Aneurysms and Dissections

Question 1

What is an aneurysm?

Answer 1

A localized dilation of a blood vessel or chamber of the heart

Question 2

What are the most common sites of aneurysm in order of frequency?

Answer 2

1. Aorta
2. Iliac
3. Splenic
4. Renal
5. Vertebral

Question 3

What are the two broad categories of aneurysms?

Answer 3

True and False

Question 4

What is a true aneurysm?

Answer 4

Aneurysm is bound by arterial wall components; all three layers dilate

Question 5

What is a false aneurysm?

Answer 5

Breach in the vascular wall leads to a vascular hematoma; bleeding into tunica media/adventitia

Question 6

What are four examples of true aneurysm?

Answer 6

• MC atherosclerotic
• Syphilitic
• Congenital
• Left ventricular

Question 7

Syphilitic aneurysm tends to localize around…

Answer 7

ascending aorta

Question 8

What is a left ventricular aneurysm?

Answer 8

Can occur following a heart attack weakening and dilating the heart: dilative cardiomyopathy

Question 9

What are three examples of false aneurysm?

Answer 9

• MC post myocardial infarctive
• Junctional leak at vascular graft
• Genetic

Question 10

What is an example of a junctional leak at a vascular graft leading to false aneurysm?

Answer 10

Cardiac bypass tearing of stitches or new vessel

Question 11

What are some genetic reasons for false aneurysm?

Answer 11

Collagen vascular diseases:

• Marfan’s syndrome (defect in fibrillin protein)
• Ehler’s Danlos syndrome (very flexible and stretchy because of collagen)

Question 12

Is a berry aneurysm true or false?

Answer 12

True

Question 13

Is a fusiform aneurysm true or false?

Answer 13

True

Question 14

Is a saccular aneurysm true or false?

Answer 14

True

Question 15

Is a dissecting aneurysm true or false?

Answer 15

False

Question 16

What is a berry aneurysm?
What does is occur most frequently?

Answer 16

Very small spherical dilation, rarely greater than 1-1.5cm
Occurs most frequently at the brain base

Question 17

What is a saccular aneurysm?

Answer 17

Larger spherical dilation, usually 5-10cm in diameter, occasionally up to 20cm

Question 18

What is a fusiform aneurysm?

Answer 18

Gradual and progressive dilation of a blood vessel producing a spindle-shaped expansion; may be unilateral (eccentric)

Question 19

What is a dissecting aneurysm?

Answer 19

Escape of blood into tunica media; dilation need not exist

Question 20

How does the lumen present in a dissecting aneurysm?

Answer 20

“Double barrel” presentation

Question 21

What is a Type A dissecting aneurysm of the aorta?

Answer 21

Bleeding occurs on both sides of aorta

Question 22

What is a Type B dissecting aneurysm of the aorta?

Answer 22

Bleeding occurs on one side of aorta

Question 23

What is a pseudoaneurysm?

Answer 23

False aneurysm due to traumatic injury to muscle layer producing a focal dilation
Also referred to as traumatic aneurysm and can reverse itself

Question 24

What are five etiologies/locations of aneurysm?

Answer 24

• Atherosclerosis
• Infection
• Syphilis
• Arteritis
• Miscellaneous (congenital, etc.)

Question 25

A mycotic aneurysm is due to…

Answer 25

bacterial infection affecting blood vessel wall

Question 26

Where does a dissecting aneurysm usually take place?

Answer 26

Thoracic aorta

Question 27

In a clinical scenario of atherosclerotic aneurysm, how can claudication present?

Answer 27

Appears as difficulty walking
Walking hurts constantly if neurogenic
Can walk a bit before difficulty if vascular

Question 28

When is aneurysm commonly accidentally discovered?

Answer 28

When plain film, MRI, or CT is taken for back pain evaluation

Question 29

The larger the aneurysm, the ___ chance of rupture

Answer 29

greater/higher

Question 30

What does treatment of aneurysm consist of?

Answer 30

Removal of dilation and replacement with endovascular graft