Abdominal aortic aneurysms

Question 1

Definition of an aneurysm

Answer 1

Permanent localised dilation of an artery >50% of normal diameter

Question 2

Definition of ectasia

Answer 2

Localised enlargement of an artery <50% of normal diameter

Question 3

Contrast a true and false aneurysm

Answer 3

True: degeneration of artery vessel wall (smooth muscle and elastin in tunica media)
False: cavity enclosed by CT gets filled with blood therefore is pulsatile

Question 4

Who gets false aneurysms

Answer 4

Angioplasty patients

IVDU

Question 5

Most common site of AAA

Answer 5

Infrarenal

Question 6

Rate of AAA expansion

Answer 6

10% per year

Question 7

How may a AAA present

Answer 7

Screening
Weight loss
Abdo pain
Distal embolus

Question 8

Cut off size for AAA surveillance

Answer 8

<5.5cm

Question 9

Indications for AAA repair

Answer 9

Symptomatic
Rapidly expanding
Ruptured

Question 10

Surgical options

Answer 10

Open repair

Endovascular graft

Question 11

Advantages and disadvantages of open repair

Answer 11

Advantages: better long term
Disadvantages: haemorrhage, cardiac/resp complications, renal failure, embolisation, 5-10% mortality

Question 12

Advantages and disadvantages of endovascular graft

Answer 12

Advantages: small incision, shorter hospital stay
Disadvantages: can move, endoleak endotension, need long length between AAA and renal arteries

Need monitoring every 6 months due to long term risks

Question 13

Screening for AAA

Answer 13

US for >65M

Reduces mortality by 42%