Aneurysms & Carotid Artery Surgery Flashcards
what is an aneurysm
it is a localised, abnormal, weak spot on a blood vessel wall that causes an outward bulging, likened to a bubble or balloon
what are aneurysms a result of
a weakened blood vessel wall, aneurysms may also be a result of a hereditary condition of an acquired disease
state 3 causes of aneurysm disease
degenerative disease
connective tissue disease - Marfan’s syndrome
infection
what are risk factors for degenerative aortic abdominal aortic aneurysm disease
male sex age smoking hypertension family history
what is the prevalence of aneurysm disease in the UK
3%
what is the presentation of symptomatic aneurysm disease
impending rupture:
increasing back pain
tender abdominal aortic aneurysm
rupture abdominal pain back pain flank pain painful pulsatile mass haemodynamic instibiltiy hypo-perfusion
what is abdominal aortic aneurysm screening
it is a way of checking if there is a bulge or swelling in the aorta, this bulge or swelling is called an abdominal aortic aneurysm
what is endovascular aneurysm repair
it is a type of endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm
describe general complications of open repair of abdominal aortic aneurysms
wound infection
bleeding
pain
scar
describe technial complications of open repair treatment of abdominal aortic aneurysm
damage to the bowel, ureters, veins, nerves incisional hernia graft infection distal emboli renal failure colonic ischaemia
describe patient factor complications of open repair of abdominal aortic aneurysm
DVT PE MI stroke death
describe general complications of endovascular repair of abdominal aortic aneurysms
wound infection bleeding pain scar radiation
describe technical complications of endovascular repair of abdominal aortic aneurysms
endoleak femoral artery dissection rupture colonic ischaemia damage to femoral vein
describe patient factor complications of endovascular repair of abdominal aortic aneurysms
DVT PE MI stroke death
what is endoleak
it is persistent blood flow in the aneurysm sac extrinsic to the endograft and is the most common complication after endovascular aneurysm repair
what is atherosclerosis of the carotid arteries associated with
transient ischaemic attacks and ischaemic stroke
what is an transient ischaemic attack
it is a focal central nervous system disturbance caused by vascular events such as micro emboli and occlusion, leading to cerebral ischaemia
how long do symptoms last for transient ischaemic attack
symptoms last less than 24 hours and there are no permanent neurological sequelae
state 3 causes of stroke
cerebral infarction
primary intracerebral haemorrhage
subarachnoid haemorrhage
describe a carotid ultrasound
it is an imaging technique which uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain
describe a doppler sound study
it is a technique that evaluates blood flow through a blood vessel
what is Poiseuille’s law
it is a statement in physics
what does Poiseuille’s law state
the velocity of the steady flow of a fluid through a narrow tube varies directly as the pressure and the fourth power of the radius of the tube and inversely as the length of the tube and coefficient of viscosity
basically describe Poiseuille’s law in relation to vessel radius, resistance to flow and viscosity
as the radius of a vessel decreases (i.e. stenosis), velocity increases
what is a stent
a short narrow metal or plastic tube often in the form of a mesh that is inserted into the lumen of an anatomical vessel especially to keep a previously blocked passageway open, the anatomical vessels include an artery or a bile duct
what is carotid endarterectomy
it is a surgical procedure used to reduce the risk of stroke by correcting stenosis in the common carotid artery or internal carotid artery
what can rupture of plaque cause
the formation of a blood clot in the artery
describe carotid endarterectomy
it is the removal of material on the inside of an artery
when carotid endarterectomies carried out
when one or both carotid arteries become narrowed because of the build up of fatty deposits - plaques
what are the strengths of carotid endarterectomy
reduces risk of additional stroke reduces risk of first time stroke safe procedure the procedure has durable outcomes postoperative lifestyle changes some positive lifestyle changes may include controlling high blood pressure keeping cholesterol under control exercising regularly eating a healthy diet losing excess weight
what are the 2 main risks associated with carotid endarterectomy
stroke and death
what are complications after having carotid endarterectomy
pain or numbers at the wound site bleeding at the site of the wound wound infection nerve damage narrowing of the carotid artery again - restenosis
what is arterial occlusive disease
obstruction of a major artery, resulting in ischaemia distal to the obstruction
what does arterial occlusive disease usually refer to
the popliteal, femoral or innominate arteries
describe the presentation of arterial occlusive disease
mottling pallor coolness paralysis of the affected limb pulselessness sudden pain of affected limb
what is aneurysmal disease also known as
aneurysmal arterial disease
what is aneurysmal disease
it is a slow progressive process during which arteries lose their resilience and become less durable
