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https://www.readbyqxmd.com/read/29777851/point-of-care-ultrasound-performed-by-a-medical-student-compared-to-physical-examination-by-vascular-surgeons-in-the-detection-of-abdominal-aortic-aneurysms
#1
Trinh Mai, Michael Y Woo, Kim Boles, Prasad Jetty
OBJECTIVE: To determine the test characteristics of point-of-care ultrasonography performed by a medical student versus physical examination by vascular surgeons compared to a gold standard reference scan for the detection of abdominal aortic aneurysms. METHODS: We conducted a prospective, observer-blinded study recruiting patients from an outpatient vascular surgery clinic. Participants were screened for abdominal aortic aneurysms by standardized physical examination by a blinded vascular surgeon, followed by a point-of-care ultrasound examination by a blinded medical student...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777669/repair-of-thoracic-and-thoracoabdominal-mycotic-aneurysms-and-infected-aortic-grafts-using-allograft
#2
Joel S Corvera, David Blitzer, Hannah Copeland, Daniel Murphy, Philip J Hess, Saila T Pillai, John W Fehrenbacher
BACKGROUND: Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. METHODS: Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777203/ginkgo-biloba-extracts-prevent-aortic-rupture-in-angiotensin-ii-infused-hypercholesterolemic-mice
#3
Xiao-Fang Huang, Song-Zhao Zhang, Ya-Yu You, Na Zhang, Hong Lu, Alan Daugherty, Xiao-Jie Xie
Abdominal aortic aneurysms (AAAs) are a chronic vascular disease characterized by pathological luminal dilation. Aortic rupture is the fatal consequence of AAAs. Ginkgo biloba extracts (GBEs), a natural herb extract widely used as food supplements, drugs, and cosmetics, has been reported to suppress development of calcium chloride-induced AAAs in mice. Calcium chloride-induced AAAs do not rupture, while angiotensin II (AngII)-induced AAAs in mice have high rate of aortic rupture, implicating potentially different mechanisms from calcium chloride-induced AAAs...
May 18, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29775657/stabilization-of-the-abdominal-aorta-during-the-cardiac-cycle-with-the-sac-anchoring-nellix-device
#4
Nathan K Itoga, Ga-Young Suh, Christopher P Cheng
The Nellix device utilizes polymer filled endobags to stabilize the abdominal aortic aneurysm (AAA) sac described as endovascular aneurysm sealing (EVAS). We analyzed cardiac gated CTA scans of repaired AAA with EVAS in four patients to evaluate geometry and cardiac pulsatility-induced deformation. Graft translation and aortic curvature changes were found to be minimal during the cardiac cycle. The mean±SD changes in renal-aorta angles (1.0±0.9°) were less than the changes in the SMA-aorta angle (4.0±2...
May 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#5
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29773491/association-between-number-of-preventive-care-guidelines-and-preventive-care-utilization-by-patients
#6
Glen B Taksler, Elizabeth R Pfoh, Kurt C Stange, Michael B Rothberg
INTRODUCTION: The number of preventive care guidelines is rapidly increasing. It is unknown whether the number of guideline-recommended preventive services is associated with utilization. METHODS: The authors used Poisson regression of 390,778 person-years of electronic medical records data from 2008 to 2015, in 80,773 individuals aged 50-75 years. Analyses considered eligibility for 11 preventive services most closely associated with guidelines: tobacco cessation; control of obesity, hypertension, lipids, or blood glucose; influenza vaccination; and screening for breast, cervical, or colorectal cancers, abdominal aortic aneurysm, or osteoporosis...
May 8, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#7
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29772329/impact-of-stent-graft-oversizing-on-gutter-areas-after-chimney-graft-repair-for-complex-abdominal-aortic-aneurysms
#8
Romain de Blic, Frédéric Cochennec, Faris Alomran, Hicham Kobeiter, Eric Allaire, Pascal Desgranges, Jean-Pierre Becquemin
PURPOSE: The aim of this retrospective study was to examine the impact of graft oversizing on gutter area and stent compression in chimney graft (CG) for complex abdominal aortic aneurysms (CAAA) repair. The influence of stent graft oversizing on type Ia endoleaks and bridging stent occlusion rates were also examined. METHODS: Preoperative and postoperative computed tomographic angiography (CTA) scans of patients requiring chimney grafts for CAAA between June 2009 and April 2013 in our institution were analysed...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772328/current-evidence-on-management-of-aortic-stent-graft-infection-a-systematic-review-and-meta-analysis
#9
REVIEW
Hai Lei Li, Yiu Che Chan, Stephen W Cheng
OBJECTIVE: Aortic stent-graft infection is rare, but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). METHODS: A systematic literature review of all published literature from January 1991 to September 2016 on stent-graft infection was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772327/creation-of-abdominal-aortic-aneurysms-in-sheep-by-extrapolation-of-rodent-models-is-it-feasible
#10
Peter Verbrugghe, Jelle Verhoeven, Marnick Clijsters, Dominique Vervoort, Walter Coudyzer, Eric Verbeken, Bart Meuris, Paul Herijgers
BACKGROUND: Aortic abdominal aneurysms are a potentially deathly disease, needing surgical or endovascular treatment. To evaluate potentially new diagnostic tools and treatments a large animal model, which not only resembles the morphological characteristics but also the pathophysiological background, would be useful. MATERIALS AND METHODS: Rodent animal aneurysm models were extrapolated to sheep. Four groups were created: intraluminal infusion with an elastase-collagenase solution (n=4), infusion with elastase-collagenase solution combined with proximal stenosis (n=7), aortic xenograft (n=3), and elastase-collagenase treated xenograft (n=4)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772324/morphology-related-limitations-of-evar-applicability-in-the-treatment-of-aaa-in-west-central-poland
#11
Łukasz Dzieciuchowicz, Jolanta Tomczak, Ewa Strauss, Grzegorz Oszkinis
BACKGROUND: To analyze the current applicability of endovascular aneurysm repair (EVAR) in patients with an infrarenal abdominal aortic aneurysm (AAAs) with indication for elective treatment in West-Central Poland. METHODS: Computed tomography angiograms of 100 consecutive patients with infrarenal AAA deemed to require treatment were analyzed with an OsiriX DICOM viewer in 3D-MPR mode. Proximal neck diameter, length, angulation, shape, the presence of thrombus and calcification, distal neck diameter, and morphology of the iliac arteries were determined...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772314/urgent-use-of-gore-excluder-iliac-branch-endoprosthesis-ibe-with-left-transaxillary-approach-for-preservation-of-the-residual-hypogastric-artery-a-case-series
#12
D'Oria Mario, Chiarandini Stefano, Pipitone Marco, Calvagna Cristiano, Riccitelli Francesco, Rotelli Alice, Zamolo Francesca, Griselli Filippo
Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. MethodsWe report the case of two high-risk patients (unfit for open surgery), with previous EVAR and exclusion of one HGA, treated in emergency setting. Both patients met the anatomical requirements for Gore IBE use...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772312/early-and-late-outcomes-of-endovascular-aortic-aneurysm-repair-versus-open-surgical-repair-of-an-abdominal-aortic-aneurysm-a-single-center-study
#13
Kyunghak Choi, Youngjin Han, Gi-Young Ko, Yong-Pil Cho, Tae-Won Kwon
OBJECTIVE: To compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. METHODS: Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment that they received (EVAR or OSR). Patient demographics, and in hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772311/mid-term-outcomes-of-endovascular-aortic-aneurysm-repair-with-carbon-dioxide-guided-angiography
#14
Yuriko Takeuchi, Noriyasu Morikage, Yutaro Matsuno, Tamami Nakamura, Makoto Samura, Koshiro Ueda, Takasuke Harada, Yoshitaka Ikeda, Kotaro Suehiro, Hiroshi Ito, Kensuke Sakata, Kimikazu Hamano
BACKGROUND: Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO2 -guided angiography. METHODS: Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO2 -EVAR group (n=30)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#15
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770795/cytokines-as-biomarkers-of-inflammatory-response-after-open-versus-endovascular-repair-of-abdominal-aortic-aneurysms-a-systematic-review
#16
REVIEW
Diamantis I Tsilimigras, Fragiska Sigala, Georgios Karaolanis, Ioannis Ntanasis-Stathopoulos, Eleftherios Spartalis, Michael Spartalis, Nikolaos Patelis, Alexandros Papalampros, Chandler Long, Demetrios Moris
The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome...
May 17, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29768367/the-phenotypic-heterogeneity-of-patients-with-marfan-related-disorders-and-their-variant-spectrums
#17
Go Hun Seo, Yoon-Myung Kim, Eungu Kang, Gu-Hwan Kim, Eul-Ju Seo, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS) are the connective tissue disorders characterized by aortic root aneurysm and/or dissection and various additional features. We evaluated the correlation of these mutations with the phenotypes and determined the clinical applicability of the revised Ghent criteria.The mutation spectrum and phenotypic heterogeneities of the 83 and 5 Korean patients with suspected MFS and LDS were investigated as a retrospective manner. In patients with suspected MFS patients, genetic testing was conducted in half of 44 patients who met the revised Ghent criteria clinically and half of 39 patients who did not meet these criteria...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767819/is-there-a-prospect-for-hybrid-aortic-arch-surgery
#18
REVIEW
Mohamad Bashir, Amer Harky, Haris Bilal
The surge of endovascular repair of aortic aneurysm in current modern aortic surgery practice has been the key for surgical management of elective cases of thoracic aortic aneurysms. This has paved way for the combined hybrid approach to be amongst the armamentarium for the management of aortic arch disease. The pivotal understanding of the aortic arch natural history coupled with device technology advancement allowed surgeons insight into delivery of hybrid surgery with acceptable morbidity and mortality results...
May 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29766011/use-of-iliac-branch-device-for-endovascular-treatment-for-abdominal-aorta-aneurysm-with-small-diameter-neck
#19
Umberto G Rossi, Davide Santuari, Raffaello Dallatana, Maurizio Cariati
We present the case of a 78-year-old woman with a 4.5-cm symptomatic abdominal aortic aneurysm with a small diameter (13-mm diameter) infrarenal aortic neck who underwent endovascular treatment using an iliac branch device as a bifurcated aortic stent-graft.
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29766010/single-stage-endovascular-treatment-of-a-penetrating-aortic-ulcer-with-a-concomitant-isolated-iliac-aneurysm
#20
Haidi Hu, Jianming Guo, Hualong Bai, Alan Dardik
Penetrating aortic ulcer (PAU) is an acute aortic syndrome that can proceed to life-threatening aortic dissection or even aortic rupture. Isolated iliac aneurysms are relatively rare and often asymptomatic due to their deep pelvic location but are frequently associated with high mortality with rupture. We report a case of a 68-year-old man with a symptomatic penetrating ulcer in the descending aorta and an asymptomatic right iliac aneurysm involving the common and internal iliac arteries. The patient was successfully treated by endovascular repair in a single-stage manner using stent grafts in the descending aorta and right common iliac artery after coil embolization of the right internal iliac artery...
December 2017: Aorta (Stamford, Conn.)
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