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ruptured abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#1
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
August 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28808955/exploring-the-biological-and-mechanical-properties-of-abdominal-aortic-aneurysms-using-uspio-mri-and-peak-tissue-stress-a-combined-clinical-and-finite-element-study
#2
Noel Conlisk, Rachael O Forsythe, Lyam Hollis, Barry J Doyle, Olivia M B McBride, Jennifer M J Robson, Chengjia Wang, Calum D Gray, Scott I K Semple, Tom MacGillivray, Edwin J R van Beek, David E Newby, Peter R Hoskins
Inflammation detected through the uptake of ultrasmall superparamagnetic particles of iron oxide (USPIO) on magnetic resonance imaging (MRI) and finite element (FE) modelling of tissue stress both hold potential in the assessment of abdominal aortic aneurysm (AAA) rupture risk. This study aimed to examine the spatial relationship between these two biomarkers. Patients (n = 50) > 40 years with AAA maximum diameters > = 40 mm underwent USPIO-enhanced MRI and computed tomography angiogram (CTA). USPIO uptake was compared with wall stress predictions from CTA-based patient-specific FE models of each aneurysm...
August 14, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28807385/external-validation-of-a-5-year-survival-prediction-model-after-elective-abdominal-aortic-aneurysm-repair
#3
Randall R DeMartino, Ying Huang, Jay Mandrekar, Philip P Goodney, Gustavo S Oderich, Manju Kalra, Thomas C Bower, Jack L Cronenwett, Peter Gloviczki
OBJECTIVE: The benefit of prophylactic repair of abdominal aortic aneurysms (AAAs) is based on the risk of rupture exceeding the risk of death from other comorbidities. The purpose of this study was to validate a 5-year survival prediction model for patients undergoing elective repair of asymptomatic AAA <6.5 cm to assist in optimal selection of patients. METHODS: All patients undergoing elective repair for asymptomatic AAA <6.5 cm (open or endovascular) from 2002 to 2011 were identified from a single institutional database (validation group)...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28802250/a-population-based-study-of-abdominal-aortic-aneurysm-treatment-in-finland-2000-2014
#4
Matti T Laine, Sani J Laukontaus, Reijo Sund, Pekka S Aho, Ilkka Kantonen, Anders Albäck, Maarit Venermo
Background -In the event of rupture of an abdominal aortic aneurysm (AAA), mortality is very high. AAA prevalence and incidence of ruptures has been reported to be decreasing. The treatment of AAA has also undergone a change in recent decades with a shift towards endovascular aneurysm repair (EVAR). Our aim was to evaluate how these changes have affected the elective and emergency treatment of AAA and their results in Finland. Methods -All patients treated for AAA in Finland, a country with a population of 5...
August 11, 2017: Circulation
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#5
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28782461/a-meta-analysis-of-monthly-variation-in-occurrence-of-abdominal-aortic-aneurysm-rupture
#6
Hisato Takagi, Tomo Ando, Takuya Umemoto
BACKGROUND: We performed a meta-analysis to assess the presence of an annual rhythmic variability of ruptured abdominal aortic aneurysm (RAAA) onset. PATIENTS AND METHODS: Eligible studies were observational studies enrolling patients with RAAA and reporting monthly incidence of RAAA. Study-specific estimates, i. e. monthly incidence of RAAA, were combined using the random-effects model. Chronobiological analysis was performed by applying a partial Fourier series to pooled monthly incidence by using the weighted least-squares method...
August 7, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28782417/improving-patient-compliance-with-post-evar-surveillance-may-prevent-late-rupture
#7
Alicia L Skervin, Chung S Lim, Kaji Sritharan
Endovascular aneurysm repair (EVAR) has gained increasing popularity in the treatment of infrarenal abdominal aortic aneurysm. Despite its favorable early outcomes, the long-term efficacy of EVAR remains a concern. Late rupture is the ultimate treatment failure and continues to complicate EVAR. Univariate and multivariate analyses have identified factors predictive of late rupture. The importance of EVAR surveillance to prevent late complications is equally widely acknowledged. This article aims to present our current understanding of the precipitating factors of late rupture after EVAR and explores whether the key to its prevention lies within improving patient factors, particularly compliance to follow-up appointments or whether physicians hold the solution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28780975/short-term-and-long-term-results-of-endovascular-and-open-repair-of-abdominal-aortic-aneurysms-in-germany
#8
Christian-Alexander Behrendt, Art Sedrakyan, Henrik Christian Rieß, Franziska Heidemann, Tilo Kölbel, Jörg Petersen, Eike Sebastian Debus
BACKGROUND: Endovascular aortic repair (EVAR) has emerged as a standard of care for abdominal aortic aneurysm (AAA) repair. However, real-world evidence to compare this technology to open aortic repair (OAR) is limited. Major gaps exist related to long-term outcomes of therapies worldwide. METHODS: Health insurance claims data of Germany's third largest insurance provider, DAK-Gesundheit, were used to determine outcomes after interventions for intact AAA (iAAA) and ruptured AAA (rAAA)...
August 3, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28779856/renal-complications-after-evar-with-suprarenal-versus-infrarenal-fixation-among-all-users-and-routine-users
#9
S L Zettervall, S E Deery, P A Soden, K Shean, J J Siracuse, M Alef, V I Patel, M L Schermerhorn
BACKGROUND: Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE). METHODS: All patients undergoing EVAR in the VSGNE from 2003 to 2014 were identified...
August 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28773988/investigation-on-the-regional-loss-factor-and-its-anisotropy-for-aortic-aneurysms
#10
Nastaran Shahmansouri, Mohammed Alreshidan, Alexander Emmott, Kevin Lachapelle, Ismaïl El-Hamamsy, Raymond Cartier, Richard L Leask, Rosaire Mongrain
An aortic aneurysm is a lethal arterial disease that mainly occurs in the thoracic and abdominal regions of the aorta. Thoracic aortic aneurysms are prevalent in the root/ascending parts of the aorta and can lead to aortic rupture resulting in the sudden death of patients. Understanding the biomechanical and histopathological changes associated with ascending thoracic aortic aneurysms (ATAAs), this study investigates the mechanical properties of the aorta during strip-biaxial tensile cycles. The loss factor-defined as the ratio of dissipated energy to the energy absorbed during a tensile cycle-the incremental modulus, and their anisotropy indexes were compared with the media fiber compositions for aneurysmal (n = 26) and control (n = 4) human ascending aortas...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28765014/follow-up-on-small-abdominal-aortic-aneurysms-using-three-dimensional-ultrasound-volume-versus-diameter
#11
Q M Ghulam, K K Bredahl, L Lönn, L Rouet, H H Sillesen, J P Eiberg
OBJECTIVES: Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. DESIGN: This was a prospective cohort study with repeated diameter and volume measurements by 3D-US...
July 29, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28756762/update-on-the-prevention-of-death-from-ruptured-abdominal-aortic-aneurysm
#12
Jo Jacomelli, Lisa Summers, Anne Stevenson, Tim Lees, Jonothan J Earnshaw
Objectives To monitor the early effect of a national population screening programme for abdominal aortic aneurysm in 65-year-old men. Setting The study used national statistics for death rates from abdominal aortic aneurysm (Office of National Statistics) and hospital admission data in England (Hospital Episode Statistics). Methods Information concerning deaths from abdominal aortic aneurysm (ruptured and non-ruptured) (1999-2014) and hospital admissions for ruptured abdominal aortic aneurysm (2000-2015) was examined...
September 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28745787/short-term-and-long-term-effects-of-covered-stent-endovascular-graft-exclusion-for-the-treatment-of-abdominal-aortic-aneurysm-rupture
#13
L Li, Y-Q Li, B Liu, H Wang, D-M Zhang
OBJECTIVE: We studied short-term and long-term effects of covered stent endovascular graft exclusion for the treatment of abdominal aortic aneurysm rupture. PATIENTS AND METHODS: From January 2013 to January 2016, 88 patients with fractured abdominal aortic aneurysm were enrolled in this study. Patients were divided into the control group or the open abdomen group (n=52) and the observation group or the isolated group (n=36). Patients in the control group were treated with open abdominal aneurysm resection and artificial blood vessel transplant technique, while patients in the observation group were treated with percutaneous stent graft endovascular graft exclusion...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28745403/sex-differences-in-mortality-after-abdominal-aortic-aneurysm-repair-in-the-uk
#14
D A Sidloff, A Saratzis, M J Sweeting, J Michaels, J T Powell, S G Thompson, M J Bown
BACKGROUND: The UK abdominal aortic aneurysm (AAA) screening programmes currently invite only men for screening because the benefit in women is uncertain. Perioperative risk is critical in determining the effectiveness of screening, and contemporary estimates of these risks in women are lacking. The aim of this study was to compare mortality following AAA repair between women and men in the UK. METHODS: Anonymized data from the UK National Vascular Registry (NVR) for patients undergoing AAA repair (January 2010 to December 2014) were analysed...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28743219/use-of-a-thoracic-endograft-in-an-acute-abdominal-aortic-setting-case-report-and-literature-review
#15
Sebastiano Tasselli, Paolo Perini, Elisa Paini, Luca Milan, Stefano Bonvini
PURPOSE: We report the case of a thoracic endograft used to achieve exclusion of a ruptured proximal paranastomotic abdominal aortic aneurysm (PAAA) as a consequence of aortic ballooning. CASE REPORT: A type I proximal endoleak was evidenced following endovascular repair of a PAAA with an aortic cuff. The leak was treated with ballooning, which caused distal aortic rupture. A thoracic endograft was deployed inside the cuff, achieving complete exclusion. At 1 year, there are no signs of migration or endoleak with complete PAAA thrombosis, according to computed tomographic angiography...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28741441/atmospheric-pressure-and-abdominal-aortic-aneurysm-rupture-results-from-a-time-series-analysis-and-case-crossover-study
#16
Bas B L Penning de Vries, Joé L P Kolkert, Robbert Meerwaldt, Rolf H H Groenwold
BACKGROUND: Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature. METHODS: Associations between atmospheric pressure and AAA rupture risk were investigated using local meteorological data and a case series of 358 patients admitted to hospital for ruptured AAA during the study period, January 2002 to December 2012...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28739467/epidemiology-and-outcomes-of-abdominal-aortic-aneurysms-in-new-zealand-a-15-year-experience-at-a-regional-hospital
#17
Nathaniel Chiang, Jitendra K Jain, Katherine R Hulme, Thodur Vasudevan
INTRODUCTION: Abdominal aortic aneurysms (AAA) account for approximately 400 deaths per year in New Zealand (NZ). Waikato Hospital caters to a diverse population comprising a high proportion of the indigenous Māori ethnic group considered to be at higher risk of mortality and morbidity. Despite these population factors, there is no screening program for AAA. The aim of this study was to further define the epidemiology and outcomes of AAA repairs in NZ to investigate the utility of implementing a population-specific screening program...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739458/effects-of-chemotherapy-in-patients-with-concomitant-aortic-aneurysm-and-malignant-disease
#18
Marco Leopardi, Evelina Di Marco, Aldo Musilli, Enrico Ricevuto, Gemma Bruera, Marco Ventura
BACKGROUND: The aim of the study is to present the results in a consecutive series of patients affected by aortic abdominal aneurysm and to underline the aneurysmal growth and evolution in oncological patients submitted to dedicated oncological medical therapy. METHODS: Between January 2010 and June 2016 we treated in our center 19 patients for coexisting aortic aneurysms (>3cm) and malignancy. We observed patients undergoing oncological treatment and patients who did not undergo medical treatment...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28734943/deficits-in-col5a2-expression-result-in-novel-skin-and-adipose-abnormalities-and-predisposition-to-aortic-aneurysms-and-dissections
#19
Arick C Park, Noel Phan, Dawiyat Massoudi, Zhenjie Liu, John F Kernien, Sheila M Adams, Jeffrey M Davidson, David E Birk, Bo Liu, Daniel S Greenspan
Classic Ehlers-Danlos syndrome (cEDS) is characterized by fragile, hyperextensible skin and hypermobile joints. cEDS can be caused by heterozygosity for missense mutations in genes COL5A2 and COL5A1, which encode the α2(V) and α1(V) chains, respectively, of collagen V, and is most often caused by COL5A1 null alleles. However, COL5A2 null alleles have yet to be associated with cEDS or other human pathologies. We previously showed that mice homozygous null for the α2(V) gene Col5a2 are early embryonic lethal, whereas haploinsufficiency caused aberrancies of adult skin, but not a frank cEDS-like phenotype, as skin hyperextensibility at low strain and dermal cauliflower-contoured collagen fibril aggregates, two cEDS hallmarks, were absent...
July 19, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28728780/detecting-regional-stiffness-changes-in-aortic-aneurysmal-geometries-using-pressure-normalized-strain
#20
Doran S Mix, Ling Yang, Camille C Johnson, Nathan Couper, Ben Zarras, Isaac Arabadjis, Lauren E Trakimas, Michael C Stoner, Steven W Day, Michael S Richards
Transabdominal ultrasound elasticity imaging could improve the assessment of rupture risk for abdominal aortic aneurysms by providing information on the mechanical properties and stress or strain states of vessel walls. We implemented a non-rigid image registration method to visualize the pressure-normalized strain within vascular tissues and adapted it to measure total strain over an entire cardiac cycle. We validated the algorithm's performance with both simulated ultrasound images with known principal strains and anatomically accurate heterogeneous polyvinyl alcohol cryogel vessel phantoms...
October 2017: Ultrasound in Medicine & Biology
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