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Abdominal Aortic Aneurysm

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1. PIUR tUS for abdominal aortic aneurysm surveillance and endovascular aneurysm repair endoleak detection

PIUR tUS for abdominal aortic aneurysm surveillance and endovascular aneurysm repair endoleak detection PIUR tUS for abdominal aortic aneurysm surveillance and endovascular aneurysm repair endoleak detection Medtech innovation briefing Published: 9 December 2019 www.nice.org.uk/guidance/mib200 pathways Summary Summary The technology technology described in this briefing is PIUR tUS (3D tomographic ultrasound). It is for abdominal aortic aneurysm (AAA) surveillance and endovascular aneurysm (...) vessel by extending regular 2D ultrasound scanners. This imaging can be used for abdominal aortic aneurysm (AAA) surveillance and endovascular aneurysm repair (EVAR) endoleak detection and classification. PIUR tUS can be used with any 2D ultrasound device and transducer. It turns the images collected into high-resolution tomographic 3D ultrasound images. The images are viewed and reported in a similar way to other 3D imaging techniques using multi-planar reconstructions and 3D volume, such as CT

2019 National Institute for Health and Clinical Excellence - Advice

2. Systematic review and meta-analysis of the risk of bowel ischemia after ruptured abdominal aortic aneurysm repair (Abstract)

Systematic review and meta-analysis of the risk of bowel ischemia after ruptured abdominal aortic aneurysm repair Outcomes after repair of ruptured abdominal aortic aneurysm (RAAA) have improved in the last decade. It is unknown whether this has resulted in a reduction of postoperative bowel ischemia (BI). The primary objective was to determine BI prevalence after RAAA repair. Secondary objectives were to determine its major sequelae and differences between open repair (OR) and endovascular (...) aneurysm repair (EVAR).This systematic review (PROSPERO CRD42017055920) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. MEDLINE and Embase were searched for studies published from 2005 until 2018. The methodologic quality of observational studies was assessed with the Methodological Index for Non-Randomized Studies (MINORS) tool. The quality of the randomized controlled trials (RCTs

2018 EvidenceUpdates

3. 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

4. Risk factors and outcomes for bowel ischemia after open and endovascular abdominal aortic aneurysm repair. (Abstract)

Risk factors and outcomes for bowel ischemia after open and endovascular abdominal aortic aneurysm repair. Bowel ischemia (BI) is a serious complication after abdominal aortic aneurysm (AAA) repair. We sought to identify the incidence and risk factors associated with the development of postoperative BI and the post-BI outcomes for patients undergoing open aortic repair (OAR) and endovascular aortic repair (EVAR) of AAAs.A retrospective analysis was conducted for all patients who had undergone (...) was associated with a threefold increased odds of BI compared with EVAR (adjusted odds ratio [aOR], 3.24; 95% confidence interval [CI], 2.49-4.22; P < .001). The independent factors associated with BI after OAR included older age (aOR per year of age, 1.02; 95% CI, 1.00-1.03), congestive heart failure (aOR, 1.44; 95% CI, 1.05-1.98), and ruptured aneurysm (aOR, 4.16; 95% CI, 2.98-5.81; P < .01 for all). We also found that transfusion ≥1 U (aOR, 1.69; 95% CI, 1.30-2.20), a transperitoneal approach (aOR, 2.13

2019 Journal of Vascular Surgery

5. Limb Remote Ischemic Preconditioning for Intestinal and Pulmonary Protection during Elective Open Infrarenal Abdominal Aortic Aneurysm Repair: A Randomized Controlled Trial: Erratum. (Abstract)

Limb Remote Ischemic Preconditioning for Intestinal and Pulmonary Protection during Elective Open Infrarenal Abdominal Aortic Aneurysm Repair: A Randomized Controlled Trial: Erratum. 31149931 2019 07 23 1528-1175 131 1 2019 07 Anesthesiology Anesthesiology Limb Remote Ischemic Preconditioning for Intestinal and Pulmonary Protection during Elective Open Infrarenal Abdominal Aortic Aneurysm Repair: A Randomized Controlled Trial: Erratum. 222 10.1097/ALN.0000000000002766 eng Journal Article

2019 Anesthesiology Controlled trial quality: predicted high

6. 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

7. 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

8. Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm. Full Text available with Trip Pro

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

9. 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

10. Participation in bowel screening among men attending abdominal aortic aneurysm screening. Full Text available with Trip Pro

Participation in bowel screening among men attending abdominal aortic aneurysm screening. Uptake of population-based screening for colorectal cancer in Scotland is around 55 per cent. Abdominal aortic aneurysm (AAA) screening has recently been introduced for men aged 65 years and the reported uptake is 78 per cent. The aim was to determine the impact of a brief intervention on bowel screening in men who attended AAA screening, but previously failed to complete bowel screening.Men invited (...) for AAA screening between September 2015 and March 2016 within NHS Tayside were included. Attendees who had not responded to their latest bowel screening invitation were seen by a colorectal cancer clinical nurse specialist. Reasons for not completing the faecal occult blood test (FOBT) were recorded; brief information on colorectal cancer screening was communicated, and participants were offered a further invitation to complete a FOBT. Those who responded positively were sent a further FOBT from

2018 British Journal of Surgery

13. Endovascular aneurysm sealing for abdominal aortic aneurysm

Endovascular aneurysm sealing for abdominal aortic aneurysm Endovascular aneurysm sealing for abdominal aortic aneurysm | Guidance | NICE Endovascular aneurysm sealing for abdominal aortic aneurysm Interventional procedures guidance [IPG547] Published date: February 2016 Guidance March 2019: We have withdrawn the guidance because the CE mark for the Nellix Endovascular Aneurysm Sealing (EVAS) System has been withdrawn. Endologix is recalling unused stock. The MHRA recommends (see MDA/2019/002

2016 National Institute for Health and Clinical Excellence - Interventional Procedures

14. 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

15. Abdominal Aortic Aneurysm: Screening

results from a large United Kingdom abdominal aortic aneurysm screening center in the context of optimizing United Kingdom National Abdominal Aortic Aneurysm Screening Programme protocols. J Vasc Surg . 2016;63(2):301-4. 5. Choke E, Vijaynagar B, Thompson J, Nasim A, Bown MJ, Sayers RD. Changing epidemiology of abdominal aortic aneurysms in England and Wales: older and more benign? Circulation . 2012;125(13):1617-25. 6. Anjum A, Powell JT. Is the incidence of abdominal aortic aneurysm declining (...) Abdominal Aortic Aneurysm: Screening Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation Men aged 65 to 75 years who have ever smoked The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. B Men aged 65 to 75 years who have never smoked The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography

2019 U.S. Preventive Services Task Force

16. 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 (...) -abdominal-aortic-aneurism/protocol/ (accessed 2017 Jan. 16). 24. Ali MU, Fitzpatrick-Lewis D, Raina P, et al. Screening for abdominal aortic aneurysm: updated GRADE tables. Hamilton (ON): Evidence Review and Syn- thesis Centre, McMaster University; 2017. Available: http://canadiantaskforce. ca/guidelines/published-guidelines/abdominal-aortic-aneurysm/ (accessed on 2017 May 14). 25. Ali MU, Fitzpatrick-Lewis D, Raina P, et al. Absolute effects for harms out- comes; one-time AAA screening in men

2017 CPG Infobase

17. Endovascular treatment for ruptured abdominal aortic aneurysm. Full Text available with Trip Pro

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

2017 Cochrane

18. Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair. Full Text available with Trip Pro

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

2017 Cochrane

19. Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm. Full Text available with Trip Pro

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

2017 Cochrane

20. Laparoscopic surgery for elective abdominal aortic aneurysm repair. Full Text available with Trip Pro

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 (...) . Prevalence of AAA has been reported to range from 1.3% in women aged 65 to 80 years to between 4% and 7.7% in men aged 65 to 80 years.There is evidence that the risk of rupture increases as the aneurysm diameter increases from 50 mm to 60 mm. People with AAAs over 55 mm in diameter are therefore generally referred for consideration of repair, as the risk of rupture exceeds the risk of repair. The traditional treatment for AAA is open surgical repair (OSR) which involves a large abdominal incision

2017 Cochrane

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