FACTS AND FIGURES

(ANEURYSMAL DISEASE)
(localized)
2
1. True
2. False
aneurysm
Fusiform aneurysm axis of vessel
Saccular aneurysm tangential of axis
Dissecting aneurysm intima

1.3.1.Congenital
Berry aneurysm
Marfans syndrome
Ehler-Danlos
1.3.2.Acquired
1.3.2.1 Trauma / iatrogenic
o Instrumentation (arterial monitoring lines )
o Intravenous drug abusers
1.3.2.2 Inflammation / infection
o Syphilis ,TB
o Mycotic
o Retroperitoneal fibrosis
1.3.2.3 Degeneration - atherosclerosis


Aorta 95% atherosclerosis
(infra-renal aorta) 95%
Iliac artery, femoral artery, popliteal artery
Circle of Willis
Splenic artery/ hepatic artery / mesenteric artery ( < 1%)

Rupture
Thrombosis
Local pressure symptoms
Source of embolism
ABDOMINAL AORTIC ANEURYSM

Ultrasound and CT scan
ANEURYSM
o 1.
o 2.
o 3. infra suprarenal
o 4. iliac artery

 U/S Abdominal aortic aneurysm

CT abdomen Abdominal aortic aneurysm

 CT reconstruction Abdominal aortic aneurysm

angiogram Abdominal aortic aneurysm

> 60
atherosclerosis

 2
1.


Hypovolemic shock
2.

Myocardial infarction
Peptic ulcer disease
Pancreatitis
Renal colic

2
1. Aneurysm
(Resuscitation)
(Emergency abdominal aortic repair)
50% 100%
2. Aneurysm
Aneurysm
Aneurysm
50 %
5%
(UK
small aneurysm trial)
.

- 5.5 cm Aneurysm
( )
- Aneurysm Aneurysm
12 %
. < 5.5 cm
ultrasound CT scan
0.5%

- 5.5 cm
- > 1.0 cm
-

Abdominal aortic aneurysm

(early complication)

o Hypovolaemic shock
o Cardiogenic shock
o ARDS
o DIC

 Anastomotic leak haemorrhage

Reperfusion injury
o Systemic hyperkalaemia
o Myoglobinuria causing renal failure / cardiac arrhythmia
Acute ischaemia embolism thrombus aneurysm
embolectomy
Inferior mesenteric artery ligation gut ischaemia
Renal hypoperfusion- renal failure
Spinal- paraplegia
(late complication)
Graft
Thrombosis
Infection
Aorto-enteric fistula
Sexual dysfunction
abdominal aortic repair 5
80%
Endovascular aortic stenting
aneurysm
aneurysm (Endovascular stenting)

 endovascular surgery in abdominal aortic aneurysm