aneurysm large group Flashcards
what are the predictors of expansion of an aneurysm ?
COPD and hypertension
how would you tell the difference between venous, arterial and neurologic claudication ?
venous - relived by walking
arterial - relived by rest
neurologic - relieved by certain positions usually flexion at the waist
pulsate popliteal ?
usually not that palpable so if it. is felt especially with a wide pulse pressure then it is usually an aneurysm
what is the management for a popliteal aneurysm ?
avoid using synthetic grafts below the level of the knee
use a femrodistal saphenous vein graft (inverted ) along with excision of the aneurysm
in the presence of a fistula what is the best management ?
exclusion of the fistula rather than excision
what method is used for surveillance and screening of an aneurysm ?
US
when to use MRA and when to use CTA ?
CTA if normal kidney function
MRA in impaired kidney function
differentials of blood diarrhea after AAA repair ?
aorto-enteric fistula - painless diarrhea
ischemic colitis - painful diarrhea
what artery is affected inn ischemic colitis ?
inferior mesenteric artery
what factor has no influence on the type of operative approach selected ?
size of the aneurysm
what investigations would be performed in cases of ischemic colitis ?
colonoscopy or sigmoidoscopy
what is the management for aorto-enteric fistulas ?
axillary bifemoral bypass orr anastomosis
bypass through a non contaminated field
what happens in aorto enteric fistula ?
the graft erodes through the 3rd and 4th part of the duodenum leaving behind a fistula
what are the features of leriche syndrome ?
absent femoral pulses
thigh claudication
calf claudication
in ischemic colitis which parts are spared ?
the middle and distal rectum as they are supplied by the middle and inferior rectal arteries which are branching from the internal iliac artery
what is the treatment for common iliac artery stenosis ?
PTA
percutaneous transluminal angioplasty
loss of pulses with plantar flexion ?
popliteal entrapment syndrome
where is the occlusion if there is occlusion of both femoral pulses ?
aortoiliac
