AAA

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AAA

• Tim Brandys MD MEd FRCSC

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CASE PRESENTATION

• 69 yo male presents to the office for an annual
  check up .He is having no symptoms .His past
  medical history is significant for a myocardial
  infarction 9 years ago ,mild hypertension and 40
  pack year smoking history.
• On screening physical exam he is noted to have a
  pulasitile mass in the midline of the upper
  abdomen and no other obvious abnormalities.

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What other facts on history are significant ?
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HISTORY

• History of present illness
• Family history
• Risk factor assessment

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Specific findings on physical exam ?
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Define AAA ?
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What are the risk factors for development of an
AAA?

• Hint There are 10 or more

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Who should be screened for AAA?
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What investigations does this patient require?
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Investigations
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Physical Exam
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Plain x-ray
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Ultrasound
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Angiogram
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CT SCAN
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In what ways do aneurysms present ?
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Ruptured AAA
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What are the possible complications of an
untreated AAA ?
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Complications AAA
RAAA
Ann Rate Rupture lt4cm ..0 lt5 ..
lt5 5-5.9..10 6-7 15 7-8 30 gt8 40
Emboli
Aortoenteric Fistula
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What is the management of a patient with a
symptomatic or asymptomatic aneurysm ?
Risk Surgery
Risk Surgery
Risk Rupture
Risk Rupture
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What Surgical Procedures are available for AAA?
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OPEN REPAIR
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Stent Graft Repair
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What are the possible complications of Surgery ?