Chapter 69 - Arterial aneurysms etiology epidemiology and natural history

Question 1

Factors associated with degenerative aneurysms environmental

Answer 1

1) duration of smoking 2) intensity of smoking

Question 2

% of CFA aneurysm with another aneurysm elsewhere

Answer 2

88%

Question 3

Isolated internal iliac aneurysm rupture mortality

Answer 3

31% difficult to repair

Question 4

Matas 1923 on aortic aneurysm

Answer 4

Ligated aorta, pt lived 18 months until TB killed

Question 5

Juan Parodi in 1991

Answer 5

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

Question 6

Factors associated with degenerative aneurysms microscopically

Answer 6

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

Question 7

Increase in incidence of aortic aneurysm with every decade after 65

Answer 7

6%

Question 8

Arteriomegaly

Answer 8

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

Question 9

Dysphagia lusoria

Answer 9

Caused by aberrant right subclavian

Question 10

Developmental/congenital aneurysms: persistent sciatic artery association

Answer 10

40% have aneurysms

Question 11

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

Answer 11

70% maternal 100% fetal

Question 12

Antyllus on aneurysm

Answer 12

Proximal and distal ligation of extremity aneurysms and pack the sac

Question 13

Popliteal aneurysm rate

Answer 13

Most common peripheral 1% in men 65-80

Question 14

Definition of aneurysm

Answer 14

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

Question 15

Aortic aneurysm incidence in siblings

Answer 15

20-30%

Question 16

Splenic aneurysm rate and association

Answer 16

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

Question 17

Most prevalent type of aneurysm

Answer 17

Infrarenal AAA

Question 18

Matas 1888 on aneurysm

Answer 18

Endo-aneurysmorrhaphy for brachial artery aneurysm

Question 19

Polyester graft developed by

Answer 19

DeBakey

Question 20

Normal diameter of peripheral vessels

Answer 20

Celiac 0.5 SMA 0.6 CFA 0.8 pop 0.9 tib 0.3

Question 21

Average aneurysm size aorta men and women

Answer 21

Question 22

Specific inflammatory aneurysm cases

Answer 22

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

Question 23

Galland found popliteal aneurysm association

Answer 23

59% have contralateral popliteal aneurysm 49% had AAA

Question 24

John Hunter 1785 on aneurysm

Answer 24

Ligated SFA to treat popliteal aneurysm

Question 25

Femoral artery when to treat

Answer 25

1) 3.5 cm or 2) thrombus

Question 26

Connective tissue disorder associated with aneurysm

Answer 26

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

Question 27

Dubost 1951 on aneurysm

Answer 27

Replace aorta with homograft suggested

Question 28

Type of aneurysm etiology

Answer 28

1) Degenerative/atherosclerotic 2) inflammatory 3) secondary to dissection 4) developmental/congenital 5) infectious

Question 29

Radiographic finding of inflammatory aneurysm

Answer 29

1) inflammatory rind 2) ureteral obstruction

Question 30

Kommerell diverticulum

Answer 30

Aneurysm degeneration at origin of aberrant right subclavian

Question 31

Vinyon N cloth developed by

Answer 31

1) Voorhees 2) Jaretski 3) Blakemore

Question 32

Crawford found association % TAA with AAA and vice versa

Answer 32

50% TAA have AAA 12% AAA have TAA

Question 33

Isolated internal iliac artery rupture on presentation %

Answer 33

40% difficult to diagnose asymptomatically

Question 34

Repair renal artery aneurysm when

Answer 34

1) \> 2-3 cm 2) women of child bearing age 3) refractory HTN 4) flank pain 5) hematuria

Question 35

Normal aortic size at 70 yo men and women

Answer 35

Question 36

Definition of ectasia

Answer 36

Intermediate enlargement not yet 50% Associated with family history of siblings getting aneurysms

Question 37

Ebers Papyrus in 2000 BC on aneurysms

Answer 37

"Treat it with a knife and burn it with fire so that it bleeds not too much"

Question 38

Aneurysm shapes

Answer 38

1) Fusiform 2) Concentric saccular 3) Eccentric saccular

Question 39

Typical location for eccentric true sac aneurysm

Answer 39

1) Renal 2) Intracranial 3) Cerebral

Question 40

Percent of CFA with bilateral aneurysm

Answer 40

26%

Question 41

Percent of iliac aneurysms without AAA

Answer 41

11!

Question 42

Aortic aneurysm incidence at 65 years of age

Answer 42

female: 1.7% male 5%

Question 43

Danger in open repair of inflammatory aneurysms

Answer 43

1) duodenal injury 2) ureteral injury