Chapter 69 - Arterial aneurysms etiology epidemiology and natural history Flashcards

1
Q

Factors associated with degenerative aneurysms environmental

A

1) duration of smoking 2) intensity of smoking

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2
Q

% of CFA aneurysm with another aneurysm elsewhere

A

88%

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3
Q

Isolated internal iliac aneurysm rupture mortality

A

31% difficult to repair

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4
Q

Matas 1923 on aortic aneurysm

A

Ligated aorta, pt lived 18 months until TB killed

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5
Q

Juan Parodi in 1991

A

Used balloon-expandable stent and polyester graft to devise EVAR using femoral access only

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6
Q

Factors associated with degenerative aneurysms microscopically

A

1) Increase metalloproteinase 2) decrease tissue inhibitor of metalloproteinase 1 (antiproteolytic enzymes)

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7
Q

Increase in incidence of aortic aneurysm with every decade after 65

A

6%

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8
Q

Arteriomegaly

A

Diffuse continuous enlargement with multiple arterial segments > 50% increase Associated with family history of siblings getting aneurysms

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9
Q

Dysphagia lusoria

A

Caused by aberrant right subclavian

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10
Q

Developmental/congenital aneurysms: persistent sciatic artery association

A

40% have aneurysms

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11
Q

Renal artery aneurysm in 3rd trimester of pregnancy mortality if rupture

A

70% maternal 100% fetal

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12
Q

Antyllus on aneurysm

A

Proximal and distal ligation of extremity aneurysms and pack the sac

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13
Q

Popliteal aneurysm rate

A

Most common peripheral 1% in men 65-80

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14
Q

Definition of aneurysm

A

Localized dilation with more than 50% increase compared to expected size Developed by Ad Hoc Committee Reporting Standard of SVS 1991

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15
Q

Aortic aneurysm incidence in siblings

A

20-30%

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16
Q

Splenic aneurysm rate and association

A

most common visceral, 60% of all 1) female 2) portal HTN

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17
Q

Most prevalent type of aneurysm

A

Infrarenal AAA

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18
Q

Matas 1888 on aneurysm

A

Endo-aneurysmorrhaphy for brachial artery aneurysm

19
Q

Polyester graft developed by

20
Q

Normal diameter of peripheral vessels

A

Celiac 0.5 SMA 0.6 CFA 0.8 pop 0.9 tib 0.3

21
Q

Average aneurysm size aorta men and women

22
Q

Specific inflammatory aneurysm cases

A

1) Takayasu 2) Giant Cell 3) Polyarteritis Nodosa 4) Behcet disease 5) Cogon Syndrome 6) Cystic medial necrosis

23
Q

Galland found popliteal aneurysm association

A

59% have contralateral popliteal aneurysm 49% had AAA

24
Q

John Hunter 1785 on aneurysm

A

Ligated SFA to treat popliteal aneurysm

25
Femoral artery when to treat
1) 3.5 cm or 2) thrombus
26
Connective tissue disorder associated with aneurysm
1) Ehlers-Danlos 2) Marfan 3) Loey-Dietz Syndrome 4) Cystic medial degeneration (bicuspid valve, biopsy + 75%) 5) familial thoracic aortic aneurysm syndrome 6) Turner syndrome
27
Dubost 1951 on aneurysm
Replace aorta with homograft suggested
28
Type of aneurysm etiology
1) Degenerative/atherosclerotic 2) inflammatory 3) secondary to dissection 4) developmental/congenital 5) infectious
29
Radiographic finding of inflammatory aneurysm
1) inflammatory rind 2) ureteral obstruction
30
Kommerell diverticulum
Aneurysm degeneration at origin of aberrant right subclavian
31
Vinyon N cloth developed by
1) Voorhees 2) Jaretski 3) Blakemore
32
Crawford found association % TAA with AAA and vice versa
50% TAA have AAA 12% AAA have TAA
33
Isolated internal iliac artery rupture on presentation %
40% difficult to diagnose asymptomatically
34
Repair renal artery aneurysm when
1) \> 2-3 cm 2) women of child bearing age 3) refractory HTN 4) flank pain 5) hematuria
35
Normal aortic size at 70 yo men and women
36
Definition of ectasia
Intermediate enlargement not yet 50% Associated with family history of siblings getting aneurysms
37
Ebers Papyrus in 2000 BC on aneurysms
"Treat it with a knife and burn it with fire so that it bleeds not too much"
38
Aneurysm shapes
1) Fusiform 2) Concentric saccular 3) Eccentric saccular
39
Typical location for eccentric true sac aneurysm
1) Renal 2) Intracranial 3) Cerebral
40
Percent of CFA with bilateral aneurysm
26%
41
Percent of iliac aneurysms without AAA
11!
42
Aortic aneurysm incidence at 65 years of age
female: 1.7% male 5%
43
Danger in open repair of inflammatory aneurysms
1) duodenal injury 2) ureteral injury