AAA Flashcards
typical presentation of rupture
sudden onset of epigastric/central abdominal pain radiating to back
rupture may mimic
renal colic
people with Marfans are more likely to get what aneurysm
dissecting
dissecting aneurysm main location
thoracic aorta
dissecting aneurysm features
acute chest pain with hypertension or shock
berry aneurysm main location
branching points of circle of willis and cerebral arteries
berry aneurysm rupture causes
subarachnoid haemorrhage
pathogenesis of AAA - affects which layer of the wall
middle
pathogenesis of AAA - what happens to enzymes and protein
imbalance in things that break down and build up - elastin and collagen
pathogenesis of AAA - imbalance in proteins etc leads to
weakening of the wall - aneurysmal dilatation
prevalence
age males > female
presentation
75% asymptomatic 25% symptomatic
what pain may AAA mimic
renal colic
examination
pulsatile expansible mass
examine peripheral pulses
screening
all men are screened at 65 years, decreasing mortality from rupture (75% are asymptomatic until rupture)
imaging
duplex ultrasound and CT scan
duplex ultrasound will show
AP diameter and whether there or not
how to see if AAA has ruptured (imaging )
CT scan
what phase is the CT scan in
arterial phase
management options
open repair and EVAR
open repair - mortality risk and effectiveness
possible in all patients greater mortality risk but effective for life
EVAR - mortality risk and effectiveness
possible in 25% patients
less mortality risk, but may require follow up operations
how is EVAR done
X ray guided
when to intervene - symptomatic
pain, trashing or rupture
when to intervene - asymptomatic
size: >5.5 AP diameter expanded >0.5cm/6 months or >1cm/year
