Aneurysms

Question 1

What is the definition of an aneurysm?

Answer 1

Dilation of an artery to >50% of its original diameter.

Question 2

What are the three types of aneurysm?

Answer 2

Saccular aneurysm, fusiform aneurysm, false aneurysm.

Question 3

What is an example of a saccular aneurysm?

Answer 3

Berry aneurysm.

Question 4

What is an example of a fusiform aneurysm?

Answer 4

AAA.

Question 5

What is a false aneurysm?

Answer 5

Blood accumulates in the adventitia following trauma, but can communicate with the lumen.

Question 6

What are some common sites for aneurysms to occur?

Answer 6

Aortic (commonly infra-renal).
Iliac.
Femoral.
Popliteal.

Question 7

Who is offered AAA screening?

Answer 7

All men >65 years.

Question 8

What width of AAA is the boundary for stenting?

Answer 8

> 5.5cm or >1cm/yr growth should be offered stenting.

Question 9

What action is taken for AAAs <5.5cm?

Answer 9

Rupture rates are very low so monitor only.

Advise to stop smoking and lower BP to reduce rupture risk.

Question 10

What are the symptoms of a ruptured AAA?

Answer 10

Intermittent or continuous abdominal pain radiating to back, groin, iliac fossa.
Collapse.
Expansile abdominal mass.
Shock.

Question 11

What action should be taken for a ruptured AAA?

Answer 11

1. Call vascular surgeon.
2. ECG.
3. Take blood to crossmatch and do amylase and Hb.
4. IV access.
5. Give blood but keep BP<100 systolic.
6. Theatre to clamp artery and insert graft.