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Abdominal Aortic Aneurysm

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61. Prognostic value of D-dimer and markers of coagulation for stratification of abdominal aortic aneurysm growth Full Text available with Trip Pro

Prognostic value of D-dimer and markers of coagulation for stratification of abdominal aortic aneurysm growth Abdominal aortic aneurysm (AAA) is associated with high morbidity and mortality and is an established cause of unbalanced hemostasis. A number of hemostatic biomarkers have been associated with AAA; however, the utility of hemostatic biomarkers in AAA diagnosis and prognosis is unclear. The aim of the present study was to characterize the potential prognostic value of D-dimer (...) and markers of altered hemostasis in a large cohort of patients with AAAs characterized by either fast or slow aneurysm growth (frequency matched for baseline diameter) and subaneurysmal dilations. We measured plasma concentrations of thrombin-antithrombin (TAT) complex, platelet factor 4 (PF4), and D-dimer in 352 patients with either fast-growing AAAs (>2 mm/y), slow-growing AAAs (<2 mm/y), subaneurysmal aortic dilations, or nonaneurysmal aortas. Plasma D-dimer and TAT were significantly elevated in both

2018 Blood advances

62. Preliminary analysis of proteome alterations in non-aneurysmal, internal mammary artery tissue from patients with abdominal aortic aneurysms. Full Text available with Trip Pro

Preliminary analysis of proteome alterations in non-aneurysmal, internal mammary artery tissue from patients with abdominal aortic aneurysms. The pathogenesis of abdominal aortic aneurysms (AAA) involves a disturbed balance of breakdown and buildup of arterial proteins. We envision that individuals with AAA carry generalized arterial protein alterations either because of effects of genetically or environmental AAA risk factors or because of compensatory changes due to signaling molecules (...) released from the affected aneurysmal tissue.Protein extraction and quantitative proteome analysis by LC-MS/MS (liquid chromatography-mass spectrometry) was done on individual samples from the internal mammary artery from 11 individuals with AAA and 33 sex- and age-matched controls without AAA. Samples were selected from a biobank of leftover internal mammary arterial tissue gathered at coronary by-pass operations.We identified and quantitated 877 proteins, of which 44 were differentially expressed

2018 PLoS ONE

63. Fenestrated Endovascular Aortic Aneurysm Repair (FEVAR) for Complex Thoracoabdominal and Abdominal Aortic Aneurysms: First Iranian FEVAR Series Report with Mid-Term Follow-Up Full Text available with Trip Pro

Fenestrated Endovascular Aortic Aneurysm Repair (FEVAR) for Complex Thoracoabdominal and Abdominal Aortic Aneurysms: First Iranian FEVAR Series Report with Mid-Term Follow-Up Endovascular treatment of aortic diseases has improved in recent years. More complex thoracoabdominal and juxtarenal abdominal aortic aneurysms can now be treated with new stent grafts and techniques. Fenestrated endovascular aortic aneurysm repair (FEVAR) with fenestrated stent grafts was commenced in our center after (...) hundred cases of endovascular aortic repair, and so far 4 serial complex cases deemed inoperable (2 juxtarenal abdominal aortic aneurysms, 1 thoracoabdominal aneurysm, and 1 thoracoabdominal pseudoaneurysm) have been treated with FEVAR. All these patients needed custom-made stent grafts, which were designed and implanted successfully under general anesthesia in the catheterization laboratory. They were followed up for more than 1 year, with a median follow-up period of 23.0 months. There were no major

2018 The Journal of Tehran University Heart Center

64. Five-year results of endovascular abdominal aortic aneurysm repair with the Ovation abdominal stent graft. (Abstract)

Five-year results of endovascular abdominal aortic aneurysm repair with the Ovation abdominal stent graft. Endovascular abdominal aortic aneurysm repair (EVAR) has been rigorously compared with open repair for the treatment of abdominal aortic aneurysms in randomized trials and observational studies, but a comparison of individual devices is lacking, and single-device registries and trials are limited by small sample size. Here we report a descriptive analysis of the Effectiveness of Custom (...) rates of type IA and type I or III endoleak. Secondary outcomes included were 30-day mortality, 30-day major adverse event, technical success (successful deployment of the aortic body and iliac limbs), as well as 5-year survival, and freedom from aneurysm-related mortality, type II endoleak, device-related intervention, aneurysm rupture, sac expansion, and conversion to open repair.A total of 1296 patients were included in the analysis. The average age was 73 ± 8 years and 81% of patients were male

2019 Journal of Vascular Surgery

65. A large proportion of patients with small ruptured abdominal aortic aneurysms are women and have chronic obstructive pulmonary disease. Full Text available with Trip Pro

A large proportion of patients with small ruptured abdominal aortic aneurysms are women and have chronic obstructive pulmonary disease. In a population-based cohort of ruptured abdominal aortic aneurysms (rAAAs), our aim was to investigate clinical, morphological and biomechanical features in patients with small rAAAs.All patients admitted to an emergency department in Stockholm and Gotland, a region with a population of 2.1 million, between 2009-2013 with a CT-verified rupture (n = 192) were (...) rupture index (PWRI, 0.35 ± 0.08 vs 0.43 ± 0.11, p = 0.016) were higher for small rAAAs compared to matched iAAAs. Aortic size index, peak wall stress and aneurysm volume did not differ.More than one tenth of ruptures occur at smaller diameters, women continuously suffer an even higher risk of presenting with smaller diameters, and this must be considered in surveillance programs. The increased supra-renal aortic size index and PWRI are potential markers for rupture risk, and patients under

2019 PLoS ONE

66. A systematic review of short-term vs long-term effectiveness of one-time abdominal aortic aneurysm screening in men with ultrasound (Abstract)

A systematic review of short-term vs long-term effectiveness of one-time abdominal aortic aneurysm screening in men with ultrasound An up-to-date systematic review on the long-term benefits of one-time abdominal aortic aneurysm (AAA) screening in men with ultrasound is required as new evidence is available. This report was produced for the Canadian Task Force on Preventive Health Care to provide evidence on screening for AAA with ultrasound. The aim of this systematic review was to examine (...) more pronounced in men at a mean age of <70 years with a relatively lower prevalence of AAA than in men at a mean age of >70 years with a relatively higher prevalence of AAA. Future research should explore the long-term benefits of a targeted AAA screening approach based on risk factors such as age, sex, smoking status, family history, aortic diameter, and baseline risk of rupture.Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

2018 EvidenceUpdates

67. Analysis of clinical benefit, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm. Full Text available with Trip Pro

Analysis of clinical benefit, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm. A third of deaths in the UK from ruptured abdominal aortic aneurysm (AAA) are in women. In men, national screening programmes reduce deaths from AAA and are cost-effective. The benefits, harms, and cost-effectiveness in offering a similar programme to women have not been formally assessed, and this was the aim of this study.We developed a decision model to assess predefined outcomes (...) at age 70 years, diagnosis at 2·5 cm and repair at 5·0 cm) was estimated to have an incremental cost-effectiveness ratio of £23 000 (9500-71 000) per quality-adjusted life year and 1800 invitations to screening required to prevent one AAA-death, but an overdiagnosis rate of 55%. There was considerable uncertainty in the cost-effectiveness ratio, largely driven by uncertainty about AAA prevalence, the distribution of aortic sizes for women at different ages, and the effect of screening on quality

2018 Lancet

68. Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms Full Text available with Trip Pro

Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms Randomized trials have shown an initial survival benefit of endovascular over conventional open abdominal aortic aneurysm repair but no long-term difference up to 6 years after repair. Longer follow-up may be required to demonstrate the cumulative negative impact on survival of higher reintervention rates associated with endovascular repair.We updated the results of the Dutch Randomized (...) of follow-up, there was no survival difference between patients who underwent open or endovascular abdominal aortic aneurysm repair, despite a continuously increasing number of reinterventions in the endovascular repair group. Endograft durability and the need for continued endograft surveillance remain key issues.Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

2018 EvidenceUpdates

69. Renin-angiotensin system blockade does not attenuate abdominal aortic aneurysm growth, rupture rate, or perioperative mortality after elective repair Full Text available with Trip Pro

Renin-angiotensin system blockade does not attenuate abdominal aortic aneurysm growth, rupture rate, or perioperative mortality after elective repair The objective of this study was to summarize the literature regarding the effects of renin-angiotensin system blockade (RASB) using angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs) on human abdominal aortic aneurysm (AAA) growth, rupture, and perioperative mortality.We conducted a systematic review

2018 EvidenceUpdates

70. Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study. (Abstract)

Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study. Large reductions in the incidence of abdominal aortic aneurysm (AAA) and AAA-related mortality mean that results from randomised trials of screening for the disorder might be out-dated. The aim of this study was to estimate the effect of AAA screening in Sweden on disease-specific mortality, incidence, and surgery.Individual data on the incidence of AAA, AAA mortality, and surgery for AAA (...) surgery (aOR 1·59, 95% CI 1·20-2·10; p=0·001), such that for every 10 000 men offered screening, 49 men (95% CI 25-73) were likely to be overdiagnosed, 19 of whom (95% CI 1-37) had avoidable surgery that increased their risk of mortality and morbidity.AAA screening in Sweden did not contribute substantially to the large observed reductions in AAA mortality. The reductions were mostly caused by other factors, probably reduced smoking. The small benefit and substantially less favourable benefit-to-harm

2018 Lancet

71. Endosuture aneurysm repair in patients treated with Endurant II/IIs in conjunction with Heli-FX EndoAnchor implants for short-neck abdominal aortic aneurysm. Full Text available with Trip Pro

Endosuture aneurysm repair in patients treated with Endurant II/IIs in conjunction with Heli-FX EndoAnchor implants for short-neck abdominal aortic aneurysm. Endovascular repair of abdominal aortic aneurysm (AAA) remains a challenging clinical scenario when there is a short or nonexistent segment of healthy infrarenal aorta. This study sought to determine the safety and effectiveness of endosuture aneurysm repair (ESAR) using the Endurant II/IIs endograft (Medtronic Vascular, Santa Rosa, Calif (...) ) in conjunction with Heli-FX EndoAnchors (Medtronic Vascular) in the treatment of short-neck AAA.In this subgroup analysis, 70 patients were identified from the Aneurysm Treatment Using the Heli-FX EndoAnchor System Global Registry (ANCHOR) who had an infrarenal neck length <10 mm down to 4 mm based on core laboratory measurements. Primary outcomes included technical success of the index procedure, rate of type IA endoleak at 1 month and 12 months, and rate of secondary procedures at 12 months.In this short

2019 Journal of Vascular Surgery

72. Recent Advances and Mid-to-Long Term Results of Endovascular Aneurysm Repair for Abdominal Aortic Aneurysms. Full Text available with Trip Pro

Recent Advances and Mid-to-Long Term Results of Endovascular Aneurysm Repair for Abdominal Aortic Aneurysms. Endovascular aneurysm repair (EVAR) has become the standard therapy alongside open surgery repair (OSR) for abdominal aortic aneurysm (AAA) and it is rapidly becoming prevalent. There has been substantial technical progress with respect to EVAR since its introduction. Technical contrivance can be used to manage even inappropriate EVAR cases, including those involving a hostile neck (...) , deficient access route, or aneurysm rupture. However, there are some controversies over reinterventions in relation to long-term outcomes. Although a long-term result has not yet been analyzed in Japan a randomized controlled trial (RCT) held in the West reported that OSR is superior to EVAR for avoiding reinterventions and aneurysm-related death. The RCT involved the use of older devices and proceeded in a different way from the present study; therefore, different results may be obtained for Japanese

2019 Annals of vascular diseases Controlled trial quality: uncertain

73. Systematic review and meta-analysis of sex differences in outcomes after endovascular aneurysm repair for infrarenal abdominal aortic aneurysm. Full Text available with Trip Pro

Systematic review and meta-analysis of sex differences in outcomes after endovascular aneurysm repair for infrarenal abdominal aortic aneurysm. Women face distinctive challenges when they receive endovascular aneurysm repair (EVAR) treatment, and according to the previous studies, sex differences in outcomes after EVAR for infrarenal abdominal aortic aneurysm (AAA) remains controversial. This study aimed to compare the short-term and long-term outcomes between women and men after EVAR

2019 Journal of Vascular Surgery

74. Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry. (Abstract)

Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry. Endovascular aneurysm repair (EVAR) has become the preferred approach to abdominal aortic aneurysm (AAA) because of lower early morbidity and mortality than open repair. However, the ability of EVAR to prevent long-term aneurysm-related mortality (ARM) has been questioned in light of recent trial data. We have updated our long-term EVAR (...) experience in a large multicenter registry to further examine this issue.Between 2000 and 2010, 1736 patients with AAA underwent EVAR in a large integrated regional healthcare system. We extended follow-up in this previously reported cohort through 2015 and identified predictors associated with ARM and need for major reintervention. The primary outcome was ARM. Secondary outcomes were all-cause mortality, delayed aneurysm rupture, major adverse event, major reintervention, sac growth of more than 5 mm

2019 Journal of Vascular Surgery

75. Is Abdominal Aortic Aneurysm Behavior after Endovascular Repair Associated with Aneurysm Wall Density on Computed Tomography Angiography? Full Text available with Trip Pro

Is Abdominal Aortic Aneurysm Behavior after Endovascular Repair Associated with Aneurysm Wall Density on Computed Tomography Angiography? Background and objectives: Abdominal aortic aneurysm (AAA) growth is unpredictable after the endovascular aneurysm repair (EVAR). Continuing aortic wall degradation and weakening due to hypoxia may have a role in post-EVAR aneurysm sac growth. We aimed to assess the association of aortic wall density on computed tomography angiography (CTA) with aneurysm (...) growth following EVAR. Materials and Methods: A total of 78 patients were included in the study. The control group consisted of 39 randomly assigned patients without aortic pathology. Post-EVAR aneurysm sac volumes on CTA were measured twice during the follow-up period to estimate aneurysm sac behavior. A maximum AAA sac diameter, aortic wall and lumen densities in Hounsfield units (HU) on CTA were measured. A relative aortic wall density (the ratio of aortic wall to lumen densities) was calculated

2019 Medicina (Kaunas, Lithuania) Controlled trial quality: uncertain

76. Decreased mortality with local versus general anesthesia in endovascular aneurysm repair for ruptured abdominal aortic aneurysm in the Vascular Quality Initiative database. (Abstract)

Decreased mortality with local versus general anesthesia in endovascular aneurysm repair for ruptured abdominal aortic aneurysm in the Vascular Quality Initiative database. Endovascular aneurysm repair (EVAR) is an accepted approach for patients presenting with ruptured abdominal aortic aneurysm (rAAA) and suitable anatomy. The effect of anesthesia modality on mortality outcomes in rAAA has not been well described. Using the Vascular Quality Initiative database, this study compares local

2019 Journal of Vascular Surgery

77. Information for health insurance fund members on ultrasound screening for abdominal aortic aneurysms: addendum to commission S13-04

Information for health insurance fund members on ultrasound screening for abdominal aortic aneurysms: addendum to commission S13-04 Versicherteninformation zum Ultraschall-Screening auf Bauchaortenaneurysmen: Addendum zum Auftrag S13-04; Auftrag P16-01 [Information for health insurance fund members on ultrasound screening for abdominal aortic aneurysms: addendum to commission S13-04] Versicherteninformation zum Ultraschall-Screening auf Bauchaortenaneurysmen: Addendum zum Auftrag S13-04 (...) ; Auftrag P16-01 [Information for health insurance fund members on ultrasound screening for abdominal aortic aneurysms: addendum to commission S13-04] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen 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 Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen

2016 Health Technology Assessment (HTA) Database.

78. [Ultrasound screening for abdominal aortic aneurysms]

[Ultrasound screening for abdominal aortic aneurysms] Ultraschall-screening auf bauchaortenaneurysmen [Ultrasound screening for abdominal aortic aneurysms] Ultraschall-screening auf bauchaortenaneurysmen [Ultrasound screening for abdominal aortic aneurysms] IQWiG 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 IQWiG. Ultraschall-screening (...) auf bauchaortenaneurysmen. [Ultrasound screening for abdominal aortic aneurysms] Cologne: Institut fuer Qualitaet und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). IQWiG-Berichte 294. 2015 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Aortic Aneurysm, Abdominal; Humans; Mass Screening; Ultrasonography Language Published German Country of organisation Germany English summary There is no English language summary available. Address for correspondence IQWiG, Im

2015 Health Technology Assessment (HTA) Database.

79. [Endovascular repair of thoracic and thoraco-abdominal aortic aneurysm]

[Endovascular repair of thoracic and thoraco-abdominal aortic aneurysm] Reparación endovascular para aneurisma de aorta torácica y toraco-abdominal [Endovascular repair of thoracic and thoraco-abdominal aortic aneurysm] Reparación endovascular para aneurisma de aorta torácica y toraco-abdominal [Endovascular repair of thoracic and thoraco-abdominal aortic aneurysm] Calderón M, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L 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 Calderón M, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L. Reparación endovascular para aneurisma de aorta torácica y toraco-abdominal. [Endovascular repair of thoracic and thoraco-abdominal aortic aneurysm] Buenos Aires: Institute for Clinical Effectiveness and Health

2015 Health Technology Assessment (HTA) Database.

80. [Endovascular repair in abdominal aortic aneurysm]

[Endovascular repair in abdominal aortic aneurysm] Reparación Endovascular para Aneurisma de Aorta [Endovascular repair in abdominal aortic aneurysm] Reparación Endovascular para Aneurisma de Aorta [Endovascular repair in abdominal aortic aneurysm] Calderón M, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L 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 Calderón M, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A, López A, Rey-Ares L. Reparación Endovascular para Aneurisma de Aorta. [Endovascular repair in abdominal aortic aneurysm] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Informe de Respuesta Rapida No. 409. 2015 Authors' objectives To assess the available evidence on the efficacy, safety and coverage related

2015 Health Technology Assessment (HTA) Database.

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