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Cardiovascular > Aneurysms and Carotis Artery Surgery > Flashcards

Aneurysms and Carotis Artery Surgery Flashcards

1
Q

What is aneurysm disease?

A

Dilatation of all layers of the aorta, leading to an increase in diameter of more than 50%

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2
Q

How large is the diameter of an abnormal aorta?

A

Larger than 3cm

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3
Q

What are the possible causes of aneurysm disease?

A

Degenerative disease
Connective tissue disease
Infection

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4
Q

Give an example of a connective tissue disease

A

Marfan’s disease

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5
Q

What is an aneurysm caused by infection called?

A

Mycotic aneurysm

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6
Q

What are the risk factors for degenerative abdominal aortic aneurysm disease?

A 
Male sex 
Age 
Smoking 
Hypertension 
Family history
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7
Q

What preventative method is in place for AAA disease?

A

Ultrasound screening of men aged 65 and over

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8
Q

What are the 4 possible outcomes of screening?

A
  1. Normal aorta, discharged
  2. Small AAA, will be invited for annual USS scan
  3. Medium AAA, will be invited for 3 monthly USS scans
  4. Large AAA
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9
Q

What is the size of a small AAA?

A

3 - 4.4cm

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10
Q

What is the size of a medium AAA?

A

4.5 - 5.5cm

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11
Q

What is the size of a large AAA?

A

5.5cm or larger

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12
Q

What are the symptoms of an impending rupture of an AAA?

A

Increasing back pain

Tender AAA

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13
Q

What are the symptoms of a ruptured AAA?

A

Abdominal/back/flank pain
Painful pulsatile mass
Haemodynamic instability
Hypoperfusion

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14
Q

What are the unusual presentation of an AAA?

A 
Distal embolisation 
Aortocaval fistula 
Aortoenteric fistula 
Ureteric occlusion 
Duodenal obstruction
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15
Q

What is the management of an AAA when asymptomatic?

A

If the aneurysm is the right size and the patient is able then either endovascular or open repair will be done

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16
Q

At what size of AAA does surgery confer any benefits?

A

> 5.5cm

17
Q

What imaging is required for surgical planning?

A

CTA/MRA

18
Q

What is the treatment of an AAA?

A

Endovascular repair

Open repair

19
Q

What complications can come of open repair?

A 
Wound infection
Bleeding 
Pain 
Scar 
Damage to bowel,ureters, veins, nerves 
Incisional hernia 
Graft infection 
Distal emboli 
Renal failure 
Colonic ischaemia 
MI 
Stroke 
Death 
DVT
Pulmonary embolism
20
Q

What complications can come from endovascular repair?

A 
Wound infection 
Bleeding 
Pain 
Scar 
Radiation 
Kidney injury 
Endoleak 
Femoral artery dissection 
Rupture 
Distal emboli 
Damage to femoral vein/nerve 
DVT 
Pulmonary embolism 
MI 
Stroke 
Death
21
Q

What is the morbidity rate of emergency open repair?

A

30-50% morbidity

22
Q

What can atherosclerosis of the carrots arteries cause?

A

Ischaemic attacks and ischaemic strokes

23
Q

What is a transient ischaemic attack?

A

CNS disturbance caused by microemboli and occlusion leading to cerebral ischaemia

24
Q

What are the consequences of TIA?

A

Symptoms less than 24 hours and no permanent neurological sequelae

25
Q

What is a stroke?

A

Focal or global disturbance of cerebral function because of vascular problems

26
Q

What are the consequences of a stroke?

A

Lasts more the 24 hours or leads to death

27
Q

What are the causes of stroke?

A

Cerebral infarction
Primary intracerebral haemorrhage
Subarachnoid haemorrhage

28
Q

What can cause a cerebral infarction?

A 
AF 
Carotid atherosclerotic plaque rupture 
Endocarditis 
MI 
Carotis artery trauma 
Drug abuse 
Haematological disorder
29
Q

What are the risk factors for carotid artery atherosclerosis?

A 
Smoking 
Diabetes 
Family history 
Male sex 
Hypertension 
Hyperlipidaemia 
Hypercholesterolaemia 
Obesity 
Age
30
Q

What are the neurological symptoms of carotid disease?

A 
Paralysis 
Paresis 
Visuospatial neglect 
Dysphasia 
Ipsilateral amaurosis fugax
31
Q

What should be done during diagnosis of carotid disease?

A

History
Examination
CT
Carotid USS

32
Q

What should be done during examination for carotid disease?

A

Neurological examination
Cardiac examination
Auscultate carotids

33
Q

What is the best medical therapy for carotid disease?

A 
Smoking cessation 
Control of hypertension 
Antiplatelet 
Statin 
Diabetic control
34
Q

When is a carotid endarterectomy used?

A

When there are severely narrowed carotid arteries

35
Q

What is a carotid endarterectomy?

A

When the carotid artery is opened and plaque is removed

36
Q

What are the possible complications of a carotid endarterectomy?

A 
Wound infection 
Bleeding 
Scar 
Anaesthetic risks 
Nerve damage 
Preoperative stroke
37
Q

What can preoperative stroke after a carotid endarterectomy be caused by?

A

Plaque rupture
Hypoperfusion
Virchow’s triad

Cardiovascular (34 decks)

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