What is the natural history of abdominal aortic aneurysm (AAA), and when is intervention indicated? Aneurysms grow over time. Increased expression and activity of matrix metalloproteinases (MMPs) and decreased activity of their inhibitors result in the loss of aortic wall structural integrity, which leads to AAA formation and expansion. The rate of growth is generally …
Who is at risk for abdominal aortic aneurysm (AAA), and what are the major complications of AAA? The incidence of AAA increases after age 50 and peaks in the eighth decade of life, when the frequency rate of AAA ranges from 0.5% to 3% in autopsy studies. The prevalence of AAA is higher in older …
What is the basic composition of a stent graft? A stent graft is composed of a metallic stent structure covered by a medical-grade fabric. The stents are typically made from stainless steel or nitinol (nickel titanium alloy), and the fabric is either Dacron (polyester) or expanded polytetrafluoroethylene (ePTFE). A stent graft comes compressed and loaded …
How are biopsy specimens handled? Proper handling of the biopsy specimen is key to a successful procedure and outcome. Availability of an on-site cytologist facilitates a preliminary assessment of the biopsy aspirate. On-site cytologists can help direct whether additional sampling is needed and whether a core biopsy is recommended. They can also suggest if microbiology …
How are patients managed after percutaneous biopsy? Following biopsy, patients are observed for a period of time prior to discharge to ensure the absence of complications. The time of postprocedure observation will vary depending on the organ biopsied. If indicated, follow-up imaging or laboratory studies to evaluate for acute complications may also be performed. For …
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Risk factors of pneumothorax following percutaneous biopsy What are some factors that increase the risk of pneumothorax following percutaneous biopsy? Factors that increase the risk of pneumothorax include larger needle size, type of needle used, increased number of pleural punctures, lung lesion size <2 cm, increased depth of lesion location in the lung, relative inexperience of …
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How to manage an air embolus encountered after percutaneous biopsy? Air embolism is a rare but life-threatening complication of lung biopsy, which can result in severe cardiac and neurologic events and death. Some postulate that air embolism occurs more frequently than suspected but goes undetected in asymptomatic patients. Air embolism should be suspected in patients …
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