Aneurysm Flashcards
Definition
Dilation of artery more than 50%
Causes
Atherosclerosis
Traumatic
Connective tissue disease
Male
Increasing age
Smoking
Types
True- involves all parts of the wall
False- only one layer of the wall
Complications
What increases your risk of this?
Rupture: risk increases if >5.5cm or increases over 0.5cm in 6 months
Investigation
Ultrasound (as part of screening too 65 year old man)
CT scan
Indications for surgery
Symptomatic aneurysm
Increasing size over 5.5cm
Rupture
Management
Medical:
- Monitoring: 3-4.4cm yearly USS OR 4.5 to 5.4cm 3monthly USS
- smoking cessation
- blood pressure control
- statin and aspirin therapy
Surgery:
- Endovascular stenting
- Laparoscopic repair
- Open surgical repair
Ruptured Abdominal Aortic Aneurysm Clinical Features
Known AAA or pulsatile mass in abdomen
Severe abdominal pain (non- specific, possibly radiating to the back or loin)
Haemodynamic instability (hypotension, tachycardia)
Screening
What does action depend on?
One ultrasound scan at the age of 65. Action depends on result: <3 cm = no action needed 3 - 4.4 cm = rescan every 12 months 4.5 - 5.4 cm = rescan every 3 months 5.5 or greater = refer to vascular surgeon for endovascular repair within 2 weeks