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Abdominal Aortic Aneurysm

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1. Complex endovascular aneurysm repair in patients with juxta-renal or thoraco-abdominal aortic aneurysm

Complex endovascular aneurysm repair in patients with juxta-renal or thoraco-abdominal aortic aneurysm 78 1 Health technology description Key points ? A single prospective observational study compared 30-day outcomes of fenestrated/branched endovascular aneurysm repair (F/B-EVAR) with open surgery repair (OSR) for the treatment of complex aortic aneurysm anatomies: para/juxta-renal aortic aneurysm (PRAA/JRAA) and thoraco-abdominal aortic aneurysm (TAAA). There was no statistically significant (...) to be comparable in terms of urgency of treatment (elective/non-elective), aneurysm anatomy, risk profile, and other demographics. The systematic reviews reported a 30-day mortality for the treatment of JRAA ranging from 1.4% to 4.1% with F-EVAR, 3.1% to 4.1% with OSR, and 5.3% with chimney-EVAR (Ch-EVAR). What is the clinical and cost-effectiveness of complex endovascular aneurysm repair in patients with juxta-renal or thoraco-abdominal aortic aneurysm compared with open surgical repair, and how should

2018 Evidence Notes from Healthcare Improvement Scotland

2. Abdominal aortic aneurysm screening: ultrasound equipment guidelines

Abdominal aortic aneurysm screening: ultrasound equipment guidelines Abdominal aortic aneurysm screening: ultrasound equipment quality assurance guidelines - GOV.UK GOV.UK uses cookies to make the site simpler. Accept cookies You’ve accepted all cookies. You can at any time. Hide Search Guidance Abdominal aortic aneurysm screening: ultrasound equipment quality assurance guidelines Updated 22 March 2019 Contents © Crown copyright 2019 This publication is licensed under the terms of the Open (...) Government Licence v3.0 except where otherwise stated. To view this licence, visit or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: . Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is available at https://www.gov.uk/government/publications/abdominal-aortic-aneurysm-screening-ultrasound-equipment-guidance/abdominal-aortic-aneurysm-screening-ultrasound

2019 Public Health England

3. Strategy of endovascular versus open repair for patients with clinical diagnosis of ruptured abdominal aortic aneurysm: the IMPROVE RCT

Strategy of endovascular versus open repair for patients with clinical diagnosis of ruptured abdominal aortic aneurysm: the IMPROVE RCT Strategy of endovascular versus open repair for patients with clinical diagnosis of ruptured abdominal aortic aneurysm: the IMPROVE RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try

2018 NIHR HTA programme

4. Contrast-enhanced ultrasound and/or colour duplex ultrasound for surveillance after endovascular abdominal aortic aneurysm repair: a systematic review and economic evaluation

Contrast-enhanced ultrasound and/or colour duplex ultrasound for surveillance after endovascular abdominal aortic aneurysm repair: a systematic review and economic evaluation Contrast-enhanced ultrasound and/or colour duplex ultrasound for surveillance after endovascular abdominal aortic aneurysm repair: a systematic review and economic evaluation Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you (...) requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Current evidence, although heterogeneous, indicates that colour duplex ultrasound may be a safe option for surveillance after endovascular abdominal aortic aneurysm repair, with computed tomography angiography reserved for abnormal/inconclusive cases. {{author

2018 NIHR HTA programme

5. Magnetic resonance imaging using ultrasmall superparamagnetic particles of iron oxide for abdominal aortic aneurysm: a risk prediction study

Magnetic resonance imaging using ultrasmall superparamagnetic particles of iron oxide for abdominal aortic aneurysm: a risk prediction study Magnetic resonance imaging using ultrasmall superparamagnetic particles of iron oxide for abdominal aortic aneurysm: a risk prediction study Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from (...) the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} MRI using ultrasmall superparamagnetic particles of iron oxide predicted the rate of abdominal aortic aneurysm expansion and the future risk of aneurysm rupture or repair. {{author}} {{($index , , , , , , & . Rachael Forsythe 1 , Olivia McBride 1 , Jennifer Robson 1 , Catriona Graham 2 , Noel Conlisk 3 , Peter Hoskins 1 , Fiona

2018 NIHR HTA programme

6. Screening women aged 65 years or over for abdominal aortic aneurysm: a modelling study and health economic evaluation

Screening women aged 65 years or over for abdominal aortic aneurysm: a modelling study and health economic evaluation Screening women aged 65 years or over for abdominal aortic aneurysm: a modelling study and health economic evaluation Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find (...) the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} The criteria for a screening programme for abdominal aortic aneurysm in women were not met and there was no combination of screening options costing less than £20,000 per QALY gained. {{author}} {{($index , , , , , , , & . Simon G Thompson 1, * , Matthew J Bown 2 , Matthew J Glover 3 , Edmund Jones 1 , Katya L Masconi 1 , Jonathan A Michaels 4 , Janet T Powell 5 , Pinar Ulug 5

2018 NIHR HTA programme

7. Complex endovascular aneurysm repair for juxta-renal or thoraco-abdominal aortic aneurysm: Advice Statement

Complex endovascular aneurysm repair for juxta-renal or thoraco-abdominal aortic aneurysm: Advice Statement File name: 20171208 Complex EVAR AS v3.0.docx0 Version: 3.0 Date: 26 April 2018 Produced by: Page: 1 Review date: Advice Statement 006/18 May 2018 What is the clinical and cost- effectiveness of complex endovascular aneurysm repair in patients with juxta-renal or thoraco-abdominal aortic aneurysm compared with open surgical repair and how should these technologies be delivered (...) -abdominal aortic aneurysm (TAAA) service is currently underway, and will address issues regarding service provision. NHSScotland is required to consider Scottish Health Technology Group (SHTG) advice. Why is SHTG looking at this topic? Complex endovascular aneurysm repair techniques are high cost procedures and there was perceived to be uncertainty in their clinical and cost-effectiveness. There is variation in the use of these procedures between NHS boards and it is not clear which model of delivery

2018 SHTG Advice Statements

8. Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm. (PubMed)

Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm. An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries (...) abdominal aortic aneurysm that assessed mortality, presence of coagulopathy, intensive care unit length of stay, and the presence of myocardial infarct and renal failure. High quality studies that evaluate the best strategy for managing haemorrhagic shock in ruptured abdominal aortic aneurysms are required.

2018 Cochrane

11. Abdominal aortic aneurysm

Abdominal aortic aneurysm Abdominal aortic aneurysm - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Abdominal aortic aneurysm Last reviewed: February 2019 Last updated: June 2018 Summary Patients are usually asymptomatic and their abdominal aortic aneurysm is detected incidentally. In the minority of patients who experience symptoms, abdominal, back, and groin pain are typical. Ultrasound remains the definitive test (...) % vs. 5.2%) and endovascular aneurysm repair (EVAR) (2.1% vs. 1.3%). Complications of treatment include acute kidney injury, limb ischaemia, spinal cord ischaemia, anastomotic pseudoaneurysm, graft infection, graft limb occlusion, and distal embolisation. Endoleak is a complication of EVAR. Definition Abdominal aortic aneurysm (AAA) is a permanent pathological dilation of the aorta with a diameter >1.5 times the expected anteroposterior (AP) diameter of that segment, given the patient's sex

2018 BMJ Best Practice

12. Abdominal Aortic Aneurysm Follow-up (Without Repair)

Abdominal Aortic Aneurysm Follow-up (Without Repair) New 2018 ACR Appropriateness Criteria ® 1 AAA Follow-up (Without Repair) American College of Radiology ACR Appropriateness Criteria ® Abdominal Aortic Aneurysm Follow-up (Without Repair) Variant 1: Asymptomatic abdominal aortic aneurysm surveillance (without repair). Procedure Appropriateness Category Relative Radiation Level US duplex Doppler aorta abdomen Usually Appropriate O CTA abdomen and pelvis with IV contrast Usually Appropriate (...) contrast May Be Appropriate O MRI abdomen and pelvis without IV contrast May Be Appropriate (Disagreement) O Aortography abdomen Usually Not Appropriate ??? Radiography chest abdomen pelvis Usually Not Appropriate ??? ACR Appropriateness Criteria ® 2 AAA Follow-up (Without Repair) ABDOMINAL AORTIC ANEURYSM FOLLOW-UP (WITHOUT REPAIR) Expert Panel on Vascular Imaging: Michael Collard, MD, MA a ; Patrick D. Sutphin, MD, PhD b ; Sanjeeva P. Kalva, MD c ; Bill S. Majdalany, MD d ; Jeremy D. Collins, MD e

2019 American College of Radiology

13. Endovascular aortic repair (EVAR) surgery more beneficial for ruptured abdominal aortic aneurysms than open repair

Endovascular aortic repair (EVAR) surgery more beneficial for ruptured abdominal aortic aneurysms than open repair EVAR surgery more beneficial for ruptured abdominal aortic aneurysms than open repair Discover Portal Discover Portal Endovascular aortic repair (EVAR) surgery more beneficial for ruptured abdominal aortic aneurysms than open repair Published on 28 August 2018 doi: EVAR surgery to repair a ruptured abdominal aortic aneurysm had a slightly better survival rate after three years than (...) open repair surgery. The survival benefit in this trial wasn’t apparent 30 days after surgery, but those having EVAR did recover more quickly and went home sooner. This NIHR-funded study also found that EVAR is likely to be more cost-effective. An abdominal aortic aneurysm is a swelling in the main artery that runs from the heart through the abdomen. If it bursts, there is catastrophic bleeding. The traditional treatment is urgent open surgery to repair the rupture. EVAR is a less invasive strategy

2019 NIHR Dissemination Centre

14. Recommendations on screening for abdominal aortic aneurysm in primary care

Recommendations on screening for abdominal aortic aneurysm in primary care © 2017 Joule Inc. or its licensors CMAJ | SEPTEMBER 11, 2017 | VOLUME 189 | ISSUE 36 E1137 A n abdominal aortic aneurysm (AAA) results from a weaken- ing in a section of the aortic wall in the abdomen, which bulges because of pressure from blood flow to form an aneurysm. 1 The aneurysm may grow and eventually rupture, caus- ing death from hemorrhage. 1 It is estimated that each year, 20?000 Canadians receive a diagnosis (...) - tional review of topic lists of relevant systematic reviews. A search for evidence on overdiagnosis was conducted in MED- GUIDELINE Recommendations on screening for abdominal aortic aneurysm in primary care Canadian Task Force on Preventive Health Care* *The complete list of authors appears at the end of the article. The list of current members of the Canadian Task Force on Preventive Health Care is available at http://canadiantaskforce.ca/about/members. n Cite as: CMAJ 2017 September 11;189:E1137-45

2017 CPG Infobase

15. Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair. (PubMed)

Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair. People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less (...) invasive but considered less accurate than CT.To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR).We searched MEDLINE, Embase, LILACS, ISI Conference Proceedings, Zetoc, and trial registries in June 2016 without language restrictions and without use of filters to maximize sensitivity.Any cross-sectional

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2017 Cochrane

16. Laparoscopic surgery for elective abdominal aortic aneurysm repair. (PubMed)

Laparoscopic surgery for elective abdominal aortic aneurysm repair. Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the infradiaphragmatic aorta that is equal to or greater than 30 mm or a local dilatation of equal to or greater than 50% compared to the expected normal diameter of the artery. AAAs rarely occur in individuals under 50 years of age, but thereafter the prevalence dramatically increases with age, with men at a six-fold greater risk of developing an AAA than women (...) of hospital stay.Current evidence suggests that elective laparoscopic AAA repair has a favourable safety profile comparable with that of EVAR, with low conversion rates as well as similar mortality and morbidity rates. As a result, it has been suggested that elective laparoscopic AAA repair may have a role in treating those patients for whom EVAR is unsuitable.To assess the effects of laparoscopic surgery for elective abdominal aortic aneurysm repair.The primary objective of this review was to assess

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2017 Cochrane

17. Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm. (PubMed)

Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm. Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease. However, the role of prophylaxis in individuals with abdominal aortic aneurysm (AAA) remains unclear. Several studies have shown that despite successful repair, those people with AAA have a poorer rate (...) in people with abdominal aortic aneurysm (AAA).For this update the Cochrane Vascular Information Specialist (CIS) searched the Cochrane Vascular Specialised Register (14 April 2016). In addition, the CIS searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 3) and trials registries (14 April 2016) and We also searched the reference lists of relevant articles.Randomised controlled trials in which people with AAA were randomly allocated to one prophylactic treatment versus

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2017 Cochrane

18. Endovascular treatment for ruptured abdominal aortic aneurysm. (PubMed)

Endovascular treatment for ruptured abdominal aortic aneurysm. An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open (...) surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair. More recently emergency endovascular aneurysm repair (eEVAR) has been used successfully to treat ruptured abdominal aortic aneurysm (RAAA), proving that it is feasible in select patients; however, it is unclear if eEVAR will lead to significant improvements in outcomes for these patients or if indeed

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2017 Cochrane

19. Fenestrated endovascular aneurysm repair is associated with lower perioperative morbidity and mortality compared with open repair for complex abdominal aortic aneurysms

Fenestrated endovascular aneurysm repair is associated with lower perioperative morbidity and mortality compared with open repair for complex abdominal aortic aneurysms The Zenith Fenestrated Endovascular Graft (ZFEN; Cook Medical, Bloomington, Ind) has expanded the anatomic eligibility of endovascular aneurysm repair (EVAR) for complex abdominal aortic aneurysms (AAAs). Current data on ZFEN mainly consist of single-institution experiences and show conflicting results. Therefore, we compared (...) with an aortic cross-clamping position that was above at least one renal artery. The primary outcome was perioperative mortality, defined as death within 30 days or within the index hospitalization. Secondary outcomes included postoperative renal dysfunction (creatinine concentration increase of >2 mg/dL from preoperative value or new dialysis), occurrence of any complication, procedure times, blood transfusion rates, and length of stay. To account for baseline differences, we calculated propensity scores

2019 EvidenceUpdates

20. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm - Journal of Vascular Surgery Email/Username: Password: Remember me Search JVS Journals Search Terms Search within Search Access provided by Volume 67, Issue 1, Pages 2–77.e2 The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic (...) . Starnes Affiliations Department of Surgery, University of Washington, Seattle, Wash , MD l DOI: | | ---- Fig 1 The annual adult per capita cigarette consumption and age-adjusted abdominal aortic aneurysm ( AAA ) deaths per 100,000 white men by year in the United States. ---- | ---- Fig 2 A, Influence of smoking (current vs ex/never) on aneurysm enlargement in individual studies and meta-analysis (see primary source for individual study citations). B, Influence of diabetes on aneurysm enlargement

2018 Society for Vascular Surgery

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