Abdominal Aortic Aneurysms

Question 1

What emerges directly from the heart and contains the aortic sinuses

Answer 1

Aortic root

Question 2

What do the aortic sinuses cotain

Answer 2

Main artery that supplies blood to the heart (coronary)

Question 3

What does the aortic arch contain (2)

Answer 3

Brachiocephalic- right common carotid and right subclavian
Left common carotid
Left subclavian artery

Question 4

Coeliac Artery

Answer 4

Liver, spleen and stomach

Question 5

Mesenteric artery

Answer 5

Small and large bowel

Question 6

What is the cause of an aneurysm (2)

Answer 6

Damage to media

Damage to all 3 layers of the artery

Question 7

True aneurysm

Answer 7

Damage to all 3 walls of artery

Question 8

False Aneurysm

Answer 8

Injury to individual layer

Question 9

Fusiform

Answer 9

bulges or balloons out on all sides of the blood vessel

Question 10

Saccular

Answer 10

Most common and is asymmetrical

Question 11

Initial Risk factors (4)

Answer 11

• Genetics
• Gender
• Ethnicity
• Age

Question 12

Risk Factors that lead to rupture once initial risks are established (6)

Answer 12

• Smoking
• CHD
• Atherosclerotic
• Infection
• Trauma
• Hypertension

Question 13

Why does the pain of a rupture start in the abdomen and radiate to the back and groin

Answer 13

• Aorta is a retroperitoneal structure and blood will pass along kidneys to groin

Question 14

What differentiates an aneurysm with renal disease

Answer 14

Patient collapses

Question 15

Gangrene

Answer 15

abnormal flow of blood. Breaks off and gets lodged in the smallest arteries and blood supply is cut off in certain areas (toes)
• Causes necrosis of tissues due to blood supply being cut off in certain areas

Question 16

Aortic Fistula

Answer 16

connection between aorta and bowel (after a graft has been placed to repair aneurysm)

Question 17

What happens to HR and BP during rupture

Answer 17

rupture blood pressure decreases and heart rate initially increases to compensate before decreasing eventually when it becomes exhausted

Question 18

Treatment

Answer 18

• Statin: to decrease BP
• ACEI: to decrease BP
• Aspirin: prevents blood clots
• Open Repair: open up retroperitoneum and attach a graft to the normal parts of the aorta- better option for healthy patients or those not eligible for EVAR
• EVAR- no exposure of aorta and can use femoral artery as entry

Question 19

Complication of Treatment

Answer 19

• Pseudoaneurysm of femoral artery can be a complication

* Occlusion of renal artery can also be a complication

Question 20

Complication of open repair

Answer 20

• Bowel ischaemia can be a complication of open repair

Question 21

Complications of EVAR

Answer 21

• Endoleak- leaking from edges (sac will continue to expand)
• Migration of stent due to sheer force of blood flow- causes stent to slip down into diseased part (sac continues to expand)