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
