Aneurysms and Dissections Flashcards
What is an aneurysm?
A localized dilation of a blood vessel or chamber of the heart
What are the most common sites of aneurysm in order of frequency?
- Aorta
- Iliac
- Splenic
- Renal
- Vertebral
What are the two broad categories of aneurysms?
True and False
What is a true aneurysm?
Aneurysm is bound by arterial wall components; all three layers dilate
What is a false aneurysm?
Breach in the vascular wall leads to a vascular hematoma; bleeding into tunica media/adventitia
What are four examples of true aneurysm?
- MC atherosclerotic
- Syphilitic
- Congenital
- Left ventricular
Syphilitic aneurysm tends to localize around…
ascending aorta
What is a left ventricular aneurysm?
Can occur following a heart attack weakening and dilating the heart: dilative cardiomyopathy
What are three examples of false aneurysm?
- MC post myocardial infarctive
- Junctional leak at vascular graft
- Genetic
What is an example of a junctional leak at a vascular graft leading to false aneurysm?
Cardiac bypass tearing of stitches or new vessel
What are some genetic reasons for false aneurysm?
Collagen vascular diseases:
- Marfan’s syndrome (defect in fibrillin protein)
- Ehler’s Danlos syndrome (very flexible and stretchy because of collagen)
Is a berry aneurysm true or false?
True
Is a fusiform aneurysm true or false?
True
Is a saccular aneurysm true or false?
True
Is a dissecting aneurysm true or false?
False
What is a berry aneurysm?
What does is occur most frequently?
Very small spherical dilation, rarely greater than 1-1.5cm
Occurs most frequently at the brain base
What is a saccular aneurysm?
Larger spherical dilation, usually 5-10cm in diameter, occasionally up to 20cm
What is a fusiform aneurysm?
Gradual and progressive dilation of a blood vessel producing a spindle-shaped expansion; may be unilateral (eccentric)
What is a dissecting aneurysm?
Escape of blood into tunica media; dilation need not exist
How does the lumen present in a dissecting aneurysm?
“Double barrel” presentation
What is a Type A dissecting aneurysm of the aorta?
Bleeding occurs on both sides of aorta
What is a Type B dissecting aneurysm of the aorta?
Bleeding occurs on one side of aorta
What is a pseudoaneurysm?
False aneurysm due to traumatic injury to muscle layer producing a focal dilation
Also referred to as traumatic aneurysm and can reverse itself
What are five etiologies/locations of aneurysm?
- Atherosclerosis
- Infection
- Syphilis
- Arteritis
- Miscellaneous (congenital, etc.)
A mycotic aneurysm is due to…
bacterial infection affecting blood vessel wall
Where does a dissecting aneurysm usually take place?
Thoracic aorta
In a clinical scenario of atherosclerotic aneurysm, how can claudication present?
Appears as difficulty walking
Walking hurts constantly if neurogenic
Can walk a bit before difficulty if vascular
When is aneurysm commonly accidentally discovered?
When plain film, MRI, or CT is taken for back pain evaluation
The larger the aneurysm, the ___ chance of rupture
greater/higher
What does treatment of aneurysm consist of?
Removal of dilation and replacement with endovascular graft
