AAA treatment

if the AAA measures over 6 cm, they treat it by ….

surgery —> incision into abdomen, open up the aorta, stitch a graft into aorta, possibly iliacs and renals, and then fold everything back over graft to keep the original aorta wall

the graft material produces ___ echo reflections compared to normal aortic walls

bright, will see echogenic ridges

what are some complications when grafting

AAA or pseudoaneurysm at attachment site

hematoma

infeciton

endoleak

perigraft fluid

degeneration of graft material

to place a stent into the aorta, we can also go through the ….

femoral artery laparoscopically

more popular, less invasive, less complications, easier recovery

an ___ can occur at the attachment site and is flow within aneurysm sac

endoleak

if AAA is growing at greater than 5mm from previous measurement, endoleak is probable

what is a type 1a endoleak

endoleak origin at proximal stent attachment site

what is type 1b endoleak

endoleak origin at distal stent attachment site

what is a type 2 endoleak

endoleak originating from branch vessel due to an existing aneurysm

—> thats why it is important to stent branches too

what is a type 3 endoleak

endoleak originating at junctions between components of modular devices or fabric tears within the graft

what is a type 4 endoleak

transgraft flow filling aneurysm sac

due to porosity of graft

__ is when an aneurysm sac increases in size without an endoleak

endotension

on CT, a fresh thrombis will be __ and an old thrombus will be __

hypoechoic - fresh

hyperechoic - old

__ flow is weakened, dampened waveform usually in the distal aorta waveform is there is a leak

tartasparvas flow

post graft, we should check for

aneurysms

pseudoaneurysm

stenosis

endoleak

blood flow

fluid collections

• hematomas

• lymphoceles

• seromas

• abscesses

the most common complication with stents and grafts are …

leaks

__ can be confused with being an AAA

lymphoma

fibroid uterus

retroperitoneal tumor (sarcoma)

pancreatic carcinoma

horseshoe kidneys

when looking at lymphnodes, they will be surrounding the ..

aorta / mesenteric

hypoechoic

always check spleen for spleenomegaly

AVM stands for

arteriovenous malformations or fistulas

__ are an abnormal connection between vein and artery

AVM

most secondary to trauma

possible complication of arteriosclerotic AAA

multiple tubular structures feeding malformation

an __ aneursym may be athersclerotic, posttraumatic, mycotic, congential, or inflammatory

splanchnic

HA, SA, SMA, IMA, GDA

patients with chronic pancreatitis at risk