Vascular surgery pics

Question 1

What are the different types of aneurysms?

Answer 1

Saccular- protrusion on one side

Fusiform- all around ballooning of artery

Pseudoaneurysm.

Question 2

ADD PIC- What does this show?

Answer 2

Infection of a bypass

Question 3

What is the endovascular management of a vascular blockage/narrowing?

Answer 3

Stent

Balloon

Can be done when doing angiography

Question 4

What are the features of a viable, threatened and dead limb?

Answer 4

Viable audible tibial/ankle pulse on doppler Threatened No sound of doppler Sensory loss Tense calf Dead Discolouration- fixed mottling Tissue loss Neurological deficit

Question 5

Overall management for acute limb ischemia?

• Embolic causes
• Thrombotic causes
• If non-viable/dead

Answer 5

EMBOLIC CAUSE:

> Embolectomy

Using Fogarty catheter- catheter with balloon on end- inflate balloon + pull out embolus

• Successful if soft clot/embolus

> Fasciotomy - prevent compartment syndrome due to inflammation

THROMBOTIC CAUSE:

> Thrombolysis

• Clot usually harder

IF DEAD LIMB:

> Amputate

Question 6

How is the location of AAA defined?

Answer 6

• Juxta renal - Infra renal Defined by relationship to renal vessels

Question 7

What do these scans show?

Answer 7

CT of AAA

Question 8

Management of AAA?

Answer 8

• If less than 5.5 cm- regular observations and USS scans
• If more than 5.5 cm- elective repair
• If symptomatic/suspicion of rupture- immediate emergency surgery
  
  • Two types of surgery:
    
    • Open laparotomy repair - use graft and make anastomosis
    • EVAR- endovascular- through femoral artery- add a stent