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Diabetic aneurysms

Achille Aouba, Solange Gonzalez Chiappe, Mireille Eb, Claire Delmas, Hubert de Boysson, Boris Bienvenu, Grégoire Rey, Alfred Mahr
Objectives: Comprehensive analyses of cause-specific death patterns in GCA are sparse. We studied the patterns and time trends in GCA-related mortality using a large death certificate database. Methods; We obtained multiple-cause-of-death data from the French national death certificate database for 1980-2011. GCA-associated deaths were defined as decedents ⩾55 years old with GCA listed as an underlying or non-underlying cause of death. Time trends of death rates were analysed and the mean age at death with GCA and in the general population ⩾55 years old were calculated...
March 14, 2018: Rheumatology
S Gooran, A Javid, G Pourmand
One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor...
2018: International Journal of Organ Transplantation Medicine
Wanying Duan, Yuesong Pan, Chunjuan Wang, Yilong Wang, Xingquan Zhao, Yongjun Wang, Liping Liu
BACKGROUND: Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality. While it is important to detect early signs of DCI, patients with high risk of DCI are difficult to identify, and the potential risk factors are uncertain. This study aimed to identify independent risk factors of DCI and clarify their clinical impact on outcome and the disease course. METHODS: For this nationwide, multicenter, prospective clinical study involving consecutive patients with aSAH recruited from the China National Stroke Registry, demographic, clinical, radiological, and laboratorial data during hospitalisation, in-hospital complications, functional outcomes, and mortality at 3, 6, and 12 months were recorded...
March 12, 2018: Neuroepidemiology
Smita Kaushik, Warren J Gasper, Bala Ramanan, Shant M Vartanian, Linda M Reilly, Timothy A M Chuter, Jade S Hiramoto
OBJECTIVE: The purpose of this study was to evaluate the impact of prior aortic surgery on outcomes after multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs). METHODS: From July 2005 to October 2016, there were 153 patients who underwent elective endovascular repair of TAAA and PRAA using multibranched stent grafts. Data on demographics, procedural details, and outcomes were collected prospectively...
March 6, 2018: Journal of Vascular Surgery
Philip W Stather, James Ferguson, Ayoola Awopetu, Jonathan R Boyle
OBJECTIVE/BACKGROUND: The effect of suprarenal (SR) as opposed to infrarenal (IR) fixation on renal outcomes post-endovascular aneurysm repair (EVAR) remains controversial. This meta-analysis aims to update current understanding of this issue. METHODS: A prior meta-analysis was updated through a Preferred Reporting Items for Systematic reviews and Meta-Analyses search for additional studies published in the last 3 years reporting on renal dysfunction or related outcomes post-EVAR...
March 2, 2018: European Journal of Vascular and Endovascular Surgery
Arjun Agrawal, Rachael Snow, Erik Lehman, Faisal Aziz
OBJECTIVE: Despite advances in surgical techniques, ruptured abdominal aortic aneurysm (rAAA) remains associated with extremely high mortality. Several preoperative risk factors have been shown to predict poor prognosis after rAAA repair. Notably, a preoperative dependent functional status has previously been shown to be associated with poor outcomes after several vascular surgery procedures. The purpose of this study was to examine the effect of preoperative functional status on postoperative outcomes for patients undergoing repair of rAAA...
March 1, 2018: Journal of Vascular Surgery
Daniel A Waxman, Hemal K Kanzaria, David L Schriger
Importance: The Institute of Medicine described diagnostic error as the next frontier in patient safety and highlighted a critical need for better measurement tools. Objectives: To estimate the proportions of emergency department (ED) visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), stroke, aortic dissection, and subarachnoid hemorrhage (SAH) that end in discharge without diagnosis; to evaluate longitudinal trends; and to identify patient characteristics independently associated with missed diagnostic opportunities...
February 26, 2018: JAMA Internal Medicine
Ian C Bostock, Devin S Zarkowsky, Caitlin W Hicks, David H Stone, Mahmoud B Malas, Philip P Goodney
BACKGROUND: Time to discharge has decreased for aortic surgery since the advent of EVAR, partially due to improved perioperative management. We aimed to investigate outcomes and risk factors associated with prolonged intubation following EVAR. METHODS: The VSGNE database was queried to select all patients who underwent elective EVAR between 01/2003 and 12/2014. Patients who were not extubated in the operating room were classified as having prolonged intubation. Patients requiring prolonged intubation were compared to those extubated in the OR using t-test and chi-square statistics...
February 23, 2018: Annals of Vascular Surgery
Mark D Balceniuk, Lauren E Trakimas, Claudia Aghaie, Doran Mix, Khurram Rasheed, Jennifer Ellis, Roan Glocker, Adam Doyle, Michael C Stoner
Introduction Formation and renewal of intramural thrombus is associated with inflammation, and contributes to the complexity of aneurysm repair. Current cardiovascular pharmacotherapy includes several inflammatory modulators such as aspirin, statins, clopidogrel, and angiotensin-converting enzyme inhibitors. The purpose of our study was to investigate the effect of these inflammatory modulators on radiographically-determined thrombus sac volume. Methods Pre-operative computed tomography scans were reviewed in patients who underwent elective infrarenal aortic aneurysm repair...
January 1, 2018: Vascular
Christos Argyriou, George S Georgiadis, Nikolaos Kontopodis, Arun D Pherwani, Joost A Van Herwaarden, Constantijn E V B Hazenberg, George A Antoniou
BACKGROUND: Screening for abdominal aortic aneurysm (AAA) during transthoracic echocardiography (TTE) may be an effective targeted screening strategy. OBJECTIVE: The aim was to assess the feasibility of AAA screening during TTE and to estimate the prevalence of AAA in patients undergoing TTE. METHODS: Electronic bibliographic sources were interrogated using a combination of free text and controlled vocabulary searches to identify studies reporting on AAA screening during TTE...
February 9, 2018: European Journal of Vascular and Endovascular Surgery
Chikanori Inenaga, Kazuya Hokamura, Kazuhiko Nakano, Ryota Nomura, Shuhei Naka, Toshihiko Ohashi, Takashi Ooshima, Nagato Kuriyama, Toshimitsu Hamasaki, Koichiro Wada, Kazuo Umemura, Tokutaro Tanaka
OBJECTIVE: Among human oral bacteria, particular kinds of Streptococcus mutans (SM) known as dental caries pathogen have a collagen-binding protein called Cnm and show platelet aggregation inhibition and matrix metalloproteinase-9 activation. We have previously reported that these strains may be a risk factor for intracerebral hemorrhage. As a major sample providing hospital, we report here the clinical details including intracranial aneurysms and ischemic stroke. METHODS: Under permission of our ethical committee, 429 samples of whole saliva were taken from patients who were admitted or visited our hospital from February 16, 2010 to February 28, 2011...
February 5, 2018: World Neurosurgery
Yusuke Namba, Toshiaki Yamanaka, Jun Ida, Takefumi Oka
A 79-year-old male with diabetes mellitus and old cerebral infarction was admitted to hospital due to fever and palpitation. Diagnosis of purulent pericarditis was established by pericardial effusion examination. The patient's general condition improved temporarily after drainage of the pericardial effusion. However, computed tomography demonstrated a saccular aneurysm arising from RCA have rapidly grown even larger, up to 63 × 51 mm on 7th hospital day. This indicated that the risk of rupture of the aneurysm was high...
February 5, 2018: International Journal of Cardiovascular Imaging
Marie Dahl, Lars Frost, Rikke Søgaard, Ib Christian Klausen, Vibeke Lorentzen, Jes Lindholt
BACKGROUND: Reducing women's cardiovascular risk and the economic costs associated with cardiovascular diseases (CVD) and diabetes (DM) continues to be a challenge. Whether a multifaceted CVD screening programme is beneficial as a preventive strategy in women remains uncertain. The aim of this study was to investigate the prevalence of CVD and DM as well as the acceptability toward screening and preventive actions. METHODS: An observational study was performed among all women born in 1936, 1941, 1946 and 1951 living in Viborg Municipality, Denmark, from October 2011...
February 5, 2018: BMC Cardiovascular Disorders
Emily Harris, Courtney J Warner, Jeffrey C Hnath, Yaron Sternbach, R Clement Darling
BACKGROUND: As endovascular therapy becomes increasingly complex, adjunct techniques such as upper extremity arterial access facilitate visceral branch interventions. The purpose of this study was to assess the viability of axillary artery percutaneous access in endovascular repair. METHODS: Records of all patients undergoing axillary artery percutaneous access as part of an endovascular intervention from December 2015 to December 2016 were examined. Demographics of the patients (age, sex, medical comorbidities, smoking status, and anticoagulation) were documented...
February 1, 2018: Journal of Vascular Surgery
L F Kroese, E H Mommers, C Robbens, N D Bouvy, J F Lange, F Berrevoet
PURPOSE: Ventral hernia repair is one of the most frequently performed surgical procedures, though recurrences are common. Recurrence can be caused by impaired collagen formation or maturation; hence, patients with Ehlers-Danlos syndrome (EDS) are potentially at increased risk for hernia recurrence. EDS causes altered collagen metabolism, though little is known about the influence of EDS on ventral hernioplasty outcomes. This study aims to analyze these patients to report complication rates, recurrence rates, and, if possible, to give recommendations for surgical intervention...
January 31, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Tarik Avdic, Stefan Franzén, Moncef Zarrouk, Stefan Acosta, Peter Nilsson, Anders Gottsäter, Ann-Marie Svensson, Soffia Gudbjörnsdottir, Björn Eliasson
BACKGROUND: No studies have examined long-term risks for aortic aneurysm (AA) and aortic dissection (AD) or mortality after AA or AD hospitalization among patients with type 2 diabetes mellitus (T2DM). METHODS AND RESULTS: In this observational cohort study, we linked data for patients with T2DM in the Swedish National Diabetes Register, and 5 individually matched population-based control subjects (CSs) without diabetes mellitus (on the basis of sex, age, and county), to other national databases to capture hospitalizations and death...
January 24, 2018: Journal of the American Heart Association
Hiroki Tanaka, Naoki Unno, Yuko Suzuki, Hideto Sano, Tatsuro Yata, Tetsumei Urano
BACKGROUND: An abdominal aortic aneurysm (AAA), which affects approximately 10% of Japanese men aged ≥ 65 years, is frequently associated with hypertension, dyslipidemia, and other lifestyle-related diseases. The development of an AAA is attributed to chronic inflammation concomitant with arteriosclerotic changes. However, an accurate pathomechanism associated with AAA remains uncertain, and questions such as why only a particular group/percentage of patients with arteriosclerosis develop aneurysms and how diabetes suppresses aneurysm development remain unanswered...
January 22, 2018: Current Drug Targets
Stefan Acosta, Anders Gottsäter, Gunnar Engström, Olle Melander, Moncef Zarrouk, Peter M Nilsson, J Gustav Smith
Pathogenesis of abdominal aortic aneurysm (AAA) is unclear. The aim of this study was to evaluate inflammatory and hemodynamic plasma biomarkers as predictors for AAA in the prospective longitudinal cohort of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer Study ( n=5551; 1991-94). C-reactive protein, cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional pro-atrial natriuretic peptide (MR-proANP) and conventional risk factors at baseline were measured in patients with incident AAA during follow-up and compared to individuals without a diagnosis of AAA...
January 1, 2018: Vascular Medicine
Iván J Núñez-Gil, Pedro Marcos Alberca, Nieves Gonzalo, Luis Nombela-Franco, Pablo Salinas, Antonio Fernández-Ortiz
A 66-year-old male ex-smoker with hypertension, type 2 diabetes mellitus and dyslipidaemia was admitted due to a non-ST segment elevation myocardial infarction. The catheterisation depicted an extensive and calcified disease: chronic total obstruction of the right coronary and severe disease with a giant aneurysm at the first marginal branch as the culprit vessel. After discussion, the right coronary was treated before the circumflex-giant aneurysm was closed with a stent graft and its multiple severe stenosis solved with two drug-eluting stents...
January 6, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Jiaze Li, Pacific Huynh, Aozhi Dai, Tieqiao Wu, Yugang Tu, Bryna Chow, Helen Kiriazis, Xiao-Jun Du, Leon A Bach, Jennifer L Wilkinson-Berka, Erik Biros, Philip Walker, Maria Nataatmadja, Malcolm West, Jonathan Golledge, Terri J Allen, Mark E Cooper, Zhonglin Chai
Diabetes is a negative risk factor for aortic aneurysm, but the underlying explanation for this phenomenon is unknown. We have previously demonstrated that Cell Division Autoantigen 1 (CDA1), which enhances TGF-β signaling, is upregulated in diabetes. We hypothesized that CDA1 plays a key role in conferring the protective effect of diabetes against aortic aneurysms. Male wildtype, CDA1 knockout, Apolipoprotein E (ApoE) knockout and CDA1/ApoE double knockout (dKO) mice were rendered diabetic. Whereas aneurysms were not observed in diabetic ApoE knockout and wildtype mice, 40% of diabetic dKO mice developed aortic aneurysms...
January 8, 2018: Diabetes
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