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Aneurysms: Key Facts ((Acquired (Infection (Mycotic: SBE, Tertiary…

- - - - Mycotic: SBE
      - Tertiary syphilis (esp. thoracic)
      - Salmonella typhi: assoc. w/ AAA
  - - - Aneurysms ≥ 5.5cm should undergo repair.
      - Risk of rupture
        
        <5.5cm: 1% /yr
        
        ≥5.5cm: 10% /yr
    - - MASS trial revealed 50% ↓ aneurysm-related mortality
        in males aged 65-74 screened w/ US.
      - UK men offered one-time US screen @ 65yrs
    - - Rupture
        
        Thrombosis
        
        Distal embolisation
        
        Pressure: DVT, oesophagus, nutcracker syndrome
        
        Fistula: IVC, intestine
- - - - Dilatation of a blood vessel involving all layers of the
        wall and is >50% of its normal diameter
      - Two different morphologies
        
        Fusiform: e.g AAA
        
        Saccular: e.g Berry aneurysm
    - - Collection of blood around a vessel wall that
        communicates w/ the vessel lumen.
      - Usually iatrogenic: puncture, cannulation
    - - Vessel dilatation caused by blood splaying apart the
        media to form a channel w/i the vessel wall.
      - Used to be classified as “dissecting aneurysms” but not
        technically correct as represents a different pathology
- - - - Ultrasound compression
      - Thrombin injection
      - Surgical repair
  - - - Traumatic or iatrogenic
      - Usually in the common femoral A. following
        puncture for a radiological procedure.
  - - - Collection of blood around a vessel wall that
        communicates w/ the lumen
        i.e. a pulsating haematoma
      - Fibrous tissue forms around haematoma → false sac which communicated w/ vessel lumen