ENDOVASCULAR REPAIR OF ABDOMINAL AO...

ENDOVASCULAR REPAIR OF ABDOMINAL AORTIC ANEURYSMS

The article "Endovascular repair of abdominal aortic aneurysms," is the basis for this AORN Journal independent inquiry The behavioral objectives and examination for this program were prepared according to Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN M education program professional, Center for Perioperative Education.

A minimum score of 70% upon the multiple-choice examination is necessary to earn 32 contact hours for this independent meditation Participants receive feedback on incorrect answers. Each applicant who favorably completes this study will receive a certificate of completion. The deadline for submitting this subject of attention is March 31, 2006.

hurl the completed application form, multiple-choice examination, learner evaluation, and appropriate fee-simple to

AORN Customer Service c/o abode Study Program 2170 S Parker Rd Suite 300 Denver CO 80231-5711

or fax the information with a credit card number to (303) 750-3212

BEHAVIORAL OBJECTIVES

After reading and studying the article forward endovascular repair of abdominal aortic aneurysms (AAA), the give suck to will be able to

(1) discuss the anatomy of the normal abdominal vascular scheme in regard to the unravelling of an AAA,

(2) describe the diagnostic proofs used to diagnose an AAA,

(3) explain by what mode the anatomic measurements of an AAA allow care providers to identify candidates for the endovascular approach to AAA repair,

(4) describe the preoperative preparation of a patient scheduled for endovascular AAA repair,

(5) identify the circulating nurse's part in endovascular AAA repair,

(6) explain the degrees of an endovascular AAA repair transaction and

(7) describe the postoperative phase of the patient undergoing endovascular AAA repair.

This program confronts criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

An abdominal aortic aneurysm (AAA) is dilatation of an artery with an increase in the diameter of the tube wall when compared to normal tube size (Figure 1). An AAA is located between the renal arteries and the iliac arteries. Arteries are compos of three layers

[FIGURE 1 OMITTED]

* tunica intima (ie, inner layer),

* tunica media (ie, middle layer), and

* tunica adventitia (ie, exterior layer).

Aneurysmal evolution is caused by weakness in the muscular tunica media and stretching of the tunica intima and adventitial layers. Additionally, progressive enlargement of the canal is caused by blood hurry within the aneurysm. (1) The standard treatment for AAA has been spread surgical repair of the aneurysm. A relatively recent procedure called endovascular stent graft repair has been evolving during the last decade and is being used for treatment of AAA with increasing oftenness Endovascular repair of AAA involves deploying a graft into the duct to seal the aneurysm via a transfemoral approach to the aorta. This approach is les invasive than explain procedures, resulting in decreased hospital longitudinal dimensions of stay, reduced cost, and increased quality of life. An additional benefit of this step is the inclusion of patients who have comorbid conditions and otherwise would not be candidates for traditional exhibit repair of their aneurysm.

The primary factors that determine a lucky outcome for a patient undergoing endovascular repair of an AAA are

* patient selection focused forward anatomy,

* medical comorbid conditions,

* clinician skill,

* hospital experience, and

* access to various endovascular devices. (2)

It is important for perioperative encourages and other perioperative personnel to understand the operation and be prepared for possible complications that can arise to render certain that optimal care is delivered to the patient. The aim of this article is to provide an overview of AAAs and to familiarize perioperative encourages with the procedure, possible complications, and language specific to endovascular repair of AAAs.

EPIDEMIOLOGY

As the population ages, AAAs are an increasing health care make anxious in the United States today because the incidence and prevalence increases with age. (3) The incidence of AAAs has risen from 122 to 362 through 100,000 procedures in the last five decades. (4) The prevalence of AAAs in adults 65 to 80 years of age is 4% to 7% and the ratio of men to women affected with an AAA is 5:1 (5) contention of an AAA is the 10th leading cause of death in men 55 years of age and older That accounts for 15000 deaths by year in the United States. (6)

Aneurysmal diameter size indicates the risk of quarrel Rupture risk is measured as a five-year risk factor. An aneurysm that measures les than 5 cm in diameter has a breach risk of 1% to 2% The risk increases to 20% to 49% for aneurysmal sizes greater than 5 cm in diameter. (7) Of the patients who survive the immediate incident the mortality rate after fracture of an AAA is between 78% and 94% (8) the public who undergo elective repair solely have a 5% mortality rate. (9)