MBChB Year 5 CHM5003W: Surgery Jason Harry (HRRJAS005)

9. Mesenteric Ischaemia: Small = 4 5.5. cm in diameter; Large = > 5.5 cm

in diameter (high risk of rupture!)
Pathophysiology of Arterial Disease: Clinical Features: (1) asymptomatic, (2)
symptomatic, (3) complicated
3. Arterial Aneurysms:

Definitions:
Subclavian Aneurysms:
Aneurysm Focal permanent dilatation of
an artery > 1.5 x the normal Renal Artery Aneurysms:
diameter for that particular
artery
Ectasia Focal dilatation of an artery >
than the normal diameter, but
< 1.5 x the normal diameter.
Arteriomegal Similar to ectasia, nut the
y entire arterial segment is
diffusely dilated.

Classification of Arterial Aneurysms:

NO uniform classification may be classified
according to:

Anatomical 1. Aortic (AAA, TAAA, TAA)

Location: 2. Non-aortic (peripheral,
renal, mesenteric, carotid,
subclavian, rare)
Morphology: 1. Fusiform (spindle-shaped)
2. Saccular (outpunching)
Femoral Aneurysms:
Size: 1. Small
2. Large
Aetiology: 1. Degenerative Popliteal Aneurysms:
2. Infective
3. Inflammatory/vasculitic Extracranial Carotid Aneurysms:
4. Connective tissue
disorders Mesenteric Artery Aneurysms:
5. Post-dissection
6. Post-stenotic
7. Trauma Abdominal Aortic Aneurysms:
8. Congenital Most common non-specific, degenerative
Typical patient = elderly (>65) Caucasian male
Classified anatomically as: (1) infra-renal (90%),
(2) juxta-renal, (3) para-renal, (4) supra-renal, (5)
TAAA
Pathophysiology: many theories, including
uncontrolled hypertension,
hypercholesterolaemia, smoking, infection,
protease/anti-protease imbalance