Endovascular Grafting for Abdominal Aortic Aneurysm Repair

47 Pages·2004·0.17 MB·English

by  Liane Santilli

Endovascular
Grafting for
Abdominal Aortic
Aneurysm Repair
Liane Santilli, CRNA, MHS
Allegheny General Hospital
What Is an Aneurysm?
Weakening and
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dilatation of the
vascular wall,
primarily in the
infrarenal area
between the aortic
bifurcation and the
renal arteries
Statistical Data
1.5 million people have abdominal
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aortic aneurysm in the United
States
190,000 cases are diagnosed each
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year
Annual mortality rate from rupture
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is 15,000 patients—13th leading
cause of death in the United States
Related
Pathophysiology
Hyperlipidemia/Atherosclerosis
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Hypertension
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Familial History
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Men>Women
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Age>60
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Enzyme Abnormalities
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Connective Tissue Disorders
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Smokers
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High Risk Patients
Severe Pulmonary Disease
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Severe Coronary Artery Disease
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Chronic Renal Insufficiency
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Cirrhosis
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Previous Abdominal Surgeries
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Obesity
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Metastatic Cancers
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Signs and Symptoms
Pulsatile mass
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Back pain
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Abdominal aches and pains
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Sudden and severe pain is
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indicative of impending rupture
Complications-Rupture
Rupture of an aneurysm results in
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significant blood loss and death in
85% of patients
Arrive at the hospital but rarely
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survive
Occurs in 60% of patients with
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aneurysm > 6cm
Diagnosis of Aneurysms
Routine physical exam
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Abdominal ultrasound
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X-rays
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CT scan vs. MRI
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Angiography
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Pre-Operative
Considerations
Cardiovascular
CAD present in 30-40% patients
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HTN-Tight BP control
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Baseline EKGs
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Stress Test with severe CAD
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Echo if possible
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Pre-operative
Considerations
Respiratory
Smoking associated with COPD
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Chest X-ray
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Baseline PFTs
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Baseline ABGs
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Respiratory meds/inhalers
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Pre-operative breathing treatments
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