Abdominal Aortic Aneurysm

Question 1

What is size is considered aneurysmal

Answer 1

3.0cm

Question 2

Abnormal levels of what haven been seen in degenerative AAA?

Answer 2

Metalloproteinases in the media

Deficits of antiproteolytic enzyme that inhibits metalloproteinase-1

Question 3

Which conditions are related to inflammatory aneurysmal degeneration

Answer 3

Takayasu, GCA, PAN, Bechet, Cogan, Cystic Medial Necrosis

Question 4

Examples of aneurysms associated with developmental abnormalities

Answer 4

Persistent sciatic artery
Kommerell diverticulum
AAA (Tuberous Sclerosis)

Question 5

Connective Tissue Disorders related to AAA

Answer 5

Ehlers-Danlos (Collagen type III) Marfan, Loeys-Dietz

Question 6

smoking history and AAA

Answer 6

Direct correlation between incidence and duration of smoking

Decreased aneurysm growth rate in association with duration of smoking cessation.

Question 7

AAA rupture risk

Answer 7

3.0-3.9 = 0.3%
4.0-4.9 = 0.5-1.5%
5.0-5.9 = 1-11%
6.0-6.9 = 11-22%
>7 = >30%

Question 8

Risk of AAA rupture is independently associated with what factors?

Answer 8

larger initial AAA diameter, current AAA size, smoking, lower FEV1, female

Question 9

What is considered a fast growing AAA?

Answer 9

greater than or equal to 10mm within a 12mo period

Question 10

Other indications for repair of AAA (besides size criteria)

Answer 10

saccular aneurysm, dissection of mural thrombus, fracture of saccular calcification

Question 11

Advantage of endovascular vs open repair

Answer 11

equivalent at 2 years. Endovascular has significantly reduced early mortality and morbidity benefits

Question 12

What are the 6 approved infrarenal stent-grafts?

Answer 12

Zenith (Cook)
Aorfix (Lombard)
Excluder (Gore)
Endurant (Medtronic)
AFX (Endologix)
Ovation (Trivascular)

Question 13

Predictors of perclose proglide failure?

Answer 13

Small access vessel diameter, anterior wall calcification (p. 912)

Question 14

What size arteriotomy do you need to perform preclose technique and requires 2-suture when using the proglide device?

Answer 14

anything greater then 8 Fr

Question 15

Factors that increase change of caudal migration of endograft

Answer 15

large angulation of the neck, short neck length, neck thrombosis, large neck diameter