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Abdominal Aortic Aneurysm

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6661. Glomerular filtration rate is a predictor of mortality after endovascular abdominal aortic aneurysm repair. Full Text available with Trip Pro

Glomerular filtration rate is a predictor of mortality after endovascular abdominal aortic aneurysm repair. Clinically evident renal disease is a risk factor for mortality after aneurysm repair. Serum creatinine is widely used as a measure of renal function in the preoperative evaluation of patients. Unfortunately, serum creatinine concentration is influenced by muscle mass, hydration status, and glomerular filtration rate (GFR). Calculated GFR, which takes predictors of muscle mass such as age

2006 Journal of Vascular Surgery

6662. Decreased wall shear stress in the common carotid artery of patients with peripheral arterial disease or abdominal aortic aneurysm: relation to blood rheology, vascular risk factors, and intima-media thickness. Full Text available with Trip Pro

Decreased wall shear stress in the common carotid artery of patients with peripheral arterial disease or abdominal aortic aneurysm: relation to blood rheology, vascular risk factors, and intima-media thickness. Wall shear stress, a local risk factor of atherosclerosis, is decreased in the common carotid artery of patients with vascular risk factors. We evaluated wall shear stress in the common carotid artery of patients with symptomatic peripheral arterial occlusive disease (PAD) and abdominal (...) aortic aneurysm (AAA). As blood viscosity is a determinant of wall shear stress, we further investigated the impact of rheologic variables on wall shear stress in relation to vascular risk factors and intima-media thickness.High-resolution ultrasonography scans were used to study intima-media thickness, internal diameter, and blood velocity in the common carotid artery of 31 patients with PAD, 36 patients with AAA, and 37 controls. Furthermore, major hemorheologic variables and vascular risk factors

2006 Journal of Vascular Surgery

6663. Sac enlargement due to seroma after endovascular abdominal aortic aneurysm repair with the Endologix PowerLink device. Full Text available with Trip Pro

Sac enlargement due to seroma after endovascular abdominal aortic aneurysm repair with the Endologix PowerLink device. A patient who had undergone endovascular repair of an abdominal aortic aneurysm with the Endologix PowerLink bifurcated system presented with delayed aortic aneurysm enlargement due to assumed endotension. He was treated with aortic sac evacuation and wrapping of the endograft. This is the first report of endotension and aneurysm sac enlargement after implantation

2006 Journal of Vascular Surgery

6664. Age stratified, perioperative, and one-year mortality after abdominal aortic aneurysm repair: a statewide experience. Full Text available with Trip Pro

Age stratified, perioperative, and one-year mortality after abdominal aortic aneurysm repair: a statewide experience. The purpose of this study was to determine the in-hospital, 30-day, and 365-day mortality for the open repair of abdominal aortic aneurysms (AAAs), when stratified by age, in the general population. Age stratification could provide clinicians with information more applicable to an individual patient than overall mortality figures.In a retrospective analysis, data were obtained

2006 Journal of Vascular Surgery

6665. A decade of change in abdominal aortic aneurysm repair in the United States: Have we improved outcomes equally between men and women? Full Text available with Trip Pro

A decade of change in abdominal aortic aneurysm repair in the United States: Have we improved outcomes equally between men and women? Abdominal aortic aneurysm (AAA) repair has undergone vast changes in the last decade. We reviewed a national database to evaluate the effect on utilization of services and rupture rates.From the Centers for Medicare Services (CMS), a 5% inpatient sample was obtained for 1994 to 2003 as beneficiary encrypted files (5% BEF) and as a limited data set file after 2001 (...) repairs, the average length of stay was 6.9 days in men and 8.9 days in women (P < .01) For 2003, men were more likely to be discharged to home after rupture (32.9% of men vs 23.3% of women; P < .001) and elective repair (84.5% of men vs 70.1% of women; P < .001).Improvements in AAA management in the last decade have decreased aneurysm-related deaths and reduced the incidence of aneurysm ruptures, with a lower utilization of services. Women, however, continue to have a consistently higher mortality

2006 Journal of Vascular Surgery

6666. Contrast-enhanced Duplex surveillance after endovascular abdominal aortic aneurysm repair: improved efficacy using a continuous infusion technique. Full Text available with Trip Pro

Contrast-enhanced Duplex surveillance after endovascular abdominal aortic aneurysm repair: improved efficacy using a continuous infusion technique. Currently, postoperative endoleak surveillance after endovascular aortic aneurysm repair (EVAR) is primarily done by computed tomography (CT). The purpose of this study was to determine the efficacy of contrast-enhanced ultrasonography scans to detect endoleaks by using a novel infusion method and compare these findings with those of CT angiography (...) to minimize microsphere rupture. One minute was allowed from the time of infusion to the appearance of contrast in the endograft. Flow was evaluated within the lumen of the graft and its components, as was the presence or absence of endoleaks. Findings were compared with standard color-flow Duplex imaging and CT utilizing CTA reconstruction protocols.All patients evaluated had modular endografts implanted for elective aneurysm repair. Contrast-enhanced duplex scans identified nine endoleaks: one type I

2006 Journal of Vascular Surgery

6667. Screening and ultrasound surveillance of large abdominal aortic aneurysms do not improve suitability for endovascular repair. Full Text available with Trip Pro

Screening and ultrasound surveillance of large abdominal aortic aneurysms do not improve suitability for endovascular repair. The effect of population screening for abdominal aortic aneurysm (AAA) disease on morbidity and mortality has been comprehensively studied and reported. However, the effect of early AAA detection on suitability for endovascular aneurysm repair (EVAR) remains unknown. Considering the importance of such an effect on future health economics, we sought to assess the possible (...) with incidentally diagnosed AAA (incidental [AAA-I] group). All patients underwent preoperative computed tomographic angiography. By using three-dimensional reconstruction software, computed tomographic images were assessed by two blinded observers for suitability for EVAR by using the criteria for a modular endovascular device.Of 74 patients included in the study, 41 were in the AAA-S group, and 31 were in the AAA-I group. The median aneurysm diameter was 72.3 mm (range, 50.7-83.7 mm) for AAA-I and 65 mm

2006 Journal of Vascular Surgery

6668. Combining open and endovascular surgery for the treatment of infrarenal abdominal aortic aneurysm: a case report using a hybrid vascular graft. Full Text available with Trip Pro

Combining open and endovascular surgery for the treatment of infrarenal abdominal aortic aneurysm: a case report using a hybrid vascular graft. Migration and endoleaks after endovascular exclusion of an infrarenal abdominal aortic aneurysm may lead to long-term failure of the stent graft. We report a successful case of a novel technique that combined open and endovascular surgery to address the issues of migration and endoleak in the repair of an abdominal aortic aneurysm. The hybrid graft (...) , consisting of a proximal, conventional Dacron graft and two distal endoprosthesis limbs, was designed to reduce aortic cross-clamp time in aortic procedures. This is the first reported clinical experience with this new hybrid vascular graft for the treatment of an abdominal aortic aneurysm.

2005 Journal of Vascular Surgery

6669. Endovascular repair of abdominal aortic aneurysm reduces intraoperative cortisol and perioperative morbidity. Full Text available with Trip Pro

Endovascular repair of abdominal aortic aneurysm reduces intraoperative cortisol and perioperative morbidity. The release of catabolic stress hormones because of surgical trauma leads to a breakdown of fats, proteins, and carbohydrate stores and interference with immune function. This can delay wound healing and may increase the risk of systemic inflammatory response syndrome (SIRS)/sepsis and postoperative complications. Minimally invasive surgery can attenuate this response. Our purpose (...) significance.An attenuated glucocorticoid surge characterizes the reduced stress response experienced by patients undergoing EVAR compared with open abdominal aortic aneurysm repair. A reduction in the occurrence of SIRS is a feature of a more favorable postoperative course after an endovascular approach.

2005 Journal of Vascular Surgery

6670. Genetic analysis of polymorphisms in biologically relevant candidate genes in patients with abdominal aortic aneurysms. Full Text available with Trip Pro

Genetic analysis of polymorphisms in biologically relevant candidate genes in patients with abdominal aortic aneurysms. Abdominal aortic aneurysms (AAAs) are characterized by histologic signs of chronic inflammation, destructive remodeling of extracellular matrix, and depletion of vascular smooth muscle cells. We investigated the process of extracellular matrix remodeling by performing a genetic association study with polymorphisms in the genes for matrix metalloproteinases (MMPs), tissue (...) of the disease.Abdominal aortic aneurysms (AAAs) are an important cardiovascular disease, but the genetic and environmental risk factors, which contribute to individual's risk to develop an aneurysm, are poorly understood. Histologically, AAAs are characterized by signs of chronic inflammation, destructive remodeling of the extracellular matrix, and depletion of vascular smooth muscle cells. We hypothesized that genes involved in these events could harbor changes that make individuals more susceptible to developing

2005 Journal of Vascular Surgery

6671. Total laparoscopic versus conventional abdominal aortic aneurysm repair: a case-control study. Full Text available with Trip Pro

Total laparoscopic versus conventional abdominal aortic aneurysm repair: a case-control study. This study was designed to identify differences in the per- and postoperative outcomes between total laparoscopic and open surgical repair of abdominal aortic aneurysms (AAA).We reviewed 30 patients who underwent total laparoscopic AAA repair between July 2003 and December 2004 (group I). This group was matched in a case-control fashion by AAA morphology and American Society of Anesthesiologists class (...) ) in group II (P <.001). Median aortic clamping time was 80 minutes (range, 35 to 110 minutes) in group I and 50 minutes (range, 24 to 150 minutes) in group II (P < .0001). Total blood loss was 1600 mL (range, 400 to 4000 mL) for group I vd 1000 mL (range, 100 to 2900) for group II (P < .01). The mortality rate was 3.3% for group I (1 patient) vs 6.6% (2 patients) for group II (NS). There were no significant differences between the two groups in terms of postoperative systemic complications (23.3% vs 30

2005 Journal of Vascular Surgery

6672. Follow-up costs increase the cost disparity between endovascular and open abdominal aortic aneurysm repair. Full Text available with Trip Pro

Follow-up costs increase the cost disparity between endovascular and open abdominal aortic aneurysm repair. This study compared the hospital and follow-up costs of patients who have undergone endovascular (EVAR) or open (OR) elective abdominal aortic aneurysm repair.The records of 195 patients (EVAR, n = 55; OR, n = 140) who underwent elective aortic aneurysm repair between 1995 and 2004 were reviewed. Primary costing data were analyzed for 54 EVAR and 135 OR patients. Hospital costs were

2005 Journal of Vascular Surgery

6673. Abdominal aortic aneurysm and Coxiella burnetii infection: report of three cases and review of the literature. Full Text available with Trip Pro

Abdominal aortic aneurysm and Coxiella burnetii infection: report of three cases and review of the literature. Coxiella burnetii, the etiologic agent of Q fever, is mainly responsible for endocarditis with negative blood culture results, but only a few cases of C. burnetii infections of aortic aneurysms have been published. We report three cases of abdominal aortic aneurysms treated in patients with Q fever infection with simultaneous endocarditis (n = 1) and previous history of cardiac valve (...) replacement for endocarditis (n = 1). A coeliac aortic aneurysm was diagnosed in one patient treated for acute Q fever with persistent serologic results showing chronic infection despite adequate antibiotic therapy and without endocarditis. Resection of the aneurysm cured the chronic infection, and C. burnetii was identified by culture of the aneurysmal wall. In the two other cases, chronic infection of C. burnetii was diagnosed by serologic examination after surgery for an abdominal aortic aneurysm. One

2005 Journal of Vascular Surgery

6674. Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm. Full Text available with Trip Pro

Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm. We prospectively studied the clinical implication of plasma level of soluble fibrin monomer (FM)-fibrinogen complex, a recently established molecular marker reflecting thrombin activity, in patients with abdominal aortic aneurysm (AAA) undergoing elective aortic repair.The study included 49 patients who underwent elective aneurysm repair using a gelatin-sealed

2005 Journal of Vascular Surgery

6675. Effect of intraluminal thrombus on pressure transmission in the abdominal aortic aneurysm. Full Text available with Trip Pro

Effect of intraluminal thrombus on pressure transmission in the abdominal aortic aneurysm. To clarify the effect of intraluminal thrombus on pressure transmission.A saccular aneurysm was inserted into an artificial circulation system. Subsequently, the saccular aneurysm was filled with eight different human aortic aneurysm thrombus samples. Starch solution in an empty aneurysm was used as a control. A pressure sensor measured the pressure in the circulation, and a second piezoelectric sensor (...) in the aneurysmal sac as a follow-up method after EVAR. The aneurysmal sac is filled with thrombus. To interpret pressure measurements in the thrombus, we have to learn about the effect of the thrombus on pressure transmission and on the pressure measurements themselves. Our study demonstrates that reduction of pressure occurs as it is transmitted through a human aortic thrombus.

2005 Journal of Vascular Surgery

6676. Cost-effectiveness of different screening strategies for abdominal aortic aneurysm. Full Text available with Trip Pro

Cost-effectiveness of different screening strategies for abdominal aortic aneurysm. The primary objective of this study was to develop a simulation model to assess the cost-effectiveness of different screening strategies for abdominal aortic aneurysms (AAAs) in men.A systematic review of the literature was conducted for different screening strategies in terms of age (60, 65, or 70 years) and risk profiles (all men or specific high-risk groups) of the screened population, and rescreening after 5

2005 Journal of Vascular Surgery

6677. Midterm outcome of endovascular repair of ruptured abdominal aortic aneurysms. Full Text available with Trip Pro

Midterm outcome of endovascular repair of ruptured abdominal aortic aneurysms. We sought to analyze the clinical and morphologic outcomes of bifurcated stent grafts in patients with ruptured aortoiliac aneurysms at midterm follow-up.Thirty-seven patients (4 women; mean age, 73 years; mean abdominal aortic aneurysm [AAA] diameter, 77 mm) underwent endovascular abdominal aneurysm repair between June 1997 and July 2003 for ruptured AAA. Devices inserted were as follows: Vanguard (Boston Scientific (...) and 44.6% +/- 11% at 3 years. Aneurysmal sac shrinkage was observed in 30.8% +/- 9.1% and sac enlargement was observed in 15.3% +/- 10.8% at 2 years.Endoluminal devices are able to convert the acute life-threatening situation of ruptured AAA to a controlled situation that results in good patient survival at midterm follow-up.

2005 Journal of Vascular Surgery

6678. Functional outcome after open repair of ruptured abdominal aortic aneurysm. Full Text available with Trip Pro

Functional outcome after open repair of ruptured abdominal aortic aneurysm. Outcome after operative repair of ruptured abdominal aortic aneurysm (AAA) has traditionally been assessed in terms of survival. This study examines the functional outcome of patients who survive operation.Consecutive patients who survived open repair over an 18-month period were entered into a prospective case-control study. Age- and sex-matched controls were identified from patients undergoing elective AAA repair

2005 Journal of Vascular Surgery

6679. Retrograde migration of an abdominal aortic aneurysm endograft leading to postoperative renal failure. Full Text available with Trip Pro

Retrograde migration of an abdominal aortic aneurysm endograft leading to postoperative renal failure. The phenomenon of antegrade (distal) endograft migration is an extensively documented complication after endovascular abdominal aortic aneurysm repair. This case report describes the finding of postoperative abdominal aortic aneurysm endograft retrograde (proximal) migration occluding bilateral renal arteries and leading to dialysis-dependent renal failure.

2005 Journal of Vascular Surgery

6680. Recent advances in molecular mechanisms of abdominal aortic aneurysm formation. Full Text available with Trip Pro

Recent advances in molecular mechanisms of abdominal aortic aneurysm formation. Abdominal aortic aneurysm (AAA) is an increasingly common clinical condition with fatal implications. It is associated with advanced age, male gender, cigarette smoking, atherosclerosis, hypertension, and genetic predisposition. Although significant evidence has emerged in the last decade, the molecular mechanisms of AAA formation remain poorly understood. Currently, the treatment for AAA remains primarily surgical

2008 World Journal of Surgery

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