Endovascular approaches (TBL) Flashcards

(27 cards)

1
Q

Aortic aneurysm incidence in the US

A

60/1000

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2
Q

Deaths per year from ruptured aneurysms

A

15,000

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3
Q

Aortic aneurysm are the __ leading cause of death

A

12th

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4
Q

Aortic aneurysms occur mostly in what demographic

A

Elderly men

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5
Q

Aortic aneurysms occur mostly in what location

A

Infrarenal

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6
Q

Aortic aneurysm treatments for small size

A

(<5.0 cm)

Serial CT scans

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7
Q

Aortic aneurysm treatments for large size

A

(>5.0 cm)

Surgical repair

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8
Q

Aortic aneurysm treatment for ruptured aneurysms

A

Emergent repair

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9
Q

Surgical options

A

Trans peritoneal
Retroperitoneal
Laparoscopic
Endoluminal stent grafting (EVAR)

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10
Q

Open repair

A

Physically cut open patient to reach vessel area

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11
Q

Laparoscopic

A

Using a tool outside the body to be fed to vessel area without majorly cutting open patient

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12
Q

Endovascular stent grafting (EVAR) limitations

A

Prox neck angulation.
Delivery limited by tortuous, calcified, small iliacs.
concurring aneurysms limit use.

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13
Q

EVAR complications

A

Movement of prosthesis.
Continued/recurrent circulation of blood in aneurysm but outside stent.
Pseudoaneurysm formation.
Thrombus within stent leading to stenosis/occlusion.
Arterial dissection.

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14
Q

EVAR follow-up

A
Life-long surveillance.
Physical exam.
CT scan.
Duplex scan.
Interventions.
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15
Q

EVAR main goal

A

Aneurysm sac shrinkage

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16
Q

Endografts on Duplex (B mode)

A

Begin trans.
Document patency of renal arteries.
Measure aneurysm sac in trans, AP, lateral
Measure area.

17
Q

Endografts on duplex (color/dopp)

A
Low color scale.
Examine prox attachment site.
Patency of graft.
Evaluate each limb of graft (Bifur not in normal place).
Scroll though graft with Doppler.
18
Q

Doppler of endografts

A

Document signals in both common iliac, and both external iliac arteries.
Asses both iliac attachment sites.

19
Q

Endoleak types

A

Type 1
Type 2
Type 3
Type 4

20
Q

Type 1 endoleak

A

Occurs at attachment site. Inadequate seal.
1A=Proximal
1B=Distal

21
Q

Type 2 endoleak

A

Occurs from back bleeding from branch vessels.
Lumbars
IMA

22
Q

Type 3 endoleaks

A

Occurs from leak in fabric or modular disconnection

23
Q

Type 4 endoleaks

A

Occurs from fabric porosity.

Leak through fabric

24
Q

Result after endograft placement

A

Aneurysm should shrink over time.
Failure to shrink or begins to enlarge indicates leak.
Unrepaired leaks causing expansion leads to aneurysm rupture.

25
Assessing Endografts on Duplex
Assess the configuration of stent for bulges, kinking or fractures. Evaluate lumen of stent for thrombus/stenosis.
26
Aneurysm size changes
AAA size reduction predicts successful exclusion. Continuing endoleak and AAA enlargement are linked. Aneurysms enlarge with no leak=poor imaging.
27
EVAR pros
AAA size not a limitation. | Delivered by bilateral trans-femoral route