves all parts of the wall

False- only one layer of the wall

Question 4

Complications

What increases your risk of this?

Answer 4

Rupture: risk increases if >5.5cm or increases over 0.5cm in 6 months

Question 5

Investigation

Answer 5

Ultrasound (as part of screening too 65 year old man)

CT scan

Question 6

Indications for surgery

Answer 6

Symptomatic aneurysm

Increasing size over 5.5cm

Rupture

Question 7

Management

Answer 7

Medical:

• Monitoring: 3-4.4cm yearly USS OR 4.5 to 5.4cm 3monthly USS
• smoking cessation
• blood pressure control
• statin and aspirin therapy

Surgery:

• Endovascular stenting
• Laparoscopic repair
• Open surgical repair

Question 8

Ruptured Abdominal Aortic Aneurysm Clinical Features

Answer 8

Known AAA or pulsatile mass in abdomen

Severe abdominal pain (non- specific, possibly radiating to the back or loin)

Haemodynamic instability (hypotension, tachycardia)

Question 9

Screening

What does action depend on?

Answer 9

One ultrasound scan at the age of 65. 
Action depends on result: 
<3 cm = no action needed
3 - 4.4 cm = rescan every 12 months 
4.5 - 5.4 cm = rescan every 3 months 
5.5 or greater = refer to vascular surgeon for endovascular repair within 2 weeks