abdominal aneurysms Flashcards

1
Q

what is an aneurysm

A

dilation and essentially refers to an abnormal bulge in a blood vessel

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2
Q

what is an AAA

A

Abdominal Aortic Aneurysm is a permanent localized dilation of the abdominal aorta

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3
Q

what diameter does the abdominal aorta need to be to be classified as a aneurysm

A

> 3cm

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4
Q

diagnosis of any aneurysm size wise

A

one and a half the size of the normal vessel

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5
Q

general pathophysiology of an AAA

A

any inflammatory process that will decrease the elasticity of the vessel wall which decreases tensile strength causing the vessel the expand

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6
Q

what main factor can weaken the arterial wall and why

A

•Atherosclerotic plaque build up making it harder for oxygen and nutrients to reach all layers of the arterial wall

oWithout oxygen and nutrients these artery’s develop ischemia and become weaker making them prone to aneurysms

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7
Q

diagnosis of an AAA

A

asymptomatic generally but USS is highly sensitive

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8
Q

main risk factors for an AAA (5)

A
GASD
>60
man
smoking
hypertension
diabetes
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9
Q

other risk factors for AAA

A
  • genetic predisposition

- any condition that makes you prone to atherosclerosis

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10
Q

layers of the blood vessel

A

tunica intima
elastic layer
tunia media
tunica adventitia

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11
Q

two types of aneurysm and subtypes

A

true- all layers of the vessel expand together

  • fasiform- whole circumference of vessel effected
  • saccular- only a portion of circumference dilated

False- only tunica intima and media dilate
-mainly iatrogenic in nature

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12
Q

mortality risk rate in emergency vs elective AAA repair

A

emergency- 80%

elective- 2-7%

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13
Q

management of a AAA <4cm

A

recall annually for USS

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14
Q

management of a AAA 4-5cm

A

recall USS every 6 months

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15
Q

management of a AAA >5cm

A

intervention needed

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16
Q

when do you treat an AAA

A

more than 5cm
rupture or symptomatic
growing more than 1cm a year

17
Q

symptoms of AAA rupture

A

abdominal pain radiating to the back
pulsatile mass
chest pain
hypotension

18
Q

disadvantages to an open AAA repair

A
  • significant incision in abdomen
  • long recovery
  • high post op mortality risk
  • contraindicated in many patients
19
Q

followup for open AAA

A

ultrasound every year

20
Q

who isnt suitable for an open repair

A

high anesthesia risk
co-morbities
-previous abdo surgery

21
Q

EVAR indication

A

anyone over 70
anatomy suitable for repair
patients with co-morbidities

22
Q

EVAR contraindication

A

curvy artery

23
Q

EVAR cons

A

complications and reinterventions are common

24
Q

EVAR followup

A

6 month CT/X-ray then anually

25
Q

pros of EVAR

A

minimally invasive
faster recovery
good for younger patients
reduced risk of death