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Cardiovascular System > Aortic Aneurysms and Carotid Artery Disease > Flashcards

Aortic Aneurysms and Carotid Artery Disease Flashcards

1
Q

Aneurysm disease

A

Dilation of all layers of the aorta leading to an increase in diameter of >50%

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2
Q

Causes of aneurysm disease

A

Degenerative disease
Connective tissue disease
Infection (mycotic aneurysm)

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3
Q

Risk factors for degenerative abdominal aortic aneurysms

A 
Male
Age
Smoking
Hypertension
Family history
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4
Q

Prevalence of aortic aneurysm disease in the UK

A

3%

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5
Q

Symptoms of abdominal aortic aneurysm

A

Asymptomatic

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6
Q

Abdominal aortic aneurysm can only be detected by

A

Screening

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7
Q

Type of screening used for abdominal aortic aneurysm

A

Ultrasound scan

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8
Q

A good screening is one which

A

Minimises false positives and negatives, maximises true positives and negatives

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9
Q

Presentation of impending rupture of abdominal aortic aneurysm

A

Increasing back pain

Tender abdominal aortic aneurysm

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10
Q

Presentation of ruptured abdominal aortic aneurysm

A

Abdominal and back pain
Painful pulsatile mass
Haemodynamic instability
Hypoperfusion

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11
Q

Usual presentations of abdominal aortic aneurysms in scan

A 
Distal embolisation
Aortocaval fistula
Aortoenteric fistula
Ureteric occlusion
Duodenal obstruction
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12
Q

Treatment options for abdominal aortic aneurysm

A

Conservative
Endovascular repair
Open repair

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13
Q

Endovascular repair

A

Insertion of stent graft into aneurysm

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14
Q

Open repair general complications

A

Wound infection or separation
Bleeding
Pain
Scar

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15
Q

Open repair technical complications

A 
Damage to bowel, ureters, veins, nerves
Incisional hernia
Graft infection
Distal emboli
Renal failure
Colonic ischaemia
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16
Q

Open repair and endovascular repair patient factor complications

A

Deep vein thrombosis/pulmonary embolism
MI
Stroke
Death

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17
Q

Endovascular repair general complications

A 
Wound infection
Bleeding/haematoma
Pain
Scar
Radiation
Contrast - kidney injury
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18
Q

Endovascular repair technical complications

A

Endoleak
Femoral artery dissection/pseudo-aneurysm
Rupture
Distal emboli/ischaemia/colonic ischaemia
Damage to femoral vein/nerve

19
Q

Emergency open repair of abdominal aortic aneurysm

A

Laparotomy xiphisternum to public symphysis to occlude aortic proximally

20
Q

Surveillance of abdominal aortic aneurysm until it reaches a diameter of

A

5.5cm

21
Q

Atherosclerosis of carotid arteries can result in

A

Ischaemic attacks and stroke

22
Q

Transient ischaemic attack

A

Focal CNS disturbance caused by vascular events leading to cerebral ischaemia, lasts less than 24 hours

23
Q

Stroke

A

Clinical syndrome consisting of rapidly developing clinical signs of focal or global disturbance of cerebral function due to vascular event, lasts more than 24 hours

24
Q

Causes of stroke/TIA

A

Cerebral infarction
Primary intracerebal haemorrhage
Subarachnoid haemorrhage

25
Q

Causes of cerebral infarction

A 
Atrial fibrillation 
Carotid atherosclerosis - rupture/thrombus
Endocarditis
MI
Carotid artery trauma/dissection
Drug abuse
Haematological disorder
26
Q

Risk factors for carotid artery atherosclerosis

A 
Smoking
Dibetes
Family history
Male
Hypertension
Hyperlipidaemia/hypercholesterolaemia
Obesity
Age
27
Q

Imaging for carotid artery atherosclerosis

A

CT and carotid ultrasound

28
Q

Effect of decrease in vessel radius on velocity

A

Increases

29
Q

Degree of stenosis can be measured via

A

Measuring velocity

30
Q

Best medical therapy for carotid artery atherosclerosis

A 
Smoking cessation
Control of hypertension
Anti-platelet
Statin
Diabetic control
31
Q

Statin

A

Drug that lowers cholesterol levels in the blood

32
Q

The brain is still perfused despite carotid artery atherosclerosis due to

A

Circle of Willis

33
Q

Carotid endarterectomy

A

Removal of plaque from artery

34
Q

Complications of carotid endarterectomy

A 
Wound infection
Bleeding
Scar
Anaesthetic risks
Nerve damage - vagus and hypoglossal
Preoperative stroke
35
Q

Management of carotid artery atherosclerosis

A

Best medical therapy
Carotid endarterectomy
Stenting

36
Q

Timing of management

A

Longer carotid is left alone the more stable the plaque becomes

37
Q

The NNT to prevent one stroke for men and women

A

Men - 9

Women - 36

38
Q

Most risky period for further event is within

A

The first 2 weeks

39
Q

Prophylactic

A

Doesn’t reverse effects of stroke, just prevents further events

40
Q

Surgery is described as being

A

Prophylactic

41
Q

Carotid surgery should be offered to

A

Symptomatic patients with >70% stenosis

42
Q

Surgery in men considered if stenosis percentage is between

A

50-69%

43
Q

Surgery in asymptomatic patients considered if stenosis percentage is >

A

70%

Cardiovascular System (27 decks)

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