Chap 140 UE Aneurysm Flashcards Preview

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Flashcards in Chap 140 UE Aneurysm Deck (18):
1

What are causes of Arch vessel aneurysms?

Trauma
FMD
syphilis
cystic medial necrosis
invasion by tuberculosis lymphadenitis
idiopathic

2

What % of patients with arch vessel aneurysm will have aortoiliac or perish aneurysm?

50%

3

What are most common causes of subclavian aneurysm?

degenerative 50%
pseudoaneurysm
TOS

4

What are causes of common carotid aneurysm?

rare
pseudo more likely
degenerative most common if true aneurysm
FMD

5

What are symptoms of UE aneurysms?

pain, ischemic, brachial plexus compression, hoarseness, tracheal compression, TIA, esophageal compression, hemoptysis, fistulization

6

What are features on exam for UE aneurysms?

micro-embolization, bruit, dimished pulse, sensory/motor dysfunction, vocal cord paralysis, horner's syndrome

7

What is horners syndrome?

compression of sympathetic nerves
miosis, ptosis, anydrosis

8

What is the innominate classification of aneurysms?

A distal innominate
B proximal involving origin
C proximal involving arch as well

9

How does an aberrant R SCA aneurysm present?

dysphagia lusoria 1/3
occlusive 1/6
dyspnea/coughing from tracheal compression
chest pain from expansion

10

What % of patient rupture and at what size?

20%
not related to size

11

What is a Kommerell's diverticulum?

aberrant R subclavian artery with dilated origin or diverticula
60% of aberrant R SCA

12

What are the zones of the subclavian and what vessel come from each zone?

1st inno/arch to medial margin of ant scalene
vert, IMA, thyrocervical thrunk
2nd behind ant scalene
costocervical trunk
3rd scalene to outer border first rib
dorsal scapular artery (levator)

13

What are the zones of the axillary artery?

First part - the part of the artery medial to pectorals minor

Second part - the part of the artery that lies posteriorly to pectorals minor

Third part - the part of the artery lateral to pectoralis minor

13

What are some consideration for arch vessel endovascular repair?

Adequate landing zones
Branch coverage/CABG
Compression by first rib
Stroke

14

What is the most common congenital abnormality of the aortic arch?

Aberrant right subclavian

15

Where does the aberrant right subclavian usually travel?

Originates distal to left subclavian and usually passes posterior to and inferior to arch
Most cross midline bw esophagus and Trachea or ant to trachea

16

What nerve anomaly is associated with aberrant r subclavian artery?

A non recurrent right laryngeal nerve

17

What are treatment options for aberrant scla?

Non aneurysmal
Supraclavilar incision
Divide the artery
Distal end transposed to R common carotid artery

Aneurysmal
Extra anatomic bypass
Thoracotomy for excision aneurysm

Endovascular
Occluder