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Abdominal Aortic Aneurysm

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6801. Allogeneic versus autologous blood during abdominal aortic aneurysm surgery. (PubMed)

Allogeneic versus autologous blood during abdominal aortic aneurysm surgery. To determine if cell-salvaged autologous blood can serve as an alternative to homologous blood, and to examine the incidence of infected complications and length of postoperative stay.A prospective randomised study comprising autologous and homologous blood transfusions in patients undergoing elective infrarenal abdominal aortic surgery.Fifty patients undergoing AAA surgery were prospectively randomised to homologous

1997 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6802. Concurrent comparison of endoluminal repair vs. no treatment for small abdominal aortic aneurysms. (PubMed)

Concurrent comparison of endoluminal repair vs. no treatment for small abdominal aortic aneurysms. Endoluminal repair of abdominal aortic aneurysms (AAA) requires the aneurysm to have a proximal neck of at least 1.5 cm between the renal arteries and the aneurysm. Therefore, there may be advantages in performing endoluminal repair in the early stages of aneurysm development. However, the results of endoluminal repair performed in patients with small aneurysms with favourable morphology (...) are not known. The aim of this study was to determine whether a randomised trial of endoluminal repair vs. no treatment for small aneurysms would be justified by using a concurrent comparison of endoluminal repair vs. no treatment for AAA 5 cm or less in diameter in patients presenting to the same centre during a 4-year period.Data on 117 patients presenting with AAA 5 cm or less in diameter were entered into a registry. The decision to perform endoluminal repair vs. no treatment was based on the patient's

1997 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6803. Resource use and costs of elective surgery for asymptomatic abdominal aortic aneurysm. (PubMed)

Resource use and costs of elective surgery for asymptomatic abdominal aortic aneurysm. To determine the hospital costs of elective abdominal aortic aneurysm repair.Observational study of resource use.Forty-six elective aneurysm surgery patients in a hospital; 116 vascular surgeons participating in the U.K. Small Aneurysm Trial.Data on resource use and associated costs were obtained in 1993 for 46 patients who had undergone elective surgery in a teaching hospital. Comparability of resource use (...) with other hospitals in the U.K. was obtained from data on surgical patients in the U.K. Small Aneurysm Trial, and by questionnaire on use of resources sent to surgeons participating in the trial.The total cost of an elective aneurysm repair calculated from patient data in the teaching hospital was Pounds 4592. One-third of costs were due to stay in a standard surgical ward, and 20% were attributable to the operation. Overall, the use of resources in U.K. hospitals was comparable to that for the teaching

1997 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6804. Autologous blood transfusion: the benefits to the patient undergoing abdominal aortic aneurysm repair. (PubMed)

Autologous blood transfusion: the benefits to the patient undergoing abdominal aortic aneurysm repair. The clinical benefits of using intraoperative autologous blood transfusion during abdominal aortic aneurysm bypass surgery become increasingly apparent when use of autologous and homologous blood transfusions is compared. That homologous blood transfusions carry some risk is widely recognized. When autologous blood is used as a sole source of blood transfusion, the risk of transmission (...) of infectious agents and potential immunologic side effects are avoided. A prospective randomized pilot study comparing autologous and homologous blood transfusion in patients undergoing elective infrarenal abdominal aortic aneurysm bypass surgery was undertaken. The purpose of this study was to determine whether autologous blood salvaged intraoperatively may serve as an alternative to homologous blood by comparing the rate of postoperative infection and duration of hospital stay for patients receiving

1997 Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing Controlled trial quality: uncertain

6805. [Choice of vascular prosthesis material in treatment of infrarenal abdominal aortic aneurysms--initial results of a prospective randomized study]. (PubMed)

[Choice of vascular prosthesis material in treatment of infrarenal abdominal aortic aneurysms--initial results of a prospective randomized study]. A prospective, randomized trial was performed to compare 40 patients with aortic aneurysms which were treated by implantation of dacron or PTFE prostheses. Follow up was done according to a defined protocol for 3 to 34 months postoperatively. There was observed neither graft failure, vascular occlusion, perigraft-reaction nor infection in any case

1997 Zentralblatt fur Chirurgie Controlled trial quality: uncertain

6806. Comparison of lumbar and thoracic epidural narcotics for postoperative analgesia in patients undergoing abdominal aortic aneurysm repair. (PubMed)

Comparison of lumbar and thoracic epidural narcotics for postoperative analgesia in patients undergoing abdominal aortic aneurysm repair. To determine whether there is an advantage of thoracic over lumbar epidural narcotics for postoperative analgesia in patients undergoing abdominal aortic aneurysm repair.A prospective randomized study.Subjects were inpatients at an academic medical center.Fifty-two patients scheduled for elective abdominal aortic aneurysm repair.Subjects were randomly (...) in patients undergoing abdominal aortic aneurysm repair.

1997 Journal of cardiothoracic and vascular anesthesia Controlled trial quality: uncertain

6807. Gastric intramucosal pH changes after volume replacement with hydroxyethyl starch or crystalloid in patients undergoing elective abdominal aortic aneurysm repair. (PubMed)

Gastric intramucosal pH changes after volume replacement with hydroxyethyl starch or crystalloid in patients undergoing elective abdominal aortic aneurysm repair. Gastric intramucosal pH (pHi), a surrogate marker of tissue oxygenation, falls following abdominal aorta aneurysm (AAA) repair. We tested the hypothesis that volume replacement with a hydroxyethyl starch solution would result in better preserved splanchnic oxygenation than would volume replacement with crystalloid solutions.This

1997 Journal of critical care Controlled trial quality: uncertain

6808. The effects of recombinant human growth hormone on cardiopulmonary function in elective abdominal aortic aneurysm repair. (PubMed)

The effects of recombinant human growth hormone on cardiopulmonary function in elective abdominal aortic aneurysm repair. Cardiorespiratory complications are the predominant source of morbidity in patients undergoing major surgery. Recombinant human growth hormone (rhGH) has previously been shown to be effective in improving respiratory and cardiac function in compromised patients.The aim of this study was to assess the effects of perioperative rhGH on cardiac function in 33 patients undergoing (...) elective infrarenal abdominal aortic aneurysm repair.Patients were randomised to one of three groups: placebo for 6 days before and after surgery (control, n = 12); genotropin (GH) 0.3 units/kg/day for 6 days before and after surgery (pre and postop GH, n = 10) and placebo for 6 days before and GH (0.3 units/kg/day) for 6 days after surgery (postop EH, n = 11). Patients were assessed on days 7 and 1 before and days 7, 14 and 50 after operation. Intraoperative cardiac index (CI) was measured after

1998 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6809. Haemodynamic effects of diaspirin crosslinked haemoglobin (DCLHb) given before abdominal aortic aneurysm surgery. (PubMed)

Haemodynamic effects of diaspirin crosslinked haemoglobin (DCLHb) given before abdominal aortic aneurysm surgery. We studied 34 patients undergoing elective repair of an abdominal aortic aneurysm under combined general anaesthesia and epidural block to evaluate the acute effects of diaspirin crosslinked haemoglobin (DCLHb) 50, 100 and 200 mg kg-1 i.v. Haemodynamic variables were measured continuously using pulmonary and radial artery catheters, and oxygen delivery and consumption were

1999 British Journal of Anaesthesia Controlled trial quality: uncertain

6810. Cytokine patterns and the effects of a preoperative steroid treatment in the patients with abdominal aortic aneurysms. (PubMed)

Cytokine patterns and the effects of a preoperative steroid treatment in the patients with abdominal aortic aneurysms. The aim of this study was to investigate the cytokine patterns of patients with abdominal aortic aneurysms and the effects of preoperative steroid administration on surgical stress.From January 1996 to August 1996, 20 consecutive patients underwent an elective reconstruction of infrarenal abdominal aortic aneurysms. The patients were randomly divided into two groups consisting (...) values at one postoperative day in the steroid group were also significantly lower than those in the control group. In one patient with a ruptured abdominal aortic aneurysm, the interleukin-6 values were higher than those in the patients undergoing elective surgery throughout the study.These results thus suggest that preoperative steroid administration using methylprednisolone in patients with abdominal aortic aneurysms appears to reduce surgical stress by decreasing cytokine release.

1999 International angiology : a journal of the International Union of Angiology Controlled trial quality: uncertain

6811. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. (PubMed)

Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysm (AAA) in a community-based sample of men and women aged 65-79 years was correlated with known risk factors. In addition, the effect of high blood pressure and the use of antihypertensive medication on growth of AAAs were studied.Aortic diameter was assessed by ultrasonography and data on risk factors were collected by self-administered questionnaire (...) for 5356 men and women as part of a randomized controlled trial.Current hypertension increased the risk of having an aortic aneurysm by 30-40 per cent while use of antihypertensive medication increased the risk by 70-80 per cent, adjusting for current blood pressure. There was no clear relationship between hypertension and growth rates of existing aneurysms in this study, although these results were largely from data on small aneurysms. Men were nearly six times more likely to develop an AAA than women

2000 British Journal of Surgery Controlled trial quality: uncertain

6812. Nutritional, respiratory, and psychological effects of recombinant human growth hormone in patients undergoing abdominal aortic aneurysm repair. (PubMed)

Nutritional, respiratory, and psychological effects of recombinant human growth hormone in patients undergoing abdominal aortic aneurysm repair. Recombinant human growth hormone (rhGH) has been shown to have powerful anabolic effects and to reduce or even prevent nitrogen catabolism in stressed patients. The effects of rhGH on functional parameters are less clearly defined. The aim of this study was to assess the effects of perioperative rhGH on nutritional markers, skeletal muscle function (...) , and psychological well-being in patients undergoing infrarenal, abdominal aortic aneurysm repair.Thirty-three patients undergoing elective infrarenal abdominal aortic aneurysm repair were randomized to one of three groups: (1) control (n = 12): placebo for 6 days before and after surgery; (2) preop + postop (n = 10): rhGH (Genotropin; Pharmacia Ltd, Uppsala, Sweden) 0.3 IU/kg/d for 6 days before and after surgery; and (3) postop (n = 11): placebo for 6 days before and rhGH 0.3 IU/kg/d for 6 days after surgery

1999 JPEN. Journal of parenteral and enteral nutrition Controlled trial quality: uncertain

6813. Hemodynamic effects of hypertonic hydroxyethyl starch 6% solution and isotonic hydroxyethyl starch 6% solution after declamping during abdominal aortic aneurysm repair. (PubMed)

Hemodynamic effects of hypertonic hydroxyethyl starch 6% solution and isotonic hydroxyethyl starch 6% solution after declamping during abdominal aortic aneurysm repair. Fluid resuscitation with hypertonic hydroxyethyl starch solutions (HES) is effective in haemorrhagic shock due to the rapid mobilisation of fluids into the intravascular compartment. Declamping of the abdominal aorta with acute redistribution of blood into the vessels of the lower body half causes declamping-induced hypotension (...) . Usually large amount of fluids or vasopressors are necessary to restore hemodynamic stability. Therefore, infusion of a hypertonic colloid solution may be an attractive option to achieve hemodynamic stability. This study was conducted to determine the amount of fluid of either hypertonic HES (HES 6%;7.2% NaCl) or isotonic HES (HES 6%;0.9% NaCl) needed to attain best wedge pressure (PCWP) cardiac index (CI) relation after declamping. Thirty-two high-risk patients undergoing elective abdominal aneurysm

2000 Shock (Augusta, Ga.) Controlled trial quality: uncertain

6814. Role of duplex scan in endoleak detection after endoluminal abdominal aortic aneurysm repair. (PubMed)

Role of duplex scan in endoleak detection after endoluminal abdominal aortic aneurysm repair. to validate the role of duplex scan in endoleak detection in postoperative surveillance of endoluminal abdominal aneurysm repair (EAAR).between April 1997 and March 1999, 103 patients were eligible for duplex and computed tomography (CT) scan after EAAR. Mean follow-up was 8 months (range 1-24 months). The study protocol comprised concurrent examination with colour-duplex and CT scan at 1, 6, and 12

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2000 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6815. Randomized, multicentre, double-blind, placebo-controlled trial of the use of aprotinin in the repair of ruptured abdominal aortic aneurysm. On behalf of the Joint Vascular Research Group. (PubMed)

Randomized, multicentre, double-blind, placebo-controlled trial of the use of aprotinin in the repair of ruptured abdominal aortic aneurysm. On behalf of the Joint Vascular Research Group. The use of aprotinin in cardiac surgery reduces blood transfusion requirements. The aim of this trial was to see whether the same benefit applies in the repair of ruptured abdominal aortic aneurysm (AAA).In this prospective, randomized trial, nine centres with local ethics committee approval recruited 77

2000 British Journal of Surgery Controlled trial quality: predicted high

6816. The natural history of abdominal aortic aneurysms and their risk of rupture. (PubMed)

The natural history of abdominal aortic aneurysms and their risk of rupture. The UK Small Aneurysm Trial has shown that ultrasound surveillance is a safe management option for patients with small abdominal aortic aneurysms (4.0 to 5.5 cm in diameter), with an annual rupture rate of only 1%. We investigated baseline risk factors associated with aneurysm rupture in the 1090 trial patients and an additional 1167 patients enrolled in the UK Small Aneurysm Study. In this cohort of 2257 patients (...) was that women had a 3-fold higher risk of aneurysm rupture than men. Effective control of blood pressure and cessation of smoking are two simple measures that are likely to diminish the risk of aneurysm rupture and improve the cardiovascular health of patients with abdominal aortic aneurysm.

2001 Acta chirurgica Belgica Controlled trial quality: uncertain

6817. The potential for a selective screening strategy for abdominal aortic aneurysm. (PubMed)

The potential for a selective screening strategy for abdominal aortic aneurysm. To investigate the feasibility of selective screening for abdominal aortic aneurysm (AAA) based on identification of a target group of manageable size defined by risk factors for AAA.Male residents of Perth, Western Australia, aged 65-83 years, who participated in a randomised controlled trial of ultrasound screening for AAA.Eligible men were identified from the electoral roll and invited to attend a screening

2000 Journal of medical screening Controlled trial quality: uncertain

6818. Alpha-tocopherol (vitamin E) and beta-carotene supplementation does not affect the risk for large abdominal aortic aneurysm in a controlled trial. (PubMed)

Alpha-tocopherol (vitamin E) and beta-carotene supplementation does not affect the risk for large abdominal aortic aneurysm in a controlled trial. Antioxidants may retard atherogenesis and limit inflammatory processes involved in aneurysm formation. We evaluated effects of alpha-tocopherol and beta-carotene supplementation on incidence of large abdominal aortic aneurysm (AAA) in a randomised, double-blind, placebo-controlled trial. Subjects (n=29133) were 50-69-years-old male smokers

2001 Atherosclerosis Controlled trial quality: predicted high

6819. The long-term benefits of a single scan for abdominal aortic aneurysm (AAA) at age 65. (PubMed)

The long-term benefits of a single scan for abdominal aortic aneurysm (AAA) at age 65. To investigate the efficacy of a single ultrasonic scan at age 65 to identify patients at risk from ruptured abdominal aortic aneurysm (AAA).A total of 6058 men aged 64-81 were recruited to a randomised trial, and 3000 were invited to attend a single screening test. An additional population of 1011 men was offered screening as they reached age 65. If a normal aorta was identified in this sub-group, further (...) by 68% at 5 years (screened group compared to the age-matched control population), and by 42% in the study arm (screened and refusers) compared with controls. The benefit persisted at ten years (53% and 21% respectively). Of the uncontrolled sample of 1011 men offered a scan at age 65, 681 attended and 649 of these were found to have a normal aortic diameter; re-screening demonstrated new aneurysm development in 4% over ten years. The aortic diameters of the new AAAs were under 4 cm and would

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2001 European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Controlled trial quality: uncertain

6820. Alterations in carbon dioxide release during abdominal aortic clamping for aneurysmal or occlusive repair. (PubMed)

Alterations in carbon dioxide release during abdominal aortic clamping for aneurysmal or occlusive repair. Application and removal of an infrarenal aortic clamp is associated with changes in oxygen consumption, especially when collateral perfusion is limited. Carbon dioxide production during abdominal aortic clamping is expected also to change. The aim of this study was to evaluate the alterations of CO2 release during abdominal aortic surgery.prospective study.University Hospital, Greece.17 (...) patients undergoing abdominal aortic aneurismal (AAA) repair and 8 patients undergoing repair of aortoiliac occlusive disease.intraoperative record or calculation of PaCO2, PetCO2, PECO2, VD, VDalv, and VCO2. Patients with aneurysms were randomly divided to have constant ventilation (group AA) or modified ventilation to preserve normocapnia (group AB) during clamping. Ventilation was kept constant in the occlusive patients group (group OD).Patients with AAA showed a significant decrease of VCO2 during

2001 Minerva anestesiologica Controlled trial quality: uncertain

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