Flashcards in Abdominal Aortic Aneurysms Deck (24):
What is an aneurysm?
Permanent localised dilatation of an artery of more than 50% of the normal diameter of the artery.
What is ectasia?
Localised area of enlargement in the artery but less than 1.5 x.
What is arteriomegaly?
Generalised enlargement of arterial tree.
What are the types of aneurysm?
True and false.
What is a true aneurysm?
Pathological degeneration involving all or part of the vessel wall.
What is a false aneurysm?
Leakage of blood out of an artery into a cavity surrounded by connective tissue that's expansile and pulsatile.
What is an example of congenital aneurysms?
Berry aneurysms on the circle of Willis.
What are the causes of degenerative aneurysm formation?
Smoking, hypertension causing degeneration of the vessel wall.
What are the risk factors of aneurysms?
Male, familial history, Caucasian, connective tissue disease (Marfans, Ehlers-Danlos).
What are the common sites of aneurysms?
Aorta, popliteal artery, common femoral arteries, intra-abdominal splanchnic arteries, subclavian arteries, carotid arteries.
What is the most common site for arterial aneurysms?
How many people have infra-renal AAAs?
5% of elderly males.
What is the pathophysiology of aneurysms?
Loss of elastin and smooth muscle from medial wall, systemic dilating disease, possible genetic component.
What is the natural history of AAAs?
Aneurysms expand by about 10% per year. Rupture made more likely if HTN and smoking.
What is the presentation of AAAs?
Asymptomatic mostly. Distal embolisation sometimes. Abdominal pain, general malaise, weight loss - inflammatory aneurysm. Rupture -> abdo pain, pulsatile mass, hypovolaemia.
What are the indications for AAAs repair?
Operative risk < risk of rupture. Symptomatic, rapidly expanding or ruptured. <5.5cm and asymptomatic should be monitored.
What are the features of pre-operative assessment for AAA repair?
Medical assessment, risk assessment and modification, radiological assessment of AAA.
What are the methods of AAA repair?
Conventional open repair, endovascular repair.
What are the complications of open AAA surgery?
Haemorrhage, cardiac events, respiratory complications, renal failure, embolisation/thrombosis of distal arterial tree, colonic ischaemia, death 5-10%.
What is endovascular AAA repair?
Radiographically guided intraluminal placement of stent-graft.
What are the positives of endovascular AAA repair vs open repair?
Avoids laparotomy, intraperitoneal manipulation, reduces aortic occlusion time, small incisions, less painful, shorter hospital stay.
What are the complications of endovascular AAA repair?
Graft migration, fracture of supporting wires, endoleak, endotension.
What have the benefits of AAA screening been?
Reduces deaths by 42%.