AAA Flashcards
Who should get screened for AAA?
Men and women 65-75y with any history of smoking should get a one time ultrasound screening
1st deg relatives of AAA pts between 65-75 or 75+ in good health
How often do you ultrasound AAA 3-4cm? 4-5 cm? 5-5.5cm?
3 year, 6 months and 3 months
What are protective factors for AAA
Caucasian, DM, female
What are risk factors for AAA
Smoking most impt (ADAM study). Hyperhomocystein, hernia, Fam hx, cv risk factors.
What is the 5 year rapture risk of a 5 cm AAA?
< 2.5%
What is the 5 year rupture risk of a 6 cm AAA?
> 20%
Which trials compare EVAR vs open AAA repair?
EVAR-1, DREAM, OVER
What are conclusions for RCTs comparing EVAR to open?
EVAR has less periop morbidity and mortality. At 2 years survival is similar. EVAR has more reinterventions.
What are 5 contraindications to PEVAR?
Obesity, scarred, high bifurcation, significant anterior or circumferential calcium, significant prox iliac occlusive disease.
What is the minimum neck seal zone for EVAR?
10 Medtronic, 15 mm Cook
How long does the distal/iliac seal zone need to be?
10-15 mm
How much overlap is required for limbs and main body junctions?
3 mm
What is the maximum neck angle in IFU?
60 degrees
What are contraindications to EVAR?
Severe renal impairment, iliofemoral too small, connective tissue disorders, infected AAA, large patent IMA, unwilling/able to follow up annually
What are risk factors for increased risk of rupture?
Smoking, diameter > 60 mm, COPD
