“ Considered either true (aneurysm bound by all three walls of the vessel) or false (pseudoaneurysm, part of the wall of the aneurysm is for...
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Considered either true (aneurysm bound by all three walls of the vessel) or false (pseudoaneurysm, part of the wall of the aneurysm is formed by surrounding soft tissue). Aneurysms are described as being saccular or fusiform.
- Saccular aneurysms are eccentric in shape, the aneurysm only forming from part of the circumference of the vessel wall. Associated with mycotic aneurysms.
- Fusiform aneurysms involve the full vessel circumference and feature cylindrical dilatation. More commonly seen with atherosclerotic aneurysms
CT
• Thoracic aortic aneurysms are mostly atherosclerotic and calcified in 75%. Other causes include cystic medial necrosis (a disorder of the large arteries with formation of cyst-like lesions in the media, associated with e.g. Marfan and Ehlers-Danlos syndromes) and syphilis (expect extensive calcification).• Abdominal aortic aneurysms —mostly atherosclerotic.• Popliteal aneurysms, associated with an Abdominal aortic aneurysms in 30%-50%.
INTERVENTION
• Advised when diameter >5.5 cm (the risk of rupture is greatly increased over this).• Endovascular stents are generally oversized by 10%. The presence of perigraft air is a common finding in the immediate post-operative period; however, if present >1 week after surgery, suspect infection.• Endoleak is defined as the continued perfusion of the aneurysm despite placement of a stent graft
Saccular aneurysm. CT angiogram demonstrating a saccular aneurysm arising from the abdominal aorta
Fusiform aneurysm. CT angiogram demonstrating a fusiform abdominal aortic aneurysm.
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