Abdominal Aortic Aneurysms Flashcards
What emerges directly from the heart and contains the aortic sinuses
Aortic root
What do the aortic sinuses cotain
Main artery that supplies blood to the heart (coronary)
What does the aortic arch contain (2)
Brachiocephalic- right common carotid and right subclavian
Left common carotid
Left subclavian artery
Coeliac Artery
Liver, spleen and stomach
Mesenteric artery
Small and large bowel
What is the cause of an aneurysm (2)
Damage to media
Damage to all 3 layers of the artery
True aneurysm
Damage to all 3 walls of artery
False Aneurysm
Injury to individual layer
Fusiform
bulges or balloons out on all sides of the blood vessel
Saccular
Most common and is asymmetrical
Initial Risk factors (4)
- Genetics
- Gender
- Ethnicity
- Age
Risk Factors that lead to rupture once initial risks are established (6)
- Smoking
- CHD
- Atherosclerotic
- Infection
- Trauma
- Hypertension
Why does the pain of a rupture start in the abdomen and radiate to the back and groin
• Aorta is a retroperitoneal structure and blood will pass along kidneys to groin
What differentiates an aneurysm with renal disease
Patient collapses
Gangrene
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
Aortic Fistula
connection between aorta and bowel (after a graft has been placed to repair aneurysm)
What happens to HR and BP during rupture
rupture blood pressure decreases and heart rate initially increases to compensate before decreasing eventually when it becomes exhausted
Treatment
- 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
Complication of Treatment
- Pseudoaneurysm of femoral artery can be a complication
* Occlusion of renal artery can also be a complication
Complication of open repair
• Bowel ischaemia can be a complication of open repair
Complications of EVAR
- 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)
