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Aortic_Dissection_and_Aneurysms

Aortic_Dissection_and_Aneurysms - Aortic Dissection and...

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Aortic Dissection and Aneurysms
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Definition Aneurysm focal dialation greater than 1.5 times normal diameter True aneurysm contains all layers of arterial wall False aneurysm dialation covered by thick fibrinous capsule Dissection tear of intimal layer allowing blood to dissect between intima and adventitial layers
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Location Aneurysms Anywhere in arterial tree greatest incidence in infrarenal abdominal aorta Dissections 95% in the ascending and descending aorta 5% in aortic arch and abdominal aorta
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Risk Factors Familial History 20% of patients with AA have first Degree relative Connective tissue disease Marfans Ehlers-Danlos Atherosclerosis (90%) Smoking Hyperlipidemia Diabetes Gender Males > Females Age
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Marfans Syndrome
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Ehlers-Danlos
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Pathogenesis Damage to arterial wall from risk factors weakens vasculature Law of Laplace Wall Stress = pressure x radius Bottom Line Greater the diameter greater the wall stress Growth rate 0.25 – 0.5 cm year Aneurysms > 5.0 cm greater risk of rupture
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  • Winter '11
  • LaurieBlondy
  • Aortic dissection, descending Aorta, Abdominal aorta, infrarenal abdominal aorta, Anterior chest pain

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