Abdominal Vasculature

Question 1

What are the three different types of aortic aneurysms?

Answer 1

• True aneurysms
• False aneurysms (Pseudoaneurysms)
• Dissecting aneurysms

Question 2

What is a Berry aneurysm?

Answer 2

small saccular aneurysm commonly located in the cerebrum

Question 3

What is a Mycotic aneurysm?

Answer 3

Infected aneurysm

Question 4

What is a Atherosclerotic aneurysm?

Answer 4

weakening of the media in severe atherosclerosis

Question 5

What is a fusiform aneurysm?

Answer 5

spindle-shaped dilatation in which the stretching process affects the entire circumference of the artery

Question 6

What is a Saccular aneurysm?

Answer 6

localized spherical outpouching of the vessel wall

Question 7

What is a True aneurysm?

Answer 7

• involve all three layers of the aorta
• most common cause for AAA is arteriosclerotic disease
• Fusiform and rarely Saccular
• Most AAA are Infrarenal

Question 8

What is a False aneurysm?

Answer 8

Injury to the vessel wall and extravasated blood is walled off by surrounding tissues

• Can mimic true AAA
• Most common cause of false aneurysm is Trauma
• Bidirectional waveform seen at the stalk

Question 9

What is a Dissecting aneurysm?

Answer 9

Originate at the aortic arch in the thorax

• separation of the intima from the media of the aortic wall
• can extend into carotid arteries or down aorta to femoral arteries
• Most common: Iatrogenic cardiac intervention

Question 10

What is a Endovascular Stent Graft?

Answer 10

• alternative to open abdominal surgical repair of AAA

- graft is inserted through groin and deplored within aorta

Question 11

What is Mesenteric Ischemia?

Answer 11

• chronic mesenteric ischemia, rare, recurring postprandial abdominal pain and weight loss
• chronic not present until at least two of the three major mesenteric arteries are occluded or highly stenosed

Question 12

What are the velocities for the Celiac axis and SMA in Mesenteric Ischemia?

Answer 12

SMA velocity > 275 cm/sec

CA velocity > 200 cm/sec

Question 13

What is Celiac Axis Compression Syndrome?

Answer 13

• AKA arcuate ligament compression syndrome
• compression of proximal celiac axis by the median arcuate ligament of the diaphragm
• Expiration: median ligament compresses the ventral aspect of the celiac axis producing “S” shaped celiac axis and stenosis
• Inspiration: Celiac axis straightens and stenosis disappears and elevated systolic velocities decrease to normal values

Question 14

What are Arteriovenous Shunts?

Answer 14

• shunt or fistula is an abnormal connection between an artery and a vein
• Associated: angiographic punctures of the common femoral artery just inferior to groin

Question 15

What is a Intrarenal arteriovenous shunt?

Answer 15

• result of renal biopsy
• Percutaneous renal biopsy is most common known cause of acquired renal arteriovenous fistula
• produce high velocity, low resistance waveform