Abdominal Aortic Aneurysm

Question 1

what is the screening process for AAA?

Answer 1

single abdominal ultrasound for males aged 65

Question 2

screening outcome

<3 cm

Answer 2

normal
no further action

Question 3

screening outcome

3 - 4.4 cm

Answer 3

small aneurysm
rescan every 12 months

Question 4

screening outcome

4.5 - 5.4 cm

Answer 4

medium aneurysm
rescan every 3 months

Question 5

screening outcome

> /= 5.5 cm

Answer 5

large aneurysm
refer within 2 weeks to vascular surgery for intervention

Question 6

what AAAs are low rupture risk?

Answer 6

• asymptomatic
• aortic diameter <5.5 cm

Question 7

what AAAs are high rupture risk?

Answer 7

• symptomatic
• aortic diameter >/= 5.5 cm
• rapidly enlarging (>1cm/year)

Question 8

what is the management of high rupture risk AAA?

Answer 8

• elective endovascular repair (EVAR)
• open repair

Question 9

what is classed as a rapidly enlarging AAA?

Answer 9

> 1cm / year

Question 10

what is elective endovascular repair?

Answer 10

• sent placed in the abdominal aorta via the femoral artery
• prevents blood from collecting in the aneurysm

Question 11

what is a complication of EVAR?

Answer 11

endo-leak
stent fails to exclude blood from the aneurysm

Question 12

what are the features of ruptured AAA?

Answer 12

• severe, central abdominal pain radiating to the back
• pulsatile, expansile mass in the abdomen
• shock
• collapse

Question 13

what is the management of suspected ruptured AAA?

Answer 13

immediate vascular review

Question 14

suspected ruptured AAA + haemodynamically unstable

Answer 14

straight to theatre

Question 15

suspected ruptured AAA + haemodynamically stable

Answer 15

CT angiogram