Abdominal aortic aneurysm

on 17.3.09 with 0 comments

  • abdominal aorta is most common site for aortic aneurysm

CT scan

  • aorta shouldn’t be that big

  • white is blood, but there is a thrombus around it


  • most common site: infrarenal aorta—above the iliacs

  • when you open the aortas up, they are packed in with thrombus


  • destruction and thinning of aortic media

  • atheromatous changes

  • usually, large thrombus


  • atherosclerosis and hypertension

  • genetic factors (“this is sort of disturbing because my uncle had one”)

  • imbalance in collagen degradation and synthesis, related to inflammation

Clinical features

  • rupture: massive, often fatal hemorrhage

  • obstruction of branch vessel—ischemia

  • impingement of adjacent structures

Risk of rupture increases with size

  • <>

  • 5 cm or above: 11% per year, which is when vascular surgeons intervene

  • Laplace’s law: at constant pressure, surface tension is directly related to radius, so if the blood pushes the wall out a bit, then the surface tension increases, weakening the wall; then the blood pushes the wall out a little bit more, and surface tension goes up and the wall gets even weaker, and eventually the wall rips open


  • open surgery

  • endovascular stents

  • treat before rupture. after rupture, mortality is 50%

Category: Medical Subject Notes , Pathology Notes



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