MedWorm: Abdominal Aortic Aneurysm

Preoperative Cardiac Evaluation and Perioperative Cardiac Therapy in Patients Undergoing Open Surgery for Abdominal Aortic Aneurysms: Effects on Cardiovascular Outcome

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: These data suggest a significant benefit of an intensive cardiac preoperative evaluation in reducing the incidence of perioperative and postoperative cardiac morbidity and mortality. (Source: Annals of Vascular Surgery)

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Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in (Source: Annals of Vascular Surgery)

Current Endovascular Management of Abdominal Aortic Aneurysm

Current Cardiology Reports — Sat, 28 Jan 2012 16:52:05 +0100

Abstract Fatal rupture of abdominal aortic aneurysm (AAA) remains a feared complication. Development of vascular surgery techniques over 50 years ago has fulfilled the promise of preventing rupture, but the significant morbidity associated with open repair causes physicians and their older patients pause. With the advent of less invasive endovascular techniques and devices, patients now have another viable treatment option. We review some of the important trials as well as discuss developments in the continually evolving field of endovascular repair of AAAs. Content Type Journal ArticleCategory Peripheral Vascular Disease (M Shishehbor, Section Editor)Pages 1-10DOI 10.1007/s11886-012-0247-0Authors April A. Grant, 701 Grove Road, Greenville, SC 20605, USAStephen L...

Assessment of the Accuracy of AortaScan for Detection of Abdominal Aortic Aneurysm (AAA)

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:16 +0100

AortaScan AMI 9700 is a portable 3D ultrasound device that automatically measures the maximum diameter of the abdominal aorta without the need for a trained sonographer. It is designed to rapidly diagnose or exclude an AAA and may have particular use in screening programs. Our objective was to determine its accuracy to detect AAA. (Source: Journal of Vascular Surgery)

Benchmark Renal Outcome Measures of Open Repair of Complex Abdominal Aortic Aneurysms for Comparison with Fenestrated Endografts

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:16 +0100

This study provides a detailed, long-term analysis of clinical and anatomic renal outcome measures in a cohort of patients treated by open repair of cAAAs. (Source: Journal of Vascular Surgery)

Is the Incidence of Abdominal Aortic Aneurysm Declining in the 21st Century? Mortality and Hospital Admissions for England & Wales and Scotland

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:15 +0100

Between 1951 and 1995 there was a steady increase in age-standardised deaths from all aortic aneurysms in men, from 2 to 56 per 100,000 population in England & Wales, supporting an increase in incidence. More recently, evidence from Sweden and elsewhere suggests that now the incidence of abdominal aortic aneurysm (AAA) may be declining. (Source: Journal of Vascular Surgery)

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A one-stage operation for abdominal aortic aneurysm and intraductal papillary mucinous neoplasms of the pancreas: report of a case

Surgery Today — Wed, 25 Jan 2012 18:04:10 +0100

Abstract Pancreatic surgery concomitant with abdominal aortic repair is rarely chosen due to concerns about prosthetic infection following pancreatic leakage and the poor prognosis of pancreatic neoplasms. We herein report a successfully treated case of infrarenal abdominal aortic aneurysm and intraductal papillary mucinous neoplasms of the pancreas treated by a one-stage operation. A 75-year-old male with a history of cerebral infarction and chronic subdural hematoma was referred to our department with a pulsatile abdominal mass. A 70-mm infrarenal abdominal aortic aneurysm with severe proximal neck angulation and a 28-mm multilocular cystic tumor with mural nodules in the pancreas body were detected. Abdominal aortic repair with a prosthetic graft and distal pancreatecto...

Extracorporeal membrane oxygenation support for abdominal aortic aneurysms surgery in high-risk patients

Interactive CardioVascular and Thoracic Surgery — Wed, 25 Jan 2012 05:00:00 +0100

Surgical treatment of an abdominal aortic aneurysm in patients with a heart disease is risky. Aortic cross-clamping is featured by important consequences on cardiac, renal and gastrointestinal functions. Endovascular aortic repair is considered to be the gold standard in patients with severe comorbidities. However, in the case of unsuccessful endovascular treatment, surgery can be reconsidered with the use of extracorporeal membrane oxygenation, which seems to be a new tool for the management of cardiac and gastrointestinal events ensuring better post-operative outcomes. (Source: Interactive CardioVascular and Thoracic Surgery)

Evidence for the credibility of health economic models for health policy decision-making: a systematic literature review of screening for abdominal aortic aneurysms

Journal of Health Services Research and Policy — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions Researchers in the field seem to have benefited from general advances in health economic modelling and some improvements in reporting were noted. However, the low level of agreement between studies in model structures and assumptions, and difficulty in justifying these (convergent validity), remain a threat to the credibility of health economic models. Decision-makers should not accept the results of a modelling study if the methods are not fully transparent and justified. Modellers should, whenever relevant, supplement a primary report of results with a technical report detailing and discussing the methodological choices made. (Source: Journal of Health Services Research and Policy)

Inhibition of microRNA-29b reduces murine abdominal aortic aneurysm development

Journal of Clinical Investigation — Tue, 24 Jan 2012 19:12:02 +0100

MicroRNAs (miRs) regulate gene expression at the posttranscriptional level and play crucial roles in vascular integrity. As such, they may have a role in modifying abdominal aortic aneurysm (AAA) expansion, the pathophysiological mechanisms of which remain incompletely explored. Here, we investigate the role of miRs in 2 murine models of experimental AAA: the porcine pancreatic elastase (PPE) infusion model in C57BL/6 mice and the AngII infusion model in Apoe–/– mice. AAA development was accompanied by decreased aortic expression of miR-29b, along with increased expression of known miR-29b targets, Col1a1, Col3a1, Col5a1, and Eln, in both models. In vivo administration of locked nucleic acid anti–miR-29b greatly increased collagen expression, leading to an early fib...

MicroRNAs, fibrotic remodeling, and aortic aneurysms

Journal of Clinical Investigation — Tue, 24 Jan 2012 19:12:02 +0100

This study highlights the relevance of miR-29b in aortic disease but also raises questions about its specific role. (Source: Journal of Clinical Investigation)

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Three-Dimensional Microstructural Changes in Murine Abdominal Aortic Aneurysms Quantified Using Immunofluorescent Array Tomography

Journal of Histochemistry and Cytochemistry — Tue, 24 Jan 2012 05:00:00 +0100

This study investigated the spatial and temporal remodeling of blood vessel wall microarchitecture and cellular morphology during abdominal aortic aneurysm (AAA) development using immunofluorescent array tomography (IAT), a high-resolution three-dimensional (3D) microscopy technology, in the murine model. Infrarenal aortas of C57BL6 mice (N=20) were evaluated at 0, 7, and 28 days after elastase or heat-inactivated elastase perfusion. Custom algorithms quantified volume fractions (VF) of elastin, smooth muscle cell (SMC) actin, and adventitial collagen type I, as well as elastin thickness, elastin fragmentation, non-adventitial wall thickness, and nuclei amount. The 3D renderings depicted elastin and collagen type I degradation and SMC morphological changes. Elastin VF decreased 37.5% (p<...

Assessment of insertion/deletion polymorphism of the angiotensin-converting enzyme gene in abdominal aortic aneurysm and inguinal hernia.

Vascular — Mon, 23 Jan 2012 05:00:00 +0100

In conclusion, an association between the heterozygote ACE I/D state and the presence of AAA and/or hernia was identified. The role of the ACE I/D polymorphism in aneurysm and hernia needs further investigation. PMID: 22271804 [PubMed - as supplied by publisher] (Source: Vascular)

Self‐rated health status as a risk factor for future vascular events and mortality in patients with symptomatic and asymptomatic atherosclerotic disease: the SMART study

Journal of Internal Medicine — Sat, 21 Jan 2012 13:43:36 +0100

Conclusions: Poorer self‐rated physical and mental health status increases the risk of vascular events and mortality in a broad population of patients with symptomatic and asymptomatic atherosclerotic disease. (Source: Journal of Internal Medicine)

Endovascular Therapy of Saccular Aortic Aneurysm

Journal of Vascular and Interventional Radiology : JVIR — Sat, 21 Jan 2012 08:07:50 +0100

Based on a computed tomographic (CT) angiography study, a 23-year-old woman with Takayasu aortitis and abdominal pain was diagnosed with large 5.2-cm saccular abdominal aortic aneurysm near an occluded left renal artery (a; available in color online at www.jvir.org) and nonfunctional left kidney, small ectasia of inferior mesenteric artery origin, and mild diffuse aortic disease. There was no previous trauma or abdominal sepsis. Open surgical repair was undesirable, as the aortic tissue in the vicinity of the aneurysm was abnormal. The close proximity to right renal artery precluded endovascular stent-grafting. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Prosthetic Vascular Graft Infections Between Blood and Concordance of Graft Culture Pathogen.

The American Journal of the Medical Sciences — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: The yield of blood cultures in late-onset abdominal PVGIs is low. Presence of microorganisms in blood cultures does not necessarily indicate a causal relationship with graft infection. An empirical broad-spectrum antimicrobial therapy is advised in all suspected cases until a definitive etiology has been made. PMID: 22270396 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

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Indocyanine Green Angiography for Intra-operative Assessment in Vascular Surgery.

PubMed: Eur J Vasc Endovasc ... — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: HEMS angiography can accurately assess peripheral arterial perfusion in surgical cases with ASO and AAA. PMID: 22264591 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Candidates and major determinants for endovascular repair of abdominal aortic aneurysms in Korean patients

Heart and Vessels — Thu, 19 Jan 2012 08:04:40 +0100

Abstract The purpose of this study was to determine what proportion of patients with an abdominal aortic aneurysm (AAA) would be eligible for endovascular aneurysm repair (EVAR) and to examine the major determinants for suitability of EVAR with the currently available indications. We retrospectively reviewed 3-D reconstructed computed tomography angiography of 88 patients with an atherosclerotic AAA who underwent open repair or EVAR between October 2003 and October 2010 at the Cardiovascular Center, Seoul National University Bundang Hospital. Of the 88 patients, 71 (80.7%) were treated with open repair and 17 (19.3%) were treated with EVAR. The rate of minor complications, postprocedural intensive care unit stay, and total hospital stay were significantly lower in the EVAR...

Perioperative Myocardial Injury and Hemostasis in Patients Undergoing Endovascular Aneurysm Repair for Asymptomatic Infrarenal Abdominal Aortic Aneurysm

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: Endovascular aortic aneurysm repair is associated with a significant risk of perioperative myocardial injury that is underdetected clinically and associated with a procoagulopathic state. (Source: Vascular and Endovascular Surgery)

A Meta-Analysis of Randomized and Risk-Adjusted Observational Studies of Endovascular Versus Open Repair for Ruptured Abdominal Aortic Aneurysm

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

(Source: Vascular and Endovascular Surgery)

Listeria monocytogenes: A Rare Cause for an Infected Abdominal Aortic Aneurysm

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

We describe a case of an infrarenal abdominal aortic aneurysm infected by Listeria monocytogenes. The aneurysm was diagnosed using a contrast-enhanced computed tomography (CT) scan and the infective organism identified within positive blood cultures. The patient underwent a successful urgent open aortic aneurysm repair and completed a 6-week course of antibiotics. (Source: Vascular and Endovascular Surgery)

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Mid-term Outcomes following Emergency Endovascular Aortic Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms.

PubMed: Eur J Vasc Endovasc ... — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSION: EEVAR is associated with excellent mid-term survival in this cohort. We would recommend eEVAR as the management of choice for rAAA in anatomically suitable patients where local facilities and expertise exist. PMID: 22261485 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Prevalence of Abdominal Wall Hernia in Participants With Abdominal Aortic Aneurysm Versus Peripheral Arterial Disease--A Population-Based Study

Angiology — Mon, 16 Jan 2012 05:00:00 +0100

Small studies suggest an association between abdominal aortic aneurysms (AAAs) and hernias, possibly related to connective tissue weakness. We evaluated the association between AAA and abdominal wall hernia (AWH), using peripheral arterial disease (PAD) patients as controls, in Olmsted County, Minnesota. In a retrospective cohort study we queried the electronic medical records for the diagnosis of AAA. The resulting data were then queried for prevalence of AWH. The same set of queries was repeated for PAD. Occurrence of AWH in the 2 groups was compared using the chi-square test. Of the 187 151 patient records queried, 939 had AAA and 3465 had PAD. Abdominal wall hernia occurred in 157 (16.7%) patients with AAA and in 343 (9.9%) patients with PAD. Abdominal wall hernia was 1.7 times more pr...

Hospital Competitiveness Influences Ruptured Abdominal Aortic Aneurysm Management

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:14 +0100

(Source: Journal of Surgical Research)

Inhibition of CXCL4-CCL5 Chemokine Interaction Ameliorates the Development of Abdominal Aortic Aneurysm in Mice

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:19 +0100

Abdominal aortic aneurysm (AAA) is a macrophage-driven arterial degenerative disease. Given the importance of CXCL4-CCL5 chemokine interaction in macrophage/monocytes migration into inflamed arteries, we evaluated the effect of a novel synthetic peptide inhibitor to CXCL4-CCL5 interaction on AAA progression in the porcine pancreatic elastase (PPE)-induced AAA mouse model. (Source: Journal of Surgical Research)

Hospital Characteristics and Participation in the National Surgical Quality Improvement Program

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:02 +0100

Conclusions: NSQIP participants do not represent the diversity of hospitals performing high-risk general and vascular surgery nationwide. to enable quality improvement efforts in small, rural, and critical access hospitals, which may have high surgical mortality rates and limited resources, other methods of outcome feedback are needed. (Source: Journal of Surgical Research)

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An Objective System for Measuring Surgical Complexity in Elderly Patients

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:02 +0100

Conclusions: This pilot study demonstrates that clinical data from ACS NSQIP can be used to assess surgical complexity. the CRS provides a single index value, reflecting both severity and likelihood of adverse outcomes that allows objective comparisons of the surgical risk across procedure groups. the work RVU does not strongly correlate with the CRS. the CRS more strongly correlated to the surgeons' rankings of procedures compared to the work RVU. in the next phase, the CRS will be refined based on surveys from a larger group of surgeons. (Source: Journal of Surgical Research)

Reliability of Risk-Adjusted Outcomes as Hospital Quality Measures

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:01 +0100

Conclusions: Except for rates of colon resection morbidity, risk-adjusted outcome measures are unreliable as indicators of hospital quality. to improve the reliability of outcome measures, quality measurement programs should increase sample size by collecting one hundred percent of cases for targeted procedures, and use statistical techniques to adjust for reliability. (Source: Journal of Surgical Research)

Racial Disparities in Readmission Rates Among Medicare Beneficiaries Undergoing Aortic Aneurysm Surgery

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:01 +0100

Conclusions: Black patients experience a significantly higher risk-adjusted 30-day readmission rate following AAA repair compared to non-black patients. This disparity was even more pronounced at minority-serving hospitals. (Source: Journal of Surgical Research)

Inhalational Carbon Monoxide Protects from Abdominal Aortic Aneurysm Formation in Mice

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:00 +0100

(Source: Journal of Surgical Research)

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Unique Features of Smooth Muscle Cells Derived from Abdominal Aortic Aneurysms

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:00 +0100

(Source: Journal of Surgical Research)

Increased Monocyte-Endothelial Cell Dysfunction in Patients With Peripheral Vascular Disease (PVD) Versus Patients With Abdominal Aortic Aneurysms (AAA)

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:00 +0100

(Source: Journal of Surgical Research)

Osteoclast-like Cells in Abdominal Aortic Aneurysm

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:59 +0100

(Source: Journal of Surgical Research)

Surgical repair for abdominal aortic aneurysm concomitant with iliac arterial disease using InterGard™ Quadrifurcated

Journal of Artificial Organs — Thu, 12 Jan 2012 16:48:10 +0100

Abstract InterGard™ Quadrifurcated [InterVascular S.A. (MAQUET Cardiovascular), La Ciotat, France], a knitted quadrifurcated prosthetic graft, is useful to simplify the procedures for patients with abdominal aortic aneurysm concomitant with iliac arterial disease. From March 2008 to April 2010, 59 patients underwent abdominal aortic aneurysm repair in our department. InterGard™ Quadrifurcated was used in 22 patients (37.3%). All patients were male with a mean age of 72.1 ± 12.1 years (range from 45 to 90 years). Four were emergency cases. Nineteen patients had common iliac arterial lesions, and 19 patients had internal iliac arterial lesions. In addition to abdominal aortic aneurysm repair, reconstruction of bilateral internal iliac arteries was per...

The management of ruptured abdominal aortic aneurysms: screening for abdominal aortic aneurysm and incidence of rupture.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:55:15 +0100

Authors: Von Allmen RS, Powell JT Abstract Twenty-five years have passed since the first randomised controlled trial began its recruitment for screening for abdominal aortic aneurysm (AAA) in men aged 65 and above. Since this and other randomised trials, all launched in the late 80s and 90s of the last century, the epidemiologic profile of abdominal aortic aneurysm may have changed. The trials reported an AAA prevalence in the range of 4-7% for men aged 65 years or more. AAA-related mortality was significantly improved by screening, and after 13 years, the largest trial showed a benefit for all-cause mortality. Screening also was shown to be cost-effective. Today, there are studies showing a substantial decrease of AAA prevalence to sometimes less than 2% in men aged ≥65 years an...

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Systematic approach to ruptured abdominal aortic aneurysm in the endovascular era: Intention-to-treat eEVAR protocol.

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:55:06 +0100

Authors: Willigendael EM, Cuypers PW, Teijink JA, Van Sambeek MR Abstract Emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysms (rAAA) is still a relatively new treatment option. A pre-defined strategy of an eEVAR first approach for rAAA is associated with improved mortality rates. After establishing and implementing the Intention-to-treat eEVAR protocol for rAAAs the mortality and morbidity rates improved significantly. The presented Intention-to-treat eEVAR protocol starts at the first telephone call to the ambulance department and lasts until the post-operative care unit. The protocol involves the close collaboration between the ambulance department, vascular surgeon, emergency department physicians, anaesthesiologists, operating room staff and, ...

Endovascular treatment of ruptured abdominal aortic aneurysm: is there a long-term benefit at follow-up?

The Journal of Cardiovascular Surgery — Wed, 11 Jan 2012 12:54:57 +0100

CONCLUSION: Our study shows that rEVAR is feasible irrespective of hemodynamic condition and that it is associated with relative low mortality rates. Challenging rAAA anatomy may not affect overall long-term survival, but six out of ten patients remain unsuitable for rEVAR because of inappropriate anatomy. PMID: 22231534 [PubMed - in process] (Source: The Journal of Cardiovascular Surgery)

Response to "Comment on 'Insulin-like Growth Factor 1 - A Novel Biomarker of Abdominal Aortic Aneurysm'"

PubMed: Eur J Vasc Endovasc ... — Wed, 11 Jan 2012 05:00:00 +0100

Response to "Comment on 'Insulin-like Growth Factor 1 - A Novel Biomarker of Abdominal Aortic Aneurysm'" Eur J Vasc Endovasc Surg. 2012 Jan 11; Authors: Lindholt JS PMID: 22244316 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Discovery of a Novel Circulating Biomarker in Patients with Abdominal Aortic Aneurysm: A Pilot Study Using a Proteomic Approach

Clinical and Translational Science — Tue, 10 Jan 2012 05:00:00 +0100

In conclusion, by using a proteomic approach, this pilot‐study provides evidence of GPI‐PLD as a novel potential plasma biomarker for AAA. Clin Trans Sci 2011; Volume #: 1–4 (Source: Clinical and Translational Science)

Long-term Results of Iliac Aneurysm Repair with Iliac Branched Endograft: A 5-Year Experience on 100 Consecutive Cases☆

PubMed: Eur J Vasc Endovasc ... — Tue, 10 Jan 2012 05:00:00 +0100

CONCLUSIONS: Long-term results show that IBD use can ensure persistent iliac aneurysm exclusion at 5 years, with low risk of reintervention. This technique can be considered as a first endovascular option in patients with extensive iliac aneurysm disease and favourable anatomy. PMID: 22240335 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

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Comment on 'Insulin-like Growth Factor 1 - A Novel Biomarker of Abdominal Aortic Aneurysm'

PubMed: Eur J Vasc Endovasc ... — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Koole D, van Herwaarden JA, Pasterkamp G, Moll FL PMID: 22240332 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

A novel 3D stereoscopic anatomy tutorial

The Clinical Teacher — Mon, 09 Jan 2012 11:25:23 +0100

Discussion: This technology has the exciting potential to use the radiographic libraries in hospitals for medical education. The computer software, however, has some limitations at present. It is not able to effectively distinguish between tissues of similar densities. Furthermore, not all tissues are amenable to CT scanning of a high enough resolution for presentation. Despite these limitations, the software continues to advance and is capable of producing very high quality anatomy images. (Source: The Clinical Teacher)

The Strange Relationship between Diabetes and Abdominal Aortic Aneurysm.

PubMed: Eur J Vasc Endovasc ... — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Lederle FA PMID: 22237512 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Outcomes after Open Surgery and Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm in Patients with Massive Neck Atheroma.

PubMed: Eur J Vasc Endovasc ... — Sat, 07 Jan 2012 05:00:00 +0100

CONCLUSION: Compared to OS patients, EVAR patients with massive neck atheroma tend to develop late-phase complications possibly related to cholesterol crystal embolisation. The clinical features of massive neck atheroma patients receiving EVAR should be carefully monitored even after hospital discharge. PMID: 22230600 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Comments Regarding 'Assessment of the Accuracy of AortaScan for Detection of Abdominal Aortic Aneurysm (AAA)'

PubMed: Eur J Vasc Endovasc ... — Sat, 07 Jan 2012 05:00:00 +0100

Authors: Hartshorne T PMID: 22230597 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

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Identification and proteomic profiling of exosomes in human cerebrospinal fluid

Journal of Translational Medicine — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: Exosomes were identified in human CSF and their proteome is a potential new reservoir for biomarker discovery in neurological disorders such as Alzheimer's disease. However, techniques used to concentrate exosomes from CSF need refinement to reduce variability. In this study we used relatively large starting volumes of human CSF, future studies will focus on exosome isolation from smaller 'real life' clinical samples; a key challenge in the development of exosomes as translational tools. (Source: Journal of Translational Medicine)

The Wonders of a Newly Available Post-analysis CT Software in the Hands of Vascular Surgeons.

PubMed: Eur J Vasc Endovasc ... — Thu, 05 Jan 2012 05:00:00 +0100

CONCLUSION: OsiriX is an image processing software and an attractive alternative to dedicated workstations and allows rendering and analysis of numerous medical imaging modalities. PMID: 22226699 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Treatment With Simvastatin Inhibits the Formation of Abdominal Aortic Aneurysms in Rabbits

Annals of Vascular Surgery — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: Simvastatin may prove clinically significant in suppressing the development and expansion of AAAs and, thereby, in reducing the risk of rupture and the need for repair. (Source: Annals of Vascular Surgery)

Arterio-venous gradients of endothelial progenitor cells reveal a complex kinetics in human limb ischemia.

Clinical Hemorheology and Microcirculation — Tue, 03 Jan 2012 05:00:00 +0100

In conclusion, we failed to show any consistent gradient of EPCs across ischemic limbs in relation to severity of atherosclerosis obliterans, but we speculatively suggest that a bidirectional traffic of EPCs in and out the ischemic tissue might be regulated by VEGF and SDF-1. PMID: 22240360 [PubMed - as supplied by publisher] (Source: Clinical Hemorheology and Microcirculation)

The Cardiac Cycle is a Major Contributor to Variability in Size Measurements of Abdominal Aortic Aneurysms by Ultrasound

Journal of Vascular Surgery — Sun, 01 Jan 2012 05:00:00 +0100

The objective of the study was to evaluate the impact of the cardiac cycle on ultrasound measurements of abdominal aortic aneurysm (AAA) diameters. In total, 603 AAAs detected by screening were investigated with respect to the maximal systolic and diastolic anterior–posterior aortic diameters during the cardiac cycle using recorded ultrasound video sequences. (Source: Journal of Vascular Surgery)

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Clinical Inquiry: Does ultrasound screening for abdominal aortic aneurysm reduce mortality?

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Miranda-Usua Y, Whitworth JD, Tillett J Abstract Yes, screening reduces mortality in men, although it's unclear whether it has the same effect in women. PMID: 22220297 [PubMed - in process] (Source: The Journal of Family Practice)

Unusual abdominal aneurysms in a patient after kidney transplantation treated by endovascular technique.

VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases — Sun, 01 Jan 2012 05:00:00 +0100

We present a patient after renal transplantation with aneurysms of both stumps of the renal arteries, abdominal aortic aneurysm and aneurysms of common iliac arteries. Because of the symptomatic course, the patient required urgent treatment. A successful endovascular procedure was performed. Follow-up imaging did not reveal any complications. PMID: 22247062 [PubMed - in process] (Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases)

Reduction of small infrarenal abdominal aortic aneurysm expansion rate by statins.

VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: This study confirms the considerable individual variations in the AAA expansion rate, and emphasizes the need for regular aortic diameter assessments. In this study, patients treated with statin demonstrate a significant decrease in the ER compared to controls. This finding need to be evaluated in prospective interventional studies powered to demonstrate the potential benefit of statin treatment. PMID: 22247058 [PubMed - in process] (Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases)

Diverse Presentation of Secondary Aortoenteric Fistulae

Journal of Biomedicine and Biotechnology — Thu, 29 Dec 2011 16:36:22 +0100

Secondary aortoenteric fistula, due to mechanical erosion or infection of a prosthetic graft, is a very rare cause of gastrointestinal bleeding and an uncommon complication of abdominal aortic aneurysm repair. A retrospective chart review conducted at our institution revealed 5 cases of secondary AEF occurring between 2006 and 2010. Presentations were diverse, including hematemesis, coffee-ground emesis, and unexplained sepsis. Delay in diagnosis was common. In reporting these cases, we seek to highlight the diverse clinical spectrum and potentially misleading features of this condition. Clinicians must retain a high index of suspicion to avoid potentially catastrophic outcomes. (Source: Journal of Biomedicine and Biotechnology)

Chimney Grafts: Is There a Need and Will They Work?

Perspectives in Vascular Surgery and Endovascular Therapy — Wed, 28 Dec 2011 05:00:00 +0100

Endovascular repair has become the primary treatment option for abdominal aortic aneurysms over the past decade. The favorable results as well as technical evolution have led endovascular repair to include fenestrated and branched technology for complex juxtarenal, suprarenal, and thoracoabdominal aneurysms. These grafts are, however, extensively customized and patient tailored at present precluding their use in emergency situations. Certain aspect of aneurysm anatomy also limits them. The chimney technique uses standard, off-the-shelf endovascular devices that extend the use of standard aortic stent grafts for aneurysms without suitable proximal landing zones particularly in acute situations. Early results are promising and warrant a continued development of the technique until such time ...

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Endovascular Iliac Branch Devices for Iliac Aneurysms

Perspectives in Vascular Surgery and Endovascular Therapy — Wed, 28 Dec 2011 05:00:00 +0100

This article summarizes the state of the art on IBD design, procedure planning, implantation, and clinical results. (Source: Perspectives in Vascular Surgery and Endovascular Therapy)

Group X secretory PLA2 in neutrophils plays a pathogenic role in abdominal aortic aneurysms in mice

AJP: Heart and Circulatory Physiology — Fri, 23 Dec 2011 05:00:00 +0100

In conclusion, sPLA2-X in neutrophils plays a pathogenic role in AAA in a mice model. (Source: AJP: Heart and Circulatory Physiology)

Surgery Volume Predicts AAA Outcomes (CME/CE)

MedPage Today Surgery — Thu, 22 Dec 2011 13:00:00 +0100

(MedPage Today) -- Patients treated by surgeons who perform more open vascular operations of various types have better outcomes following open repair of an abdominal aortic aneurysm, researchers found. (Source: MedPage Today Surgery)

Response to Letter to Editor re “Differential Protein Expression in Serum of Abdominal Aortic Aneurysm Patients – A Proteomic Approach”

European Journal of Vascular and Endovascular Surgery — Thu, 22 Dec 2011 05:00:00 +0100

We would like to thank Dr. Nordon for his interest in and remarks on our manuscript. We fully agree that the translation of proteomics-discovered biomarkers into clinically meaningful assays is difficult. However, our aim was to find differential protein expression related to aneurysm size and progression. These differentially expressed proteins could help to elucidate the mechanisms behind abdominal aortic aneurysm. (Source: European Journal of Vascular and Endovascular Surgery)

Abdominal Aorta Aneurysms in Children: Single-Center Experience of Six Patients [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions Our experience indicates that good outcomes can be obtained in children with AAAs with prompt and accurate diagnosis and surgical management with artificial grafts. (Source: The Annals of Thoracic Surgery)

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Midterm Results With Endovascular Approach to Abdominal Aortic Pathologies in Behçet’s Disease

Annals of Vascular Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusion: Endovascular approach provides a reasonable alternative to open repair for the treatment of abdominal aortic aneurysms in select cases; however, in emergency settings, endovascular repair may well have an important, but limited, role in select patients with aortoenteric fistulae, it may yet require a surgical intervention. (Source: Annals of Vascular Surgery)

Deep Venous Thrombosis After Abdominal Aneurysm Repair

Journal of Vascular Surgery — Mon, 19 Dec 2011 23:06:58 +0100

The objective of this study was to examine venous thromboembolism (VTE) rates, timing and risk factors after nonruptured open or endoluminal (ELG) Abdominal Aortic Aneurysm repair. (Source: Journal of Vascular Surgery)

Correction

Journal of Vascular Surgery — Mon, 19 Dec 2011 23:06:58 +0100

In the October 2011 issue of the Journal of Vascular Surgery, the article by Dr Matthew P. Sweet et al (Sweet MP, Fillinger MF, Morrison TM, Abel D. The influence of gender and aortic aneurysm size on eligibility for endovascular abdominal aortic aneurysm repair. J Vasc Surg 2011;54:931-7) listed the affiliations for the authors incorrectly. The correct affiliations are as follows: (Source: Journal of Vascular Surgery)

The Cardiac Cycle is a Major Contributor to Variability in Size Measurements of Abdominal Aortic Aneurysms by Ultrasound

Journal of Vascular Surgery — Mon, 19 Dec 2011 23:06:57 +0100

Fenestrated endovascular aneurysm repair

British Journal of Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Conclusion:FEVAR for repair of suprarenal and juxtarenal aneurysms is a viable alternative to open repair. However, there is no level 1 evidence for FEVAR, and current evidence is weak with many unanswered questions. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

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Clarithromycin suppresses the periodontal bacteria‐accelerated abdominal aortic aneurysms in mice

Journal of Periodontal Research — Mon, 19 Dec 2011 05:00:00 +0100

Conclusion: These findings suggest that CAM administration is useful to suppress periodontal bacteria‐accelerated abdominal aortic aneurysms via MMP regulation. (Source: Journal of Periodontal Research)

Is the Incidence of Abdominal Aortic Aneurysm Declining in the 21st Century? Mortality and Hospital Admissions for England & Wales and Scotland

European Journal of Vascular and Endovascular Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions: These data suggest that the age at which clinically-relevant aneurysms present has increased by 5–10 years and that incidence of clinically-relevant AAA in men in England & Wales and Scotland is declining rapidly. The reasons for this are unclear. (Source: European Journal of Vascular and Endovascular Surgery)

What are the Risk Factors for Renal Failure following Open Elective Abdominal Aortic Aneurysm Repair?

European Journal of Vascular and Endovascular Surgery — Mon, 19 Dec 2011 05:00:00 +0100

The objective of this study was to identify risk factors for renal failure following open elective AAA repair.Design: A retrospective analysis of prospectively collected multi-centre data.Materials: Consecutive data on patients undergoing open elective AAA repair were collected between January 2000 and December 2010. Patients with pre-operative serum creatinine >200 μmol/L were excluded.Methods: Renal failure was reported by clinicians and included all patients requiring post-operative renal-replacement therapy. Univariate and multivariate analyses were used to identify renal failure risk factors. A simplified clinical risk score was developed.Results: Post-operative renal failure occurred in 140 (6.0%) of 2347 patients and was associated with age >75 (OR = 1.58, 95%CI 1.11–2.26), sy...

Letter to Editor Re “Differential Protein Expression in Serum of Abdominal Aortic Aneurysm Patients – A Proteomic Approach”

European Journal of Vascular and Endovascular Surgery — Mon, 19 Dec 2011 05:00:00 +0100

In their paper “Differential expression in serum of abdominal aortic aneurysm patients – A proteomic approach”, Pulinx et al. mined the proteome of patients with AAAs in search of novel biomarkers. They report elevated factor XII and α-1 antitrypsin levels in the serum of patients with progressive aneurysms, but found these proteins to have little ability to predict aneurysm progression above the established marker, AAA diameter. (Source: European Journal of Vascular and Endovascular Surgery)

Emergency Abdominal Aortic Aneurysm Repair in a Patient with Failing Heart: Axillofemoral Bypass Using a Centrifugal Pump Combined with Levosimendan for Inotropic Support

Clinical and Developmental Immunology — Sun, 18 Dec 2011 23:53:19 +0100

We describe the case of an 83-year-old patient requiring repair of a large symptomatic abdominal aortic aneurysm (AAA). The patient was known to have coronary artery disease (CAD) with symptoms and signs of significant myocardial dysfunction, left-heart failure, and severe aortic insufficiency. The procedure was performed with the help of both mechanical and pharmacological circulatory support. Distal perfusion was provided by an axillofemoral bypass with a centrifugal pump, with dobutamine and levosimendan administered as pharmacological inotropic support. The patient's hemodynamic status was monitored with continuous cardiac output monitoring and transesophageal echocardiography. No serious circulatory complications were recorded during the perioperative and postoperative periods. This p...

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Increasing Complexity in the Open Surgical Repair of Abdominal Aortic Aneurysms

Annals of Vascular Surgery — Fri, 16 Dec 2011 23:24:35 +0100

Conclusions: OSR of AAAs has become increasingly complex, with the increased utilization of EVAR. Despite this complexity, risk-adjusted outcomes may remain good in high-volume centers. (Source: Annals of Vascular Surgery)

Preservation of Hypogastric Artery Blood Flow During Endovascular Aneurysm Repair of an Abdominal Aortic Aneurysm With Bilateral Common and Internal Iliac Artery Involvement: Utilization of Off-the-Shelf Stent-Graft Components

Annals of Vascular Surgery — Fri, 16 Dec 2011 23:24:35 +0100

A 72-year-old male presented with a 7.4-cm abdominal aortic aneurysm with bilateral common and internal iliac involvement. To maintain pelvic perfusion, preservation of the patient’s left hypogastric artery (HA) was pursued. Two weeks after right HA embolization, endovascular repair of the patient’s aneurysms was performed using a branched endograft approach. A 22-mm main body bifurcated endograft was unsheathed and the proximal covered stent was removed. The contralateral gate was preloaded with a wire and catheter. The device was resheathed and placed in the left common iliac artery. The preloaded wire in the contralateral gate was snared from the right side, establishing through-and-through femoral access. A contralateral femoral sheath was advanced up and over the aortic bifurcatio...

Is the Incidence of Abdominal Aortic Aneurysm Declining in the 21st Century? Mortality and Hospital Admissions for England & Wales and Scotland.

PubMed: Eur J Vasc Endovasc ... — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS: These data suggest that the age at which clinically-relevant aneurysms present has increased by 5-10 years and that incidence of clinically-relevant AAA in men in England & Wales and Scotland is declining rapidly. The reasons for this are unclear. PMID: 22178251 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

What are the Risk Factors for Renal Failure following Open Elective Abdominal Aortic Aneurysm Repair?

PubMed: Eur J Vasc Endovasc ... — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS: Renal failure following open elective AAA repair was associated with an increased risk of mortality. Risk factors for post-operative renal failure were identified and a simple clinical risk score developed to facilitate focussed care strategies for high-risk patients. PMID: 22178250 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Syndecan-1 Displays a Protective Role in Aortic Aneurysm Formation by Modulating T Cell-Mediated Responses.

Arteriosclerosis, Thrombosis and Vascular Biology — Thu, 15 Dec 2011 05:00:00 +0100

CONCLUSIONS: These investigations identify cross-talk between Sdc-1-expressing macrophages and AAA-localized CD4(+) T cells, with Sdc-1 providing an important counterbalance to T-cell-driven inflammation in the vascular wall. PMID: 22173227 [PubMed - as supplied by publisher] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)

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Assessment of the Accuracy of AortaScan for Detection of Abdominal Aortic Aneurysm (AAA)

European Journal of Vascular and Endovascular Surgery — Thu, 15 Dec 2011 05:00:00 +0100

Conclusion: A device to detect AAA without the need for a trained operator would have potential in a community-based screening programme. The AortaScan, however, lacks adequate sensitivity and significant technical improvement is necessary before it could be considered a replacement for trained screening personnel. (Source: European Journal of Vascular and Endovascular Surgery)

Contralateral Iliac Occlusion can be Successfully Achieved Using an Amplatz Vascular Plug During Aorto-uni-iliac Endovascular Aneurysm Repair

EJVES Extra — Thu, 15 Dec 2011 05:00:00 +0100

Discussion: Access limitations are a consideration for both device deployment and contralateral occlusion whilst undertaking aorto-uni-iliac endovascular aneurysm repair. This paper describes a simple and effective method for achieving iliac occlusion when access vessels are stenosed. (Source: EJVES Extra)

HOXA4 protein levels and localization in the aorta and in human abdominal aortic aneurysms

BMC Physiology - Latest articles — Wed, 14 Dec 2011 05:00:00 +0100

This report presents evidence for the specificities of select commercially available HOXA4 antibodies in regards to concerns about the specificity of the HOXA4 antibody used by Lillvis et al. (Regional expression of HOXA4 along the aorta and its potential role in human abdominal aortic aneurysms. BMC Physiol 2011, 11:9). Using an antibody characterized extensively by us, Lillvis et al. report detecting HOXA4 at a size of 33kDa despite our previous reports that HOXA4 is detected at ~37-39kDa and that the ~30-33kDa band is non-specific. Using small interfering RNA targeting HOXA4, forced expression of full-length HOXA4 and HOXA4-positive and -negative ovarian cancer cell lines, we confirm our previous findings that the ~30-33kDa band is non-specific and that HOXA4 is detected at ~37-39kDa. M...

Increased plasma levels of NGAL, a marker of neutrophil activation, in patients with abdominal aortic aneurysm

Atherosclerosis — Wed, 14 Dec 2011 05:00:00 +0100

Abstract: Objective: Neutrophil gelatinase-associated lipocalin (NGAL) plasma concentrations have been associated with cardiovascular diseases. We aimed to assess the association of NGAL with abdominal aortic aneurysm (AAA).Methods: NGAL concentrations were analyzed by Western blotting in conditioned medium of polymorphonuclear neutrophils (PMNs) from AAA patients (n=22) and controls (n=11), and also in aortic biopsies from AAA patients and healthy controls (n=10). Plasma NGAL concentrations were measured by ELISA in three groups of subjects from France (n=60), Spain (n=75) and Australia (n=100) and associated with AAA presence and growth.Results: PMNs isolated from AAA patients secreted significantly greater amounts of NGAL than PMNs from controls. Luminal thrombus released large amounts ...

Assessment of the Accuracy of AortaScan for Detection of Abdominal Aortic Aneurysm (AAA).

PubMed: Eur J Vasc Endovasc ... — Tue, 13 Dec 2011 05:00:00 +0100

CONCLUSION: A device to detect AAA without the need for a trained operator would have potential in a community-based screening programme. The AortaScan, however, lacks adequate sensitivity and significant technical improvement is necessary before it could be considered a replacement for trained screening personnel. PMID: 22172238 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

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Plasma Levels of Matrix Metalloproteinase-9: A Possible Diagnostic Marker of Successful Endovascular Aneurysm Repair.

PubMed: Eur J Vasc Endovasc ... — Tue, 13 Dec 2011 05:00:00 +0100

CONCLUSIONS: Plasma MMP-9 levels appear to discriminate between patients with and without an endoleak with high sensitivity and specificity. PMID: 22172237 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

A Systematic Review of Protocols for the Three-Dimensional Morphologic Assessment of Abdominal Aortic Aneurysms Using Computed Tomographic Angiography

CardioVascular and Interventional Radiology — Sat, 10 Dec 2011 06:41:23 +0100

Abstract The morphology of infrarenal abdominal aortic aneurysms (AAAs) directly influences the perioperative outcome and long-term durability of endovascular aneurysm repair. A variety of methods have been proposed for the characterization of AAA morphology using reconstructed three-dimensional (3D) computed tomography (CT) images. At present, there is lack of consensus as to which of these methods is most applicable to clinical practice or research. The purpose of this review was to evaluate existing protocols that used 3D CT images in the assessment of various aspects of AAA morphology. An electronic search was performed, from January 1996 to the end of October 2010, using the Embase and Medline databases. The literature review conformed to PRISMA statement standards. T...

Treatment of Delayed Neurological Deficits after Surgical Repair of Thoracic Aortic Aneurysm.

Annals of Thoracic and Cardiovascular Surgery — Fri, 09 Dec 2011 05:00:00 +0100

We describe one patient (Case 1), in whom descending thoracic and abdominal aortic aneurysms were treated by endovascular aortic repair, and another (Case 2) with Crawford type II TAAA, who developed delayed neurological deficits that were treated with immediate COPS therapy (Modified Tarlov scale; Case1, improved from 2 to 4; Case 2, from 0 to 4). These findings indicate the benefit of COPS for treating delayed neurological deficits after descending thoracic and TAAA. PMID: 22156278 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovascular Surgery)

Deficiency of receptor-associated protein attenuates angiotensin II-induced atherosclerosis in hypercholesterolemic mice without influencing abdominal aortic aneurysms

Atherosclerosis — Fri, 09 Dec 2011 05:00:00 +0100

Conclusions: Whole body RAP deficiency attenuated atherosclerosis without influencing AAAs in hypercholesterolemic mice infused with AngII. The anti-atherogenic effect was not attributable to RAP deficiency in bone marrow-derived cells. (Source: Atherosclerosis)

Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery.

The British Journal of Surgery — Sat, 03 Dec 2011 22:50:03 +0100

CONCLUSION: Coding consistency was high. The proposed framework could define homogeneous groups by combining diagnosis, procedure and administrative codes. It also allows an assessment of potential miscoding at national and hospital level. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22105834 [PubMed - in process] (Source: The British Journal of Surgery)

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The association between the gene encoding 5-lipoxygenase activating protein and abdominal aortic aneurysms

Atherosclerosis — Fri, 02 Dec 2011 05:00:00 +0100

Conclusion: A genetic predisposition to up-regulation of LT mediators is unlikely to play a dominant role in the pathogenesis of AAA. (Source: Atherosclerosis)

Acute thrombosis of abdominal aortic aneurysm presenting with lower limb ischaemia

ANZ Journal of Surgery — Thu, 01 Dec 2011 05:00:00 +0100

(Source: ANZ Journal of Surgery)

Long-term single institution comparison of endovascular aneurysm repair and open aortic aneurysm repair

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: EVAR requires more late secondary vascular interventions than open AAA repair, but patients who undergo open repair have more nonvascular long-term morbidity. Long-term survival is better after EVAR compared to open repair in this selected patient group. (Source: Journal of Vascular Surgery)

Discussion

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Dr Karthikeshwar Kasirajian, (Atlanta, Ga). I thank the authors for getting me the manuscript well ahead of time. Over a 24-year period, the authors evaluated vascular and nonvascular complications in patients undergoing open or endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs). Both groups included close to 1000 patients, making this one of the largest series reported. Although the study period started in 1985, EVAR was only incorporated in their practice in 1999. Despite significantly higher levels of comorbidities in the EVAR group, advances over the last decade in anesthesia and perioperative care, the use of statins, β-blockers, and antiplatelet agents may bias outcomes in favor of the EVAR group. The authors concluded that patients who had EVAR required more...

Comparative Predictors of Mortality for Endovascular and Open Repair of Ruptured Infrarenal Abdominal Aortic Aneurysms

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Mortality rates for EVAR treatment and open treatment of ruptured aortic aneurysm are equal with regard to 30 day and long term mortality. Many patients with ruptured abdominal aortic aneurysm (rAAA) die before reaching surgery (Acosta S. J Vasc Surg 2006;44:237-43). In-hospital mortality rates range between 30 and 70%. A large meta analysis found an overall 48% mortality (Brown MJ Br J Surg 2002;89:714-30). EVAR for rAAA was first described in 1994 (Marin ML et al. Ann Surg 1995;222:449-65) and is gaining in popularity. The authors sought to evaluate their results of treatment of rAAA with a particular focus in comparing endovascular repair of rAAA versus open surgery repair. Between January of 1990 and May of 2008 there were 160 patients who underwent repair of rAAA. Twenty percent (n =...

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Systematic Review and Meta-Analysis of Growth Rates of Small Abdominal Aortic Aneurysms

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

In studies reporting growth rates of small abdominal aortic aneurysms (AAA) there is considerable variation in growth rate, beyond that which can be explained by aneurysm diameter alone. (Source: Journal of Vascular Surgery)

A Meta-analysis and Metaregression Analysis of Factors Influencing Mortality after Endovascular Repair of Ruptured Abdominal Aortic Aneurysms

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

To determine factors that may influence the perioperative mortality after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs) using metaregression analysis. A meta-analysis of all English-language literature with information on mortality rates after endovascular repair of RAAAs was conducted. A metaregression was subsequently performed to determine the impact on mortality of the following 8 factors: patient age; mid-time study point; anaesthesia; endograft configuration; haemodynamic instability; use of aortic balloon; conversion to open repair; and abdominal compartment syndrome. (Source: Journal of Vascular Surgery)

Single-centre Prospective Comparison Between Contrast-Enhanced Ultrasound and Computed Tomography Angiography after EVAR

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

To evaluate contrast-enhanced ultrasound (CEUS) as an effective alternative to CT-angiography (CTA) for endoleak detection and aneurismal sac diameter measurement in the follow-up after endovascular abdominal aortic aneurysm repair (EVAR). (Source: Journal of Vascular Surgery)

Novel Endovascular Approach to an Aortocaval Fistula Complicating a Ruptured AAA

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

We report a novel method of endovascular repair of a AAA rupture into the inferior vena cava. (Source: Journal of Vascular Surgery)

Endovascular Management of Inflammatory Abdominal Aortic Aneurysms

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Inflammatory abdominal aortic aneurysms (IAAA) have been traditionally managed with open repair. Endovascular repair of aortic aneurysms (EVAR) was approved September of 1999. Some authors have suggested EVAR is not an acceptable option for management of IAAA. However, several recent reports have suggested EVAR is a reasonable management option in these patients. The purpose of our study was to review our experience with the contemporary management of IAAA involving both open and endovascular approaches. (Source: Journal of Vascular Surgery)

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Survival Comparison of Patients Undergoing Secondary Aortic Repair

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Infrarenal abdominal aortic aneurysm (AAA) repair requires lifelong surveillance due to continued disease. The outcome of a second aortic intervention may further be affected by therapeutic approach. In the current study, we evaluated outcomes in patients who underwent secondary aortic procedures after initial aortic repair, either EVAR or open. (Source: Journal of Vascular Surgery)

Aortoduodenal Fistula After Endograft Repair of Abdominal Aortic Aneurysm Secondary to a Retained Guidewire

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

This report describes a unique complication of aortoduodenal fistula secondary to duodenal perforation by previously placed embolic material. (Source: Journal of Vascular Surgery)

Iliac Artery Recanalization of Chronic Occlusions to Facilitate EVAR - Midterm Multicenter Results

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Concurrent iliac occlusion and abdominal aortic aneurysm is rare. Traditionally, the endovascular approach to these patients has consisted of aorto-uni-iliac devices combined with femoral-femoral bypass. This approach may hinder future endovascular interventions and potentially increase the risk of groin infections. With improved facility of subintimal angioplasty techniques, standard bifurcated endografts represent an alternative option in these patients. The purpose of this study was to examine outcomes of patients undergoing iliac recanalization and traditional bifurcated EVAR in the face of access vessel occlusion. (Source: Journal of Vascular Surgery)

Regarding “Evaluation of the Endurant stent graft under instructions for use vs off label conditions for endovascular aortic aneurysm repair”

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

We read the article by Torsello et al with interest. While the use of endovascular aneurysm repair (EVAR) has revolutionized the management of infrarenal abdominal aortic aneurysm (AAA) its use has only been shown feasible in 40% to 60% of AAA. Advances in technology, imaging, graft design, and operator experience has lead to an extension of their use beyond initial manufacturer's guidelines. The device studied in this article is licensed to a 10-mm neck extending or rather shortening the previous benchmark of 15 mm. Nevertheless, the ability to place the graft at operation outside this use is shown to be associated with increased type I endoleak. Numbers did not reach significance as the primary endpoint frequency was low and study group small. (Source: Journal of Vascular Surgery)

Regarding “Repairing immediate proximal endoleaks during abdominal aortic aneurysm repair”

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Rajani et al retrospectively reviewed data of 72 infrarenal abdominal aortic aneurysm (AAA) patients with an intraoperatively diagnosed type Ia endoleak requiring a Palmaz stent or covered stent graft cuff placement. They concluded that both methods appear to be durable long-term options to facilitate endovascular exclusion of AAA, with the results that no recurrent type Ia endoleak developed in the Palmaz stent group and three reinterventions were required in the cuff group. Given the lack of data assessing long-term outcomes of cuff and Palmaz (Cordis, Miami Lakes, Fla) stent placement after immediate type Ia endoleak, we would like to provide our single-center results and support their conclusions. (Source: Journal of Vascular Surgery)

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Impact of 3D culture of mesenchymal stem cells to repair expanding AAAS

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

This study proposes to investigate a cellular therapy by using a 3D structure of MSCs encapsulated in a hyaluronic acid (HA) hydrogel. We show that the morphological remodeling is induced when the MSC is seeded in the hydrogel. The expression marker is not modified and the cell plasticity is better preserved in 3D culture in comparison with the 2D case. The comparison also shows that the ratio of apoptosis cell is reduced when physiological environment is mimicked by applying dynamical strain. Based on these results, the Xenograft model of AAA on the rat [1] is used to test the capability of the MSC to repair the aneurysm. Thus, after 7 days, the endovascular injection in rats tends to stabilize the diameter of AAAs. In summary, preliminary results indicate that (i) the proposed 3D HA hydr...

Abdominal aortic aneurysms exhibit greater metabolic activity detected by positron emission tomography/computed tomography (PET/CT) compared to matched controls

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

In this study we sought to prospectively investigate whether there was a greater degree of inflammation in the aortas of AAA patients compared to matched controls with atherosclerosis. (Source: Artery Research)

Multifocal fibrosclerosis and IgG4-related disease involving the cardiovascular system.

Journal of Cardiology — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Ishizaka N, Sakamoto A, Imai Y, Terasaki F, Nagai R Abstract The cardiovascular system may be involved as a target organ of multifocal fibrosclerosis, which may manifest as idiopathic retroperitoneal fibrosis, inflammatory aortic aneurysm, inflammatory periarteritis, and inflammatory pericarditis. These pathological conditions can sometimes occur concomitantly. Idiopathic retroperitoneal fibrosis and inflammatory abdominal aortic aneurysm are both characterized by the presence of fibro-inflammatory tissue around the abdominal aorta expanding into the surrounding retroperitoneal structures, and together they may be termed 'chronic periaortitis'. Cardiovascular fibrosclerosis has become non-uncommonly encountered condition since imaging modalities have made its diagnosis mor...

In Vivo Characterization of a New Abdominal Aortic Aneurysm Mouse Model With Conventional and Molecular Magnetic Resonance Imaging

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

Conclusions: High-resolution, multisequence MRI allowed longitudinal monitoring of AAA progression while the presence of collagen was visualized by nanoparticle-enhanced MRI. (Source: Journal of the American College of Cardiology)

Improved Risk Assessment for Abdominal Aortic Aneurysm Rupture: Off-the-Wall Imaging⁎

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

Vessel dimensions are currently the primary imaging parameter used to risk-stratify patients with abdominal aortic aneurysms (AAAs). Intervention is recommended for an AAA with a diameter >5.5 cm. But there is more to the story. Both the stresses experienced by the aortic wall and the intrinsic strength of the wall itself are crucial in predicting rupture. New developments in imaging enable the direct evaluation of these factors and allow a more complete, patient-specific assessment of risk for disease progression. (Source: Journal of the American College of Cardiology)

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New GORE EXCLUDER AAA Endoprosthesis Sizing Options Available

Medical Design Online News — Tue, 29 Nov 2011 15:00:00 +0100

W. L. Gore & Associates, Inc. (Gore) has received FDA approval for the 23 mm and 27 mm diameter sizes of the contralateral leg component of the GORE EXCLUDER AAA Endoprosthesisfor treatment of abdominal aortic aneurysm (AAA) (Source: Medical Design Online News)

Surveillance strategies according to the rate of growth of small abdominal aortic aneurysms

Vascular Medicine recent issues — Tue, 29 Nov 2011 05:00:00 +0100

In conclusion, the rate of growth increased steadily with AAA size. An aneurysm < 3.5 cm does not require a repeat scan for 5 years, while those measuring 3.5–3.9 cm and 4.0–4.4 cm require a repeat scan after 17 and 11 months. (Source: Vascular Medicine recent issues)

Cardiovascular predictors for long-term mortality after EVAR for AAA

Vascular Medicine recent issues — Tue, 29 Nov 2011 05:00:00 +0100

In conclusion, ischemia on ECG and anemia were independently related to an increased long-term mortality rate after EVAR, and these predictive factors seem to be most important for critical assessment in the preoperative medical work-up. (Source: Vascular Medicine recent issues)

Use of a bifurcated endovascular graft for treatment of endograft migration with major endoleak.

Vascular — Tue, 29 Nov 2011 05:00:00 +0100

In conclusion, treatment with a bifurcated Zenith endograft has advantages over the use of an aortic cuff or aortouniiliac reconstruction. To perform this technique, there must be a sufficient distance between the proximal landing zone and the flow divider of the migrated endograft to allow for deployment of the Zenith device. While there remain limitations in its applicability, the use of a bifurcated endovascular graft is a viable alternative for endovascular salvage in treatment of endograft migration with major endoleaks. PMID: 22126799 [PubMed - as supplied by publisher] (Source: Vascular)

Guide rates best and worst hospitals in 2011

NHS News Feed — Mon, 28 Nov 2011 00:15:00 +0100

The Daily Telegraph has today revealed the findings of the latest Dr Foster Hospital Guide. The guide, published annually, closely scrutinises a range of healthcare data to measure hospital performance and detect trends that could save lives. As well as listing the hospital trusts in England that score above and below average on a range of different mortality measures, this year’s guide also found that: The rate of patient deaths in England is 20% lower than it was 10 years ago, in part because of improved hospital care. For certain conditions, patients admitted to hospital at the weekend are less likely to get treated quickly and have a higher chance of dying. Hospitals that perform certain operations infrequently pose a significantly greater risk to patients than those which c...

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Computational comparison of the bending behavior of aortic stent-grafts.

Journal of the Mechanical Behavior of Biomedical Materials — Fri, 25 Nov 2011 03:24:30 +0100

In conclusion, A-SG was more flexible than Z-SG according to FEA. A-SG may decrease the incidence of complications in the setting of tortuous aorto-iliac aneurysms. Our numerical model could be used to assess flexibility of further manufactured as well as newly designed SGs. PMID: 22100102 [PubMed - in process] (Source: Journal of the Mechanical Behavior of Biomedical Materials)

Associations of Insulin-like Growth Factor-I and its binding proteins with abdominal aortic aneurysm and aortic diameter in older men.

European Journal of Endocrinology — Wed, 23 Nov 2011 05:00:00 +0100

ConclusionsIn older men, higher IGF-I and an increased ratio of IGF-I/IGFBP3 are associated with AAA, while IGFBP1 is independently associated with increased aortic diameter. Components of the IGF-I system may contribute to, or be a marker for, aortic dilation in ageing men. PMID: 22113073 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Aptus Endosystems receives FDA clearance

bizjournals.com Health Care:Physician Practices headlines — Mon, 21 Nov 2011 22:57:42 +0100

Aptus Endosystems Inc. said Monday it received U.S. Food and Drug Administration (FDA) clearance for its Aptus EndoStapling System, which it now plans to call the branded HeliFX Aortic Securement System. The Sunnyvale-based medical device company develops advanced technology for endovascular aneurysm repair. The technology is "designed to mimic the hand suturing performed during open surgical repair of abdominal aortic aneurysms," according to Aptus. About 200,000 people in the United States and 100,000 in Europe suffer from the condition every year... (Source: bizjournals.com Health Care:Physician Practices headlines)

Use of Hospital Episode Statistics to investigate abdominal aortic aneurysm surgery

British Journal of Surgery — Mon, 21 Nov 2011 05:00:00 +0100

Conclusion:Coding consistency was high. The proposed framework could define homogeneous groups by combining diagnosis, procedure and administrative codes. It also allows an assessment of potential miscoding at national and hospital level. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Preliminary intraobserver and interobserver variability in wall stress and rupture risk assessment of abdominal aortic aneurysms using a semiautomatic finite element model

Journal of Vascular Surgery — Mon, 21 Nov 2011 05:00:00 +0100

Objective: We investigated the intraobserver and interobserver variability of using semiautomatic finite element analysis to calculate the von Mises stress and peak wall rupture risk (PWRR) in patients with an abdominal aortic aneurysm (AAA) in longitudinal studies. Methods: Four independent observers made 3-dimensional (3D) reconstructions, with minimal manual adjustments, of small AAAs ( (Source: Journal of Vascular Surgery)

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The controversial role of the urokinase system in abdominal aortic aneurysm formation and rupture.

Arteriosclerosis, Thrombosis and Vascular Biology — Sat, 19 Nov 2011 21:37:27 +0100

Authors: Rein CM, Cardenas JC, Church FC PMID: 22096092 [PubMed - in process] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)

Plasmatic vasopressin in patients undergoing conventional infra-renal abdominal aorta aneurysm repair

Revista Brasileira de Cirurgia Cardiovascular — Fri, 18 Nov 2011 11:23:26 +0100

Aortic-neck dilation after endovascular abdominal aortic aneurysm repair (EVAR): can it be predicted?

La Radiologia Medica — Fri, 18 Nov 2011 06:53:20 +0100

Conclusions Dynamic CT provided insight into the abdominal aorta pathophysiology. Identifying patients with higher infrarenal distensibility could change selection of graft size to improve proximal fixation. Content Type Journal ArticleCategory Vascular and Interventional Radiology / Radiologia Vascolare e InterventisticaPages 1-11DOI 10.1007/s11547-011-0750-1Authors R. Iezzi, Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital, Catholic University, L.go A. Gemelli 8, 00168 Rome, ItalyM. Santoro, Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital, Catholic University, L.go A. Gemelli 8, 00168 Rome, ItalyG. Di Natale, Department of Bioimaging and Radiological Sciences,...

Emergency ultrasound in the prehospital setting: the impact of environment on examination outcomes

Emergency Medicine Journal — Fri, 18 Nov 2011 05:00:00 +0100

This study aimed to compare ultrasound examinations performed within a land ambulance (stationary and moving) with those completed in a simulated emergency department (ED) to determine the feasibility of undertaking ultrasound examinations within the UK prehospital care environment. The findings suggest that abdominal aortic aneurysm and extended focused assessment with sonography in trauma emergency ultrasound examinations can be performed in the stationary or moving land ambulance environment to a standard consistent with those performed in the hospital ED. (Source: Emergency Medicine Journal)

Polymorphisms of genes involved in extracellular matrix remodeling and abdominal aortic aneurysm

Journal of Vascular Surgery — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions: These findings suggest that polymorphisms in MMP2, MMP3, MMP-13, and ELN genes may independently contribute to the pathogenesis of AAA. Clinical Relevance: This study identifies polymorphisms in MMP2, MMP3, MMP-13, TIMP1, and ELN genes as genetic markers of abdominal aortic aneurysm (AAA) and underline the need to concentrate our efforts in studying the role of these markers in the aneurysmal disease to improve the understanding of its pathophysiology and pathogenesis. This study is part of the task for the identification of AAA genetic susceptibility factors, fundamental to design and develop gene-based clinical studies in the future to validate diagnostic or prognostic scores based on clinical, biochemical, genetic, and proteomic information to be applied in the everyday ...

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Association found between LRP1 and abdominal aortic aneurysm

MedWire News - Lipidology — Thu, 17 Nov 2011 00:00:00 +0100

Researchers have found an association between a common and potentially functional variant in the low-density lipoprotein receptor-related protein 1 gene and risk for abdominal aortic aneurysm. (Source: MedWire News - Lipidology)

Repeated Cerebral Ischemia Caused by Extracranial Carotid Artery Dolichoectasia

Journal of Neuroimaging — Mon, 14 Nov 2011 05:00:00 +0100

We report the case of a 67‐year‐old man with repeating cerebral embolism caused by a dolichoectatic right common carotid artery. The patient had a history of hypertension, hypercholesterolemia, cigarette smoking, and a postoperative abdominal aortic aneurysm. He presented with a sudden onset of weakness of the left arm and leg. Magnetic resonance imaging revealed old and fresh infarction in the right cerebral hemisphere. Carotid duplex ultrasonography showed a dolichoectatic right common carotid artery with a maximum diameter of 39 mm with thick plaque and strong spontaneous echo contrast. The flow velocity was considerably reduced, which caused thrombus formation, and strong antithrombotic therapy was required. This case provides a rare example of ischemic stroke caused by extracrania...

Endovascular Treatment of Aorto-caval Fistula

EJVES Extra — Mon, 14 Nov 2011 05:00:00 +0100

Abstract: We discuss the endovascular management of an 87 year old lady who presented with a ruptured abdominal aortic aneurysm, complicated by an aorto-caval fistula, under local anaesthesia. (Source: EJVES Extra)

Abdominal aortic aneurysm

Journal of Men's Health — Sun, 13 Nov 2011 18:29:51 +0100

This article reviews the prevalence, diagnosis, including screening guidelines, and treatment options for AAA, with reference to a case study of a 72 year old male smoker diagnosed with an AAA. (Source: Journal of Men's Health)

Endovascular Treatment of Aorto-caval Fistula

European Journal of Vascular and Endovascular Surgery — Fri, 11 Nov 2011 05:00:00 +0100

We discuss the endovascular management of an 87 year old lady who presented with a ruptured abdominal aortic aneurysm, complicated by an aorto-caval fistula, under local anaesthesia. (Source: European Journal of Vascular and Endovascular Surgery)

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Comparison of Ascending Aortic Size in Patients With Severe Bicuspid Aortic Valve Stenosis Treated With Versus Without a Statin Drug

The American Journal of Cardiology — Thu, 10 Nov 2011 00:17:56 +0100

Ascending aortic dilation commonly occurs in patients with bicuspid aortic valve (BAV). Statins have been shown to reduce the expression of matrix metalloproteinases and slow the progression of abdominal aortic aneurysms. The role of statins in slowing ascending aortic dilation in patients with BAV is unknown. We sought to compare the ascending aortic dimensions in patients with BAV stenosis treated with versus without a statin. From our catheterization laboratory database, all patients undergoing preoperative coronary angiography before aortic valve with or without ascending aorta replacement for bicuspid aortic stenosis (AS) from 2004 to 2007 were identified. The ascending aortic size was measured on their preoperative transesophageal echocardiogram. Data on statin use were obtained from...

Cost disparity between open repair and endovascular aneurysm repair for abdominal aortic aneurysm: a single-institute experience in Japan

Surgery Today — Wed, 09 Nov 2011 17:45:26 +0100

Conclusions New technologies should not only be clinically effective, but also cost effective. EVAR is less invasive clinically, but the cost of endovascular prostheses and other materials remains high. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00595-011-0041-4Authors Hirofumi Morimae, Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, JapanTakashi Maekawa, Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, JapanHiroaki Tamai, Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-c...

Fast Track Echo of Abdominal Aortic Aneurysm Using a Real Pocket‐Ultrasound Device at Bedside

Echocardiography — Tue, 08 Nov 2011 05:00:00 +0100

Conclusion: Considering its low cost, diagnostic accuracy, and widespread availability, screening for AAA using an ultraportable ultrasound device such as VSCAN by an experienced physician is promising and should be used as an extension of routine physical examination in vascular patients. (Echocardiography ****;**:1‐6) (Source: Echocardiography)

TriVascular abdominal stent graft gets FDA approval

Hospital Management — Tue, 08 Nov 2011 00:00:00 +0100

The US Food and Drug Administration (FDA) has approved TriVasculars' Ovation abdominal stent graft system to treat abdominal aortic aneurysm. (Source: Hospital Management)

Evolution of the upper and lower landing site after endovascular aortic aneurysm repair

Journal of Vascular Surgery — Mon, 07 Nov 2011 05:00:00 +0100

Conclusions: Our results show a trend toward dilatation of the aortic neck and iliac arteries, with no correlation between the two levels, even in patients with a regression of the aneurysm sac during follow-up. Although this study found no correlation with the occurrence of endoleaks, our results suggest the need for a longer follow-up, especially on the landing sites. (Source: Journal of Vascular Surgery)

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Endovascular abdominal aortic aneurysm repair: methods of radiological risk reduction.

The Journal of Cardiovascular Surgery — Sun, 06 Nov 2011 18:52:25 +0100

CONCLUSION: The optimum strategy, including equipment-related factors, procedure-conduct factors and follow-up procedures, has to be studied, justified and optimized in each medical facility. PMID: 22051986 [PubMed - in process] (Source: The Journal of Cardiovascular Surgery)

New Methods To Treat Aneurysms May Result From Gene Discovery

Health News from Medical News Today — Sun, 06 Nov 2011 08:00:00 +0100

Medical scientists have for the first time identified a gene responsible for a fatal abdominal condition that afflicts tens of thousands of people across the world. An international team led by Matt Bown, a vascular surgeon from the University of Leicester, identified a single gene that is linked to the development of abdominal aortic aneurysms (AAAs). What is more, the team discovered that the gene, LRP1, was not linked to other cardiovascular diseases, suggesting that it is specific to AAA... (Source: Health News from Medical News Today)

Abdominal Aortic Aneurysm Gene Discovered

Health News from Medical News Today — Fri, 04 Nov 2011 16:00:00 +0100

In a study published today in The American Journal of Human Genetics, an international team of medical scientists has for the first time discovered a gene responsible for a fatal abdominal condition that afflicts tens of thousands of people worldwide. Abdominal aortic aneurysm (AAA) is a swelling of the abdominal aorta to more than 1.5 times its usual size, usually representing an underlying weakness in the aorta's wall at that location. The biggest concern is the risk of rupture, causing severe pain and massive internal hemorrhage... (Source: Health News from Medical News Today)

FDA Approves System To Repair Abdominal Aneurysms In People With Small Arteries

Health News from Medical News Today — Fri, 04 Nov 2011 10:00:00 +0100

The U.S. Food and Drug Administration has approved a stent graft system that provides patients with small arteries the option of less invasive surgery to repair their potentially life-threatening abdominal aortic aneurysm. An abdominal aortic aneurysm is a bulge in the part of the aorta that runs through the abdomen and divides into the arteries that supply blood to each leg. Over time, this bulge can become weak, and the force of normal blood pressure can cause it to rupture, which can be life-threatening... (Source: Health News from Medical News Today)

Open repair of ruptured abdominal aortic aneurysm in patients aged 80 years and older.

The British Journal of Surgery — Fri, 04 Nov 2011 05:47:26 +0100

CONCLUSION: Survival after open repair of RAAA among patients aged 80 years and older is sufficient to justify the procedure, particularly in patients in a stable haemodynamic condition. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22034180 [PubMed - in process] (Source: The British Journal of Surgery)

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Long-term follow-up of type II endoleak embolization reveals the need for close surveillance

Journal of Vascular Surgery — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Embolization of type II endoleaks is successful early in preventing aneurysm sac growth and rupture after EVAR. However, a significant number of patients require more than one procedure, and at 5 years, many patients who underwent embolization of a type II endoleak continued to experience sac growth. Patients with hyperlipidemia who undergo coil embolization are more likely to require a second embolization procedure, and patients who smoke have a higher likelihood of AAA sac expansion after embolization. Continued long-term surveillance is necessary in this cohort of patients. (Source: Journal of Vascular Surgery)

Common gene mutation raises risk of life-threatening aneurysms

Guardian Unlimited Science — Thu, 03 Nov 2011 16:26:39 +0100

This article was amended on 4 November 2011. The original stated that the NHS screening programme would start in 2013 and that doctors would carry out the screening. This has been corrected.GeneticsMedical researchBiologyHealthIan Sampleguardian.co.uk © 2011 Guardian News and Media Limited or its affiliated companies. All rights reserved. | Use of this content is subject to our Terms & Conditions | More Feeds (Source: Guardian Unlimited Science)

Aneurysm stent okayed for patients with small arteries

theHeart.org — Thu, 03 Nov 2011 14:45:05 +0100

The stent for abdominal aortic aneurysms, which uses a delivery catheter narrower than any on the market, gives patients with small arteries the option of less invasive surgery. (Source: theHeart.org)

FDA OKs Stent Graft for AAA Repair

MedPage Today Primary Care — Thu, 03 Nov 2011 14:10:23 +0100

(MedPage Today) -- A new stent graft system has won FDA approval for repairing abdominal aortic aneurysms in patients with vessels too small for standard endograft products, the agency said Wednesday. (Source: MedPage Today Primary Care)

Preoperative Spirometry Results as a Determinant for Long-term Mortality after EVAR for AAA

European Journal of Vascular and Endovascular Surgery — Thu, 03 Nov 2011 04:00:00 +0100

Abstract: Objectives: The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA).Design: Retrospective analysis.Materials: Three-hundred and four consecutive patients treated electively with EVAR (Zenith® stent grafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerised database.Methods: The Global Initiative for Chronic Obstructive Lung Diseases (GOLD) guideline was used to grade the severity of obstructive lung disease. Mortality was checked until 1 December 2010. Median follow-up time was 68 (interquartile range (IQR) 40–94) months.Results: The percentage of patients with mild, moderate or severe (grade 3) chronic obstr...

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Long-term incidence of myocardial infarct, stroke, and mortality in patients operated on for abdominal aortic aneurysms

Journal of Vascular Surgery — Thu, 03 Nov 2011 04:00:00 +0100

Conclusion: AAA patients of both sexes have a high risk of atherosclerotic events (MI, stroke) and death, so lifelong prophylaxis must be considered from our epidemiologic data. Randomized trials investigating the potential benefit of aspirin and statin therapy in AAA patients are needed. (Source: Journal of Vascular Surgery)

Aneurysm Stent Okayed for Patients With Small ArteriesAneurysm Stent Okayed for Patients With Small Arteries

Medscape Today Headlines — Wed, 02 Nov 2011 21:13:05 +0100

FDA approves system to repair abdominal aneurysms in people with small arteries

Food and Drug Administration — Wed, 02 Nov 2011 16:59:00 +0100

Funnel Technique for EVAR: “A Way Out” for Abdominal Aortic Aneurisms With Ectatic Proximal Necks

Annals of Vascular Surgery — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions: Through four examples, we illustrate the feasibility of placing a straight endograft as proximal extension of a bifurcated or aorto-uni-iliac graft in patients with a dilated proximal aortic neck. It appears secure and effective, with no type I endoleak or migration over a midterm follow-up. (Source: Annals of Vascular Surgery)

Immunosuppression and the abdominal aortic aneurysm: doctor jekyll or mister hyde?

Circulation — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Lindeman JH, Rabelink TJ, van Bockel JH PMID: 22042930 [PubMed - in process] (Source: Circulation)

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Preoperative Spirometry Results as a Determinant for Long-term Mortality after EVAR for AAA.

PubMed: Eur J Vasc Endovasc ... — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: Our findings strengthen the need for formal evaluation of lung function with spirometry prior to proceeding to AAA repair. PMID: 22051733 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Unusual emergent presentations of abdominal aortic aneurysm: Can simple blood tests predict the state of emergency?

Turkish Journal of Trauma and Emergency Surgery : TJTES — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: To avoid a delay in diagnosis, it is important to know the different presentations of emergency AAA. In the emergency room, simple laboratory parameters may be highly directive in suspicion of ruptured AAA. PMID: 22290006 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

Aortic Emergencies

Emergency Medicine Clinics of North America — Mon, 31 Oct 2011 22:44:24 +0100

Aortic emergencies present a diagnostic and treatment challenge for emergency physicians. Both acute aortic dissection and abdominal aortic aneurysms can be difficult to recognize, and a missed or delayed diagnosis may be fatal. A high clinical suspicion and rapid patient evaluation are important. Although many patients ultimately require surgical intervention, early and aggressive attention to hemodynamic stability by the emergency physician can provide a window to definitive treatment. (Source: Emergency Medicine Clinics of North America)

Less Invasive Anesthetic Methods Better For Endovascular Aneurysm Repair

Health News from Medical News Today — Mon, 31 Oct 2011 07:00:00 +0100

Researchers have identified a safer, more cost effective way to provide anesthesia for patients undergoing endovascular repair of an abdominal aortic aneurysm - a common, often asymptomatic condition that, if not found and treated, can be deadly. A new study done by investigators at Wake Forest Baptist Medical Center found that using less invasive spinal, epidural and local/monitored anesthesia care (MAC) is better than general anesthesia for elective endovascular repair of infrarenal abdominal aortic aneurysms (EVAR)... (Source: Health News from Medical News Today)