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ruptured abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29682111/the-obsolete-maximum-diameter-criterion-the-evident-role-of-biomechanical-pressure-indices-the-new-role-of-hemodynamic-flow-indices-and-the-multi-modal-approach-to-the-rupture-risk-assessment-of-abdominal-aortic-aneurysms
#1
REVIEW
Nikolaos Kontopodis, Konstantinos Tzirakis, Christos V Ioannou
Although the therapeutic management of abdominal aortic aneurysms (AAAs) is currently based on the maximum diameter criterion, this has often proved inaccurate and misleading. Conversely, the biomechanical approach, which takes into account the pressure-induced wall stress exerted at every point throughout the aneurysmal surface, has been proven superior in predicting the rupture risk of AAAs, and its value is being increasingly recognized among physicians. More recently, hemodynamic indices, such as flow-induced wall shear stresses, have been indicated as potentially significant determinants of AAA natural history...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29682110/igg4-related-arterial-disease
#2
REVIEW
Fuminori Kasashima, Kengo Kawakami, Yasushi Matsumoto, Masamitsu Endo, Satomi Kasashima, Atsuhiro Kawashima
Immunoglobulin G4-related diseases (IgG4-RD) are systemic inflammatory conditions, characterized by high serum IgG4 concentrations, and pathologically IgG4-positive plasmacytes infiltrations and storiform fibrosis. We described IgG4-related inflammatory abdominal aortic aneurysm in 2008, and revealed the existence of vascular lesions. IgG4-related vascular lesions frequently occur in the aorta and branching medium-sized arteries with or without aneurysmal change. The inflammatory lesion mainly involves in the adventitia, indicating remarkable adventitial fibrous thickening with infiltration of inflammatory cells...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29678652/octogenarians-undergoing-open-repair-have-higher-mortality-compared-to-fenestrated-endovascular-repair-of-intact-abdominal-aortic-aneurysms-involving-the-visceral-vessels
#3
Satinderjit Locham, Muhammad Faateh, Hanaa Dakour Aridi, Besma Nejim, Mahmoud Malas
BACKGROUND: Prior studies have shown that octogenarians have a higher risk of mortality compared to non-octogenarians undergoing open (OAR) and endovascular (EVAR) abdominal aortic aneurysm (AAA) repair. Fenestrated-endovascular repair (F-EVAR) was approved by Food and Drug Administration (FDA) in 2012 and has been populated as a less invasive approach to treat patients with suboptimal neck anatomy with favorable outcomes compared to traditional OAR. The aim of the study is to compare 30-day outcomes of F-EVAR vs...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29673298/initial-clinical-experience-using-the-low-profile-altura-endograft-system-with-double-d-shaped-proximal-stents-for-endovascular-aneurysm-repair
#4
Dainis Krievins, Albrecht Krämer, Janis Savlovskis, Georgij Oszkinis, E Sebastian Debus, Alexander Oberhuber, Christopher K Zarins
PURPOSE: To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double "D-shaped" stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. METHODS: From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft...
April 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29672411/the-weekend-effect-in-aaa-repair
#5
Thomas F X O'Donnell, Chun Li, Nicholas J Swerdlow, Patric Liang, Alexander B Pothof, Virendra I Patel, Kristina A Giles, Mahmoud B Malas, Marc L Schermerhorn
BACKGROUND: Conflicting reports exist regarding whether patients undergoing surgery on the weekend or later in the week experience worse outcomes. METHODS: We identified patients undergoing abdominal aortic aneurysm (AAA) repair in the Vascular Quality Initiative between 2009 and 2017 [n = 38,498; 30,537 endovascular aneurysm repair (EVAR) and 7961 open repair]. We utilized mixed effects logistic regression to compare adjusted rates of perioperative mortality based on the day of repair...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29656146/genetics-of-the-extracellular-matrix-in-aortic-aneurysmal-diseases
#6
REVIEW
Chien-Jung Lin, Chieh-Yu Lin, Nathan O Stitziel
Aortic aneurysms are morbid conditions that can lead to rupture or dissection and are categorized as thoracic (TAA) or abdominal aortic aneurysms (AAA) depending on their location. While AAA shares overlapping risk factors with atherosclerotic cardiovascular disease, TAA exhibits strong heritability. Human genetic studies in the past two decades have successfully identified numerous genes involved in both familial and sporadic forms of aortic aneurysm. In this review we will discuss the genetic basis of aortic aneurysm, focusing on the extracellular matrix and how insights from these studies have informed our understanding of human biology and disease pathogenesis...
April 12, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29643016/development-and-validation-of-a-predictive-model-to-aid-in-the-management-of-intact-abdominal-aortic-aneurysms
#7
Manar Khashram, Giorgi Kvizhinadze, Ziad Khashram, Jonathan A Williman, Gregory T Jones, Justin A Roake
OBJECTIVE/BACKGROUND: Predicting outcomes prior to elective abdominal aortic aneurysm repair (AAA) requires critical decision making, as the treatment offered is a prophylactic procedure to prevent death from a ruptured AAA. The aim of this work was to develop and validate a model that may predict outcomes for patients with an AAA and hence aid in clinical decision making. METHODS: A discrete event simulation model was built to simulate the natural history of a patient with an AAA and to predict the 30 day and 2-5 year survival of patients undergoing treatment and surveillance...
April 9, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29628493/effect-of-a-high-sucrose-diet-on-abdominal-aortic-aneurysm-development-in-a-hypoperfusion-induced-animal-model
#8
Chie Miyamoto, Hirona Kugo, Keisuke Hashimoto, Ayaka Sawaragi, Nobuhiro Zaima, Tatsuya Moriyama
Abdominal aortic aneurysm (AAA) is a vascular disease that results in rupture of the abdominal aorta. The risk factors for the development of AAA include smoking, male sex, hypertension, and age. AAA has a high mortality rate, but therapy for AAA is restricted to surgery in cases of large aneurysms. Clarifying the effect of dietary food on the development of AAA would be helpful for patients with AAAs. However, the relationship between dietary habits and the development of AAA is largely unknown. In our previous study, we demonstrated that adipocytes in vascular wall can induce the rupture of AAA...
April 9, 2018: Journal of Oleo Science
https://www.readbyqxmd.com/read/29618036/quantification-of-aortic-stiffness-and-wall-stress-in-healthy-volunteers-and-abdominal-aortic-aneurysm-patients-using-time-resolved-3d-ultrasound-a-comparison-study
#9
Emiel M J van Disseldorp, Niels J Petterson, Frans N van de Vosse, Marc R H M van Sambeek, Richard G P Lopata
Aims: Using non-invasive 3D ultrasound, peak wall stress (PWS) and aortic stiffness can be evaluated, which may provide additional criteria in abdominal aortic aneurysm (AAA) risk assessment. In this study, these measures were determined in both young and age-matched individuals, and AAA patients while its relation to age, maximum diameter, and growth was assessed statistically. Methods and results: Time-resolved 3D-US data were acquired for 30 volunteers and 65 AAA patients...
March 29, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29602473/early-outcomes-with-a-single-sided-access-endovascular-stent
#10
Michael Hofmann, Felice Pecoraro, David Planer, Thomas Pfammatter, Gilbert Puippe, Dominique Bettex, Frank J Veith, Mario Lachat, Lyubov Chaykovska
OBJECTIVE: The objective of this study was to report the 1-year follow-up study results of the new Horizon stent graft (Endospan, Herzliya, Israel) from two different prospective consecutive trials. The Horizon abdominal aortic aneurysm stent graft system is a 14F profile system requiring only a single access site. It consists of three modules, introduced separately: base limb (iliac to iliac limb); distal aortic limb; and proximal aortic limb with a bare suprarenal crown and active fixation...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602471/early-and-midterm-outcome-of-multilayer-flow-modulator-stent-for-complex-aortic-aneurysm-treatment-in-germany
#11
Walid Ibrahim, Konstantinos Spanos, Andreas Gussmann, Christoph A Nienaber, Joerg Tessarek, Heinrich Walter, Jörg Thalwitzer, Sebastian E Debus, Nikolaos Tsilimparis, Tilo Kölbel
OBJECTIVE: The objective of this study was to assess the early and midterm outcomes of endovascular repair of complex aortic aneurysm cases using the Multilayer Flow Modulator (MFM; Cardiatis, Isnes, Belgium) endograft in Germany. METHODS: A retrospective study including patients presenting with abdominal aortic aneurysm (AAA), thoracic aortic aneurysm, or thoracoabdominal aortic aneurysm treated with the MFM was conducted in Germany. Mortality and morbidity (in terms of spinal cord ischemia, visceral ischemia, and stroke) at 30 days postoperatively were evaluated...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29580855/statin-therapy-is-associated-with-higher-long-term-but-not-perioperative-survival-after-abdominal-aortic-aneurysm-repair
#12
Thomas F X O'Donnell, Sarah E Deery, Katie E Shean, Murray A Mittleman, Jeremy D Darling, Mohammad H Eslami, Randall R DeMartino, Marc L Schermerhorn
BACKGROUND: Although preoperative and perioperative statin therapy improves postoperative outcomes in several populations, few data examine its association with survival after abdominal aortic aneurysm (AAA) repair. In addition, no data exist regarding the benefits of starting statins in patients with AAA not currently taking them. METHODS: We performed a registry-based study of all patients undergoing repair of AAAs in the Vascular Quality Initiative between 2003 and 2017 without documented statin intolerance...
March 23, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29571627/long-term-decline-in-renal-function-is-more-significant-after-endovascular-repair-of-infrarenal-abdominal-aortic-aneurysms
#13
Ziad Al Adas, Alexander D Shepard, Timothy J Nypaver, Mitchell R Weaver, Thomas Maatman, Lenar T Yessayan, Praveen Balraj, Loay S Kabbani
OBJECTIVE: It is not clear whether endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) results in an increase in renal insufficiency during the long term compared with open repair (OR). We reviewed our experience with AAA repair to determine whether there was a significant difference in postoperative and long-term renal outcomes between OR and EVAR. METHODS: A retrospective cohort study was conducted of all patients who underwent AAA repair between January 1993 and July 2013 at a tertiary referral hospital...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29571624/tissue-factor-levels-and-the-fibrinolytic-system-in-thin-and-thick-intraluminal-thrombus-and-underlying-walls-of-abdominal-aortic-aneurysms
#14
Aldona Siennicka, Marta Zuchowski, Mariusz Kaczmarczyk, Miłosław Cnotliwy, Jeremy Simon Clark, Maria Jastrzębska
BACKGROUND: The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29571623/real-world-evidence-of-superiority-of-endovascular-repair-in-treating-ruptured-abdominal-aortic-aneurysm
#15
Akshay Kumar Gupta, Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Frank J Veith, Mahmoud B Malas
OBJECTIVE: The majority of previous studies, including randomized controlled trials, have failed to provide sufficient evidence of superiority of endovascular aneurysm repair (EVAR) over open aortic repair (OAR) of ruptured abdominal aortic aneurysm (rAAA) while comparing mortality and complications. This is in part due to small study size, patient selection bias, scarce adjustment for essential variables, single insurance type, or selection of only older patients. This study aimed to provide real-world, contemporary, comprehensive, and robust evidence on mortality of EVAR vs OAR of rAAA...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29560961/-ten-year-results-of-abdominal-aortic-and-great-vessels-aneurysms-management
#16
Yu V Chervyakov, I N Staroverov, A V Borisov, S Yu Smurov
AIM: To present own 10-year experience of abdominal aortic and great vessels aneurysms management. MATERIAL AND METHODS: There were 369 patients with abdominal aortic aneurysms (AAA) for the period 1995-2016 at the Yaroslavl Regional Clinical Hospital. 25% of patients suffered from abdominal aortic and great vessels aneurysms. Mean age was 70.3±7.5. There were 79 (86%) men and 13 (14%) women. 93 patients had 212 aneurysms of other sites besides AAA (from 1 to 6 aneurysms in each case)...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29555253/accuracy-of-routine-endoscopy-diagnosing-colonic-ischaemia-after-abdominal-aortic-aneurysm-repair-a-meta-analysis
#17
REVIEW
Gerdine C I von Meijenfeldt, Tryfon Vainas, George A Mistiotis, Sarah L Gans, Clark J Zeebregts, Maarten J van der Laan
BACKGROUND: Colonic ischaemia (CI) is a devastating complication after abdominal aortic aneurysm (AAA) surgery. The aim of this review was to evaluate the diagnostic test accuracy of routine endoscopy in diagnosing CI after treatment for elective and acute AAA. PATIENTS AND METHODS: The Pubmed and Embase database searches resulted in 1188 articles. Prospective studies describing routine post-operative colonoscopy or sigmoidoscopy after elective or emergency AAA repair were included...
March 16, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29548813/outcomes-of-using-endovascular-aneurysm-repair-with-active-fixation-in-complex-aneurysm-morphology
#18
Rami O Tadros, Alex Sher, Martin Kang, Ageliki Vouyouka, Windsor Ting, Daniel Han, Michael Marin, Peter Faries
OBJECTIVE: The ideal treatment option for patients with complex aneurysm morphology remains highly debated. The aim of this study was to investigate the impact of endovascular aneurysm repair (EVAR) with active fixation on outcomes in patients with complex aneurysm morphology. METHODS: There were 340 consecutive patients who underwent EVAR using active fixation devices, 234 with active infrarenal fixation (AIF; Gore Excluder; W. L. Gore & Associates, Flagstaff, Ariz) and 106 with active suprarenal fixation (ASF; 85 Medtronic Endurant [Medtronic, Santa Rosa, Calif] and 21 Cook Zenith [Cook Medical, Bloomington, Ind])...
March 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29541693/ruptured-abdominal-aortic-aneurysm-repair-in-pediatric-marfan-syndrome-patient
#19
Joyce J Lu, Jason D Slaikeu, Peter Y Wong
Marfan syndrome is a well-described autosomal dominant connective tissue disorder with a constellation of anatomic characteristics including aortic degeneration as a result of the spontaneous mutation of the fibrillin gene, FBN1 . Whereas life-threatening dissection and ascending aneurysmal rupture have been thoroughly documented in the literature, aneurysms of the abdominal aorta and those present in the pediatric population have only rarely been reported. In this case report, we describe presentation, successful open surgical repair, and recovery of a pediatric Marfan syndrome patient with a ruptured abdominal aortic aneurysm...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29540292/-evar-for-aortic-abdominal-aneurysms-a-20-year-s-experience-of-1900-patients
#20
Pascal Desgranges, Hicham Kobeiter, Frederic Cochennec, Vania Tacher, Joseph Touma, Marek Majewski, Jean Marzelle, Éric Allaire, Jean-Pierre Becquemin
Abdominal aortic aneurysms (AAA), also called "silent killer" as they grow without symptoms until the final rupture, are the 3rd cause of cardiovascular deaths, after myocardial infarction and stroke. Surgery is the only efficient way of preventing aortic rupture. The initial technique, described by Charles Dubost in 1952 has evolved and results and provides fair long-term results: open repair (OR) is performed under general anesthesia, via a transperitoneal or a retroperitoneal approach. Laparoscopic repair aims to reduce the consequences of surgery, but its role is still debated due to limited experience and to variable results...
March 11, 2018: La Presse Médicale
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