WlwG Vascular/IR/NM Flashcards
True vs false aneurysm? 4 differences
True aneurysm: Wall intact, wide neck, due to MI/congenital/myocarditis. Low risk of rupture, high risk of THROMBUS. Involves all 3 wall layers.
False pseudoaneurysm: Wall ruptured, narrow neck/saccular outpouching, due to MI/trauma/infn/syphilis. High risk of RUPTURE. 1-2 wall layers.
Signs of Penetrating ulcer
HTN patient with atherosclerotic plaques eroding the aortic wall BETWEEN CALCIFICATIONS causing outpouching sac.
Ascending aorta aneurysm >40 year old, dx and cause
Cystic medial necrosis: >40 year old with vessel wall degeneration, thus ascending aortic aneurysms. Due to HTN/connective tissue diseases.
Ascending aorta aneurysm <30 year old, dx and cause
Syphilitic aortitis: <30 year old with inflammation/fibrosis/aneurysm of ASCENDING aorta > abdominal aorta.
Cause of ascending aortic calcifications
Takayasu or Syphilis
Cause of descending aortic calcifications
Atherosclerosis, descending aorta aneurysm/haematoma/dissection due to HTN
T1-hyper CT-hyper crescent shape in vessel
Intra-mural haematoma, from HTN/atherosclerosis
Dissection: Stanford A vs B location and management
Stanford A (ascending aorta, Tx surgery), Stanford B (descending aorta distal to LEFT SUBCLAVIAN, Tx medical control of HTN).
Ix Trans-Oesophageal echo (TOE) if stable, Aortography/Coronary angiography if Stanford A or unstable type B.
Dissection: Stanford A vs B location and investigation
Stanford A (ascending aorta, Tx surgery), Stanford B (descending aorta distal to LEFT SUBCLAVIAN, Tx medical control of HTN).
Ix Trans-Oesophageal echo (TOE) if stable, Aortography/Coronary angiography if Stanford A or unstable type B.
Signs of aorto-iliac occlusion
Hip and thigh claudication, impotence, reduced femoral pulses. Ix arteriography.
Signs of abdominal aortic coarctation
<30 year old with HTN, claudication, abdominal angina, renal failure.
Signs of Hypothenar-Hammer syndrome
Thrombosis of ulnar artery at Guyon’s canal after trauma/excessive vibration/hand sports. Pain/sensitivity/cyanosis commonly over 4-5th fingers.
Signs of Thoracic outlet syndrome
Compression of brachial plexus or subclavian vessels, usually at scalene triangle, costoclavicular space or pectoralis tunnel.
Signs of Paget-Schroetter syndrome
Upper limb DVT of axillary of subclavian VEIN due to repetitive shoulder sports, upper limb pain/swelling symptoms (“Page a SAD Sporter” = Subclavian/Axillary DVT in sports).
Signs of Subclavian steal syndrome
Subclavian artery occlusion with reversal of flow in vertebral artery. Results in dizziness/visual/motor/sensory changes, worst on neck movement. Tx angioplasty/stent.
Signs of Subclavian vein thrombosis
Either spontaneous or Paget-Schroetter disease, due to impingement of vein between anterior scalene muscle, first rib, subclavian tendon. Tx anticoagulation/surgery.
Signs of Brachiocephalic vein obstruction
UNILATERAL ARM/FACE swelling in DIALYSIS patient (compared to SVCO which is bilateral).
Signs of Popliteal artery entrapment syndrome
In young athletes with cold feet/calf numbness/tingling. May also trap popliteal vein causing leg cramps/swelling. Due to gastrocnemius muscle abnormal positioning.
Signs of Cystic adventitial degeneration
T2-hyper mucous CYSTS in the wall of the popliteal artery in young males, causing claudication.
Signs of Arterial thromboembolism
(“P’s”) Pain, Pallor, Pulselessness, Paresthesia, Paralysis. Due to cardiac mural thrombus, MI, arrhythmia, aneurysms. Tx embolectomy.
Signs of May Thurner
“LID” = Left common Iliac vein DVT from compression by right common iliac artery, thus swollen left leg +/- PE.
Vasculitis dx: Head artery inflamed
GCA (“giant arteritis”)
Vasculitis dx: Aorta inflammed with pulmonary artery aneurysm/stenosis
Takayasu aortitis
Vasculitis dx: Child aorta inflammation
Cogan
