Flashcards in Chap 140 UE Aneurysm Deck (18):
What are causes of Arch vessel aneurysms?
cystic medial necrosis
invasion by tuberculosis lymphadenitis
What % of patients with arch vessel aneurysm will have aortoiliac or perish aneurysm?
What are most common causes of subclavian aneurysm?
What are causes of common carotid aneurysm?
pseudo more likely
degenerative most common if true aneurysm
What are symptoms of UE aneurysms?
pain, ischemic, brachial plexus compression, hoarseness, tracheal compression, TIA, esophageal compression, hemoptysis, fistulization
What are features on exam for UE aneurysms?
micro-embolization, bruit, dimished pulse, sensory/motor dysfunction, vocal cord paralysis, horner's syndrome
What is horners syndrome?
compression of sympathetic nerves
miosis, ptosis, anydrosis
What is the innominate classification of aneurysms?
A distal innominate
B proximal involving origin
C proximal involving arch as well
How does an aberrant R SCA aneurysm present?
dysphagia lusoria 1/3
dyspnea/coughing from tracheal compression
chest pain from expansion
What % of patient rupture and at what size?
not related to size
What is a Kommerell's diverticulum?
aberrant R subclavian artery with dilated origin or diverticula
60% of aberrant R SCA
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
3rd scalene to outer border first rib
dorsal scapular artery (levator)
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
What are some consideration for arch vessel endovascular repair?
Adequate landing zones
Compression by first rib
What is the most common congenital abnormality of the aortic arch?
Aberrant right subclavian
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
What nerve anomaly is associated with aberrant r subclavian artery?
A non recurrent right laryngeal nerve