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Rupture aortic aneurysm

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https://www.readbyqxmd.com/read/28241301/battle-of-the-bulge-aortic-aneurysm-management-from-early-modernity-to-the-present
#1
Justin Barr
For centuries, physicians have recognized aortic aneurysms as an acute threat to life. Therapeutic approaches to the disease began in the 18th century when leading physicians, such as René Laennec and Antonio Valsalva, applied research on circulation and blood coagulation to devise whole-body fasting and bleeding regimens to prevent rupture. After John Hunter's success in ligating arteries to treat peripheral aneurysms, surgeons attempted analogous operations on the aorta, but even the renowned Sir Astley Cooper and William Halsted met with disastrous results...
February 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28238929/comparison-between-open-and-endovascular-repair-for-the-treatment-of-juxtarenal-abdominal-aortic-aneurysms-a-single-center-experience-with-midterm-results
#2
Koji Maeda, Takao Ohki, Yuji Kanaoka, Takeshi Baba, Kenjirou Kaneko, Kota Shukuzawa
PURPOSE: To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA) we compared outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) utilizing a variety of fenestrated and snorkel EVARs. METHODS: We evaluated overall survival, aneurysm-related death, re-intervention and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28238928/endovascular-and-open-repair-of-ruptured-infrarenal-aortic-aneurysms-at-a-tertiary-care-center
#3
Matthew A Schechter, Luigi Pascarella, Steven Thomas, Richard L McCann, Leila Mureebe
OBJECTIVE: The mortality of ruptured infrarenal abdominal aortic aneurysms (rAAA) has been reported as high as 90%. Loss of consciousness and a systolic blood pressure of < 80mmHg on presentation are the most important predictors of mortality after emergent open repair (OR). Endovascular repair of abdominal aortic aneurysm (EVAR) has reduced short-term operative mortality and morbidity for elective abdominal aortic aneurysm repair, and many be advocated for wider application of EVAR for rAAA...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28238237/immediate-early-and-late-failure-after-transcatheter-aortic-valve-implantation-how-to-deal-with-the-inoperable
#4
Sabina P W Guenther, Maximilian A Pichlmaier, Erik Bagaev, Florian Herrmann, René Schramm, Steffen Massberg, Christian Hagl, Nawid Khaladj
BACKGROUND: Currently, the use of transcatheter aortic valve implantation (TAVI) is constantly increasing, whilst cardiosurgical back-up varies substantially. Besides immediate conversion to surgical aortic valve replacement (SAVR) for periprocedural complications, SAVR for TAV failure may be necessary within the early or late post-implant course. The etiology, incidence, risk-stratification, management and outcome for both scenarios are largely unclear. The study aim was to provide details of the authors' experience of SAVR after the failure of TAVI at a single institution...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28237189/ct-for-acute-nontraumatic-abdominal-pain-is-oral-contrast-really-required
#5
Rivka Kessner, Sophie Barnes, Pinchas Halpern, Vadim Makrin, Arye Blachar
RATIONALE AND OBJECTIVES: This study aims to compare the diagnostic performance of abdominal computed tomography (CT) performed with and without oral contrast in patients presenting to the emergency department (ED) with acute nontraumatic abdominal pain. MATERIALS AND METHODS: Between December 2013 and December 2014, 348 adult patients presenting to the ED of a large tertiary medical center with nontraumatic abdominal pain were evaluated. Exclusion criteria for the study were history of inflammatory bowel disease, recent abdominal operation and suspected renal colic, abdominal aortic aneurysm rupture, or intestinal obstruction...
February 22, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28236914/western-vascular-society-guidelines-for-transfer-of-patients-with-ruptured-abdominal-aortic-aneurysm
#6
Matthew W Mell, Benjamin W Starnes, Larry W Kraiss, Peter A Schneider, William C Pevec
INTRODUCTION: When a patient with ruptured abdominal aortic aneurysm (rAAA) presents at a facility ill-equipped to provide care, transfer may provide the best chance for survival. Large distances and long travel times provide challenging barriers to prompt and appropriate care in the western United States. METHODS: The Western Vascular Society (WVS) adopted a set of guidelines in considering transfer of a patient with an rAAA using published literature, membership survey and input, and existing recommendations...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28235521/aneurysmal-hemorrhage-in-a-pregnant-patient-with-coarctation-of-aorta-an-anesthetic-challenge
#7
G S Tomar, K Goyal, R Chandran, A Luthra, V Chauhan, N Kumar
A 25years old female patient with pregnancy of 16weeks (G2 P1), diagnosed to have distal anterior cerebral artery aneurysm (DACA) with Hunt & Hess grade I, subarachnoid hemorrhage (SAH) and coexisting atretic type of aortic coarctation posted for aneurysmal clipping under general anesthesia is a challenge to anesthesiologists in perioperative period. Hypertensive surges in a pregnant patient may result in rupture of aneurysms. Mortality in the mothers with CoA has been reported to be in the range of 0 to 9%...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28230898/manifestations-and-medicolegal-significance-of-loeys-dietz-syndrome
#8
Roger W Byard
Loeys-Dietz syndrome is a recently described autosomal dominant disorder with underlying vasculopathy characterized by aortic and other vascular aneurysmal dissection/rupture. A 61-year-old man is reported who died suddenly and unexpectedly and at autopsy was found to have a ruptured abdominal aortic aneurysm. Additional findings included dolichostenomelia, high-arched palate, and pectus excavatum. There was a strong family history of Loeys-Dietz syndrome, although the decedent had never been tested. Death was, therefore, due to a ruptured abdominal aortic aneurysm in a case of probable Loeys-Dietz syndrome...
February 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28224953/perceived-learning-needs-of-patients-with-abdominal-aortic-aneurysm
#9
Olga Nilsson, Rebecka Hultgren, Anna Letterstål
BACKGROUND: Patients undergoing surgical treatment of abdominal aortic aneurysm (AAA) should receive adequate information about the disease, treatment options, and self-care. Patients' learning needs should be acknowledged. The aim was to describe the perceived learning needs in patients with AAA. A secondary aim was to explore their experience of methods for patient education. METHODS: Three focus group interviews were conducted with 14 patients treated with open or endovascular repair of AAA...
March 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28222985/concurrent-renal-artery-stent-during-endovascular-infrarenal-aortic-aneurysm-repair-confers-higher-risk-for-30-day-acute-renal-failure
#10
Besma Nejim, Isibor Arhuidese, Muhammmad Rizwan, Lana Khalil, Satinderjit Locham, Devin Zarkowsky, Philip Goodney, Mahmoud B Malas
OBJECTIVE: Concurrent renal artery angioplasty and stenting (RAAS) during endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysm (AAA) has been practiced in an attempt to maintain renal perfusion. The aim of this study was to identify the current practice of RAAS during EVAR and its effect on perioperative renal outcome. METHODS: Patients with infrarenal AAA were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP, 2011-2014) database...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28221665/totally-percutaneous-versus-surgical-cut-down-femoral-artery-access-for-elective-bifurcated-abdominal-endovascular-aneurysm-repair
#11
REVIEW
Madelaine Gimzewska, Alexander Ir Jackson, Su Ern Yeoh, Mike Clarke
BACKGROUND: Abdominal aortic aneurysms (AAAs) are a vascular condition with significant risk attached, particularly if they rupture. It is, therefore, critical to identify and repair these as an elective procedure before they rupture and require emergency surgery. Repair has traditionally been an open surgical technique that required a large incision across the abdomen. Endovascular abdominal aortic aneurysm repairs (EVARs) are now a common alternative. In this procedure, the common femoral artery is exposed via a cut-down approach and a graft introduced to the aneurysm in this way...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28218569/associations-of-coronary-and-peripheral-artery-disease-with-presence-expansion-and-rupture-of-abdominal-aortic-aneurysm-a-grin-without-a-cat
#12
Hisato Takagi, Takuya Umemoto
Both coronary and peripheral artery disease are representative atherosclerotic diseases, which are also known to be positively associated with presence of abdominal aortic aneurysm. It is still controversial, however, whether coronary and peripheral artery disease are positively associated with expansion and rupture as well as presence of abdominal aortic aneurysm. In the present article, we overviewed epidemiological evidence, i. e. meta-analyses, regarding the associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm through a systematic literature search...
February 20, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#13
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216354/outcomes-of-endovascular-and-open-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-elderly-patients
#14
Tze-Woei Tan, Mohammad Eslami, Denis Rybin, Gheorghe Doros, Wayne W Zhang, Alik Farber
BACKGROUND: Endovascular aneurysm repair (EVAR) is becoming the preferred treatment modality for patients with a ruptured abdominal aortic aneurysm (rAAA). Although the survival advantage of EVAR over open aortic repair (OAR) has been shown in some studies, it is unclear whether this benefit extends to elderly patients. We sought to evaluate the outcomes of rAAA repair in octogenarians. METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set (2005-2014) to identify patients older than 80 years who were treated with EVAR and OAR for rAAA...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216352/outcome-of-endovascular-repair-for-intact-and-ruptured-thoracic-aortic-aneurysms
#15
Tina Hellgren, Anders Wanhainen, Johnny Steuer, Kevin Mani
OBJECTIVE: The objective of this study was to assess long-term outcome after thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysm (TAA). METHODS: All patients who underwent TEVAR for TAA at Uppsala University Hospital from December 1999 to December 2014 were included. Characteristics of the patients and outcome data were collected from medical records, national population registry, and cause of death registry. Perioperative survival was analyzed with the χ(2) test, and 5-year survival was estimated with Kaplan-Meier analysis...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216351/the-fate-of-endovascular-aortic-aneurysm-repair-after-5%C3%A2-years-monitored-with-duplex-ultrasound-imaging
#16
Danielle M Pineda, Zachary M Phillips, Keith D Calligaro, Emilia Krol, Matthew J Dougherty, Douglas A Troutman, Alan Dietzek
BACKGROUND: Interventions for aortic aneurysm sac growth have been reported across multiple time points after endovascular aortic aneurysm repair (EVAR). We report the long-term outcomes of patients after EVAR monitored with duplex ultrasound (DUS) imaging with respect to the need for and type of intervention after 5 years. METHODS: We report a series of patients who were monitored with DUS imaging for a minimum of 5 years after EVAR. DUS imaging was performed in an accredited noninvasive vascular laboratory, and computed tomography angiography was only performed for abnormal DUS findings...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28212412/a-mathematical-model-of-aortic-aneurysm-formation
#17
Wenrui Hao, Shihua Gong, Shuonan Wu, Jinchao Xu, Michael R Go, Avner Friedman, Dai Zhu
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta, such that the diameter exceeds 3 cm. The natural history of AAA is progressive growth leading to rupture, an event that carries up to 90% risk of mortality. Hence there is a need to predict the growth of the diameter of the aorta based on the diameter of a patient's aneurysm at initial screening and aided by non-invasive biomarkers. IL-6 is overexpressed in AAA and was suggested as a prognostic marker for the risk in AAA. The present paper develops a mathematical model which relates the growth of the abdominal aorta to the serum concentration of IL-6...
2017: PloS One
https://www.readbyqxmd.com/read/28203369/is-endovascular-treatment-with-multilayer-flow-modulator-stent-insertion-a-safe-alternative-to-open-surgery-for-high-risk-patients-with-thoracoabdominal-aortic-aneurysm
#18
Carolline Pinto, George Garas, Leanne Harling, Ara Darzi, Roberto Casula, Thanos Athanasiou
A best evidence topic in cardiothoracic and vascular surgery was written according to a structured protocol. The question addressed was whether endovascular treatment with multilayer flow modulator stents (MFMS) can be considered a safe alternative to open surgery for high-risk patients with thoracoabdominal aortic aneurysm (TAAA). Altogether 27 papers were identified using the reported search, of which 11 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study limitations are tabulated...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#19
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28195071/spatial-differences-of-matrix-metalloproteinase-2-and-matrix-metalloproteinase-9-within-abdominal-aortic-aneurysm-wall-and-intraluminal-thrombus
#20
A Siennicka, M Zuchowski, M Kaczmarczyk, M Cnotliwy, J S Clark, M Jastrzebska
Formation of an abdominal aortic aneurysm is a complex process involving aortic wall degradation. The matrix metalloproteinases (MMPs) mainly involved in this process are MMP-2 and MMP-9. Most aneurysms contain an intraluminal thrombus. It is suggested that the thrombus' thickness correlates with the risk of aneurysm rupture and may be a new prognostic factor. The purpose of the present study was to investigate enzyme protein levels in thick (A1) and thin (B1) segments of the thrombus and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1)...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
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