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Abdominal Aortic Aneurysm

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

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 (...) 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

2019 NIHR Dissemination Centre

22. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm Full Text available with Trip Pro

approach for patients requiring OSR of an inflammatory aneurysm, a horseshoe kidney, or an aortic aneurysm in the presence of a hostile abdomen. Level of recommendation 1 (Strong) Quality of evidence C (Low) We suggest a retroperitoneal exposure or a transperitoneal approach with a transverse abdominal incision for patients with significant pulmonary disease requiring OSR. Level of recommendation 2 (Weak) Quality of evidence C (Low) We recommend a thrombin inhibitor, such as bivalirudin or argatroban (...) ., and Mahmood, A. Outcome of open versus endovascular abdominal aortic aneurysm repair in obese patients: a systemic review and meta-analysis. Int Angiol . 2015 ; 34 : 9–15 | Open vs endovascular repair (obese patients) • EVAR had lower 30-day postoperative mortality and fewer early postoperative complications (MI, chest infection, renal failure, wound infection); risks of postoperative bowel ischemia and stroke were similar (low) Rayet, 2008 16 x 16 Rayt, H.S., Sutton, A.J., London, N.J., Sayers, R.D

2018 Society for Vascular Surgery

23. Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid and economic evaluation Full Text available with Trip Pro

Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid and economic evaluation Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid 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

2015 NIHR HTA programme

24. Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysm Canadian Task Force on Preventive Health Care | Abdominal Aortic Aneurysm (2017) English Menu Get Involved Abdominal Aortic Aneurysm (2017) Abdominal Aortic Aneurysm (2017) Click to view article Tools Additional Documents Click to see additional documents Endorsements This Clinical Practice Guideline has been endorsed by the Nurse Practitioners’ Association of Canada (NPAC). This clinical practice guideline has been endorsed by the College of Family Physicians (...) for Abdominal Aortic Aneurysm (AAA) with ultrasound reduces the risk of AAA-related mortality, rupture and emergency repair. On the other hand, screening can also lead to identification of AAAs that would never rupture and increases the number of elective repairs which are conducted. The prevalence of AAA in screened populations has declined since these RCTs were conducted, which would reduce the absolute benefit of screening from that reported in the trials. Despite evidence showing increased risk of AAA

2017 Canadian Task Force on Preventive Health Care

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

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

26. Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery

Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Discover Portal Discover Portal Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Published on 18 September 2018 doi: Mesh reinforcement may result in patients developing fewer hernias at the incision site after aortic aneurysm surgery. This type of hernia is a common complication (...) incisions, which are less commonly used in the UK than horizontal incisions. These findings provide evidence to support using mesh in appropriately selected patients who may be at high risk of wound hernia. Share your views on the research. Why was this study needed? An abdominal aortic aneurysm is a swelling or bulge in the wall of the aorta which tends to enlarge, sometimes to the point where the wall ruptures, causing catastrophic bleeding. They are most frequent in men older than 65 years and cause

2019 NIHR Dissemination Centre

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

Recommendations on screening for abdominal aortic aneurysm in primary care. Recommendations on screening for abdominal aortic aneurysm in primary care. | National Guideline Clearinghouse success fail JUN 10 2017 2018 2019 14 Apr 2018 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites for the sake of history and digital (...) at . TIMESTAMPS Search Sign In Username or Email * Password * Remember Me Don't have an account? The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. For additional information, read our . Guideline Summary NGC:011262 2017 Sep 11 NEATS Assessment Recommendations on screening for abdominal aortic aneurysm in primary care. Canadian Task Force

2017 National Guideline Clearinghouse (partial archive)

28. Abdominal aortic aneurysm screening for women is unlikely to be a fair use of NHS resources

is a life-threatening emergency with low survival. Men are known to be at higher risk of an aneurysm and are offered screening at age 65 to allow early diagnosis of aneurysms large enough to warrant surgical repair. However, a third of deaths from rupture are in women. This NIHR-funded study is the first to model the potential benefits, harms and cost-effectiveness of abdominal aortic aneurysm screening in women. All screening scenarios were estimated to exceed the NHS cost-effectiveness threshold (...) Abdominal aortic aneurysm screening for women is unlikely to be a fair use of NHS resources Abdominal aortic aneurysm screening for women not cost effective Discover Portal Discover Portal Abdominal aortic aneurysm screening for women is unlikely to be a fair use of NHS resources Published on 13 November 2018 doi: Nearly 4,000 women would need screening to prevent one death, and a third of aneurysms detected wouldn’t have influenced the individual woman's health or lifespan. Aneurysm rupture

2019 NIHR Dissemination Centre

29. Abdominal Aortic Aneurysm: Interventional Planning and Follow-up

Abdominal Aortic Aneurysm: Interventional Planning and Follow-up Revised 2017 ACR Appropriateness Criteria ® 1 AAA: Interventional Planning & Follow-Up American College of Radiology ACR Appropriateness Criteria ® Abdominal Aortic Aneurysm: Interventional Planning and Follow-up Variant 1: Planning for pre-endovascular repair (EVAR) or open repair of AAA. Procedure Appropriateness Category Relative Radiation Level CTA abdomen and pelvis with IV contrast Usually Appropriate ????? MRA abdomen (...) and pelvis without IV contrast and US aorta abdomen with duplex Doppler May Be Appropriate ??? MRA abdomen and pelvis without IV contrast May Be Appropriate O US aorta abdomen with duplex Doppler May Be Appropriate O CT abdomen and pelvis without IV contrast May Be Appropriate ??? CT abdomen and pelvis with IV contrast May Be Appropriate (Disagreement) ??? X-ray abdomen and pelvis May Be Appropriate ??? ACR Appropriateness Criteria ® 2 AAA: Interventional Planning & Follow-Up ABDOMINAL AORTIC ANEURYSM

2017 American College of Radiology

30. No clear difference between open and keyhole surgery for the repair of ruptured abdominal aortic aneurysms

months, though keyhole surgery leads to slightly shorter hospital stays. Women were found to benefit slightly more from the keyhole technique than men, according to this review and meta-analysis. An abdominal aortic aneurysm is a swelling of the aorta – the body’s main artery. Large aneurysms are rare but if they burst there is catastrophic bleeding. The traditional treatment for abdominal aortic aneurysm is open repair: keyhole repair (also known as endovascular repair or EVAR) is a less invasive (...) common vascular emergencies. A ruptured aneurysm is nearly always fatal if not repaired. Ruptured abdominal aortic aneurysms account for more than 1 in 50 of all deaths in the over 65 age group and a total of 6,000 deaths in England and Wales each year. There are two surgical techniques used to treat large aneurysms: open repair and endovascular repair (a type of keyhole surgery). See Definitions for more information. The aim of the study was to determine if endovascular repair offers an improvement

2019 NIHR Dissemination Centre

31. CRACKCast E086 – Abdominal Aortic Aneurysm

the lumen / false lumens and any fistulae But contrast isn’t mandatory Helps see retroperitoneal hemorrhage and peri-aortic hematoma 1) List 6 presentations of an abdominal aortic aneurysm. The Natural Hx of AAA: enlarge→ rupture → hemorrhagic cardiac arrest Risk increases with size, most ruptures are > 5 cm Most (any anyone can!) rupture retroperitoneally But can rupture intraperitoneally, into the IVC, or into the GI tract Some can embolize clots and atheromatous material distally; others can erode (...) CRACKCast E086 – Abdominal Aortic Aneurysm CRACKCast E086 - Abdominal Aortic Aneurysm - CanadiEM CRACKCast E086 – Abdominal Aortic Aneurysm In , , by Adam Thomas June 15, 2017 This episode of CRACKCast covers Rosen’s Chapter 86, Abdominal Aortic Aneurysm. This episode covers the diagnosis of Abdominal Aortic Aneurysm including the risk factors, red flags to watch out for, as well as treatment and management. Shownotes – Rosen’s in Perspective AAA = is a TRUE aneurysm in that it involves

2017 CandiEM

32. Measuring of Abdominal Aortic Aneurysm with Three-Dimensional Computed Tomography Reconstruction before Endovascular Aortic Aneurysm Repair Full Text available with Trip Pro

Measuring of Abdominal Aortic Aneurysm with Three-Dimensional Computed Tomography Reconstruction before Endovascular Aortic Aneurysm Repair Conventional computed tomography (CT) is the gold standard method for case planning for endovascular aortic aneurysm repair (EVAR). However, aortography with a marking catheter is needed for measuring the actual length of an aneurysm. With advances in imaging technology, a 3-dimensional (3D) workstation can obviate the need for the aortography (...) . The objective of this study was to determine whether a 3D workstation could obviate the need for aortography for EVAR.One vascular surgeon and 1 interventional radiologist retrospectively assessed axial CT scans and reformatted the 3D CT scans by using the iNtuition workstation (TeraRecon Inc., San Mateo, CA, USA) for 25 patients who underwent EVAR. Four measurements of diameter and length were obtained from each modality. The actual length of an aneurysm for the proper graft was decided by 2 observers

2017 Vascular specialist international

33. Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report. Full Text available with Trip Pro

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report. Primary aortoduodenal fistula (ADF) is a rare cause of gastrointestinal (GI) bleeding and is difficult to diagnose as the clinical presentation is subtle. Clinicians should keep a high level of suspicion for an unknown etiology of GI bleeding, especially in older patients with or without abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA) can (...) be used to detect primary ADF. Open surgery or endovascular aortic repair (EVAR) for ADF with bleeding will improve the survival rate.We report a rare case of AAA complicating ADF with massive GI bleeding in a 73-year-old Taiwanese man. He presented with abdominal pain and tarry stool for 5 days and an initial upper GI endoscopy at a rural hospital showed gastric ulcer only, but hypotension with tachycardia and a drop in hemoglobin of 9 g/dl from 12 g/dl occurred the next day. He was referred to our

2018 BMC Cardiovascular Disorders

34. Accuracy of Routine Endoscopy Diagnosing Colonic Ischaemia After Abdominal Aortic Aneurysm Repair: A Meta-analysis. Full Text available with Trip Pro

Accuracy of Routine Endoscopy Diagnosing Colonic Ischaemia After Abdominal Aortic Aneurysm Repair: A Meta-analysis. 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.The Pubmed and Embase database searches resulted in 1188 articles. Prospective studies describing routine post-operative colonoscopy

2018 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

35. Novel surgical treatment of abdominal aortic aneurysm complicated with primary aorto-colonic fistula: A case report. Full Text available with Trip Pro

Novel surgical treatment of abdominal aortic aneurysm complicated with primary aorto-colonic fistula: A case report. Primary aorto-colonic fistula is a rare complication of an abdominal aortic aneurysm. Without surgical treatment, the associated mortality rate is 100%. Even if patients receive timely surgical treatment, they may still die of complications such as infection.A 65-year-old male patient was transferred to our hospital because of massive hematochezia and abdominal pain.Aortic (...) computed tomography angiography demonstrated abdominal aortic aneurysm complicated with aorto-enteric fistula.We used a gelatin-impregnated knitted vascular prosthesis to re-establish the aneurysm in its original position combined with local drainage to treat the fistula.The patient had an uneventful postoperative course, and there was no recurrence during the 18-month follow-up.This surgical treatment is suitable for patients with abdominal aortic aneurysms complicated with primary aorto-colonic

2018 Medicine

36. Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair

Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (...) (100). Please remove one or more studies before adding more. Intraoperative Perfusion Patterns of the Sigmoid Colon During Elective Open Abdominal Aortic Aneurysm Repair The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03429647 Recruitment Status : Completed First Posted : February 12, 2018 Last

2018 Clinical Trials

37. Long-term outcome of sac filling with fibrin sealant after endovascular aneurysm repair of abdominal aortic aneurysm with challenging aortic neck anatomy. (Abstract)

Long-term outcome of sac filling with fibrin sealant after endovascular aneurysm repair of abdominal aortic aneurysm with challenging aortic neck anatomy. A retrospective single-center study is reported here to assess the safety and long-term effectiveness of applying a fibrin sealant (FS) sac-filling strategy to eliminate type IA endoleak (TIAE) after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm.Characteristics of abdominal aortic aneurysm patients who had challenging (...) proximal aortic neck anatomy (short or angulated) and underwent FS sac filling to resolve TIAE after traditional EVAR in Changhai Hospital between December 2006 and July 2010 were collected and reviewed. Intrasac pressure was measured with a preloaded catheter before and after FS filling to observe the immediate curative effect. The 7- to 10-year long-term effect was evaluated on the basis of the occurrence of endoleak, maximum aneurysm diameter, all-cause mortality, and other severe complications

2019 Journal of Vascular Surgery

38. Transperitoneal versus retroperitoneal approach for elective open abdominal aortic aneurysm repair. (Abstract)

Transperitoneal versus retroperitoneal approach for elective open abdominal aortic aneurysm repair. There has been extensive debate in the surgical literature regarding the optimum surgical access approach to the infrarenal abdominal aorta during an operation to repair an abdominal aortic aneurysm. The published trials comparing retroperitoneal (RP) and transperitoneal (TP) aortic surgery show conflicting results.To assess the effectiveness and safety of the transperitoneal versus (...) retroperitoneal approach for elective open abdominal aortic aneurysm repair on mortality, complications, hospital stay and blood loss.The Cochrane Vascular Trials Search Co-ordinator searched the Cochrane Vascular Specialised Register (last searched May 2015) and CENTRAL (2015, Issue 4) and trials databases (May 2015). The review authors searched the Chinese Biomedical Literature Database and other resources including clinical trials registers.We included randomized controlled trials (RCTs) that assessed

2016 Cochrane

39. Intravenous heparin during ruptured abdominal aortic aneurysmal repair. (Abstract)

Intravenous heparin during ruptured abdominal aortic aneurysmal repair. There have been enormous advances in the screening, diagnosis, intervention and overall prognosis of abdominal aortic aneurysms (AAAs) in the last decade, but despite these, ruptured AAAs (rAAAs) still cause around 3500 to 6000 deaths in England and Wales each year. Open repair remains standard treatment for rAAA in most centres but increasingly endovascular aneurysm repair (EVAR) is being adopted. This has a 30-day (...) has been demonstrated in elective repairs.The primary objective was to assess the effect of intravenous heparin on all-cause mortality in ruptured abdominal aortic aneurysm (rAAA) management in people undergoing an emergency repair.The secondary objectives were to assess the effect of intravenous heparin in rAAA management on the incidence of general arterial disease, for example, cardiovascular, cerebral, pulmonary and renal pathologies, in people undergoing emergency repair.The Cochrane Vascular

2016 Cochrane

40. 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 (...) for potential inclusion in the review. We used standard methodological procedures in accordance with the Cochrane Handbook for Systematic Review of Interventions.We identified no RCTs that met the inclusion criteria.We found no RCTs that compared controlled hypotension and normotensive resuscitation strategies in the management of haemorrhagic shock in patients with ruptured abdominal aortic aneurysm that assessed mortality, presence of coagulopathy, intensive care unit length of stay, and the presence

2016 Cochrane

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