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Abdominal Aortic Aneurysm

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6641. Cost-effectiveness analysis of elective endovascular repair compared with open surgical repair of abdominal aortic aneurysms for patients at a high surgical risk: A 1-year patient-level analysis conducted in Ontario, Canada. Full Text available with Trip Pro

Cost-effectiveness analysis of elective endovascular repair compared with open surgical repair of abdominal aortic aneurysms for patients at a high surgical risk: A 1-year patient-level analysis conducted in Ontario, Canada. Abdominal aortic aneurysm (AAA) is a prevalent health condition affecting up to 14% of men and 6% of women. The objective of this study was to estimate the cost-effectiveness and cost-utility of elective endovascular aneurysm repair (EVAR) compared with open surgical repair

2008 Journal of Vascular Surgery

6642. Cardiovascular risk profile and outcome of patients with abdominal aortic aneurysm in out-patients with atherothrombosis: data from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Full Text available with Trip Pro

Cardiovascular risk profile and outcome of patients with abdominal aortic aneurysm in out-patients with atherothrombosis: data from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Datasets regarding patients with abdominal aortic aneurysm (AAA) have almost universally been restricted to single geographic regions. We aimed to obtain data on the risk factor profile and cardiovascular (CV) co-morbidity among multi-ethnic patients with known AAA in the global REACH

2008 Journal of Vascular Surgery

6643. Expanding use of emergency endovascular repair for ruptured abdominal aortic aneurysms: disparities in outcomes from a nationwide perspective. Full Text available with Trip Pro

Expanding use of emergency endovascular repair for ruptured abdominal aortic aneurysms: disparities in outcomes from a nationwide perspective. Endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) has become widely accepted in the elective setting but remains controversial for emergency repair of ruptured aneurysms (rAAA). We sought to examine the national trends in use and associated outcomes with EVAR.The Nationwide Inpatient Sample (NIS) was used to analyze all admissions for rAAA

2008 Journal of Vascular Surgery

6644. The impact of race and insurance type on the outcome of endovascular abdominal aortic aneurysm (AAA) repair. Full Text available with Trip Pro

The impact of race and insurance type on the outcome of endovascular abdominal aortic aneurysm (AAA) repair. Although mortality and complication rates for abdominal aortic aneurysm (AAA) have declined over the last 20 years, operative complication rates and perioperative mortality are still high, specifically for repair of ruptures. The goal of this study was to determine the influence of insurance type and ethnicity while controlling for the influences of potential confounders on procedure

2008 Journal of Vascular Surgery

6645. Endovascular technology, hospital volume, and mortality with abdominal aortic aneurysm surgery. Full Text available with Trip Pro

Endovascular technology, hospital volume, and mortality with abdominal aortic aneurysm surgery. To determine whether the introduction of endovascular technology changed the relationship of hospital volume to mortality with abdominal aortic aneurysm repair.Data from all hospitals in the United States that performed abdominal aortic aneurysm surgery on Medicare patients from 2001 to 2003 were obtained from the national Medicare database. The primary outcome variable was death abdominal aortic aneurysms repaired with an endovascular approach increased from 27% to 39% during the 3-year study period. Hospital volume was significantly related to operative mortality in all comparisons. Mortality rates were 80

2008 Journal of Vascular Surgery

6646. Outcomes following endovascular abdominal aortic aneurysm repair (EVAR): an anatomic and device-specific analysis. Full Text available with Trip Pro

Outcomes following endovascular abdominal aortic aneurysm repair (EVAR): an anatomic and device-specific analysis. We performed a device-specific comparison of long-term outcomes following endovascular abdominal aortic aneurysm repair (EVAR) to determine the effect(s) of device type on early and late clinical outcomes. In addition, the impact of performing EVAR both within and outside of specific instructions for use (IFU) for each device was examined.Between January 8, 1999 and December 31 (...) , 2005, 565 patients underwent EVAR utilizing one of three commercially available stent graft devices. Study outcomes included perioperative (< or =30 days) mortality, intraoperative technical complications and need for adjunctive procedures, aneurysm rupture, aneurysm-related mortality, conversion to open repair, reintervention, development and/or resolution of endoleak, device related adverse events (migration, thrombosis, or kinking), and a combined endpoint of any graft-related adverse event

2008 Journal of Vascular Surgery

6647. Growth predictors and prognosis of small abdominal aortic aneurysms. Full Text available with Trip Pro

Growth predictors and prognosis of small abdominal aortic aneurysms. Evidence regarding the influence of cardiovascular risk factors, comorbidities, and patient characteristics on the growth of small abdominal aortic aneurysms (AAA) is limited. We assessed, in an observational cohort study, rupture rates, risks of mortality, and the effects of cardiovascular risk factors and patient demographics on growth rates of small AAAs.Between September 1996 and January 2005, 5057 patients with manifest (...) growth rates. The risk of rupture of these small abdominal aortic aneurysms was low, which pleads for watchful waiting.

2008 Journal of Vascular Surgery

6648. Ruptured abdominal aortic aneurysm in an 11-year-old boy. (Abstract)

Ruptured abdominal aortic aneurysm in an 11-year-old boy. We present a case of a ruptured aortic aneurysm in an 11-year-old boy presenting with loss of consciousness. The presentation, management, pathology, and gravity of this condition are discussed.

2008 Journal of Pediatric Surgery

6649. Is the size of an abdominal aortic aneurysm associated with coagulopathy? (Abstract)

Is the size of an abdominal aortic aneurysm associated with coagulopathy? Abdominal aortic aneurysm (AAA) volume and intraluminal thrombi were analyzed with respect to the number and function of platelets, blood cells, and coagulation factors. A group of 43 patients who underwent repair of an AAA were enrolled in this study. The maximum diameter and volume of the AAA, and the volume of intraluminal thrombi and lumen were measured by computed tomography with planimetry. The platelet count

2005 World Journal of Surgery

6650. Outcome and survival of patients aged 65 years and younger after abdominal aortic aneurysm rupture. (Abstract)

Outcome and survival of patients aged 65 years and younger after abdominal aortic aneurysm rupture. Advanced age (> 80 years) confers a survival disadvantage after operative repair of a ruptured abdominal aortic aneurysm (AAA). This study aimed to determine if young age (< or =65 years) confers a survival benefit. Consecutive patients undergoing attempted repair of a ruptured AAA between 1995 and 2001 were included in the study. Demographic, clinical, and operative factors were analyzed

2005 World Journal of Surgery

6651. Risk-adjusted analysis of early mortality after ruptured abdominal aortic aneurysm repair. Full Text available with Trip Pro

Risk-adjusted analysis of early mortality after ruptured abdominal aortic aneurysm repair. Ruptured abdominal aortic aneurysms (RAAAs) continue to result in early mortality in up to 50% of patients. Additionally, it remains difficult to compare outcomes given the variability in patient comorbidities and presentation. The purpose of this study was to describe an instrument that permits the prospective analysis of outcomes after RAAA repair while adjusting for the variability in preoperative

2005 Journal of Vascular Surgery

6652. Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: a comparison of AneuRx and Zenith endografts. Full Text available with Trip Pro

Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: a comparison of AneuRx and Zenith endografts. Freedom from migration is key to the durability of endovascular aneurysm repair (EVAR). This study evaluates the mid- and long-term incidence of migration with two different endografts.Between September 1997 and June 2004, 235 patients were scheduled for EVAR with an AneuRx (Medtronic/AVE Inc.) or Zenith (Cook) endograft. Patients with fusiform, infrarenal (...) aneurysms and a minimum 12 months of follow-up were analyzed, for a final cohort of 130 patients. Migration was assessed on axial computed tomography (CT) (2.5 to 3 mm cuts) as the distance from the most caudal renal artery to the first slice containing endograft (AneuRx) or to the top of the bare suprarenal stent (Zenith). Aortic neck diameters were measured at the most caudal renal artery. The initial postoperative CT scan was the baseline. Migration was defined by caudal movement of the endograft

2005 Journal of Vascular Surgery

6653. Local anesthesia for endovascular abdominal aortic aneurysm repair. Full Text available with Trip Pro

Local anesthesia for endovascular abdominal aortic aneurysm repair. This study reports the results of a prospective continuous cohort of patients treated for endovascular aneurysm repair (EVAR) with a unified anesthetic strategy based on the use of local anesthesia (LA) in all patients, while reserving regional (RA) or general anesthesia (GA) only for those with predefined individually or surgically specific indications.All patients treated by EVAR for an elective aortic abdominal aneurysm (AAA

2005 Journal of Vascular Surgery

6654. National audit of the recent utilization of endovascular abdominal aortic aneurysm repair in Canada: 2003 to 2004. Full Text available with Trip Pro

National audit of the recent utilization of endovascular abdominal aortic aneurysm repair in Canada: 2003 to 2004. Worldwide, increasing proportions of aortic aneurysms are repaired electively via the endovascular route. The purpose of this study was to report the recent utilization of endovascular repair in Canada by reviewing a national administrative database.The Canadian Institute for Health Information database (a collection of all acute care hospitalizations) was reviewed to identify (...) patients who received nonemergent repair of an abdominal aortic aneurysm (AAA) between April 1, 2003 and March 31, 2004. During this 1-year period, differentiation between endovascular (EVAR) and open repair was possible using ICD-10-CA procedural codes in eight of ten provinces. Case volumes, patient age, length of hospitalization, and mortality were stratified by method of repair, province, and size and teaching status of hospitals.In this 1-year period, 1996 patients in eight provinces (representing

2005 Journal of Vascular Surgery

6655. eNOS G894T polymorphism as a mild predisposing factor for abdominal aortic aneurysm. Full Text available with Trip Pro

eNOS G894T polymorphism as a mild predisposing factor for abdominal aortic aneurysm. Abdominal aortic aneurysm (AAA) represents a chronic degenerative condition associated with atherosclerosis. Actually, data from experimental and clinical studies suggest that nitric oxide (NO) is a modulator in maintaining endothelial function and antithrombotic intravascular environment. Reduced vascular NO generation in subjects carrying the rare variants of the eNOS gene might predispose to AAA

2005 Journal of Vascular Surgery

6656. Emergency endovascular treatment for ruptured abdominal aortic aneurysm and the risk of spinal cord ischemia. Full Text available with Trip Pro

Emergency endovascular treatment for ruptured abdominal aortic aneurysm and the risk of spinal cord ischemia. Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence and pathogenesis of spinal cord ischemia after eEVAR in greater detail.This (...) was a retrospective analysis of patients who had eEVAR for rAAA in three hospitals in The Netherlands and Belgium during a 3-year study period that ended in February 2004. The use of aortouniiliac devices combined with a femorofemoral crossover bypass was the preferred technique. Patients with postoperative symptoms of spinal cord ischemia were identified and the influence of potential risk factors was assessed. These factors included the presence of common iliac artery aneurysms necessitating device limb

2005 Journal of Vascular Surgery

6657. Endovascular management of ruptured abdominal aortic aneurysms: 6-year experience from a Greek center. Full Text available with Trip Pro

Endovascular management of ruptured abdominal aortic aneurysms: 6-year experience from a Greek center. To report our early experience with endovascular treatment of patients with ruptured abdominal aortic aneurysms (RAAAs).Between March 1998 and October 2004, 40 consecutive patients with an RAAA presented to our unit; 38 underwent assessment by computed tomography, whereas 2 died on arrival before any assessment and treatment was possible. Twenty-three patients (61%) were suitable for stent

2005 Journal of Vascular Surgery

6658. Endovascular repair of abdominal aortic aneurysm in octogenarians: an analysis based on EUROSTAR data. Full Text available with Trip Pro

Endovascular repair of abdominal aortic aneurysm in octogenarians: an analysis based on EUROSTAR data. To investigate the early and late outcome after endovascular treatment of abdominal aortic aneurysm (EVAR) in octogenarians compared with patients aged < 80 years.Patients treated for abdominal aortic aneurysm (AAA) with endovascular repair during the period 1996 to 2004 were collated in the EUROSTAR registry. This study group consisted of 697 patients aged > or = 80 years. Comparison was made (...) patients (P < .0001); they also had a larger aneurysm diameter (62 vs 58 mm, respectively; P < .0001). The 30-day and in-hospital mortality in octogenarians was 5% vs 2% in the younger group (P < .0001). More device-related complications and systemic complications, including cardiac disease, were noted in octogenarians (7% vs 5% and 19% vs 11%, P = .03 and P < .0001, respectively). This group of patients also had a higher incidence of postoperative hemorrhagic complications, including hematoma (7% vs 3

2005 Journal of Vascular Surgery

6659. Secondary conversion of the Gore Excluder to operative abdominal aortic aneurysm repair. Full Text available with Trip Pro

Secondary conversion of the Gore Excluder to operative abdominal aortic aneurysm repair. Reports continue to document the occurrence of major adverse events after endovascular aortic aneurysm repair. Although many of these problems can be successfully managed through endovascular salvage, operative conversion with explantation of the endoprosthesis remains necessary in some patients. We report herein a review of all patients initially enrolled in multicenter US clinical trials of the Excluder (...) with a ruptured aneurysm. Of patients who underwent conversion because of endotension, the maximal abdominal aortic aneurysm diameter (mean +/- SD) at the time of initial implantation and subsequent graft removal was 61 +/- 11 mm and 70 +/- 10 mm, respectively. The mean time to open conversion for treatment of endotension was 37 +/- 12 months (range, 20-50 months; median, 42 months). Freedom from conversion was 98.6% and 96.7% at 24 and 48 months, respectively.Endotension in the absence of a demonstrable

2005 Journal of Vascular Surgery

6660. Is abdominal aortic aneurysm repair appropriate in oxygen-dependent chronic obstructive pulmonary disease patients? Full Text available with Trip Pro

Is abdominal aortic aneurysm repair appropriate in oxygen-dependent chronic obstructive pulmonary disease patients? The life expectancy of patients with oxygen-dependent chronic obstructive pulmonary disease (COPD) is significantly reduced, but the risk of any intervention is considered prohibitive. However, severe COPD may increase the risk of abdominal aortic aneurysm (AAA) rupture. We reviewed our experience with AAA repair in oxygen-dependent patients to determine whether operative risk (...) aneurysms.Twenty-four patients underwent endovascular aneurysm repair (EVAR), and 20 underwent open procedures (14 retroperitoneal and 6 transabdominal). The mean AAA diameter was 6.1 cm (range, 5-9.5 cm). The mean age was 71.4 years, and 82% of patients were male. Operative mortality was 0%. The mean length of stay was 11.2 days for open procedures and 4.3 days for EVAR (significantly longer than that for standard-risk patients). The mean survival time was 37.9 months (range, 2-91 months). Preoperative

2005 Journal of Vascular Surgery

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