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Abdominal Aortic Aneurysm

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61. Measuring abdominal aortic diameters in routine abdominal computed tomography scans and implications for abdominal aortic aneurysm screening. (PubMed)

Measuring abdominal aortic diameters in routine abdominal computed tomography scans and implications for abdominal aortic aneurysm screening. This study aimed to determine the prevalence and relevance of incidental abdominal aortic aneurysm (AAA) on routine abdominal computed tomography (CT) and to audit the performance of radiologists to identify and report AAA.A retrospective audit of all abdominal CT scans performed on men and women ≥50 years at Dunedin Public Hospital between January 2013 (...) , large numbers of subjects with normal aortic diameters are identified who will not need to be screened. Consequently, we consider routine diagnostic abdominal CT to be an important adjunct to national and community AAA screening strategies.Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

2017 Journal of Vascular Surgery

62. Genetic Association of Lipids and Lipid Drug Targets With Abdominal Aortic Aneurysm: A Meta-analysis. (PubMed)

Genetic Association of Lipids and Lipid Drug Targets With Abdominal Aortic Aneurysm: A Meta-analysis. Risk factors for abdominal aortic aneurysm (AAA) are largely unknown, which has hampered the development of nonsurgical treatments to alter the natural history of disease.To investigate the association between lipid-associated single-nucleotide polymorphisms (SNPs) and AAA risk.Genetic risk scores, composed of lipid trait-associated SNPs, were constructed and tested for their association

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2018 JAMA cardiology

63. Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm (PubMed)

Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm Abdominal aortic aneurysm (AAA) is an irreversible condition where the abdominal aorta is dilated leading to potentially fatal consequence of aortic rupture. Multiple mechanisms are involved in the development and progression of AAA, including chronic inflammation, oxidative stress, vascular smooth muscle (VSMC) apoptosis, immune cell infiltration and extracellular matrix (ECM) degradation. Currently surgical (...) therapies, including minimally invasive endovascular aneurysm repair (EVAR), are the only viable interventions for AAAs. However, these treatments are not appropriate for the majority of AAAs, which measure <50 mm. Substantial effort has been invested to identify and develop pharmaceutical treatments such as statins and doxycycline for this potentially lethal condition but these interventions failed to offer a cure or to retard the progression of AAA. Chinese herbal medicine (CHM) has been used

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2018 Frontiers in cardiovascular medicine

64. Educational Case: Symptomatic but Unruptured Abdominal Aortic Aneurysm (PubMed)

Educational Case: Symptomatic but Unruptured Abdominal Aortic Aneurysm The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies

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2018 Academic pathology

65. Prognostic value of D-dimer and markers of coagulation for stratification of abdominal aortic aneurysm growth (PubMed)

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

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2018 Blood advances

66. A large proportion of patients with small ruptured abdominal aortic aneurysms are women and have chronic obstructive pulmonary disease. (PubMed)

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

67. Nellix® EndoVascular Aneurysm Sealing System for abdominal aortic aneurysm repair

Nellix® EndoVascular Aneurysm Sealing System for abdominal aortic aneurysm repair Nellix® EndoVascular Aneurysm Sealing System for abdominal aortic aneurysm repair Nellix® EndoVascular Aneurysm Sealing System for abdominal aortic aneurysm repair NIHR HSC 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 NIHR HSC. Nellix® EndoVascular (...) Aneurysm Sealing System for abdominal aortic aneurysm repair. Birmingham: NIHR Horizon Scanning Centre (NIHR HSC). Horizon Scanning Review. 2014 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Proceduress; Prosthesis Design Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NIHR

2014 Health Technology Assessment (HTA) Database.

68. Stent graft types for endovascular repair of abdominal aortic aneurysms. (PubMed)

Stent graft types for endovascular repair of abdominal aortic aneurysms. The UK prevalence of abdominal aortic aneurysm (AAA) is estimated at 4.9% in over 65-year olds. Progressive and unpredictable enlargement can lead to rupture. Endovascular repair of AAAs involves a stent graft system being introduced via the femoral artery and manipulated within the aorta under radiological guidance. Following endograft deployment, a seal is formed at the proximal and distal landing zones to exclude (...) . It was not possible to review the quality of the evidence in the absence of studies eligible for inclusion in the review.Unfortunately, no data exist regarding direct comparisons of the performance of different stent graft types. High quality randomised controlled trials evaluating stent graft types in abdominal endovascular aneurysm repair are required.

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2015 Cochrane

69. Endovascular repair versus open repair for inflammatory abdominal aortic aneurysms. (PubMed)

Endovascular repair versus open repair for inflammatory abdominal aortic aneurysms. Inflammatory abdominal aortic aneurysm (IAAA) is a rare but potentially life-threatening condition characterised by marked thickening of the aortic wall, peri-aneurysmal and retroperitoneal fibrosis, and dense adhesions of adjacent abdominal organs. The pathogenesis of IAAA remains an enigma. The main aim of invasive or surgical therapy of AAAs is prevention or correction of aortic rupture. Prevention (...) or treatment of AAA rupture by open or endovascular repair is proven by numerous studies published in the literature. Treatment of IAAA poses a different challenge to surgeons compared with traditional atherosclerotic AAA because of the potential for iatrogenic injury in open repair or, alternatively, potential increased inflammatory response to endoprosthesis implantation.To assess the effects of elective endovascular versus open repair for inflammatory abdominal aortic aneurysms.The Cochrane Peripheral

2015 Cochrane

70. Systematic review and meta-analysis of the risk of bowel ischemia after ruptured abdominal aortic aneurysm repair

Systematic review and meta-analysis of the risk of bowel ischemia after ruptured abdominal aortic aneurysm repair Outcomes after repair of ruptured abdominal aortic aneurysm (RAAA) have improved in the last decade. It is unknown whether this has resulted in a reduction of postoperative bowel ischemia (BI). The primary objective was to determine BI prevalence after RAAA repair. Secondary objectives were to determine its major sequelae and differences between open repair (OR) and endovascular (...) aneurysm repair (EVAR).This systematic review (PROSPERO CRD42017055920) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. MEDLINE and Embase were searched for studies published from 2005 until 2018. The methodologic quality of observational studies was assessed with the Methodological Index for Non-Randomized Studies (MINORS) tool. The quality of the randomized controlled trials (RCTs

2018 EvidenceUpdates

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

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

2018 Lancet

72. Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms

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.

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2018 EvidenceUpdates

73. Renin-angiotensin system blockade does not attenuate abdominal aortic aneurysm growth, rupture rate, or perioperative mortality after elective repair

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

74. Endovascular treatment for ruptured abdominal aortic aneurysm. (PubMed)

Endovascular treatment for ruptured abdominal aortic aneurysm. An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) can develop in both men and women as they grow older. It is most commonly seen in men over the age of 65 years. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, a fatal event unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open (...) surgical repair. A newer minimally invasive technique, endovascular aneurysm repair (EVAR), has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair. Emergency endovascular aneurysm repair (eEVAR) has been used successfully to treat ruptured abdominal aortic aneurysm (RAAA), proving that it is feasible in selected patients. However, it is not yet known if eEVAR will lead to significant improvements in outcomes for these patients or indeed

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2014 Cochrane

75. Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm. (PubMed)

Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm. Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in patients with atherosclerotic occlusive arterial disease. However, the role of prophylaxis in patients with abdominal aortic aneurysm (AAA) remains unclear. Several studies have shown that despite successful repair, those with AAA have a poorer rate of survival (...) than healthy controls. People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events. Despite this association, little is known about the effectiveness of pharmacological prophylaxis in reducing cardiovascular risk in people with AAA.To determine the long-term effectiveness of antiplatelet, antihypertensive or lipid-lowering medication in reducing mortality and cardiovascular events in people with abdominal aortic aneurysm (AAA).The Cochrane Peripheral

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2014 Cochrane

76. Endovascular repair of abdominal aortic aneurysm. (PubMed)

Endovascular repair of abdominal aortic aneurysm. An abnormal dilatation of the abdominal aorta is referred to as an abdominal aortic aneurysm (AAA). Due to the risk of rupture, surgical repair is offered electively to individuals with aneurysms greater than 5.5 cm in size. Traditionally, conventional open surgical repair (OSR) was considered the first choice approach. However, over the past two decades endovascular aneurysm repair (EVAR) has gained popularity as a treatment option (...) %) deaths in the EVAR and 470 (37.8%) deaths in the OSR group (OR 0.98, 95% CI 0.83 to 1.15; P = 0.78). Similarly, there was no significant difference in aneurysm-related mortality between groups, either at the intermediate- or long-term follow up.Studies showed that both EVAR and OSR were associated with similar incidences of cardiac deaths (OR 1.14, 95% CI 0.86 to 1.52; P = 0.36) and fatal stroke rate (OR 0.81, 95% CI 0.42 to 1.55; P = 0.52). The long-term reintervention rate was significantly higher

2014 Cochrane

77. Analysis of clinical benefit, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm. (PubMed)

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 (...) National Health Service reference costs.AAA screening for women, as currently offered to UK men (at age 65 years, with an AAA diagnosis at an aortic diameter of ≥3·0 cm, and elective repair considered at ≥5·5cm) gave, over 30 years, an estimated incremental cost-effectiveness ratio of £30 000 (95% CI 12 000-87 000) per quality-adjusted life year gained, with 3900 invitations to screening required to prevent one AAA-related death and an overdiagnosis rate of 33%. A modified option for women (screening

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2018 Lancet

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

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

79. A meta-analysis of monthly variation in occurrence of abdominal aortic aneurysm rupture. (PubMed)

A meta-analysis of monthly variation in occurrence of abdominal aortic aneurysm rupture. We performed a meta-analysis to assess the presence of an annual rhythmic variability of ruptured abdominal aortic aneurysm (RAAA) onset.Eligible studies were observational studies enrolling patients with RAAA and reporting monthly incidence of RAAA. Study-specific estimates, i. e. monthly incidence of RAAA, were combined using the random-effects model. Chronobiological analysis was performed by applying

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2017 VASA. Zeitschrift fur Gefasskrankheiten

80. Comparison of Clinical Outcomes between Surgical Repair and Endovascular Stent for the Treatment of Abdominal Aortic Aneurysm (PubMed)

Comparison of Clinical Outcomes between Surgical Repair and Endovascular Stent for the Treatment of Abdominal Aortic Aneurysm This study was performed to compare the treatment outcomes between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) in a South Korean population.We performed a retrospective review of the medical records of 99 patients with AAAs who were managed at Gyeongsang National University Hospital between January 2005

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2017 Vascular specialist international

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