Aneurysm

Definition- Diameter>1.5 fold, 1~1.5 fold called ectasia

Site- Abdominal aorta> thoracic aorta> abdominal+iliac> thoracic+abdominal> iliac> popliteal> femoral

Risk factor- Aging, male, HTN, smoking, HyperTG, Marfan syndrome

Type

1.True aneurysm- 3 layers

2.False aneurysm- 1 or 2 layers

3.Fusiform aneurysm- Artherosclerosis, AAA(95%infrarenal)

4.Saccular aneurysm- Syphilis, ascending and arch

5.Degenerative aneurysm- atherosclerosis

6.Infected(mycotic) aneurysm

7.Traumatic/dissection

8.Microaneurysm- HTN(Charcot-Bouchard microaneurysm), DM

9.Berry aneurysm- Willis circle


Presentation- Pulsatile mass, distal embolism

Surgical risk factor- Age, functional status, Cardiac, Pulmonary, Renal, AAA type

Management

1.Low risk→ Quit smoking, BP control, ACEi/ARB/B-blocker, Doxycycline(MMP inhibitors)

2.Surgery

Indication- Diameter>5.5cm(Female>4.5cm), 1cm/year, rupture

a)Open repair

Complication- AMI> AKI> pneumonia, ischemia colitis(improper ligation of IMA), Sexual dysfunction (autonomic nerve injury), paresis(Adamkiewicz), graft infection

b)Endovascular aortic aneurysm repair(EVAR)

Method- Femoral artery→ stent graft

Complication- Hematoma, wound infection, pseudoaneurysm, distal embolization, Endoleak


Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

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