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infrarenal abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29221957/endovascular-repair-of-complex-juxtarenal-aortic-aneurysm-using-a-combined-fenestrated-endograft-and-chimney-technique
#1
REVIEW
Zaher Fanari, Nilesh J Goswami
Chimney EVAR (CHEVAR) and Fenestrated EVAR (FEVAR) are two options for management of very complex abdominal aortic aneurysm (AAA). While some anatomical factors may favor one strategy over the other, there are some cases where the anatomical challenges may require using a hybrid approach. We are reporting the case of an 84-year-old male with a 6.8×5.7cm infrarenal abdominal aortic aneurysm that arises immediately below the level of the renal arteries and extends down to just above the iliac bifurcation with occluded celiac and inferior mesenteric arteries and severe bilateral renal artery stenosis with caudally oriented right renal and cranially oriented left renal artery...
November 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#2
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29158067/psoas-muscle-area-as-a-prognostic-factor-for-survival-in-patients-with-an-asymptomatic-infrarenal-abdominal-aortic-aneurysm-a-retrospective-cohort-study
#3
Reza Indrakusuma, Jendé L Zijlmans, Hamid Jalalzadeh, R Nils Planken, Ron Balm, Mark J W Koelemay
OBJECTIVES: Loss of muscle mass has been associated with poor survival in several surgical patient populations, including those with an abdominal aortic aneurysm (AAA). We wanted to replicate these findings and assesse the association between psoas muscle area (PMA) and survival in patients with an asymptomatic AAA. METHODS: Patients with an asymptomatic infrarenal AAA who underwent computed tomography (CT) scanning between January 1, 2007, and December 31, 2013, were included in this single-centre retrospective cohort study...
November 17, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29155740/creation-of-a-rodent-model-of-abdominal-aortic-aneurysm-by-blocking-adventitial-vasa-vasorum-perfusion
#4
Hiroki Tanaka, Naoki Unno, Tatsuro Yata, Hirona Kugo, Nobuhiro Zaima, Takeshi Sasaki, Tetsumei Urano
The adventitial vasa vasorum (VV) provides oxygen and nourishment to the aortic wall. Hypoxia in the aortic wall can cause enlarged abdominal aortic aneurysms (AAAs). This article introduces and describes a standard protocol used to induce AAAs through adventitial VV hypoperfusion created with a combination of polyurethane catheter insertion into the aortic lumen and suture ligation of the infrarenal abdominal aorta. The protocol involves the use of male rats weighing 300-400 g, which are provided food and water ad libitum...
November 8, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29145894/inositol-in-the-management-of-abdominal-aortic-aneurysm-imagen-study-protocol-for-a-randomised-controlled-trial
#5
Sophie E Rowbotham, Jenna L Pinchbeck, Georgina Anderson, Bernie Bourke, Michael Bourke, T Christian Gasser, Rene Jaeggi, Jason S Jenkins, Corey S Moran, Susan K Morton, Christopher M Reid, Ramesh Velu, Lisan Yip, Joseph V Moxon, Jonathan Golledge
BACKGROUND: An abdominal aortic aneurysm (AAA) is a focal dilation of the abdominal aorta and is associated with a risk of fatal rupture. Experimental studies suggest that myo-inositol may exert beneficial effects on AAAs through favourable changes to biological pathways implicated in AAA pathology. The aim of the Inositol in the MAnaGemENt of abdominal aortic aneurysm (IMAGEN) trial is to assess if myo-inositol will reduce AAA growth. METHODS/DESIGN: IMAGEN is a multi-centre, prospective, parallel-group, randomised, double-blind, placebo-controlled trial...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29123158/inhibition-of-phosphatidylinositol-3-kinease-suppresses-formation-and-progression-of-experimental-abdominal-aortic-aneurysms
#6
Jing Yu, Rui Liu, Jianhua Huang, Lixin Wang, Wei Wang
Accumulating evidence suggests an important role of Phosphatidylinositol 3-kinease (PI3K) pathway in inflammatory cells infiltration. Given  the essential role of inflammatory cells infiltration during the formation and progression of abdominal aortic aneurysm (AAA), to investigate the possibility of preventing AAA formation and progression via targeting PI3K is anticipated. Here, experimental AAAs was created in rats by transient intraluminal porcine pancreatic elastase (PPE) infusion into the infrarenal aorta firstly...
November 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29097041/comparable-perioperative-mortality-outcomes-in-younger-patients-undergoing-elective-open-and-endovascular-abdominal-aortic-aneurysm-repair
#7
Nathan L Liang, Katherine M Reitz, Michel S Makaroun, Mahmoud B Malas, Edith Tzeng
BACKGROUND: Evidence for benefit of endovascular aneurysm repair (EVAR) over open surgical repair for de novo infrarenal abdominal aortic aneurysms (AAAs) in younger patients remains conflicting because of heterogeneous study populations and small sample sizes. The objective of this study was to compare perioperative and short-term outcomes for EVAR and open surgery in younger patients using a large national disease and procedure-specific data set. METHODS: We identified patients 65 years of age or younger undergoing first-time elective EVAR or open AAA repair from the Vascular Quality Initiative (2003-2014)...
October 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29079007/ten-year-outcome-analysis-of-the-italian-excluder-registry-with-the-gore-excluder-endograft-for-infrarenal-abdominal-aortic-aneurysms
#8
Giovanni Pratesi, Gabriele Piffaretti, Fabio Verzini, Giovanni De Blasis, Patrizio Castelli, Carlo Pratesi
OBJECTIVE: The objective of this study was to report the 10-year outcomes of the multicenter Italian Excluder Registry for elective endovascular aneurysm repair (EVAR). METHODS: A retrospective analysis of all patients who underwent elective EVAR using the Gore Excluder (W. L. Gore & Associates, Flagstaff, Ariz) endograft (EG) at four Italian centers between 1998 and 2006 was carried out. Follow-up consisted of duplex ultrasound scan and computed tomography performed at 1 month, 6 months, and 12 months and yearly thereafter...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29078246/-surgeon-modified-stent-grafts-in-emergency-cases-as-addition-to-off-the-shelf-stent-grafts-for-complex-abdominal-and-thoracoabdominal-aortic-pathologies
#9
Franziska Heidemann, Tilo Kölbel, Sebastian Debus, Christian-Alexander Behrendt, Holger Diener, Fiona Rohlffs, Nikolaos Tsilimparis
Background Endovascular techniques have revolutionised the therapy of abdominal and thoracoabdominal aortic disease. For infrarenal abdominal aortic aneurysm, the endovascular aortic repair has become a standard for elective and emergent cases. In complex abdominal or thoracoabdominal aortic pathologies, involving reno-visceral vessels, there are technical challenges for open and endovascular surgery. Due to high mortality and morbidity of open surgery of complex aortic lesions, especially in emergent cases, endovascular techniques have developed as well...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29074113/prospective-cohort-20%C3%A2-years-after-endovascular-treatment-for-abdominal-aortic-aneurysm
#10
Gaudencio Espinosa, Giovanni di Luccio, Marcia Ribeiro Alves, Bianca Gutfilen, Ronir Raggio, Pedro Saad, Lukasz Dzieciuchowicz, Carlos Magliano
OBJECTIVE: To describe the factors associated with survival 20 years after endovascular treatment of an abdominal aortic aneurysm (AAA) in a single center. METHODS: Prospective cohort of asymptomatic patients with an infrarenal aortic aneurysm treated with a bifurcated endovascular graft (Talent) between June 1997 and August 2008. Cox proportional hazard multivariable regression was used for analysis of independent risk factors for survival. Kaplan-Meier curves were done with the long-rank test...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074109/racial-disparities-in-outcomes-after-intact-abdominal-aortic-aneurysm-repair
#11
Sarah E Deery, Thomas F X O'Donnell, Katie E Shean, Jeremy D Darling, Peter A Soden, Kakra Hughes, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: We aimed to compare perioperative morbidity and mortality and late survival among black, white, and Asian patients undergoing intact abdominal aortic aneurysm (AAA) repair. METHODS: We identified all patients undergoing intact, infrarenal AAA repair in the Vascular Quality Initiative (VQI) from 2003 to 2017. We compared in-hospital outcomes by race using the Fisher exact and Kruskal-Wallis tests. Multivariable logistic and linear regression models of perioperative outcomes adjusted for differences in demographics, comorbidities, hospital volume, and procedure...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29062457/late-type-iii-endoleak-after-thoracic-endovascular-aneurysm-repair-and-previous-infrarenal-stent-graft-implantation-a-case-report-and-review-of-the-literature
#12
Jerzy Leszczyński, Waldemar Macioch, Witold Chudziński, Zbigniew Gałązka
Thoracic endovascular aortic repair (TEVAR) effectively improved the results of thoracic aortic aneurysm treatment. TEVAR is a less invasive procedure that can be performed under local anesthesia with shorter hospital stay. The perioperative morbidity and mortality rates are lower for endovascular than open repair, but the rate of secondary interventions is higher for TEVAR. We report a case of an elderly man with synchronous abdominal and thoracic aortic aneurysms. A type III dangerous endoleak was recognized 3 years after TEVAR...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29046239/increased-peak-wall-stress-but-not-maximum-diameter-is-associated-with-symptomatic-abdominal-aortic-aneurysm
#13
Begoña Soto, Luis Vila, Jaime F Dilmé, Jose R Escudero, Sergi Bellmunt, Mercedes Camacho
OBJECTIVE: Maximum diameter (MD) is the established rupture predictor for abdominal aortic aneurysm (AAA). However, biomechanical markers from finite element analysis (FEA) could be more accurate predictors for these patients. In this study, the association between peak wall stress (PWS) and MD with symptoms of AAA was evaluated. METHODS: Patients diagnosed with infrarenal non-ruptured AAA at the centre between 2009 and 2015 were included. Clinical data, morphological variables (including MD), and the biomechanical variables PWS and diameter normalised PWS (dnPWS) in symptomatic (sAAA) and asymptomatic AAA patients (aAAA) were included...
October 15, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29034042/description-of-the-surgical-strategy-used-for-the-treatment-of-a-complex-disease-report-of-a-case
#14
Kazuki Kihara, Miwa Tashiro, Kohei Miyashita, Masaki Yamamoto, Hironobu Hirose, Takashi Fukutomi, Hideaki Nishimori, Kazumasa Orihashi
We report a rare case in which a patient required three surgeries with competing priorities. In a 68-year-old man diagnosed with an abdominal aortic aneurysm (AAA), computed tomography (CT) revealed an infrarenal AAA, unusual thickening of the sigmoid colon that suggested cancer, and a filling defect in the left atrium. We considered the disease stage, which affects prognosis, and the risk of complications that could interfere with the treatment of the other pathologies and developed a three-stage surgical strategy: (i) endovascular aortic repair, (ii) sigmoid colectomy, and (iii) resection of the left atrial mass...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28977379/single-centre-experience-with-the-frozen-elephant-trunk-technique-in-251-patients-over-15%C3%A2-years
#15
Malakh Shrestha, Andreas Martens, Tim Kaufeld, Erik Beckmann, Sebastian Bertele, Heike Krueger, Julia Neuser, Felix Fleissner, Fabio Ius, Firas Abd Alhadi, Jasmin Hanke, Jan D Schmitto, Serghei Cebotari, Matthias Karck, Axel Haverich, Ajay Chavan
OBJECTIVES: Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. METHODS: A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 31) or the Vascutek Thoraflex hybrid (n = 154) prosthesis...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28956729/the-use-of-thoracic-stent-grafts-for-endovascular-repair-of-abdominal-aortic-aneurysms
#16
V P Bastiaenen, Mgj Snoeijs, Jgam Blomjous, J Bosma, V J Leijdekkers, R C van Nieuwenhuizen, A C Vahl
Objectives Stent grafts for endovascular repair of infrarenal aneurysms are commercially available for aortic necks up to 32 mm in diameter. The aim of this study was to evaluate the feasibility of endovascular repair with large thoracic stent grafts in the infrarenal position to obtain adequate proximal seal in wider necks. Methods All patients who underwent endovascular aneurysm repair using thoracic stent grafts with diameters greater than 36 mm between 2012 and 2016 were included. Follow-up consisted of CT angiography after six weeks and annual duplex thereafter...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28947230/indications-risk-factors-and-outcomes-of-30-day-readmission-after-infrarenal-abdominal-aneurysm-repair
#17
Hanaa N Dakour Aridi, Satinderjit Locham, Besma Nejim, Nasr S Ghajar, Husain Alshaikh, Mahmoud B Malas
OBJECTIVE: Reducing readmissions is an important target for improving patient care and enhancing health care quality and cost-effectiveness. The aim of this study was to assess rates, risk factors, and indications of 30-day readmission after open aortic repair (OAR) and endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs). METHODS: A retrospective analysis of the Premier Healthcare Database from 2009 to 2015 was performed. Indications for readmission after the index procedure, risk factors, and outcomes of the index admission and rehospitalization were evaluated...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28943483/permanent-decline-of-renal-function-after-infrarenal-abdominal-aortic-aneurysm-repair-frequency-and-risk-factors
#18
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Andreas Kribben, Stefan Herget-Rosenthal
BACKGROUND: Permanent renal function decline, and development and deterioration of chronic kidney disease (CKD) are associated with serious complications. How frequent is renal function decline after infrarenal abdominal aortic aneurysm (iAAA) repair according to current definitions and what are its risk factors, especially potentially modifiable ones? METHODS: Retrospective observational study including all patients with elective or urgent iAAA repair from 2007 to 2011...
September 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28943011/early-reintervention-after-open-and-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-high-mortality
#19
Sarah E Deery, Thomas F X O'Donnell, Thomas C F Bodewes, Barbara A Dalebout, Alexander B Pothof, Katie E Shean, Jeremy D Darling, Marc L Schermerhorn
OBJECTIVE: Although reinterventions are generally considered more common after endovascular aneurysm repair (EVAR) than after open surgical repair (OSR), less is known about reintervention in the early postoperative period. Furthermore, there are few data regarding the impact of early reintervention on 30-day mortality. We sought to evaluate the rates and types of reintervention after abdominal aortic aneurysm (AAA) repair and the impact of reintervention on postoperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) was queried from 2012 to 2014 for all intact, infrarenal AAA repairs...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28935757/resveratrol-inhibits-growth-of-experimental-abdominal-aortic-aneurysm-associated-with-upregulation-of-angiotensin-converting-enzyme-2
#20
Corey S Moran, Erik Biros, Smriti M Krishna, Yutang Wang, Chris Tikellis, Susan K Morton, Joseph V Moxon, Mark E Cooper, Paul E Norman, Louise M Burrell, Merlin C Thomas, Jonathan Golledge
OBJECTIVE: Recent evidence suggests an important role for angiotensin-converting enzyme 2 (ACE2) in limiting abdominal aortic aneurysm (AAA). This study examined the effect of ACE2 deficiency on AAA development and the efficacy of resveratrol to upregulate ACE2 in experimental AAA. APPROACH AND RESULTS: Ace2 deletion in apolipoprotein-deficient mice (ApoE(-/-)Ace2(-/y) ) resulted in increased aortic diameter and spontaneous aneurysm of the suprarenal aorta associated with increased expression of inflammation and proteolytic enzyme markers...
November 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
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