Aortic aneurysms Flashcards
Where do most AAA occur
below renal arteries
Why do AAA occur
primarily as result of failure of elastic proteins within ECM
loss of intima with loss of elastic fibres from the media
What is meant by a true aneurysms
if it involves all three layers expanding
What diameter are aortas considered aneursymal
diameters of 3cm or greater
How does an unruptured aortic aneurysm present
usually asymptomatic
pulsing sensation in abdomen
may have abdominal/lower back pain
How do ruptured aneurysms present
severe, central abdominal pain radiating to the back
dizziness
sweaty,pale and clammy skin
tachycardia
SOB
syncope
What are some risk factors for AAA
smoking
more common in men
hypertension
family history
hypercholesterolaemia
syphillis
connective tissue disorder
-Ehlers danlos type 1
-Marfans syndrome
What investigations are required for AAA
abdominal ultrasound
CT angiogram
Bloods- cross match in case surgery is needed
How are AAA less than 3cm managed
this is normal
no further action
How are AAA 3-4.4cm managed
small aneurysm
rescan annually
How are AAA 4.5-5.4cm managed
medium aneurysm
rescan every 3 MONTHS
How are AAA >5.5cm managed
large aneurysm
refer within 2 weeks to vascular surgery for intervention
not that common
What is immediate management if ruptured AAA
emergency endovascular repair- open repair if patient is unstable
What can be a complication of emergency endovascular repair
Endo-leak - when blood finds a way around the stent graft and into the aneurysm
usually asymptomatic
