TAA & Thoracic Dissection Flashcards
Name 5 risk factors that are associated with TAAA rupture
- Age
- Pain
- COPD
- Descending aortic diameter
- Abdominal aortic diameter
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/113/a_image_thumb.png?1555320561)
Name 2 differences in the composition of the aortic wall as you progress from the ascending aorta to the iliac bifurcation
- Ascending aorta has greater concentration of elastin (therefore more compliant)
- Media becomes thinner from proximal to distal aorta
Name 5 causes for TAAA from most frequent to least.
- Degenerative/atherosclerotic 80%
- Dissections 15-20%
- Infection 2%
- Connective tissue disorders (Loeys Dietz, Marfans, EDIV)
- Vasculitis: takayasu, giant cell, rheumatoid
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/115/a_image_thumb.png?1555320962)
What percentage of TAAA are type 4?
< 25%
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/116/a_image_thumb.png?1555321283)
What percentage of TAAA are type 3?
< 25%
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/117/a_image_thumb.png?1555321270)
What percentage of TAAA are type 2?
30%
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/118/a_image_thumb.png?1555321254)
What percentage of TAAA are type 1?
25%
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/119/a_image_thumb.png?1555321228)
What is a Type 4 TAAA?
Confined to abdo aorta, including visceral and renal arteries
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/120/a_image_thumb.png?1555321200)
What is a Type 3 TAAA?
Involves variable lengths of the descending thoracic and abdo aorta
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/121/a_image_thumb.png?1555321172)
What is a Type 2 TAAA?
Involves entire descending thoracic aorta and most of the abdominal aorta
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/122/a_image_thumb.png?1555321148)
What is a Type 1 TAAA?
Involves entire descending thoracic aorta
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/123/a_image_thumb.png?1555321141)
What percentage of TAAAs also have an AAA?
20-30%
Name 4 chest xray findings in keeping with TAAA?
- Widened mediastinum
- Dilated aortic knob
- Tracheal deviation
- Left main stem bronchus displacement
Inadequate to definitively exclude TAAA
What is the threshold size for repair of TAAA?
> 6 cm.
Maybe more or less.
More: Type 1 - 3 because of spinal cord ischemia
Less: Symptomatic, connective tissue disease, Type 4.
Name 5 risk factors predictive of periop mortality following TEVAR
- Age
- Renal insufficiency
- History of stroke
- Placement of > 2 devices
- Maximal aortic diameter
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/127/a_image_thumb.png?1555408099)
How do you treat an aberrant right subclavian artery?
Hybrid approach:
- Embolize side branches off the aberrant subclavian pre-op
- R CCA to distal R SCA bypass with ligation of RSCA prox to vertebral artery
- Stent the abnormal descending thoracic aorta
- Often to achieve proximal seal may need to cover L SCA so it may need a left carotid subclavian bypass/transposition as well.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/128/a_image_thumb.png?1555494368)
How do Gore C-tag TEVARs prevent the “wind sock” effect?
Deploys from middle of the graft
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/129/a_image_thumb.png?1555581830)
What is the lowest profile TEVAR?
Cook Alpha (16F)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/660/130/a_image_thumb.png?1555582232)