Aneurysm Case Studies

Aneurysm Case Studies
In the case of this patient, the patient has been admitted after an abdominal aortic aneurysm (Jim &
Thompson, 2015). An abdominal aortic aneurysm can happen because of the wall surrounding the
aorta is compromised and becomes weak (Jim & Thompson, 2015). When the wall is compromised,
the blood can seep out and create issues, therefore the aneurysm is seen (Jim & Thompson, 2015).
There are many risk factors that may increase the chances of having an abdominal aortic aneurysm
such as smoking, hypertension, other aneurysms and being male (Collins, 2013). In order to assess
the aneurysm, there are 2 lab tests that need to be performed to get an accurate understanding and
those are the pulmonary artery pressure, or PAP, and the pulmonary artery wedge pressure, or PAWP
(Silvestry, 2015).
In order to perform the tests accurately the test must be zeroed, or setting it back to where nothing
else can intervene with the testing (Silvestry, 2015). The test must also use referencing, or the ability
to have a starting line when the test is concluded. The reference is something to compare to,
therefore, creating a value that can be used as a comparison (Silvestry, 2015). It is also important
when performing these tests that the placement is ... Show more content on Helpwriting.net ...
These values are important to have to understand the severity of disease process that is causing the
problem. For the PAP value, the result should be between 10 and 22 (Silvestry, 2015). This range is
important because any value outside of this range can signify a more serious disease process such as
a myocardial infarction, and possibly a form of stenosis (Silvestry, 2015). When looking at the
PAWP value the result should be between 6 and 15 (Silvestry, 2015). This value is also important
because this test can show a disease process such as hypervolemia (Silvestry, 2015). Both values
should be decreased with the patient having hypovolemia (Silvestry,
... Get more on HelpWriting.net ...

A Subarachnoid Hemorrhages
A Subarachnoid Hemorrhage, or SAH, is devastating and usually has a traumatic outcome.
Basically, an SAH is bleeding that occurs between the brain and what surrounds it. This surrounding
area is known as the arachnoid, thus the reasoning behind the name. The main cause of SAH is
cerebral, or brain aneurysms, because aneurysms usually have more fragile walls than normal
vessels, putting them at more of a risk to rupture. Subarachnoid hemorrhages are not something to
be taken lightly, as they have many dangers. Many people lack awareness of the dangers
accompanied with subarachnoid hemorrhages as soon as they occur, during the treatment of them,
and even with life after surviving the hemorrhage. First, as soon as a subarachnoid hemorrhage
occurs, there are many dangers to consider. While a brain aneurysm may not have any symptoms, an
SAH does and they are unfortunately very sudden. Since an SAH is bleeding from the arteries, the
rupture causes abrupt bleeding. From The Gale Encyclopedia of Medicine, Ms. Julia Barrett
describes that the immediate danger caused by subarachnoid hemorrhages would be ischemia. She
states, "Ischemia refers to tissue damage caused by restricted or blocked blood flow. The areas of
the brain that do not receive adequate blood and oxygen can suffer irreparable injury, leading to
permanent brain damage or death," thus agreeing that danger is present from the very start with
subarachnoid hemorrhages (Barrett). The rapid bleeding outside of the brain

Portal Vein Aneurysms
Discussion: Occurrence of venous aneurysms remains much less common when compared to
arterial ones. However with extensive use of cross–sectional imaging, the incidence portal vein
aneurysms have increased. Over 210 cases have been described since the first case report in 1956 by
Barzilai and Kleckner [6].They represent about 3% [6]of all venous aneurysms and a reported
prevalence of 0.43%[7]. There is no correlation between incidence of portal aneurysm and age or
sex of the patient [7]. Portal vein aneurysms may be congenital or acquired. However the exact
etiology is still controversial. Congenital variety is believed to develop from persistent right vitelline
vein which later on enlarges to form saccular aneurysm [8]. Acquired aneurysms ... Show more
content on Helpwriting.net ...
Thus a diameter of greater than 20 mm is regarded as aneurysm. The intrahepatic portal branch
aneurysms are considered if they measure greater than 7 mm in normal and 8.5 mm in cirrhotics [1].
The two most common locations for venous aneurysm are the main portal vein and at the
splenoportal confluence [6]. In this case, we encountered with aneurysmal dilatation of extra–
hepatic portal vein extending upto confluence of SMV and splenic vein. The typical B–mode
ultrasonography finding is a hypoechoic or anechoic structure at porta hepatis. Doppler shows
monophasic colour flow in it, thus differentiating it from a liver cyst. It may mimic a tumor due to
presence of echogenic mural thrombus. Ultrasound with Doppler study is an excellent tool for
demonstrating and monitoring the size of the aneurysm. Contrast enhanced CT and magnetic
resonance angiography is helpful in case of equivocal ultrasound findings or to make out the exact
anatomical detail for pre–operative planning; however in most instances, ultrasound is sufficient to
make final diagnosis [6]. Most portal venous system aneurysms are asymptomatic. External
compression and rupture are rare complications. Complete and non–occlusive thrombus in portal
vein occur in 13.6% and 6%, respectively

Intracranial Aneurysm Case Study
DSA iSAP Clinical Action Plan
Clinical Concerns and Imaging Goals
An intracranial aneurysm occurs when a blood vessel's structure is compromised, resulting in a focal
dilation of the vessel. These aneurysms have a propensity to rupture, when a sudden increased
arterial pressure forces blood into the subarachnoid space. This results in a subarachnoid
haemorrhage (SAH) and could "have catastrophic clinical consequences for the patient". Aneurysms
of the anterior communicating artery (ACommA) make up the majority of intracranial aneurysms
and account for 40% of SAH. Depending on several variables, such as the extent of the SAH, there
is an associated 30–day mortality of approximately 45%, survival morbidity of 50%, and possible
prognosis of a ... Show more content on Helpwriting.net ...
A medium FOV will be used to image the necessary arteries.
After the power injector parameters are selected, it is connected to the catheter. 4 mask images of
the anterior cerebral circulation are first taken within the 2s delay period, before the imaging
sequence is performed with contrast injected (Table 2).
A microcatheter is then advanced through the end–hole catheter, into the ACommA. This will allow
the delivery of embolization material, in this case an embolization coil, to ensure cessation.
Post–intervention images are then taken to confirm the ACommA aneurysm has been embolized,
with no extravasation of contrast.
Post–procedure The catheter once removed, will have compression done over the insertion point to
allow haemostasis.
The patient's vital signs and puncture site continue to be monitored back at the observation ward.
The standard protocol to visualise the anterior cerebral circulation comprises of sequence
acquisition in PA, Lateral and transorbital oblique views. Whilst the former two views aid in
providing a good overview of the arteries, the transorbital oblique view helps to pinpoint the
location of the anterior communicating artery

Abdominal Aortic Aneurysm
Pathophysiology of Abdominal Aortic Aneurysm
An abdominal aortic aneurysm (AAA) is defined by Gordon and Toursarkissian as, "A dilation of
the vessel diameter of more than 150% of the diameter just proximal to it" (Gordon &
Toursarkissian, 2014). It is stated that in general, a diagnosis of an AAA is made if the aortic
diameter is three centimeters or larger (Gordon & Toursarkissian, 2014). The etiology of an AAA is
largely complex in which both environmental and genetic factors play vital roles, the most important
being smoking (Björck & Wanhainen, 2013). Abdominal aortic aneurysms may be secondary to
atherosclerotic changes, inflammatory conditions, infectious diseases, trauma or genetic collagen
disorders (Gordon & Toursarkissian, 2014). ... Show more content on Helpwriting.net ...
The decision to have surgery, and if so, whether to have open surgical repair or EVAR, relies heavily
on patients' preferences, yet little is known about the patient perspective (Berman, Curry, Gusberg,
Dardik, & Fraenkel, 2008). One way to protect research participants is through an informed consent.
Informed consent is a process used by researchers to provide potential and enrolled participants with
information about a clinical study ("Learn About Clinical Studies," 2015). The informed consent
process is intended to protect participants and should provide enough information for a person to
understand the risks of, potential benefits of, and alternatives to the study ("Learn About Clinical
Studies," 2015). Signing the document and providing consent is not a contract as participants may
withdraw from a study at any time, even if the study is not completed ("Learn About Clinical
Studies," 2015). Some patients choose to participate in clinical research trials because there are no
current treatments available, while others only participate if other options haven't been able to help
them (Lopienski, 2014). However, some may be reluctant to participate. "Unknown outcomes,
uncertainty if a new treatment can help them, being experimented on, possible

Abdominal Aortic Aneurysm Essay
Pathophysiology Behind Abdominal Aortic Aneurysms
The abdominal aorta supplies oxygenated blood to the abdomen, pelvis and legs. An abdominal
aortic aneurysm arises when a weakened area of the arterial wall within the abdomen becomes very
large and begins to distend outward; therefore, creating an increased susceptibility to rupture under
high pressure (Eagleton, 2012). The majority or abdominal aortic aneurysms are located inferior to
the kidneys and in order to be considered an abdominal aortic aneurysm, the local dilation must be
1.5 times its normal aortic diameter or greater than 3cm in diameter (Sun, 2012). There are two
main types of abdominal aortic aneurysms, both acquired and congenital. Predisposing factors
associated with acquired ... Show more content on Helpwriting.net ...
Wang and Tao (2015) explain that advanced technology will help diagnose these cases earlier. With
the help of improved operative skills and conservative treatment, hope to decrease the mortality rate
looks promising for future cases (Wang & Tao, 2015).
Signs and Symptoms
Aneurysms can develop slowly often with no symptoms, but symptoms may arise quickly upon
rapid expansion. With an abdominal aortic aneurysm, patients typically exhibit abdominal pain,
tachycardia, presence of a palpable, pulsatile abdominal mass, a bruit heard over the abdominal
aortic aneurysm, severe dyspnea, lower extremity edema, and elevated central venous pressure
(Kotsikoris et al., 2012). People may also experience pain near the back, abdomen, or flank, usually
signs impending rupture.

Aneurysm Definition
In between the tree–covered hills of Sand Run Metro Park lies a quiet street where I spent summers
at my grandmother's house. Each day, my grandmother planned an adventure; while most
adventures ended in a delicious black raspberry ice cream cone from our favorite creamery, one
distinctly ended with a scar. On another sweltering day, anticipating the adventure ahead, I buckled
into my grandma's car wearing my favorite watermelon sundress. When we pulled up to the state
fairgrounds, I immediately proclaimed where I wanted to go first, the horse barn. Moments after
entering the barn, a spooked mare kicked me in the forehead; my next memory consists of my
grandma applying pressure to my head and comforting me while I cried about getting blood ... Show
more content on Helpwriting.net ...
The moment we established a new routine, the discovery of an aneurysm challenged us to make
life–altering decisions. Unsure of how to battle cancer and treat the newly discovered aneurysm, a
compassionate physician approached to discuss our options. My family struggled with choosing
between surgical intervention or palliative care until the same physician assured us that she would
provide excellent comfort care and maintain my grandmother's dignity. The kind reassurance that
choosing to avoid the suffering and risk of surgery would not result in extreme pain or discomfort
enabled my family to find comfort in the painful decision. The experience of accompanying my
grandma as she struggled through cancer and illness demonstrated the value of a compassionate and
knowledgeable physician. A physician who spends the time to listen, answer questions, and comfort
the family makes a positive impact even when there is no cure. The perseverance through the
struggles of witnessing her illness and caring for her needs assured me that I posses the qualities
necessary to provide the care for others in their vulnerability and

Clipping Of Aneurysms Essay
"It's not stress that kills us, it is our reaction to it." That is a famed quote from Hans Selye, a famous
Hungarian endocrinologist, that relates to moments when a life is in a physician's hands. One wrong
move of a doctor and a patient could die. Learning to overcome fears and concentrate on the task at
hand is the most needed skill for a surgeon, a brain surgeon to be exact. Focusing on the central
nervous system I can fix the abnormalities and diseases of the brain. One of the highest pressure
surgeries neurosurgeons perform are the clipping of aneurysms.
Aneurysms are a ballooning and weak area in the wall of an artery that supplies blood to the brain.
They can burst at any moment and cause a subarachnoid hemorrhage, which is bleeding under the
layer of brain coverings called the arachnoid. This can cause increased intracranial pressure which
can lead to a stroke or even death if they aren't discovered in time. They most commonly occur in
the Circle of Willis in the anterior cerebral artery. ... Show more content on Helpwriting.net ...
I always send my patients to get an MRI or magnetic resonance image if they are complaining of
acute cephalalgia, which is a sudden and painful headache. This can mean many things but one of
the most serious reasons is the bursting of an aneurysm. In addition, I saw on her chart she had a
family history of deaths caused by ruptured aneurysms. Once her scans came back I saw indeed that
she had an immense ruptured aneurysm in her anterior cerebral artery which supplies blood to the
midline portions of the frontal lobes and superior medial parietal lobes. This meant that she would
need to be rushed into emergency surgery to clip her aneurysm. This is a life or death situation that
needs to be solved within

Aneurysm Research Paper
Understanding Aneurysm Treatment Bridgewater Surgeons Answer Your Questions.
Advanced Vascular Associates offers Aneurysm treatment Bridgewater residents can depend on to
help manage their health. Aneurysms can present for a variety of reasons and in many parts of the
body. Surgery is often recommended unless a patient has underlying medical conditions that would
put the patient at risk for complications.
Understanding Aneurysm Causes & Treatment
Weaknesses in blood vessel walls may develop an abnormal widening. This "ballooning" is called
an aneurysm. Some defects in arteries are congenital, others develop without a clear reason at
various stages of life. Surgeons have repaired aneurysms in the brain, lower extremities, intestines,
the heart

Aneurysm Report
First Report of Congenital Right Ventricular Aneurysm with Transmural Late Gadolinium
Enhancement
Clinical Presentation
A 42–year–old woman in her third trimester of an otherwise uncomplicated pregnancy was referred
with suspected fetal right ventricular (RV) structural abnormality. A fetal echocardiogram found a
moderate–sized, broad–based outpouching from the RV anterior wall. Infant was born at 40 weeks
gestation (birth weight 3.7 kg) and was asymptomatic with a normal electrocardiogram.
Echocardiography demonstrated a poorly contracting, thin walled aneurysm of the basal, anterior
RV free wall with qualitatively moderately depressed global RV dysfunction. Cardiac magnetic
resonance (CMR) examination was requested to better characterize the lesion and quantify
ventricular size and function.
Diagnostic Techniques and Important Findings:
As seen in the figure, CMR revealed a large, broad–based aneurysm (12 mm x 25 mm) at the base
of the right ventricle, under the anterior aspect of the tricuspid valve annulus. The aneurysm was
thin–walled with paradoxical motion and transmural late gadolinium enhancement (LGE). Global
right ventricular systolic function was moderately depressed with and ejection fraction of 31%. Left
ventricular size and ejection ... Show more content on Helpwriting.net ...
To our knowledge, there are no reports of LGE imaging in this lesion. This case shows the utility of
CMR in: 1) estimating the size and shape of the aneurysm including the defining its communication
with the ventricle which may be helpful in estimating risk of thrombosis, 2) tissue characterization
of the aneurysm wall, 3) estimation of right ventricular size and function including regional wall
motion abnormalities, 4) and excluding other possible diagnoses. The presence of transmural LGE
may also provide insight into the pathophysiology of this lesion which is, as yet, not well

Hesi Hypertension Essay
Assessment
Mr. Dunn's blood pressure reading is 189/110. His LDL cholesterol reading is 200 mg/dl. He asks
the student nurse if he should be concerned about his blood pressure.
1.
How should the student respond?
A) "Your blood pressure is very high. You need to see your healthcare provider today."
INCORRECT
Mr. Dunn's blood pressure is high. The student nurse needs to assess for other symptoms before
making the determination that the healthcare provider must see him that day.
B) "You have hypertension. You need to start making some lifestyle changes."
INCORRECT
The diagnosis of hypertension is not made until the client has an elevated blood pressure on two
different occasions.
C) "Please sit here quietly for a few ... Show more content on Helpwriting.net ...
C) "Hypertension is called the silent killer. I'm sure that you don't want to die at your young age."
INCORRECT
While this answer may scare the client, it does not help the client understand the disease process.
D) "It is always better to treat high blood pressure before you start having symptoms."
INCORRECT
This is true, but does not provide the client with the best information needed at this time.
A week later, Mr. Dunn has an appointment with his healthcare provider. After the exam, the
healthcare provider explains to Mr. Dunn that he has stage 2, primary (essential) hypertension.
5.
What information obtained during the assessment supports this diagnosis?
A) Blood pressure of 184/98.
CORRECT
Stage 2 hypertension is described as a Systolic blood pressure of greater than or equal to 160 mm
Hg or a Diastolic blood pressure of greater than, or equal to, 100 mm Hg.

B) Family history of hypertension.
INCORRECT
This is a risk factor not a symptom of primary hypertension.
C) Irregular pulse rate of 110.
INCORRECT
Pulse rate and rhythm do not affect blood pressure classification.
D) An auscultated heart murmur.
INCORRECT
A heart murmur does not directly support the diagnosis of stage 2 hypertension. However, a heart
murmur may be a reflection of a problem that caused the client's hypertension. If a cause for the
hypertension is found, the client would then be diagnosed with secondary hypertension.
The healthcare provider

Aneurysm Research Journal
Research Journal #3 – Left Ventricular Aneurysm Charity Rominger
Summary
The Tokyo Women's Medical University shared a new method to repair an aneurysm of the left
ventricle of the heart. The technique did not require cutting the ventricle with a ventriculotomy that
is necessary with other methods such as plication or circular patch. With this method of repair, the
weak wall of an aneurysm was pushed into the ventricle and stitched in place. This type of repair is
possible as long as the aneurysm wall is pliable, the damaged area is not too large and there is no
thrombus in the ventricle.
Reflections The method of repair utilized by the Tokyo Women's Medical University sounds very
interesting and promising for patients that need less invasive techniques due to other health issues.
The patient, in this case, had multiple co–morbidities and they were also on hemodialysis. The
article mentioned the need for less ... Show more content on Helpwriting.net ...
The article only followed the patient up to 15 days post–operative when the patient was discharged
from the hospital. I am curious how the patient recovered and if there were any other complications
that developed later. Did the patient require anticoagulants or did they experience any thrombus
issues from the repair and how well did the repair hold? I wish the article had gone into more details
about the long–term recovery of the patient and the success of the technique. This article also made
me curious about how a ventricular aneurysm develops. Does the outer pericardial layer bulge with
an aneurysm or is it missing or damaged and thus allows the ventricle to bulge? Knowing that the
pericardium does not bulge with a cardiac tamponade nor does it give way when the ventricles
hypertrophy makes me curious as to how the ventricle is able to bulge out with an aneurysm if the
pericardium is present. This aspect of a ventricular aneurysm was not covered in the article

Aneurysms Essay
To begin with, the word aneurysm derives from the Latin word "aneurysma." In Latin "aneurysma"
means dilation and dilation means that act of expanding. From this, it is easier to figure out what an
aneurysm really is. The definition of the English word aneurysm means, blood–filled dilation of a
blood vessel. There are several different types of aneurysm, but this report will only cover a cerebral
one. Intracranial aneurysms are classified as dissecting, saccular, and fusiform. There are many
causes of intracranial aneurysms. Some of the most common causes would include fibromuscular
dysphasia, atherosclerosis, and arteriovenous malformation. Some that are less common, but do
occur would include drugs, infection, and trauma. Dissecting ... Show more content on
Helpwriting.net ...
Saccular aneurysms are the most common and are easily identified because of the berrylike sacs on
the veins or arteries. They are caused by weakness in the vessel wall layers. The sac itself grows
from the intima and adventitia of an vessel. When this occurs abnormal hemodynamic pressure on
the cerebral arteries causes rupture. Saccular aneurysm can be caused by infections, tumors, or
drugs. Aneurysms occur to people in their early forties to their late fifties. Most aneurysms occur to
people that are around age sixty. Intracranial aneurysms are rare to children and only account for 2%
of the total aneurysms. The younger the patient with an intracranial aneurysm the larger the sac.
Location is a big part in classifying the type of aneurysm. About 86.5% of all intracranial aneurysms
occurs in the carotid region. The pieces all fall to place when using the Hunt and Hess scale, which
measures the current status of the expansion. There is a grade 0 to grade 5 scale. Zero is a non
ruptured aneurysm and 5 is basically the point were there is not much doctors can do to make the
patient live. Vasospasm is the term used when a constriction of a vein or artery occurs. It is also the
cause of death when an aneurysm occurs. More than 50% of all surviving patients that get an
intracranial aneurysm have neurological defects. Treatment is wonderful when treating intracranial
aneurysm. The most common approach is surgery, because blood

Aortic Aneurysm: A Case Study
The aorta is the largest artery in the body, responsible for providing oxygen to the entire body. An
aortic aneurysm occurs when an artery wall of the aorta weakens. The weakening then causes the
wall of the aorta to expand and bulge out (United States National Library of Medicine, 2014).
Dilation of at least one and a half times the normal diameter of the aorta is qualification for an
aneurysm (Novaro, 2014). Nearly 50,000 deaths in the United States annually can be attributed to a
thoracic aortic aneurysm (McLarty, A. J., Bishawi, M., Yelika, S. B., Shroyer, A. L., & Romeiser, J,
2015). Although the aorta runs from the heart through the abdomen, the section that runs through the
chest is the thoracic aorta. Three specific areas susceptible to development of an aneurysm include
the ascending aorta, aortic arch, and descending aorta (Elefterides, J., Sang, A., Kuzmik, G., &
Hornick, M, 2015).
Risk factors for the development of a thoracic aortic aneurysm include; hypertension, high
cholesterol, smoking, obesity, family history, and older age (United States National Library of
Medicine, 2014). Atherosclerosis or hardening of the arteries is especially prevalent in patients with
descending aortic aneurysms. In a study by ... Show more content on Helpwriting.net ...
Z., Halperin, J. L., Marin, M. L., Stewart, A. S., Eagle, K. A., & Fuster, V, 2014). Hypertension
leads to tremendous stress on the aortic wall and can ultimately lead to aortic dissection. Research
has also demonstrated a possible family connection in the diagnosis of thoracic aortic aneurysm. In
a study by the Journal of the American College of Cardiology, twenty one percent of thoracic aortic
aneurysms individuals have a relative with a known aneurysm. These same individuals
demonstrated higher aorta growth rate and were diagnosed at an earlier age (Elefteriades & Farkas,

Emergency Surgery Is Caused By Weak Blood Vessels That...
Brain aneurysms are caused by weak blood vessels that balloon and fill with blood which can fatally
rupture. Once an aneurysm has ruptured, emergency surgery is needed to prevent the patient from
suffering a subarachnoid hemorrhage, a fatal type of stroke. The insertion of a detachable embolic
coil can prevent rupturing of aneurysms and the need for emergency surgery. A technical study was
conducted which used an experimental model constructed in the necks of swine to simulate a
specific type of brain aneurysm (1). A combination of stents and Guglielmi Detachable Coils were
then inserted to inhibit the fatal bleeding into the brain. This research concluded that the Guglielmi
Detachable embolic coil is a high impact device because it can ... Show more content on
Helpwriting.net ...
Once this wire to correctly inserted within the aneurysm, a 1 mA current is exerted on the delivery
wire. The current is meant to dissolve the steel delivery wire close to the platinum coil. This process
is done by electrolysis so simultaneously the positively charged platinum will attract the negatively
charged red and white blood cells, and platelets which causes intra–aneurysmal thrombosis. If
thrombosis does not happen immediately, coils also most likely enforce critical protection against
re–hemorrhage by reducing blood pulsations inside the aneurysm and sealing the weak portion of
the blood vessel's wall. Eventually thrombus will build within the aneurysm and the aneurysm is
excluded from the parent blood vessel by a layer of connective tissue. This has been successfully
demonstrated in experimental dog models that were effective in producing thrombosis of the
aneurysm and suggest that the design is useful in the endovascular treatment of aneurysms (2). Once
this electrolysis process has occurred, the delivery wire can be taken out, leaving the the coil in the
proper position. Now an additional coil can be inserted into the aneurysm and this process can be
repeated until the aneurysm is densely filled with the coils to prevent it from rupturing. The coils are
constructed from platinum alloy wire that is made into the primary coil first, and then formed

Physical Status Score Improves Predictions Of Survival...
Full title: Self–reported fitness combined with American Society of Anaesthesiologists Physical
Status Score improves predictions of survival after endovascular aneurysm repair
Category: Original article
Short title: Combining self–reported fitness and ASA improves survival predictions after EVAR
Authors:
Mary Barnes (BAppSc, GradDipMath)1 , Margaret Boult (BSc (Hons), GDIM)2, Prue Cowled
(BSc(Hons), PhD)2, Robert A Fitridge (MS, FRACS)2
Affiliations:
1CSIRO, Adelaide, South Australia 5000, Australia
2Discipline of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Woodville,
South Australia 5011, Australia
Corresponding author:
Professor Robert Fitridge,
Discipline of Surgery, The Queen Elizabeth Hospital,
28 Woodville Road, Woodville South, South Australia, 5011, AUSTRALIA
Telephone number: +61 8 8222 7711, Fax number: +61 8 8222 6028
Email: robert.fitridge@adelaide.edu.au
Source of Funding: This study was funded from a project grant (565335) awarded by the National
Health and Medical Research Council of Australia
Keywords: Endovascular procedures; aortic aneurysm, abdominal; physical fitness, ASA, mortality;
registries; aged.
Abstract
Introduction:
Although the American Society of Anaesthesiologists Physical Status Score was established for
statistical purposes, it is often used prognostically. However, older patients undergoing elective
surgery are most often classified ASA 3, which limits the ability to stratify patients. We look at the

Aortic Aneurysm Essay
An aneurysm is a life–threatening arterial disease in which the wall of arteries dilates permanently.
The aortic aneurysm mainly occurs in the thoracic and abdominal regions of the aorta and can lead
to the aortic dissection or rupture resulting in mortality and morbidity of patients. It is believed that
multiple factors play roles in the initiation and progression of this disease. However, the underlying
causes of the aortic aneurysm and its failure have not been fully understood yet. The current work
aims to investigate the failure mechanisms of Ascending Thoracic Aortic Aneurysms (ATAAs) from
a biomechanical perspective by considering the histological and morphological changes of the
ATAAs. The regional mechanical, histological, and physiological properties of aneurysmal and
control human ascending aortas were examined to characterize the behavior of the aortic materials
and to explore the inter–correlations of these properties. Mechanical and histological experiments
were performed on the samples excised from four different quadrants of the aortic rings and the
results were analyzed using numerical and statistical methods. To study the effects of genetics, the
aneurysmal samples were categorized based on their valve types into two tissue groups: those with
Bicuspid Aortic Valves (BAV) and those with Tricuspid Aortic Valves (TAV). ... Show more content
on Helpwriting.net ...
The aortic aneurysm can lead to aortic dissection or rupture resulting in mortality and morbidity of
patients. It is believed that multi–factor play roles in the initiation and progression of this disease.
However, the underlying causes of the aortic aneurysm and its failure have not been fully
understood yet. The current work aims to investigate the failure mechanisms of Ascending Thoracic
Aortic Aneurysms (ATAAs) from a biomechanical perspective by considering the histological and
morphological changes of the

Intracranial Aneurysm Research Paper
Ruptured Saccular Intracranial Aneurysm associated with Arteriovenous Malformation
Introduction
An arteriovenous malformation (AVM) is an abnormal collection of blood vessels in which arterial
blood flows directly into the draining vein without the normal interposed capillaries. AVM are
tangled anastomosis of blood vessels of varying calibre in which arteriovenous shunting occurs in a
central nidus in which the area towards in which multiple feeding arteries converge and from which
enlarged vein drains.1 They have a higher rate of bleeding than normal vessels. AVMs can occur
anywhere in the body. Brain AVMs are of special concern because of the damage they cause when
they bleed. The incidence of AVM is about 1 in 100,000 per year in unselected ... Show more
content on Helpwriting.net ...
Another hypothesis is that these associations can accidentally exist together.20 Among these
hypothesis, the hemodynamic stress secondary to the increased blood flow of AVM plays a
significant role to provoke this coexistence of lesion.1,21 This hypothesis is supported by a report
showing that the associated aneurysms tend to be concentrated in feeding arteries which supply
AVM and the associated aneurysms may shrink in proportion to the occlusion of the AVM. 3
The incidence of intracranial aneurysms is higher in patients with intracranial AVM than in the
general population. This incidence varies from 2.7 to 23% in the literature.1, 22 Four types of
aneurysms occur in association with AVM are: [1] Unassociated aneurysms: this type of aneurysm
occurs on the circle of Willis in a location that is not associated hemodynamically with the

Aneurysm Embolization Paper
Aneurysm Embolization is done in Interventional Radiology, by an Interventional Neuroradiologist.
The radiologist uses guide wires, known as catheters to locate the aneurysm. Through the catheter a
small coil can be placed into the aneurysm. With these coils the body will develop blood clots
around them which prevent blood from entering the aneurysm. This eliminates the risk of rupturing
aneurysms. There are many different types of stents that can be used for aneurysm embolization.
Many of these stents depend on the type of aneurysm. A stent that's commonly used is the Solitaire
AB Stent. This stent is used for the treatment of wide–necked aneurysms in the brain as well as
small intracranial aneurysms. Another type of embolization device that's used is pipeline; this device
is used for dissecting cerebral aneurysms.
Solitaire AB stent is sometimes used in the coiling of small intracranial aneurysms that have
ruptured. With the advances in Neuroradiology techniques, the diagnosis of small aneurysms has
been improving. According to "Jifang Zhang, Donghai Wang and Xingang" (2015) in a study titled
"Solitaire AB stent–assisted coiling embolization of the treatment of ruptured very small intracranial
aneurysms" (page 1) a study was performed at the Qilu ... Show more content on Helpwriting.net ...
A few of stents are the Leo, Enterprise, and the Solitaire AB Stent. Leo stents are retrievable but
they are prone to shift when they are in mid release state (Cui, Y., Xu, H., Liu, H., & Wang, Y.
(2015). Enterprise stents can only be recovered once, and it's only when they haven't been released
over 70 percent. The Solitaire AB Stent can be recovered a number of times. This is the main
advantage of the Solitaire AB stent over other stents. The release technique is also different with the
Solitaire AB stent. The stent is released from distal end and only after the position is determined; it
also has a single open end which is different than the Leo and

Cardiovascular Diseases and Aneurysms
The human body is a highly complex system of organs that operates efficiently at a cellular level to
ensure proper functionality and longevity of the human race. However, even the slightest changes to
its operation can lead to complications. In order to better understand the human body and how it
works; an understanding of the diseases it is susceptible to is necessary. The cardiovascular system,
in particular, is vulnerable to debilitating disease such as aneurysms, which is a ballooning of a
blood vessel, or even an embolism (when any foreign body enters the blood stream). Blood vessels
include arteries, capillaries and veins and therefore these events can occur anywhere in the body (i.e.
the heart or the brain). There are different types of aneurysms including saccular, fusiform and
pseudo–aneurysms. Saccular aneurysms only develop on part of the vessel wall and are spherical in
shape. Fusiform aneurysms are ovoid in shape and develop over the entire vessel cross section.
Pseudo–aneurysms are not true aneurysms but they occur as a result of a tear in the vessel wall thus
collecting the blood pooled by extravascular tissue (Group). The exact cause of an aneurysm is not
known but is correlated with certain previous existing conditions. Existing conditions that may have
an effect on the development of an aneurysm are inherited predispositions to this disease, lifestyles,
and high blood pressure. Some individuals are predisposed to developing aneurysms if their blood

Cerebral Aneurysm Research Paper
6 cm would be 20 percent. A less common aneurysm would be the thoracic aortic aneurysm, which
is affected on the part of the aorta that is running through the chest. Studies show that Thoracic
aortic aneurysm has an annual survival rate of 50 percent without treatment and 85 percent when it
is done with surgery. The next type of aneurysm is known as a cerebral aneurysm, which is an
aneurysm of the arteries that supply blood to the brain with blood known as intracranial aneurysms.
When a brain has a ruptured aneurysm it can be fatal within 24 hours, and 40 percent of brain
aneurysms can be fatal as well as 66 percent of the people who survive will be resulted in
neurological impairment or a disability. When a cerebral aneurysm has been ruptured

Abdominal Aortic Aneurysm Research Paper
An abdominal aortic aneurysm (AAA) is an area in the lower part of the aorta that becomes
enlarged.1 The aorta is usually about the width of a garden hose,1 but when it dilates 1.5 times the
diameter of its normal width (commonly about 3 cm) it is then termed a AAA.2 Although an
aneurysm can occur along any part of the aorta, it is termed "abdominal" along any segment below
the diaphragm.3 An aneurysm above the level of the diaphragm is termed "thoracic."1 The most
common location for a AAA to occur is the infrarenal segment,2 therefore it is common practice to
restrict the term AAA to that portion of the aorta.3 There are two types of AAA, bulging and
dissecting.1,3 Bulging (or ballooning) aneurysms can be either fusiform or saccular.4 Most
aneurysms are fusiform since the whole artery is affected, but in more rare cases can be saccular.3
An aortic dissection occurs when the inner layer of the aorta tears and perfusion of blood ... Show
more content on Helpwriting.net ...
Risk factors for an AAA include: age of 65 years old, smoking, atherosclerosis, male gender, and
family history.1,2,3,4 The three most powerful predictors are age, smoking and male gender, and
smoking accounts for 78% of the excess prevalence of AAA.2 Gene defects with some of the
connective tissue disorders associated with AAA have been identified in chromosome 11 and 15,4
but genetic background paired with environmental factors is a more likely cause of AAA than
genetics alone.3 Family members are four times more at risk for an AAA if a parent, adult child, or
sibling has had an AAA4 (15–19% in relatives, compared to 1–3% in unrelated cases).3 Additional
risk factors that are seen in individuals with an aortic dissection include: hypertension, pre–existing
aortic aneurysms, an aortic valve defect, aortic coarctation, certain genetic diseases (Turner's
syndrome, Marfan syndrome, Ehlers–Danlos syndrome, and Loeys–Dietz syndrome), and
inflammation or infection (giant cell arteritis, syphilis, and sexually transmitted

Ima Aneurysm
VAA incidence is 0.01–0.2 % at routine autopsies(3). The most common VAA is splenic artery in
60% of cases followed by hepatic artery in 20% of cases. Distribution of other VAA is SMA in
5.5%, CA in 4%, gastric and gastroepiploic artery in 4%, pancreatic artery in 2% and
pancreaticoduodenal artery in 1.5% of cases.
The prevalence of IMA aneurysm is difficult to evaluate. Most were identified during necropsy
studies(4). Peacock reported the first IMA aneurysm case in 1861 (5). According to Edogawa et al
54 cases of IMA aneurysms have been published between 1861 to 2012, of these 21 cases associated
with SMA and CA occlusion including their cases(2).
The cause of IMA aneurysms are not completely clear but a possible etiology is atherosclerosis.
Sugrue et al reported a similar case in 1990. They suggested that the cause of these very rare
aneurysms may be increased, turbulent and high–velocity flow through the collateral vasculature.
This high pressure and turbulent flow ... Show more content on Helpwriting.net ...
In chronic atherosclerotic occlusion collateral circulation generally occurs and prevents ischemia of
the intestine. At fasting state, the flow volume of SMA is 230 milliliters (ml)/minute (min) and 714
ml/min at first hour postmeal. IMA flow volume is relatively stable, 63 ml/min at fasting state and
67 ml/min at first hour postmeal(7). CA receive 800ml/min blood flow(8). In occlusion of SMA and
CA, IMA gives rise of collateral blood supply of intestine. IMA flow volume increases more than
10–15 times. Increased flow volume and velocity also cause to dilatation of collateral vascular
structures. Tsukioka et al. reported regression of the middle colic artery size in the postoperative CT
angiogram after reconstruction of the SMA and IMA. In our case, IMA was the only artery
supplying all intestinal structures with collateral mesenteric arteries. This condition supports the
theory about the pathogenesis of this rare

My Father: the Person I Admire Most Essays
My Father: The Person I Admire Most
Over time, there have been several people who have influenced various aspects of my life, based on
their personal characteristics, accomplishments, and values. I have been privileged to have had
numerous teachers and professors who I respect for their patience and intelligence. There are artists
that have inspired me by their natural talents and original creativity. I value many political leaders,
who have inspired me by their contributions to society, and their ability to change our futures. Of all
the people I have encountered in my life, the person I admire most is my father. As the youngest girl
in my family, I always considered myself to be "Daddy's little girl." Growing up it always made ...
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No matter how tired he was from his long work week, he would be up bright and early Saturday
morning to attend any of our sporting events, tournaments, or recitals, and then chauffeur us and our
friends to slumber parties or school dances. He was always very protective and kept a watchful eye
over us. My father's protectiveness and selflessness generated at a young age for him. He is the
ninth of twelve children, and often told us stories of how he had to look after, and practically raise
his three younger siblings after my grandfather had passed. He made certain they completed their
chores around my grandmother's farm, maintained good hygiene practices, and kept up with their
schoolwork. School was extremely important to my father, because he knew an education was the
only way he could be successful. Proudly, he finished high school at the age of sixteen, but could
not follow the footsteps of his older brothers and join the military, because he was too young.
Therefore, he decided to continue his studies. The completion of his degree in biology was
bittersweet. He was the first and the only one in his family to have graduated from college, however,
there were not a lot of opportunities for a young African–American male in 1957, in small town
Alabama. After taking few odd jobs, he decided to enlist in the military. My father had encountered
many challenges in his life, but one of his toughest was seeking to date my mother. He was

Aneurysm Essay
An abdominal aortic aneurysm is sometimes called the triple A. AAA is often called a "silent killer"
because there are usually no obvious symptoms of the disease. It is swelling of the lower part of the
aorta that stretches out through the abdominal area and sometimes, the upper part of the aorta in the
chest can be enlarged. The aorta is the main blood vessel that carries blood from the heart to the rest
of the body. Most arteries and the aorta are stretchy, which allows it to be filled with blood under
high pressure. An aneurysm is developed when the wall of the artery becomes too weak and
inflated, like a balloon. It's like a bubble in a water hose would be the correct term for explaining an
aneurysm. Aneurysms are generally discovered before they show symptoms, such as back pain,
abdomen, or groin, but like a weak hose, they may burst if they become too large. Since a ruptured
aneurysm is very serious and can be life–threatening to the point of bleeding to death, aneurysms
are sometimes fixable by surgery usually before this happens. Once the aneurysm bursts, the
symptoms may include: Severe back or abdominal pain that begins suddenly, paleness, dry
mouth/skin and excessive thirst, nausea and vomiting, signs of shock, such as shaking, dizziness, ...
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Most abdominal aneurysms are diagnosed during a routine physical examination or on X–ray when
being tested for other health reasons. When an aneurysm is thought as a possiblity, the following
imaging test may be used to determine size, location of the aneurysm, and treatment options:
Ultrasound,. CT scans, Magnetic resonance imaging (MRI), and a Angiogram: test in which a thin
tube (catheter) is inserted into a blood vessel and a contrast dye is injected to make the blood vessels
visible on the X–ray. This is rarely used to diagnose an abdominal aortic aneurysm but may be used
to aid in the treatment of an

The Treatment Of An Abdominal Aortic Aneurysm ( Aaa )
An aneurysm is permanent, excessive dilation of a blood vessel. It can occur in the aorta and other
blood vessels; the most common location for an aneurysm is in the abdominal section of the aorta
(Humphrey and Taylor [88] from ITL biomechanics thesis). There are a couple of definitions of an
abdominal aortic aneurysm (AAA): one is a local dilation in the aorta whereby the diameter of a
dilated artery is more than 50% larger than the original diameter [1]. Another definition is when the
external AAA diameter exceeds 30mm [3].
In most cases, an AAA usually remains asymptomatic until rupture. The most common symptom of
a ruptured AAA is acute pain in the abdomen and hemodynamic shock. Ruptured AAAs have high
mortality rate; 78% – 94% of ruptured aneurysms lead to death. [1.1o] Since the mortality rate is
high for ruptured AAAs, the most promising practice for improving clinical outcomes are early
diagnosis and careful management.
The main treatment option for AAA is to eliminate the aneurysm wall from the systemic pressure to
prevent further bulging of the AAA, using a vascular graft. In open surgery, a graft is sealed to the
healthy part of the aorta by transabdominal surgery. Open surgery has a 30–day mortality rate of
around 5% [greenhalgh et al 2004 from T] Endovascular aneurysm repair (EVAR) is an alternative
treatment option to open surgery, it is a minimal invasive surgery whereby a stent graft is placed in
the AAA through a small incision in the groin area. It has a

Brain Aneurysm Research Paper
Losing Relatives from Brain Aneurysm
Chikondi Nkhoma
Brown Mackie College – Louisville
Losing Relatives from Brain Aneurysm
Have you ever lost someone you have just danced with? I have. It is heart breaking to lose your
loved one with Brain aneurysm. I know there are a lot of people who have lost their loved ones,
because of this disease. It was hard to see someone dying in my hands after I had good time with. It
make me scared, who is going to be next because they say that it runs in a family. I learned this after
my older auntie, my uncle and my younger auntie lost their lives from this disease.
My older auntie was the most beautiful woman inside out. She raised my mother, up to sending her
to nursing school. Since I didn't ... Show more content on Helpwriting.net ...
My mother was one of them. There was an angel who was always making sure that I eat, have clean
clothes, clean a house and taking me and my siblings to doctor's appointments. That was my
younger auntie, she was everything that anyone can ask for. Even if someone is bullying me at
school, she was always there. One Saturday evening, it was my birthday and my cousin's wedding
day. We left for the wedding, she never complain of any pain. We danced, eat and had good time.
We left the reception, and I was driving. After 1 mile, she told me she can't breathe, I took her
straight to the hospital, and unfortunately she was pronounced dead. That was the way I lost my
auntie because of this disease.
These three people were angels on their own way. My older auntie, my uncle and my younger
auntie, sometimes I wonder if they were still here, how my life could have been. Right now my kids
don't have a granny. But there is a say that says; there is a reason for everything. If i had known how
to avoid or cure brain aneurysm my relatives could have been here. This disease took them from us.
The pain is still there because we have no solution for this

Classification Of Aortic Dissection : Classification
Classification of aortic dissection: Classification is depends on location since treatment and
prognosis relies on upon the part of aorta included. Extent and localization of aortic dissection is
classified utilizing the Stanford or DeBakey classification (Geller et al., 2007). Stanford
classification: In the Stanford classification, which is generally utilized, type A dissections are
dissections including the ascending aorta in regardless to the site of the intimal tear or the distal
extent, while, type B are those not including the ascending aorta. The dangerous complications
predominantly happen in type A dissections which in this way command surgical intervention
(Geller et al., 2007). DeBakey classification: The DeBakey classification subdivides dissections
further: In type I the dissection starts in the ascending aorta and extends distally all through the
aorta. In type II the dissection is restricted to the ascending aorta. In type III the dissection starts in
the descending aorta and extends distally (Romano et al., 2007). Debaky II Debaky I Debaky III
Debaky I Debaky II Fig. 19: DeBakey and Stanford classification of dissections. Type A (proximal)
includes the ascending aorta, either in isolation (DeBakey II) or as feature of a more extensive
dissection (DeBakey I). Type B (Distal, or DeBakey III) dissections emerge after the

Aneurysm Essay
Introduction
Despite considerable advances in surgical treatment, the ruptured human abdominal aortic aneurysm
(AAA) is still associated with a mortality rate of 65–85% [1, 2] . A diameter is currently the only
reliable determinant of the imminent rupture of an AAA and patients exceeding 5.5 cm generally
undergo surgical or endovascular intervention [2, 3] . However, the outcome of rupture is poor with
less than half of the patients being delivered to the hospital alive [1, 4] . It is well known that
inflammation and proteolytic degradation markedly contributes to the formation and rupture of an
AAA [5, 6] . During inflammation, the aortic wall is weakened by loss of smooth muscle cells
(SMCs) and destruction of the extracellular ... Show more content on Helpwriting.net ...
Hence, another study described increased expression of ADAM–17, also known as TACE (TNF– –
converting enzyme), in human AAA [18] . Especially in the transition zone, high levels of ADAM–
17 and TNF– have been detected , implementing a certain role in the development of AAA.
Therefore, the aim of the present study was to conduct an expression analysis of ADAMs with
proteolytic function [19] such as ADAMs 8, 9, 10, 12, 15 and 17, and their tissue inhibitors of
metalloprotease (TIMP)–1 and TIMP– 3 [20] in human AAA by quantitative PCR. The localisation
of the corresponding ADAMs was determined by means of immunohistochemistry.
Discussion
The development of AAA is closely associated with alternation of connective tissue in the aortic
wall, especially fragmentation of elastic fibres and collagen degradation through various proteolytic
enzymes, particularly MMPs [8, 9, 22] . Some promising drugs inhibiting MMPs have already been
shown to be successful in experimental models [23] . However, no positive results have been
observed in clinical trials. This phenomenon may be based on the fact that MMPs are not the only
proteinases able to degrade connective tissue. There is a plethora of proteolytic enzymes belonging
to the family of metalloproteinases such as ADAMs with multiple biological roles including cell–
matrix interaction, zymogen activation (shedding) and cell adhesion. These

Gramps Aneurysm Report
Proverb once said, "Just when the caterpillar thought the world was over, it became a butterfly."
This quote relates my family to the incident that occurred last summer. Gramps, my grandpa, was in
the hospital for almost four months. This was a rough time for my whole family.
What happened? What led up to this incident? My grandpa's shoulder and neck area were really
bothering him. He had some excruciating pains, so he went in to his doctor's office and his doctor
suggested had planned a surgery in order to fix the problem, but first, he had to go in for some
testing just to be positive that everything was what it had seem to be. It wasn't. Gramps ended up
having something seriously wrong with his heart. After his testing, they had to come up with a "Plan
B." New surgery date, new doctors, new surgery altogether. ... Show more content on
Helpwriting.net ...
He was taken back for surgery around 10:00 AM. We all met at the hospital – St. John's – very early
that morning, sure to be there for him. Surgery, since they had a few complications, was not
completed until about 4:00 that same afternoon. Gramps had an aneurysm that hadn't quite burst yet.
The aneurysm was on its way through the valve and into his heart chamber. We were waiting for his
surgery to come to an end when we receive a call from the surgeons that they had run into some
complications. Ended up that he had to have his heart valve replaced and a double bypass.
One surgery was over, he had to stay in the ICU, then would be admitted into a regular hospital
room within a few days if conditions permitted him to. things didn't go as expected and gramps
ended up in ICU for about two and a half months, then finally was released to the rehabilitation
center, where he stayed for a little over a

Essay about Abdominal Aortic Aneurysm
The cardiovascular system is the most important system in our body. This system is what keeps us
alive. Beating on average 30 billion times a year, our heart is never able to stop and take a break.
With every beat of our heart, the cardiovascular system moves blood, gases, nutrients, and
hormones throughout the intricate vasculature of our bodies. An adult body contains over 60,000
miles of vessels, which can wrap around the world two and a half times. The vessel branching off of
the heart is largest artery in our body and is known as the aorta. The aorta supplies oxygenated
blood to our body. The aorta runs along the midline of our body and has many other vessels that
stem from it to deliver the blood to a specific location. The ... Show more content on
Helpwriting.net ...
Elastic tissue is very strong. The adventitia is the outermost layer. It is made of collagen and
nourishes the wall with vasa vasorum.
An aneurysm is a widening or ballooning of a vessel. It is caused by weakness in the aortic wall. In
the aortic wall, the media is mostly affected because it is the thickest. There are instances where
dilation of the wall can occur, but to the outermost layer and this is not a typical aneurysm. It is
known as a false aneurysm or a pseudoaneurysm. When the outermost layer is dilated, often times
the inner or medial wall will rupture, but the outer wall will still be intact. The extracellular matrix
proteins degenerate and the inflammatory T cells are present. The collagen and elastin dissolve and
disintegrate which will lead to an expansion of the aortic wall. If the pressure in the vessel is too
great, the aortic wall will rupture. An abdominal aortic aneurysm is a ballooning or dilating of the
abdominal aorta. An aneurysm is diagnosed when the diameter of the vessel is greater than 50% of
its original diameter. The aorta is normally two centimeters in diameter at the level or the renal
arteries. An aneurysm is named based off of their location, size and shape. An aneurysm will affect
how the vessel is shaped, therefore causing the blood flow to alter. When an aneurysm is
symmetrical on both sides of the aortic wall it is called fusiform; but if only one side of the wall is
dilated, it is saccular. Aneurysms

Arterial Aneurysms
If the patient remains at risk for further embolus immobilization from a persistent source, long–term
anticoagulant therapy is recommended to prevent further acute arterial ischemic episodes within the
clients. so as far as nursing implications we will go over the nursing implications as they relate to
your anticoagulant therapy as a whole but just making sure that the patient is adhering to their
prescribed medications that they're on also educating the patients on any of those medications that
they're not familiar with. to talk about a arterial aneurysms or aneurysms. We're going to look at the
aneurysms of central arteries, an aneurysm is an outpouching or dilation of the arterial wall and it is
a common problem that involves the aorta. over time the dilated aortic wall ... Show more content
on Helpwriting.net ...
male gender age 65 or older and tobacco use are the major risk factors for abdominal aortic
aneurysms of atherosclerotic origin. other factors include the presence of coronary or peripheral
artery disease high blood pressure and high cholesterol also there's a strong genetic component that
may exist in the development and we'll just refer to this as AAA which is abdominal aortic
aneurysm. That's less common causes of aneurysms include blunt or penetrating trauma and an
inflammatory or infections at the aorta. Aneurysms are actually classified as true and false
aneurysms. A true aneurysm is one in which the wall of the artery forms the aneurysm with at least
one vessel layer that still intact so you have one vessel layer of the arterial wall still intact. True
aneurysm is further subdivided into fusiform and secular dilation. a fusiform aneurysm is the
circumferential and relatively uniform in shape. Where as a sacular aneurysm is more like a pouch
like with a narrow neck connecting the bulge to one side of the arterial wall and there are pictures of
these in your book. false aneurysm or pseudo aneurysm and is not actually aneurysm but if this is a
disruption of all layers of all

Adolescents Ought To Have The Right To Make Autonomous...
As Albert Einstein once said, "The only source of knowledge is experience." Seeing that I agree
with Einstein, I stand in firm negation of today's resolution which states Resolved: Adolescents
ought to have the right to make autonomous medical choices. For simplicity in the debate today, I
would like to give the following definition from the Black's Law Dictionary: Adolescence is the age
which follows puberty and precedes the age of majority. It commences for males at 14, and for
females at 12 year completed. The Oxford Advanced Learner's dictionary says that the word ought
is used to indicate a desirable or expected state. Autonomous, as defined by the Oxford Dictionary
of Philosophy, is having the freedom to act independently. The negative will support the value of
paternalism, which as defined by the Stanford Encyclopedia of Philosophy, is the interference of a
state or an individual with another person, against their will, and defended or motivated by a claim
that the person interfered with will be better off or protected from harm. The value of paternalism
will be defended with the criterion of knowledge and experience.
The Oxford Journal of Medicine and Philosophy talks about paternalism ... Show more content on
Helpwriting.net ...
After visiting a doctor, clinic, or hospital, health insurance companies will send the parent of the
patient and provider an explanation of benefits. For those whom are not familiar with this term, an
explanation of benefits, or an EOB, explains what was covered by insurance. An EOB will identify
the patient and the service provided, the amount charged by the provider, the amount of the charges
that are covered and not covered under the plan, the amount paid to the provider and the amount the
parent is responsible for. It would be much too difficult for an adolescent to have a fully confidential
medical exam or treatment and would be arduous to

Aneurysms: Subarachnoid Rupture
Introduction An aneurysm is a weakening or dilation of the blood vessel wall. If the aneurysm burst
it is considered a subarachnoid hemorrhage. Aneurysms occur most commonly along the aorta or in
the brain. For the purpose of this paper, brain aneurysms will be the main focus. Aneurysms are life
threatening, especially in the case of a rupture. Therefore it is important that healthcare workers
have an understanding of the pathophysiology, clinical manifestations, diagnostic test, and the
therapeutic management of these cases. This is a brief description of this, however research in
treatment along with other areas is still being conducted.
Review of Literature Despite abundant research on the matter, the exact pathophysiology of brain
aneurysms ... Show more content on Helpwriting.net ...
A large part of the decision between these two procedures depends on the aneurysms. Factors such
as size, location, anatomy and morphology contribute to the treatment team decision as to which
procedure would be most beneficial to the patient. During surgical clipping a clip is placed across
the neck of the aneurysm cutting off the blood flow to the aneurysm. Singer et al. describes the risks
of this procedure being temporary arterial occlusion, intraoperative hemorrhage or new or
exacerbated neurologic deficits. The other commonly used surgery, endovascular coiling consist of
inserting coils in the lumen of the aneurysm. Thrombus then forms in reaction to the coils and clots
off blood flow to the aneurysm, preventing it from rupture or leaking. Complications of this
procedure are different from surgical clipping. Aneurysmal rupture and thromboembolism are the
main complications of endovascular coiling. Some patients may be placed on a combination of a
heparin and or antiplatelet therapy to help prevent a thromboembolic event (Singer et al.). New
procedures are being developed for aneurysms such as bypass surgery. This technique redirects
blood flow within the brain and uses a built vessel connection to permanently occlude the artery on
which the aneurysm sits (Zhang et al. pg. 99). Bypass surgery is more challenging and requires
specially trained neurosurgeons for a successful procedure. Decisions and information about
regarding the ideal time to treat the aneurysm needs to be addressed as well. There is some
controversy about the timing of treatment for both ruptured and unruptured aneurysms. As it in other
procedures the risk versus benefits of treating need to be taken into consideration. Risk factors for
treating a unuptured aneurysm and having poor outcomes include advanced age and having larger
aneurysms. Characteristics of the aneurysm, size,

Aortic Aneurysm
An aneurysm is a focal dilation or outpouching of a blood vessel, although it can also occur in one
of the cardiac chambers and it is more common in arteries rather than in veins. It is justified if the
localized dilation is above 50% of the normal lumen (Attenberg, 2011). The expect diameter is
based on gender, age and other factors, such as body size (Johnston, 1991). A true aneurysm is
defined by a weakening of the vessel wall and involves the three layers of an artery: tunica intima,
media and adventitia. The Laplace's law is a formula that relates some key factors about the
hemodynamics and according to that, the wall tension required to withstand a certain internal fluid
pressure is directly proportional to the vessel radius and inversely ... Show more content on
Helpwriting.net ...
DSA is not only a diagnostic procedure, it also provides ways to treat the issue in real–time. It has a
higher spatial and temporal resolution and permits the visualization of a large amount of collaterals,
which can be difficulty in other modalities. The digital subtraction technique also reduce the dose of
contrast demanded. However, DSA is time–consuming, is not widely available, once that it requires
more professionals to do the procedure than in CTA or MRA and it has the same problems regarding
the use of contrast and radiation exposure. Those aspects bring to discussion if the high quality of
the image outweigh the drawbacks of the procedure (Al–Qaisi,

Aneurysm : A Focal Dilation Of An Infected Arterial Wall
Mycotic aneurysm is a focal dilation of an infected arterial wall. This uncommon disease follows an
aggressive and unpredictable clinical course with significant mortality, and presents unique
diagnostic and therapeutic challenges. This review discusses the pathogenesis, diagnosis, and
therapeutic management of mycotic aneurysms.
Historical Perspective Virchow first described a saccular outpoutching along an arterial wall
corresponding to an embolic source in 1847 [1]. Mycotic aneurysms were initially considered a
physical change secondary to mechanical pressure of emboli against the artery wall [2]. Infectious
etiology was first hypothesized by Goodhart in 1877 [3]. The term 'mycotic' originates from Osler's
Gulstonian Lectures in 1885 [4] in which he associated aortic aneurysms resembling a fungus
growth with a severe or "malignant" form of endocarditis and coined the term "mycotic aneurysms."
The term "mycotic" is a misnomer suggesting fungal infection, though it was originally intended to
refer to all microorganisms [5]. Osler established a clear connection between endocarditis and its
bacterial origin ("micrococci") through histology using bacterial Gram staining, which at the time
was novel in medical practice. He defined the mycotic process in the setting of endocarditis as the
transference of microbes from the growth of the valves to distant parts. In 1887, Langton and
Bowlby corroborated Osler's findings with observations of numerous bacteria derived from the

Abdominal Aortic Aneurysm Essay
Definition
An AAA (abdominal aortic aneurysm) is defined as enlargement of at least 3 cm of the abdominal
aorta. The majority of abdominal aortic aneurysms begins below the renal arteries and ends above
the iliac arteries. The exact cause of (AAAs) is unknown. However, it is thought to be due to a
degenerative process of the abdominal aorta caused by atherosclerosis. Artherosclerosis represents a
response to vessel wall injury caused by inflammation, genetically regulated defects in collagen and
fibrillin, increased protease activity within the arterial wall, and mechanical factors (Stoelting p.
143).
Pathophysiology
The abdominal aorta consists of three distinct tissue layers including: the intima, media, and
adventicia. There is ... Show more content on Helpwriting.net ...
There is an increase in the concentration of proteolytic enzymes compared to their inhibitors in the
abdominal aorta as age progresses. It is also thought that metalloproteinases (MMPs) may be a
factor in the development of AAAs (Stoelting p. 143). There is an increase in expression and
activity of MMPs in people with AAAs. MMPs are present in normal aortic tissue and are
responsible for vessel remodeling. These proteinases are secreted into the extracellular matrix of
AAAs by aortic smooth muscle cells and macrophages. Increased MMP activity favors the
degradation of collagen and elastin in aneurysmal tissue (Laake).
Signs and Symptoms
Patients with ruptured AAAs present in many different ways. The most common manifestation of
rupture is back pain with a pulsatile abdominal mass and hypotension. Additional symptoms may
include syncope, flank mass, groin pain, or paralysis (Dalman and White). Unstable patients with a
suspected ruptured abdominal aortic aneurysm need immediate operation and control of the
proximal aorta without preoperative confirmatory testing or optional volume resuscitation
(Stoelting, p. 144).
Anesthesia Management
Surgical intervention is presently the only effective method of treating AAAs. The risk of surgical
repair is outweighed by the risk of aneurysm rupture or aneurysm related death. Patients

Thoreacic Aortic Aneurysm Research Paper
Imagine a main water pipe, one that supplies a major city and all outlying communities with their
main water supply; suddenly that pipe bursts and floods the entire area and all cities. The
devastation is felt for miles away. This is what happens when a Thoracic Aortic Aneurysm occurs in
a patient. The Cleveland Clinic states that thoracic aortic aneurysms affect more than 15,000 people
in the United States, every year. From those 15,000 only about twenty to thirty percent of patients,
who made it to the hospital, survive from the aneurysm. That is only 3000 to 4500 people; the others
will usually need some type of treatment to help them live a longer life. There are certain treatments
depending on where specifically the injury to the ... Show more content on Helpwriting.net ...
The most common cause is hypertension, or high blood pressure. Stress, smoking, high cholesterol,
and obesity can also lead to stress of the heart and aorta, which can lead to the aneurysm. A family
history of heart problems, high blood pressure or aneurysms may raise a patient's risk of having
their own aneurysm. Other than the health reasons above, there are also some medical disorders that
can weaken the aorta, thus increasing the chance of aneurysm. These disorders are: Marfan
Syndrome (a genetic disorder that affects the connective tissue), Ehlers–Danlos syndrome (another
inherited connective tissue disorder), syphilis and

Brain Aneurysm Analysis
When I was in first grade, there was a long delay for my father to pick me up from school. I was in
the principal's office, very annoyed that I was missing an activity with gummy bears and being able
to consume them later. I was confused, why was I called into the office? Was I in trouble? Did I
forget something? My mind was racing with a thousand thoughts per second, while I waited
impatiently twiddling my thumbs on the black leather chair. When I heard the faint footsteps
approach the front office door, I saw my father with a solemn look and went straight to the
principal's lair. His usual demeanor was missing and I sensed trouble amuck when he didn't beam at
me with his happy smile. My eyes were glued to the door, hoping that ... Show more content on
Helpwriting.net ...
The school principal requested the new teacher to correct the papers and include the scores in. To
my surprise, I bumped my grade to an A+ from the aggravating C. When the final scores were
tallied, I was honored to be the valedictorian of my middle school. There was no confusion, and
people knew that I wasn't a troublemaker at school. To this day, when I meet up with other Amy's,
we reminisce about how the Gentle Giant took the blame for their mischiefs and we would have a
good

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Aneurysm Case Studies