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Slide 1 - ppt slide no 1 content not found
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Slide 3 - Abdominal Aortic Aneurysm September 25, 2009
Slide 4 - Definition Aneurysm: irreversible dilation of an artery at least 1.5 times its normal caliber True aneurysm vs. False aneurysm Varieties: Degenerative – due to atherosclerosis, most common type Traumatic – iatrogenic, catheter-related, penetrating trauma Poststenotic – Bernoulli’s principle, occurs distally (distal to coarctation, distal to cervical rib in thoracic outlet syndrome, etc.) Dissecting Mycotic – infected Anastomotic – separation between graft and native artery
Slide 5 - Abdominal Aortic Aneurysm Fusiform dilation of abdominal aorta > 1.5 times its normal diameter Incidence: 5% of elderly population >60 years old (6-9 times more common in males) Relative risk: 11.6% in patients with first-degree relative with known AAA Risk factors: Atherosclerosis, HTN, smoking, male gender, advanced age, connective tissue disease Risk factors for rupture: diastolic HTN, initially large size at diagnosis, COPD, symptomatic, recent rapid expansion
Slide 6 - Diagnosis Exam Periumbilical palpable pulsatile mass Ultrasound Study of choice for initial diagnosis Used to follow progression of aneurysm over time Abdominal or back radiographs Calcifications of aneurysm wall may be seen in ~75% of patients
Slide 7 - Diagnosis CT scan Character, wall thickness, location with respect to renal arteries, presence of leak or rupture With Contrast for visualization of surrounding vasculature; essential for planning repair MRI Greater detail than CT or US regarding lumen, surface anatomy, neck, relationship to renal arteries Angiogram Defines vascular anatomy, assess lumen patency and iliac/renal involvement Especially important in cases of mesenteric ischemia, HTN, renal dysfunction, horseshoe kidney, claudication
Slide 8 - AAA Screening U.S. Preventive Services Task Force recommends one-time screening by ultrasonography in men age 65 to 75 years who have ever smoked No recommendation (for or against) screening in men age 65 to 75 who have never smoked, and an explicit recommendation against routine screening in women, based on the relatively low yield Repeated screening does not appear to be needed
Slide 9 - Radiograph
Slide 10 - Ultrasound
Slide 11 - Ultrasound
Slide 12 - Ultrasound
Slide 13 - CT scan
Slide 14 - CT with contrast
Slide 15 - CT with contrast
Slide 16 - CT Three Dimensional Reconstruction
Slide 17 - Angiogram
Slide 18 - Triad of Rupture Abdominal pain Pulsatile abdominal mass Hypotension
Slide 19 - X-ray
Slide 20 - CT scan
Slide 21 - ppt slide no 21 content not found
Slide 22 - Any Questions?