aneurysms Flashcards
def. aneurysm
- 50% increase in art diameter
def. ectasia
art dilation less than 50%
def. arteriomegaly
- diffuse art enlargement
def. aneurysmosis
multiple aneurysms sep . by normal art
dichotomy of aneurysms
true - all wall of artery
false - no layers of artery wall
possible causes of aneurysms
- congenital
- CT disorders
- degen
- infectious
- inflamm
- post stenotis
- pseudo
- other
common locations of aneursyms
- abdo alone -most common
thoracic alone
abdo and illiac
what is pathogen of aneursysm
- degen disease
- loss of elastin and collagen
- genes and MMP-9 degrade
main risk factors for ANs (4)
- white
- male
- age
- smokers
- NOT DM
3 general presentations of aneurysms
- aSx
- found incidentally - Sx
- back pain
- compression of bowel - rupture
what is therapy balance for aneurysms
rupture size risk Vs. comorbidity
5 predictors of rupture
- larege size (over 5.5cm)
- Ht
- female
- expansion rate
- COPD
what is med therapy
NONE
***5 indications for repair
- size
- male >5.5cm
- female > 5cm - Sx
- emboli
- enlarging
- rupture
what is benefit for endovascular repair
better as you get older (more unstable)
**triad of Sx of ruptured AAA
- back pain
- hypotension
- pulsatile mass
what is Tx of rupture
permissive hypotension
-OR
why do ruptures kill
2 hit hypothesis
- hypotension
- followed by repurfusion causes multisystem organ failure
***what is effect of screening
- reduction in ruptures if attend screenings
- proven to be cost effective
where are most peripheral aneurysm
70% popliteal
issue with pop aneurysm
- rarely rupture problem
- main issue is acute thrombosis giving limb ischemia
