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Abdominal Aortic Aneurysm

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41. Simultaneous transcatheter aortic valve implantation and endovascular aneurysm repair in a patient with very severe aortic stenosis with abdominal aortic aneurysm Full Text available with Trip Pro

Simultaneous transcatheter aortic valve implantation and endovascular aneurysm repair in a patient with very severe aortic stenosis with abdominal aortic aneurysm The safety of non-cardiac surgery is uncertain for asymptomatic patients with very severe aortic stenosis (AS). Herein, we describe a case involving an elderly and frail patient with asymptomatic, very severe AS. The patient was considered a high-risk candidate for aortic valve replacement (AVR); thus, transcatheter aortic valve (...) implantation (TAVI) was planned. On perioperative examination, an abdominal aortic aneurysm (AAA) was observed, which required endovascular aneurysm repair (EVAR). To reduce the risks involved with sequential procedures, TAVI and EVAR were performed simultaneously. In patients with severe AS who are high-risk candidates for AVR, TAVI can be considered as an alternative therapy before non-cardiac surgery. In addition, the combined TAVI and EVAR procedure can reduce the risks associated

2018 Journal of cardiology cases

42. A systematic review and meta-analysis of the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysm (Abstract)

A systematic review and meta-analysis of the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysm This study synthesized the literature comparing the long-term (5-9 years) and very long-term (≥10 years) all-cause mortality, reintervention, and secondary rupture rates between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysm (AAA).MEDLINE, Embase, and CENTRAL databases were searched from inception to May 2018 for studies

2019 EvidenceUpdates

43. Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm (Abstract)

Meta-analysis of long-term survival after elective endovascular or open repair of abdominal aortic aneurysm Endovascular aneurysm repair (EVAR) has become the preferred strategy for elective repair of abdominal aortic aneurysm (AAA) for many patients. However, the superiority of the endovascular procedure has recently been challenged by reports of impaired long-term survival in patients who underwent EVAR. A systematic review of long-term survival following AAA repair was therefore undertaken.A

2019 EvidenceUpdates

44. Ultrasound screening for abdominal aortic aneurysms

Ultrasound screening for abdominal aortic aneurysms 1 Translation of Chapters 1 to 6 of the final report Ultraschall-Screening auf Bauchaortenaneurysmen (Version 1.1; Status: 2 April 2015). Please note: This translation is provided as a service by IQWiG to English- language readers. However, solely the German original text is absolutely authoritative and legally binding. Extract IQWiG Reports – Commission No. S13-04 Ultrasound screening for abdominal aortic aneurysms 1 Executive summary (...) of final report S13-04 Version 1.1 Ultrasound screening for abdominal aortic aneurysms 2 April 2015 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Ultrasound screening for abdominal aortic aneurysms Commissioning agency: Federal Joint Committee Commission awarded on: 18 November 2013 Internal Commission No.: S13-04 Address of publisher: Institute for Quality and Efficiency in Health Care Im

2015 Institute for Quality and Efficiency in Healthcare (IQWiG)

45. Sex differences in repair rates and outcomes of patients with ruptured abdominal aortic aneurysm (Abstract)

Sex differences in repair rates and outcomes of patients with ruptured abdominal aortic aneurysm Data are conflicting on sex differences in ruptured abdominal aortic aneurysm (rAAA) repair rates and outcomes have rarely been addressed. The aim of this study was to investigate differences in the management and outcome of rAAA in men and women, and to describe time trends over a 15-year interval.Data on patients with rAAA were extracted from the Swedish National Patient Registry and the Cause

2019 EvidenceUpdates

46. Accuracy evaluations of three ruptured abdominal aortic aneurysm mortality risk scores using an independent dataset (Abstract)

Accuracy evaluations of three ruptured abdominal aortic aneurysm mortality risk scores using an independent dataset To date, no single scoring system for predicting 30-day mortality in patients with ruptured abdominal aortic aneurysms (rAAAs) has been endorsed by any vascular society or proven to definitively predict treatment futility. Three recently developed scoring systems for predicting 30-day mortality in patients with rAAA have been validated by their respective institutional data (...) under the receiver operating characteristic (AUC) curves.Complete data from 38 patients was used for accuracy evaluation. The AUCs for the Dutch Aneurysm Score, Harborview Medical Center score, and Vascular Surgery Group of New England (VSGNE) score were 0.762, 0.792, and 0.860, respectively, for all patients. When evaluating 30-day mortality for patients undergoing ruptured endovascular aneurysm repair, the scores were 0.802, 0.893, and 0.927, respectively. The difference between scores did

2019 EvidenceUpdates

47. A systematic review on the quality of life and functional status after abdominal aortic aneurysm repair in elderly patients with an average age older than 75 years (Abstract)

A systematic review on the quality of life and functional status after abdominal aortic aneurysm repair in elderly patients with an average age older than 75 years Endovascular aneurysm repair (EVAR) and open repair (OR) of abdominal aortic aneurysms (AAAs) are increasingly performed in elderly patients (>75 years of age) with satisfactory results. Quality of life (QOL) is increasingly considered a primary goal of intervention after AAA repair. However, there is currently no consensus on QOL

2019 EvidenceUpdates

48. Safety and efficacy of exercise training in patients with abdominal aortic aneurysm: A meta-analysis of randomized controlled trials (Abstract)

Safety and efficacy of exercise training in patients with abdominal aortic aneurysm: A meta-analysis of randomized controlled trials Low exercise capacity preoperatively leads to increased postoperative complications, perioperative mortality, length of stay, and inpatient costs among patients going through elective abdominal aortic aneurysm (AAA) surgery. Therefore, exercise training may be extremely important for reducing perioperative adverse events in AAA patients. This paper aimed (...) ) in AAA patients. The result of meta-regression suggested that the effects of exercise training on peak V˙o2 and AT were not modulated by the exercise duration.Our analyses suggested that exercise training among AAA patients is generally safe, although future research should be carried out to further clarify the safety among patients with large AAAs. Exercise training improved peak V˙o2 and AT in AAA patients. More data are required to identify the optimal exercise duration for improving exercise

2019 EvidenceUpdates

49. A systematic review of the impact of preoperative exercise for patients with abdominal aortic aneurysms Full Text available with Trip Pro

A systematic review of the impact of preoperative exercise for patients with abdominal aortic aneurysms Available online January 01, 2019 The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article

2019 EvidenceUpdates

50. Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm Full Text available with Trip Pro

Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm The aim of this study was to develop a 48-h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care.Data from patients in the IMPROVE (Immediate Management (...) of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C-statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based

2019 EvidenceUpdates

51. Endovascular repair versus open repair for inflammatory abdominal aortic aneurysms. (Abstract)

Endovascular repair versus open repair for inflammatory abdominal aortic aneurysms. Inflammatory abdominal aortic aneurysm (IAAA) is a rare but potentially life-threatening condition characterised by marked thickening of the aortic wall, peri-aneurysmal and retroperitoneal fibrosis, and dense adhesions of adjacent abdominal organs. The pathogenesis of IAAA remains an enigma. The main aim of invasive or surgical therapy of AAAs is prevention or correction of aortic rupture. Prevention (...) or treatment of AAA rupture by open or endovascular repair is proven by numerous studies published in the literature. Treatment of IAAA poses a different challenge to surgeons compared with traditional atherosclerotic AAA because of the potential for iatrogenic injury in open repair or, alternatively, potential increased inflammatory response to endoprosthesis implantation.To assess the effects of elective endovascular versus open repair for inflammatory abdominal aortic aneurysms.The Cochrane Peripheral

2015 Cochrane

52. Stent graft types for endovascular repair of abdominal aortic aneurysms. (Abstract)

Stent graft types for endovascular repair of abdominal aortic aneurysms. The UK prevalence of abdominal aortic aneurysm (AAA) is estimated at 4.9% in over 65-year olds. Progressive and unpredictable enlargement can lead to rupture. Endovascular repair of AAAs involves a stent graft system being introduced via the femoral artery and manipulated within the aorta under radiological guidance. Following endograft deployment, a seal is formed at the proximal and distal landing zones to exclude (...) . It was not possible to review the quality of the evidence in the absence of studies eligible for inclusion in the review.Unfortunately, no data exist regarding direct comparisons of the performance of different stent graft types. High quality randomised controlled trials evaluating stent graft types in abdominal endovascular aneurysm repair are required.

2015 Cochrane

53. Open versus Endovascular Repair of Abdominal Aortic Aneurysm. Full Text available with Trip Pro

Open versus Endovascular Repair of Abdominal Aortic Aneurysm. Elective endovascular repair of an abdominal aortic aneurysm results in lower perioperative mortality than traditional open repair, but after 4 years this survival advantage is not seen; in addition, results of two European trials have shown worse long-term outcomes with endovascular repair than with open repair. Long-term results of a study we conducted more than a decade ago to compare endovascular repair with open repair (...) are unknown.We randomly assigned patients with asymptomatic abdominal aortic aneurysms to either endovascular repair or open repair of the aneurysm. All the patients were candidates for either procedure. Patients were followed for up to 14 years.A total of 881 patients underwent randomization: 444 were assigned to endovascular repair and 437 to open repair. The primary outcome was all-cause mortality. A total of 302 patients (68.0%) in the endovascular-repair group and 306 (70.0%) in the open-repair group

2019 NEJM Controlled trial quality: predicted high

54. 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 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 Grant SW, Sperrin M, Carlson E, Chinai N, Ntais D, Hamilton M, Dunn G, Buchan I, Davies L, McCollum CN Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Grant SW, Sperrin M, Carlson E, Chinai N, Ntais D, Hamilton M, Dunn G, Buchan I, Davies L, McCollum CN. Calculating when elective abdominal aortic aneurysm repair improves

2015 Health Technology Assessment (HTA) Database.

55. Pulsatile Abdominal Mass, Suspected Abdominal Aortic Aneurysm

Pulsatile Abdominal Mass, Suspected Abdominal Aortic Aneurysm Revised 2016 ACR Appropriateness Criteria ® 1 Pulsatile Abdominal Mass, Suspected AAA American College of Radiology ACR Appropriateness Criteria ® Pulsatile Abdominal Mass, Suspected Abdominal Aortic Aneurysm Variant 1: Pulsatile abdominal mass, suspected abdominal aortic aneurysm. Radiologic Procedure Rating Comments RRL* US aorta abdomen 9 O CTA abdomen with IV contrast 8 ??? MRA abdomen without and with IV contrast 8 O CT abdomen (...) without IV contrast 7 ??? CT abdomen with IV contrast 7 ??? CT abdomen without and with IV contrast 7 ???? MRA abdomen without IV contrast 7 O Aortography abdomen 4 ??? FDG-PET/CT abdomen 2 ???? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Pulsatile Abdominal Mass, Suspected AAA PULSATILE ABDOMINAL MASS, SUSPECTED ABDOMINAL AORTIC ANEURYSM Expert Panel on Vascular Imaging: Stephen P. Reis, MD

2016 American College of Radiology

56. Acute Type B Aortic Dissection in a Patient with Previous Endovascular Abdominal Aortic Aneurysm Repair Full Text available with Trip Pro

Acute Type B Aortic Dissection in a Patient with Previous Endovascular Abdominal Aortic Aneurysm Repair Endovascular aortic repair (EVAR) was relatively safe, and became a widely performed procedure. If aortic dissection (AD) occurred in patient with previous EVAR, it could cause fatal complications like endograft collapse. Surgical treatment was limited in this situation for comorbidities and complex anatomies. Here we report a rare case of acute type B AD developed following trans-radial (...) coronary intervention in a patient with previous EVAR of abdominal aortic aneurysm, which was treated with thoracic EVAR.

2017 Vascular specialist international

57. Abdominal Aortic Aneurysm Screening Guideline

Abdominal Aortic Aneurysm Screening Guideline ? 2006 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Abdominal Aortic Aneurysm Screening Guideline Major Changes as of December 2016 2 Prevention 2 Screening Recommendations 2 Coding Tips 3 Evidence Summary 3 Clinician Lead and Guideline Development 4 Most recent guideline approval date: December 2016 Guidelines are systematically developed statements to assist patients and providers in choosing appropriate health care (...) any particular recommendation must be made by the provider in light of the circumstances presented by the individual patient. 2 Major Changes as of December 2016 Abdominal aortic aneurysm (AAA) screening is no longer recommended for: • Women of any age, regardless of smoking history or family history of AAA. • Men under age 65. Prevention Because a lifetime history of tobacco use is strongly associated with abdominal aortic aneurysm (AAA) and its associated mortality, it is important to avoid

2016 Kaiser Permanente Clinical Guidelines

58. Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm Full Text available with Trip Pro

Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm Abdominal aortic aneurysm (AAA) is an irreversible condition where the abdominal aorta is dilated leading to potentially fatal consequence of aortic rupture. Multiple mechanisms are involved in the development and progression of AAA, including chronic inflammation, oxidative stress, vascular smooth muscle (VSMC) apoptosis, immune cell infiltration and extracellular matrix (ECM) degradation. Currently surgical (...) therapies, including minimally invasive endovascular aneurysm repair (EVAR), are the only viable interventions for AAAs. However, these treatments are not appropriate for the majority of AAAs, which measure <50 mm. Substantial effort has been invested to identify and develop pharmaceutical treatments such as statins and doxycycline for this potentially lethal condition but these interventions failed to offer a cure or to retard the progression of AAA. Chinese herbal medicine (CHM) has been used

2018 Frontiers in cardiovascular medicine

59. Educational Case: Symptomatic but Unruptured Abdominal Aortic Aneurysm Full Text available with Trip Pro

Educational Case: Symptomatic but Unruptured Abdominal Aortic Aneurysm The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies

2018 Academic pathology

60. Genetic Association of Lipids and Lipid Drug Targets With Abdominal Aortic Aneurysm: A Meta-analysis. Full Text available with Trip Pro

Genetic Association of Lipids and Lipid Drug Targets With Abdominal Aortic Aneurysm: A Meta-analysis. Risk factors for abdominal aortic aneurysm (AAA) are largely unknown, which has hampered the development of nonsurgical treatments to alter the natural history of disease.To investigate the association between lipid-associated single-nucleotide polymorphisms (SNPs) and AAA risk.Genetic risk scores, composed of lipid trait-associated SNPs, were constructed and tested for their association (...) elevation of LDL-C was associated with increased AAA risk (odds ratio [OR], 1.66; 95% CI, 1.41-1.96; P = 1.1 × 10-9). For HDL-C, a 1-SD increase was associated with reduced AAA risk (OR, 0.67; 95% CI, 0.55-0.82; P = 8.3 × 10-5), whereas a 1-SD increase in triglycerides was associated with increased AAA risk (OR, 1.69; 95% CI, 1.38-2.07; P = 5.2 × 10-7). In multivariable MR analysis and both MR-Egger and weighted median MR methods, the association of each lipid fraction with AAA risk remained largely

2018 JAMA cardiology

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