Vascular teaching 3

Question 1

Stripping of SSV vein can damage

Answer 1

Sural nerve

Question 2

PMH importants for AAA differential

Answer 2

HTN, drug history, Age, ethnicity, gender, smoker, BMT (antiplatelet, statin, PPI)

Are they taking any anticoagulants

Question 3

What is EVAR

Answer 3

Endovascular aneurysm repair

Question 4

What is an AAA

Answer 4

Bulge/swelling, pierces diaphragm at T12, can rupture = surgical emergency

Question 5

Where is coeliac branch

Answer 5

T12

Question 6

Where is SMA

Answer 6

L1

Question 7

Where is renal

Answer 7

L1-L2

Question 8

AAAs are grouped into 3 sizes

Answer 8

Small = 3-4.4cm
Medium = 4.5-5.4cm
Large = 5.5cm or more (benefits of intervening outweigh conservative management —> surgery)

Question 9

Something weird that is protective to ruptured AAA

Answer 9

T2DM

Question 10

Small AAA management

Answer 10

USG scan every year, DATES

Question 11

Medium AAA management

Answer 11

USG scans every 3 months, healthy lifestyle changes/DATES

Question 12

2 types of surgery for AAA

Answer 12

Open surgery (graft placed in aorta through abdominal incision), EVAR (graft/stent placed into blood vessel in groin and passed up into aorta, opened and fixed in place)

Question 13

EVAR important complication

Answer 13

Endo leak - type 1 is if proximal or distal graft attachment site leaks

ENDOLEAK NEEDS SURGICAL MANAGEMENT