Abdominal Aortic Aneurysm Flashcards
What is an abdominal aortic aneurysm
permanent dilation of artery to twice the normal diameter (>3cm for abdominal aorta)
What are risk factors of AAA
Age
Gender (5x more likely in men)
Family history
Atherosclerosis
Infection
Trauma
Genetic
What do AAA’s usually result from
Degeneration of the media of atrial wall - most commonly due to atherosclerosis
Why do AAA’s usually happen from atherosclerosis
During formation of atheromatous plaques macrophages release enzymes which break down the collagen and elastin of the media -> media expands
Where do AAA’s most commonly occur
Below the renal arteries
What happens when an AAA ruptures
Wall of the aorta completely fails and blood escapes freely into body cavity (75% fatal)
What is the clinical symptomatic of an AAA not ruptured
Asymptomatic 75%
Can have central pain
May have trash feet
May collapse
May have Tachycardia
What are the symptoms when AAA ruptures
Sudden onset abdominal pain radiating to back with an expansile abdominal mass
What does an ultrasound scan show
Whether there is an AAA or not and its AP diameter and if there is iliac involvement
For what people is there a monitoring program in the UK for AAA’s
men over 65
What is the only imaging method which can identify a ruptured AAA
CT
How can you manage an AAA medical
Control of risk factors:
antihypertensives
smoking cessation
lipid-lowering medication
When is an Elective surgery in asymptomatic nations performed
Only if AAA is >5.5 cm in diameter - before risk of surgery outweighs the risk of rupture
What are the 2 surgery that may be performed
EVAR
open lap
What are the steps of an open repair
Laparotomy
Clamp aorta + iliac
Darcon graft
Tube vs Bifurcated graft
