Abdominal Vasc Imaging

Question 1

AAA

Answer 1

50% or 1.5xs greater than unaffected segment.

Ectasia: small bulge 20% inc. less than 3cm.

Risks: HTN, smokers, age, hyperlipidemia, obesity, Marfans disease, Ehlers-Danlos syndrome, males > females, atherosclerosis

Palpable pulsatile mass, back/abd pain

Treat if measures 5.5cm AP. Risk of rupture increases >5.5cm, low survival with rupture.

Question 2

Types of AAA

MC is _______

Answer 2

Fusiform MC. All 3 layers intact.

Saccular: mostly in thoracic AO. Adventitia and Media intact
•cannula placement
•mycotic: bacterial infection 
•vasculitis
•ruptured ulcer

Question 3

Pseudoaneurysm

Answer 3

All 3 layers ruptured.

Question 4

CIA aneurysm

Answer 4

> 1.5cm

Intervention after 3.5cm

Common in patients with AAA. Can be isolated.

Question 5

Vasculitis

Answer 5

Aortitis: inflammation of aortic wall. From outer layer, going inward.
Seen in patients with: Takayasu’s Arteritis, giant cell Arteritis, polychondritis, and bacteria

Question 6

Takayasu Arteritis

Answer 6

Granulomatous inflammation of aorta and major branches.

Question 7

Giant cell Arteritis

Answer 7

Inflammation of lining of arteries. Usually temporal artery. Aka Temporal Arteritis. Usually occurs with polymalgia rheumatica

Question 8

Dissection

Answer 8

Usually thoracic.
Lumen separate, intimal flap
False lumen. May have thrombus.

Question 9

AAA treatment

Answer 9

Surgical bypass graft
•tube graft (aorta only)
•end to end aortoiliac grafts
•end to side aortobiiliac / aortobifemoral grafts

Question 10

Ovarian vein compression syndrome

Answer 10

The ovarian vein normally crosses anterior to the ureter as it travels cephalad to join the IVC/left renal vein.

A dilated ovarian vein can cause notching dilatation, or obstruction of the ipsilateral ureter.

MC related to varicosities of the ovarian vein or ovarian vein thrombosis.