Chapter 69 - Arterial aneurysms etiology epidemiology and natural history Flashcards
Factors associated with degenerative aneurysms environmental
1) duration of smoking 2) intensity of smoking
% of CFA aneurysm with another aneurysm elsewhere
88%
Isolated internal iliac aneurysm rupture mortality
31% difficult to repair
Matas 1923 on aortic aneurysm
Ligated aorta, pt lived 18 months until TB killed
Juan Parodi in 1991
Used balloon-expandable stent and polyester graft to devise EVAR using femoral access only
Factors associated with degenerative aneurysms microscopically
1) Increase metalloproteinase 2) decrease tissue inhibitor of metalloproteinase 1 (antiproteolytic enzymes)
Increase in incidence of aortic aneurysm with every decade after 65
6%
Arteriomegaly
Diffuse continuous enlargement with multiple arterial segments > 50% increase Associated with family history of siblings getting aneurysms
Dysphagia lusoria
Caused by aberrant right subclavian
Developmental/congenital aneurysms: persistent sciatic artery association
40% have aneurysms
Renal artery aneurysm in 3rd trimester of pregnancy mortality if rupture
70% maternal 100% fetal
Antyllus on aneurysm
Proximal and distal ligation of extremity aneurysms and pack the sac
Popliteal aneurysm rate
Most common peripheral 1% in men 65-80
Definition of aneurysm
Localized dilation with more than 50% increase compared to expected size Developed by Ad Hoc Committee Reporting Standard of SVS 1991
Aortic aneurysm incidence in siblings
20-30%
Splenic aneurysm rate and association
most common visceral, 60% of all 1) female 2) portal HTN
Most prevalent type of aneurysm
Infrarenal AAA
Matas 1888 on aneurysm
Endo-aneurysmorrhaphy for brachial artery aneurysm
Polyester graft developed by
DeBakey
Normal diameter of peripheral vessels
Celiac 0.5 SMA 0.6 CFA 0.8 pop 0.9 tib 0.3
Average aneurysm size aorta men and women

Specific inflammatory aneurysm cases
1) Takayasu 2) Giant Cell 3) Polyarteritis Nodosa 4) Behcet disease 5) Cogon Syndrome 6) Cystic medial necrosis
Galland found popliteal aneurysm association
59% have contralateral popliteal aneurysm 49% had AAA
John Hunter 1785 on aneurysm
Ligated SFA to treat popliteal aneurysm
