Pathology, Causes, Symptoms, Complications, etc.

Question 1

pathology frequently includes..

Answer 1

“cystic” medial degeneration (formally called “necrosis”)
with fragmentation and loss of elastic fibers… leaving “cystic” areas of myxoid matrix in tunica media

tunica media is thinned

Question 2

Rare causes

Answer 2

specific types of autoimmune vasculitis
–i.e. giant cellarteritis
infection
–called “mycotic” even though usually not fungal

Question 3

symptoms

Answer 3

usually none

MAY cause back pain (esp. if leaking)

Question 4

Signs

Answer 4

usually none

except sometimes pulsatile mass, palpable in thin pt

Question 5

Diagnosis

Answer 5

requires imaging (ultrasound is most efficient)

Question 6

Major complication

Answer 6

rupture

Question 7

major determinant

Answer 7

diameter

Question 8

risk of abdominal aortic aneurysm rupture is…

.3% per year if

Answer 8

<4cm in diameter

Question 9

risk of abdominal aortic aneurysm rupture is…

1.5% per year if

Answer 9

4-4.9cm

Question 10

risk of abdominal aortic aneurysm rupture is…

6.5% per year if

Answer 10

5-5.9cm

Question 11

HTN..

Answer 11

accelerates aneurysm growth

Question 12

what is a major factor in rate of growth?

Answer 12

blood pressure

Question 13

general complications

Answer 13

***rupture
"mural" thrombus formation (nearly universal)
embolism of atheroma or thrombus
obstruction of aortic branches
aortoenteric fistula

Question 14

aortoenteric fistula

Answer 14

when the aorta erodes a passage into the intestine

Question 15

standard treatment

Answer 15

used to be open surgical repair with prosthetic graft (but has significant risk

Percutaneous deployment of endoluminal stent graft is becoming common

Question 16

endoluminal stent graft

Answer 16

expandable wire mesh frame covered by cloth sleeve

Question 17

are aortic aneurysms familial?

Answer 17

YES!