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Abdominal Aortic Aneurysm

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6681. The influence of 4G/5G polymorphism in the plasminogen activator inhibitor-1 gene promoter on the incidence, growth and operative risk of abdominal aortic aneurysm. (PubMed)

The influence of 4G/5G polymorphism in the plasminogen activator inhibitor-1 gene promoter on the incidence, growth and operative risk of abdominal aortic aneurysm. a single base pair deletion/insertion (4G/5G) polymorphism in the plasminogen activator inhibitor (PAI-1) promoter appears to influence PAI-1 synthesis (increased PAI-1 and inhibition of fibrinolysis with the 4G allele) and survival after severe trauma.to identify whether the 4G/5G polymorphism influences the natural history (...) of abdominal aortic aneurysm (AAA).Four hundred and sixty patients with small AAA were genotyped for the 4G/5G polymorphism. AAA growth was assessed from serial ultrasonographic measurements, subject to linear regression analysis. Mortality following eventual elective surgery was recorded.the frequency of the 3 genotypes (4G4G, 4G5G and 5G5G) was in Hardy-Weinberg equilibrium and similar to that in a healthy population. The mean aneurysm growth rate was 0.37, 0.35 and 0.44 cm/year respectively for patients

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2002 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

6682. Decreased biglycan expression and differential decorin localization in human abdominal aortic aneurysms. (PubMed)

Decreased biglycan expression and differential decorin localization in human abdominal aortic aneurysms. The hallmark feature of abdominal aortic aneurysm (AAA) is the progressive degeneration of aortic wall. Matrix proteoglycans (PGs) play important roles in the development of vascular diseases and the function of the tissue. In this study, we examined the concentration, expression and localization of the small extracellular matrix PG biglycan and decorin. The concentration of small PGs (...) , the concentration of biglycan was markedly decreased in aneurysmal aortas (57%, 0.478+/-0.04 mg uronic acid per g of dd tissue) in comparison to normal ones (1.12+/-0.10 mg uronic acid per g of dd tissue). Biglycan accounts for 22% of total PGs in normal aortas and 25% of total in aneurysmal tissue. A similar decrease (60%) in the amounts of mRNA encoding for biglycan was observed in the AAA. Immunohistochemical study showed that all aortic layers of AAA were characterized by a significant loss of elastin

2002 Atherosclerosis

6683. Emergency endovascular interventions for ruptured thoracic and abdominal aortic aneurysms. (PubMed)

Emergency endovascular interventions for ruptured thoracic and abdominal aortic aneurysms. The purpose of our study was to show the effectiveness of endovascular stent grafts in the treatment of acutely ruptured abdominal and thoracic aortic aneurysms as an alternative to the conventional surgical approach in an emergency setting.From October 1996 to October 1998 we deployed 9 emergent endovascular stent grafts--6 in the abdominal aorta and 3 in the thoracic aorta. Aortic rupture was confirmed

2002 American Heart Journal

6684. Abdominal aortic aneurysm presenting as back pain to a chiropractic clinic: a case report. (PubMed)

Abdominal aortic aneurysm presenting as back pain to a chiropractic clinic: a case report. The aim of this study was to discuss a patient with abdominal aortic aneurysm (AAA) who presented to a chiropractic teaching clinic and review the pathophysiology, therapeutic strategies, and complications associated with treatment of AAA.A 69-year-old male patient experienced right-sided low back pain with radiation into the right leg for 3 weeks. The radiologic examination of the lumbar spine showed (...) a 7.0-cm AAA and degenerative joint disease in the lumbar spine. Real-time ultrasonography showed an approximately 6.0-cm (transverse diameter), 4.1-cm (anteroposterior diameter), and approximately 7.0-cm (long) infrarenal AAA. Computed tomographic angiography showed additional bilateral iliac artery aneurysms.This patient was treated with an endovascular stent graft repair of the abdominal aorta and bilateral iliac artery aneurysms. He has done well after surgery.This article provides a case study

2006 Journal of Manipulative and Physiological Therapeutics

6685. Screening for abdominal aortic aneurysm in men ages 60 to 80 years. A cost-effectiveness analysis. (PubMed)

Screening for abdominal aortic aneurysm in men ages 60 to 80 years. A cost-effectiveness analysis. To evaluate the cost-effectiveness of screening by physical examination or abdominal ultrasonography for abdominal aortic aneurysm (AAA) in men aged 60 to 80 years.A systematic review of the pertinent literature by the Canadian Task Force on the Periodic Health Examination, augmented by an additional computerized search (MEDLINE) and references identified from bibliographies of pertinent articles (...) . Several experts reviewed the data for completeness.Published English-language studies that present data relevant to screening for abdominal aortic aneurysm.Several reviewers determined a range of data and the most probable value for each parameter.A computer spreadsheet model was constructed to simulate the costs and effectiveness of various screening protocols in a cohort of 10,000 men during a period of 20 years. The primary cost-effectiveness measure computed was incremental present-value dollar

1993 Annals of internal medicine

6686. A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. (PubMed)

A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Operative repair of ruptured abdominal aortic aneurysm (RAAA) is associated with a high mortality rate but reported figures vary widely. The aim of this study was to estimate the operative mortality of RAAA repair and determine how it has changed over time.A meta-analysis of all English language literature quoting figures for operative mortality of RAAA repair.The pooled estimate for the overall operative mortality rate

2002 British Journal of Surgery

6687. Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies. (PubMed)

Endoleak after stent-graft treatment of abdominal aortic aneurysm: a meta-analysis of clinical studies. Endoleak is the major complication after endovascular treatment of abdominal aortic aneurysm (AAA) and its incidence seems to remain significant. Little is known about the association of device type and configuration with respect to the incidence, location, time of onset and fate of endoleakage.A meta-analysis was performed via a Medline search of clinical studies after 1995 dealing (...) with the endovascular treatment of AAA. Details of number of patients treated, configuration and type of endovascular device were collected. Data concerning site of origin, time of occurrence and fate of the endoleak were retrieved, along with information on change in diameter of the aneurysm with time.The 23 publications included reported on 1189 patients. The 1118 patients with successfully inserted transfemoral endovascular grafts experienced 270 endoleaks (24 per cent). The majority arose from the distal stent

1999 British Journal of Surgery

6688. Mortality and morbidity rates after conventional abdominal aortic aneurysm repair. (PubMed)

Mortality and morbidity rates after conventional abdominal aortic aneurysm repair. To grade and analyse by levels of evidence the mortality and morbidity rates of elective abdominal aortic aneurysm (AAA) surgery as reported over the past 12 years.Articles on elective AAA surgery published between 1985 and 1996 were retrieved and classified into 5 levels of evidence. Level 1 contains prospective studies and is subdivided into population-based (Level 1a) and hospital-based (Level 1b) studies

2000 Seminars in interventional cardiology : SIIC

6689. Elective endovascular versus open surgical repair of abdominal aortic aneurysms: systematic review of short-term results. (PubMed)

Elective endovascular versus open surgical repair of abdominal aortic aneurysms: systematic review of short-term results. To summarize and compare published short-term results of elective endovascular and open surgical repair of abdominal aortic aneurysms.A MEDLINE search of the English literature was performed. Studies with at least 10 patients in each treatment group were included if they reported patient characteristics, complications, and mortality. Two reviewers independently extracted

2002 Radiology

6690. Familial abdominal aortic aneurysm: a systematic review of a genetic background. (PubMed)

Familial abdominal aortic aneurysm: a systematic review of a genetic background. Familial clustering of the abdominal aortic aneurysm (AAA) is clear, 12-19% of AAA patients have one or more first-degree relatives with an aneurysm and 4-19% is detected with ultrasound screening.To review the genetic background of AAA. DESIGN, METHODS AND MATERIALS: Computer searches of the MEDLINE, EMBASE, SUMsearch database and the Cochrane Library and searched reference lists of English language articles

2002 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

6691. Perioperative mortality of elective abdominal aortic aneurysm surgery. A clinical prediction rule based on literature and individual patient data. (PubMed)

Perioperative mortality of elective abdominal aortic aneurysm surgery. A clinical prediction rule based on literature and individual patient data. Abdominal aortic aneurysm surgery is a major vascular procedure with a considerable risk of (mainly cardiac) mortality.To estimate elective perioperative mortality, we developed a clinical prediction rule based on several well-established risk factors: age, gender, a history of myocardial infarction, congestive heart failure, ischemia

1995 Archives of internal medicine

6692. Repair of abdominal aortic aneurysm by transfemoral endovascular graft placement. (PubMed)

Repair of abdominal aortic aneurysm by transfemoral endovascular graft placement. The authors describe the initial clinical experience with a new device, approved by the FDA for investigation, for repair of abdominal aortic aneurysm by transfemoral endovascular insertion of an aortic graft.Sixty-nine patients with abdominal aortic aneurysms were screened, and ten were found to be suitable for endovascular grafting. Repair was done in the operating room using general anesthesia. One femoral (...) artery was surgically exposed, and the device, containing a premeasured graft with proximal and distal self-expanding fixation devices, was inserted with fluoroscopic control through an open arteriotomy.Eight of ten patients underwent successful graft placement, and two patients required conversion to an open repair. On follow-up, six of eight patients who underwent graft placement functioned normally, with documented aneurysm thrombosis. Two patients who underwent graft placement functioned normally

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1994 Annals of Surgery

6693. An unusual presentation of a ruptured abdominal aortic aneurysm (PubMed)

An unusual presentation of a ruptured abdominal aortic aneurysm 8581256 1996 03 20 2018 11 13 1351-0622 12 3 1995 Sep Journal of accident & emergency medicine J Accid Emerg Med An unusual presentation of a ruptured abdominal aortic aneurysm. 220-1 Haddad F S FS Homerton Hospital, London, UK Hatrick N C NC Shanahan D J DJ eng Case Reports Journal Article England J Accid Emerg Med 9433751 1351-0622 IM Aged Aneurysm, Ruptured diagnosis physiopathology surgery Aorta, Abdominal Diagnosis

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1995 Journal of accident & emergency medicine

6694. Pain, blood loss, and death from leaking abdominal aortic aneurysms. (PubMed)

Pain, blood loss, and death from leaking abdominal aortic aneurysms. The amount of blood lost from the circulation due to leaking abdominal aortic aneurysms was estimated in absolute figures by the difference in weight of the retroperitoneal tissues in 25 cases of sudden death and 25 controls matched for age, sex, height and weight. The proportion of total blood volume lost was calculated using established formulae. Eight subjects lost less than 500 ml or 10% of blood volume and only six lost (...) explanation for circulatory collapse in patients with leaking abdominal aortic aneurysms who characteristically experience severe backache or abdominal pain.

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1994 Journal of Clinical Pathology

6695. Optimal timing of abdominal aortic aneurysm repair after coronary artery revascularization. (PubMed)

Optimal timing of abdominal aortic aneurysm repair after coronary artery revascularization. The authors ascertained the optimal timing of repair of an abdominal aortic aneurysm (AAA) after coronary artery revascularization.Cardiac events are the most common cause of death after elective repair of AAA. Preoperative coronary revascularization has significantly reduced postoperative cardiac complications after elective AAA repair. Currently, most patients undergo repair of asymptomatic AAA within

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1994 Annals of Surgery

6696. Current status of endoluminal grafting for exclusion of abdominal aortic aneurysms. The beauty and the beast. (PubMed)

Current status of endoluminal grafting for exclusion of abdominal aortic aneurysms. The beauty and the beast. The exclusion of abdominal aortic aneurysms with endoluminal grafts has generated a great deal of interest since the early 1990s, and many centers are currently evaluating the procedure and comparing it to classic surgical exclusion. Although endoluminal grafting procedures show promise, development and clinical testing of devices is a time-consuming process that is influenced greatly (...) by the regulatory climate in the country where the clinical trials take place. Nevertheless, a number of devices are currently under study, and the advantages of 2nd- and 3rd-generation technology are reflected in reduced rates of complications such as endoleaks and thrombosis. Further study will be required to perfect these devices and observe their long-term success in the exclusion of abdominal aortic aneurysms.

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1998 Texas Heart Institute Journal

6697. A novel method for endoluminal treatment of abdominal aortic aneurysms. With bare-metal Wallstent endoprostheses and endovascular coils. (PubMed)

A novel method for endoluminal treatment of abdominal aortic aneurysms. With bare-metal Wallstent endoprostheses and endovascular coils. The established therapy for symptomatic, expanding abdominal aortic aneurysms is open surgical replacement with an artificial graft. Over the last several years, there has been increasing enthusiasm for the use of endoluminal graft prostheses to exclude abdominal aortic aneurysms. However, even with rapid advances in stent graft technology, certain problems (...) (i.e., large profile of the devices, risk of thromboembolism, poor flexibility, endoleak formation, and side-branch occlusion) have yet to be overcome. We present the case of an 85-year-old woman with multiple comorbid illnesses who underwent endoluminal repair of her expanding abdominal aortic aneurysms. We used bare-metal Wallstent endoprostheses (Schneider, Inc.; Minneapolis, Minn) in combination with endovascular coils (Cook, Inc.; Bloomington, Ind). The bare-metal Wallstent endoprostheses were

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1998 Texas Heart Institute Journal

6698. Oxygen delivery is an important predictor of outcome in patients with ruptured abdominal aortic aneurysms. (PubMed)

Oxygen delivery is an important predictor of outcome in patients with ruptured abdominal aortic aneurysms. The purpose of this study was to evaluate the relation of oxygen delivery (DO2) to the occurrence of multiple organ dysfunction (MOD) in patients with ruptured abdominal aortic aneurysms (AAA).Patients with ruptured AAA are at high risk for the development of MOD and death. Previous reports of high-risk general surgical patients have shown improved survival when higher levels of DO2

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1998 Annals of Surgery

6699. A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm. (PubMed)

A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm. The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypotheses of the study were as follows: 1) the rate of RAAA would increase over time and 2 (...) ) patient, surgeon, and hospital factors would be associated with survival.Ruptured abdominal aortic aneurysm is a life-threatening emergency that presents the surgeon with a technically demanding challenge that must be met and surmounted in a short time if the patient is to survive.Data were obtained from the following four separate data sources: 1) the North Carolina Hospital Discharge database, 2) the North Carolina American Hospital Association database, 3) the North Carolina State Medical

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1996 Annals of Surgery

6700. Abdominal aortic aneurysm presenting as meralgia paraesthetica. (PubMed)

Abdominal aortic aneurysm presenting as meralgia paraesthetica. A case of abdominal aortic aneurysm is reported in a patient with long standing low back pain, presenting as meralgia paraesthetica and an increase in the severity of back pain. The case highlights the need for objective assessment of new symptoms arising in a chronic condition, and for a systematic approach to the assessment of radiographs performed in the accident and emergency department.

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1997 Journal of accident & emergency medicine

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