Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular System > Aneurysms - Presentation, Investigation & Therapy > Flashcards

Aneurysms - Presentation, Investigation & Therapy Flashcards

1
Q

What is the definition of an aneurysm?

A

enlargement of an artery caused by weakness in the arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an abdominal aortic aneuruysm (AAA)?

A

localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal.

It involves rupture of all three layers of the artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are presenting symptoms of a ruptured AAA?

5

A
  • sudden, intense and persistent chest or back pain.
  • painful pulsatile mass
  • hypoperfusion (shock)
  • hypotensive
  • syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a false aneurysm?

A

A pseudoaneurysm, also known as a false aneurysm, is a collection of blood that forms between the two outer layers of an artery, the tunica media and the tunica adventitia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A dissecting aneurysm forms between which layers in the arteries?

A

intima and tunica media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is arteriomegaly and subaneurysmal dilatation?

A

dilatation of an artery less than the required size for aneurysm (i.e. <3cm in abdominal aorta).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where do the majority of AAA’s occur?

A

between the renal arteries and the bifurcation of the abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some causes of AAA’s?

3

A
  • degenerative (e.g. atheroma)
  • connective tissue damage (e.g. Marfan’s)
  • infection (e.g. mycotic aneurysm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some risk factors associated with AAA’s?

5

A 
male
age
smoking
alcohol
hypertension
Fx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do unruptured aneurysms often present?

A

asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are AAA’s often diagnosed?

3

A
  • imaging (ultrasound, CTA)
  • Hx/Fx
  • clinical examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Are AAAs screened for?

A

yes, men over 65 are screened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is patient fitness for elective repair assessed?

6

A
  • full Hx/examination
  • exercise tolerance
  • CPEX
  • aortic morphology
  • Bloods (U+E)
  • ECHO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the outcome if screening for AAA shows aorta is 3 to 4.4 cm (small aneurysm)?

A

annual surveillance (e.g. US)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the outcome if screening for AAA shows aorta is 4.5-5.5 cm (medium aneurysm)?

A

3-monthly surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the outcome if screening for AAA shows aorta is >5.5cm (large aneurysm)?

A

treatment offered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the first step in determining the best surgical intervention for AAA repair?

What information can we gather from this?

A

CT angiography

aortic morphology, is it good or bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If the CTA reveals a patient has good anatomy/aortic morphology. what would be the best treatment option?

A

EVAR (endovascular aneurysm repair)

19
Q

Outline what an EVAR is?

A
  • endovascular procedure, accessed via femoral artery

- inputs stent into abdominal aorta to provide an alternative route for blood flow

20
Q

What type of stent is usually used in EVAR?

A
  • nitinol (nickel and titanium)

- with covering fabric

21
Q

What are the contraindications to an EVAR?

A
  • patient preference
  • predictable lack of follow up
  • other CIs
22
Q

If a patient has unsuitable anatomy/aortic morphology, what would be their treatment path?

A
  • laparotomy/open repair

- only if they are a fit candidate for surgery

23
Q

If a patient was unfit for open repair surgery, what treatment options would be considered?

(3)

A
  • EVAR
  • snorkel
  • balloon expandable stent
24
Q

Why is an EVAR procedure preferred over open repair surgery?

4

A
  • less invasive
  • faster recovery
  • lower risk of complications
  • less risk of infection
25
Q

What are the patient factors for complications in EVAR/open repair of AAAs?

A

DVT/PE
MI
Stroke
Death

26
Q

What are the general complications for endovascular repair of AAA’s?

(5)

A
  • Wound infection
  • Bleeding/haematoma
  • Pain
  • contrast renal impact
  • Radiation
27
Q

what are the technical complications of endovascular repair of AAAs?

(5)

A
  • Endoleak
  • Femoral artery dissection/pseudoaneurysm
  • Rupture
  • Distal emboli / ischaemia
  • Damage to femoral vein/nerve
28
Q

What is a type I AAA?

A

inadequate circumferential seal (proximal, distal, common iliac)

29
Q

What is a type II AAA?

A

backflow from collaterals into aneurysmal sac.

30
Q

What is a type III AAA?

A

endograft/structural failure

31
Q

What is a type IV AAA?

A

leak from graft fabric (porosity)

32
Q

If a patient was unfit for an EVAR due to the proximity of the aneurysm to renal arteries, what treatment might be offered?

A

FEVAR (fenestrated EVAR)

33
Q

What scoring system is used to assess severity/mortality of a ruptured AAA?

A

ERAS (Edinburgh ruptured aneurysm score)

34
Q

What are the symptoms of an impending AAA rupture?

2

A

increasing back pain

tender AAA

35
Q

What is the role of vascular surgeons in strokes?

A

management of carotid disease to prevent further events, secondary prevention

36
Q

What are the causes of stroke?

9

A
  • AF
  • carotid atherosclerosis (15%)
  • IE
  • MI
  • Carotid artery trauma/dissection
  • Drug abuse
  • Haematological disorder e.g. sickle cell disease
  • Primary intracerebral haemorrhage (10%)
  • Subarachnoid haemorrhage (6%)
37
Q

How is stroke diagnosed?

A
  • Hx
  • Exam (neuro, cardio, auscultate carotids)
  • CT
  • Carotid USS
38
Q

What are neurological symptoms of stroke?

A

contralateral symptoms of paralysis/paresis/visuospatial neglect, dysphasia

39
Q

What happens to the velocity of flow in a vessel as radius decreases?

A

it increases

40
Q

What are the primary prevention techniques for stroke in terms of medical therapy?

A
  • antiplatelets
  • statin
  • diabetic control
  • antihypertensives
41
Q

If a carotid artery is fully occluded and there are no (stroke/TIA) symptoms is surgery performed?

A

no, only when there is risk of high speed distal embolism. i.e. partially occluded <70%

42
Q

What are the interventional procedures for carotid atheroma causing >70% stenosis?

A
  • carotid endarterectomy

- stenting

43
Q

What are the complications of carotid endarterectomy?

6

A
  • wound infection
  • bleeding
  • anaesthetic risks
  • nerve damage
  • plaque rupture
  • hypoperfusion

Cardiovascular System (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions