TY - JOUR. T1 - A novel use of ultrasound in pulseless electrical activity. T2 - The diagnosis of an acute abdominal aortic aneurysm rupture. AU - Hendrickson, Robert G.. AU - Dean, Anthony J.. AU - Costantino, Thomas G.. PY - 2001/8/20. Y1 - 2001/8/20. N2 - We report a case of a patient who presented to the Emergency Department with pulseless electrical activity. A rapid diagnosis of ruptured abdominal aortic aneurysm was made by Emergency Medicine bedside ultrasonography. On arrival, the patient was without palpable pulses and bradycardic. Therapy with epinephrine, fluids, and atropine was initiated. A bedside ultrasound was immediately performed and revealed coordinated cardiac motion with empty ventricles. A rapid search for signs of blood loss in the abdomen revealed a large abdominal aortic aneurysm. Pulses were restored with fluid, blood, and epinephrine and surgical intervention was begun within 30 min of patient arrival.. AB - We report a case of a patient who presented to the Emergency ...
We describe the case of a man who died of an abdominal aortic aneurysm rupture after an intravitreal injection of bevacizumab for neovascular age-related macular degeneration. A 74-year-old Korean man presented with visual disturbance in his right eye. He had previously been diagnosed with diabetes and hypertension, which were controlled with oral medications. We diagnosed him with neovascular age-related macular degeneration and he was treated by monthly intravitreal injection of bevacizumab for three months. Four days after his third intravitreal bevacizumab injection, he died of an abdominal aortic aneurysm rupture and uncontrolled bleeding. Abdominal aortic aneurysm rupture is highly lethal and there is a possible correlation with intravitreal injection of bevacizumab. Thus, we need to consider the risks of intravitreal bevacizumab injections for patients with abdominal aortic aneurysms.
Endovascular Abdominal Aortic Aneurysm Repair Devices Report by Material, Application, and Geography Global Forecast to 2021 is a professional and in-depth research report on the worlds major regional market conditions, focusing on the main regions (North America, Europe and Asia-Pacific) and the main countries (United States, Germany, united Kingdom, Japan, South Korea and China).. Get Sample copy of the Report: http://sacinsight.com/report/global-endovascular-abdominal-aortic-aneurysm-repair-devices-market-research-report-2017_9dimen/. The report firstly introduced the Endovascular Abdominal Aortic Aneurysm Repair Devices basics: definitions, classifications, applications and market overview; product specifications; manufacturing processes; cost structures, raw materials and so on. Then it analyzed the worlds main region market conditions, including the product price, profit, capacity, production, supply, demand and market growth rate and forecast etc. In the end, the report introduced new ...
Abdominal aortic aneurysm repair has undergone a revolution since Volodos and Parodi described endoluminal repair in the early 1990s. Subsequent data from large registries have confirmed its efficacy. Randomised controlled trials have shown that although endoluminal repair may not be as cost effective as open repair, it can be performed with a lower mortality in patients fit for open repair. Some European countries (eg, Belgium) have taken the results of these trials to rationalise the number of hospitals able to do endovascular repair. The devices continue to improve and although most require open surgical access at present, in future percutaneous access will become the norm. This article reviews the current state of endoluminal aortic aneurysm repair in the infrarenal aorta. ...
About 3 out of 4 abdominal aortic aneurysms dont cause symptoms. An aneurysm may be found by X-ray, computed tomography (CT or CAT) scan, or magnetic resonance imaging (MRI) that was done for other reasons. Since abdominal aneurysm may not have symptoms, its called the "silent killer" because it may rupture before being diagnosed. Pain is the most common symptom of an abdominal aortic aneurysm. The pain associated with an abdominal aortic aneurysm may be located in the abdomen, chest, lower back, or groin area. The pain may be severe or dull. Sudden, severe pain in the back or abdomen may mean the aneurysm is about to rupture. This is a life-threatening medical emergency. Abdominal aortic aneurysms may also cause a pulsing sensation, similar to a heartbeat, in the abdomen. The symptoms of an abdominal aortic aneurysm may look like other medical conditions or problems. Always see your doctor for a diagnosis. ...
ATLANTA--Researchers have found a link between dysregulated tryptophan metabolism and abdominal aortic aneurysm, a life-threatening vascular disease, according to a new study led by Georgia State University.. Abdominal aortic aneurysm is a permanent, localized enlargement of the abdominal aorta, the largest artery in the abdomen that provides blood to the organs and tissues of the abdomen, pelvis and legs. Because the abdominal aorta is one of four sections of the aorta, the bodys main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding, according to the Mayo Clinic.. Abdominal aortic aneurysm occurs in up to 9 percent of adults older than 65 years of age, with about 15,000 deaths each year in the United States after rupture. Abdominal aortic aneurysms often grow slowly and without symptoms, making them difficult to detect.. There are no proven therapeutic strategies to block progression of the disease and rupture of the abdominal aorta. The only possible ...
Introdução. O updated Glasgow Aneurysm Score (uGAS), projetado para prever a mortalidade/morbilidade perioperatórias após rAAA, revelou ser um bom preditor de resultados a curto prazo após o tratamento com cirurgia convencional (CC) e Endovascular Aneurysm Repair (EVAR). Os objetivos foram caracterizar os doentes operados a Aneurisma da Aorta Abdominal roto (AAAr) e avaliar a aplicabilidade do uGAS na população de doentes de uma instituição terciária nacional, com capacidade de rEVAR.. Métodos. Fizemos uma análise retrospetiva dos doentes operados, no nosso serviço, a AAAr entre fevereiro/2011 e fevereiro/2015. As variáveis foram obtidas através da pesquisa numa base de dados de AAAr da instituição e incluíram: idade, sexo, presença de doença cardíaca, doença cerebrovascular, doença renal aguda/crónica e existência de choque pré‐operatório. Foi obtida a mortalidade perioperatória (30 dias ou intra‐hospitalar). O score de risco foi aplicado retrospetivamente e a ...
“The Report Abdominal Aortic Aneurysms Global Clinical Trials Review, H1, 2015 provides information on pricing, market analysis, shares, forecast, and company profiles for key industry participants. - MarketResearchReports.biz”Abdominal Aortic Aneurysms Global Clinical Trials Review, H1, 2015" provides data on the Abdominal Aortic Aneurysms clinical trial scenario. This report provides elemental information and data relating to the clinical trials on Abdominal Aortic Aneurysms. It...
The last decade has represented a time of fundamental change in the treatment of abdominal aortic aneurysms (AAAs). Potentially, vascular surgeons will either acquire catheter-based skills or relinquish the care for many patients with infrarenal AAA. We investigated AAA referral patterns and method of AAA repair after the establishment of an endovascular AAA program at our institution. We conducted a retrospective review of elective AAA repairs after the initiation of an endovascular AAA program in April 1994. Six vascular surgeons performed all procedures with a clear distinction between the surgeons (n=3) who performed traditional AAA repair only and those (n=3) who managed AAAs by means of either endovascular or traditional treatment. From April 1994 through December 2000, 740 elective AAA repairs were performed. During this time the mean number of AAA repairs has been 106/year ranging from 75 to 155/year. More notable however is the steady increase in the percentage of endovascular AAA ...
Introduction: Smoking cessation is one of the few available strategies to decrease the risk for expansion and rupture of small abdominal aortic aneurysms (AAAs). The cost-effectiveness of an intensive smoking cessation therapy in patients with small AAAs identified at screening was evaluated. Methods: A Markov cohort simulation model was used to compare an 8-week smoking cessation intervention with adjuvant pharmacotherapy and annual revisits vs nonintervention among 65-year-old male smokers with a small AAA identified at screening. The smoking cessation rate was tested in one-way sensitivity analyses in the intervention group (range, 22%-57%) and in the nonintervention group (range, 3%-30%). Literature data on the effect of smoking on AAA expansion and rupture was factored into the model. Results: The intervention was cost-effective in all tested scenarios and sensitivity analyses. The smoking cessation intervention was cost-effective due to a decreased need for AAA repair and decreased rupture ...
An abdominal aortic aneurysm can be dangerous if it isnt spotted early on. It can get bigger over time and could burst causing life-threatening bleeding. The abdominal aortic aneurysm repair surgeries can be performed via open repair or Endovascular Aneurysm Repair. Know the recovery period, complications and survival rate following abdominal aortic aneurysm repair surgery.
The incidence of abdominal aortic aneurysm (AAA) varies among ethnic groups. Wikipedia Risk factors include genetic susceptibility, atherosclerosis, male sex, smoking, and hypertension. If detected before rupture, a dangerously large abdominal aortic aneurysm can usually be surgically repaired. Wikipedia Although of small effect each, SNPs reported to affect risk of abdominal aortic aneurysm and to be reasonably robust statistically include [PMID 24834361 ...
OBJECTIVES: To study bowel ischaemia in transfemorally placed endoluminal grafting (TPEG) for abdominal aortic aneurysms, and any relation to cytokine response or postoperative fever. DESIGN: Prospective not randomised. University hospital setting. MATERIAL: Fourteen cases of conventional surgery and 23 cases of endovascular technique for infrarenal abdominal aortic aneurysm repair. METHODS: Tonometry was used for sigmoid colon pH, and ELISAs for serum IL-6. RESULTS: Mucosal pH in the sigmoid colon fell significantly during clamping and reperfusion in both groups. Lowest measured sigmoid colon pH was 7.10 in the open group, compared to 7.22 in the TPEG group (p , 0.05). The IL-6 levels in serum peaked after 4 h of reperfusion; 249 pg/ml in the open group, compared to 89 pg/ml in the TPEG group (p , 0.05). High levels of IL-6 in the postoperative period and persisting low sigmoidal pH were associated with serious complications. Postoperative temperature did not differ significantly between the ...
OBJECTIVE: The aim of this study was to describe our early experience in the treatment of ruptured abdominal aortic aneurysms with bifurcated endografts. We report on our initial twelve-month experience using this approach. METHODS: Clinical data on patients with ruptured abdominal aortic aneurysms treated at a single tertiary center in Brazil were prospectively recorded. The eligibility for endovascular treatment was evaluated by computed tomography scanning and anatomical features were determined based on the method of treatment. RESULTS: From February 2012 to January 2013 (12 months), 28 consecutive patients (mean age 67.2 years, range 45-85 years) underwent treatment for ruptured abdominal aortic aneurysms at our hospital. Eighteen patients (64.3%) were suitable for and underwent endovascular treatment with bifurcated endografts (16 patients) or aortouniiliac endografts (two patients). Ten patients who were considered unsuitable for endograft repair underwent open repair. Seven patients were ...
This case illustrates an infrarenal abdominal aortic aneurysm rupture. An abdominal aortic aneurism (AAA) is defined as a permanent and irreversible localized dilatation of the abdominal aorta1. AAA rupture has an overall mortality rate of appro...
TY - JOUR. T1 - Intraluminal thrombus is associated with early rupture of abdominal aortic aneurysm. AU - Haller, Stephen J.. AU - Crawford, Jeffrey D.. AU - Courchaine, Katherine M.. AU - Bohannan, Colin J.. AU - Landry, Gregory J.. AU - Moneta, Gregory L.. AU - Azarbal, Amir F.. AU - Rugonyi, Sandra. PY - 2018/4. Y1 - 2018/4. N2 - Background: The implications of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA) are currently unclear. Previous studies have demonstrated that ILT provides a biomechanical advantage by decreasing wall stress, whereas other studies have associated ILT with aortic wall weakening. It is further unclear why some aneurysms rupture at much smaller diameters than others. In this study, we sought to explore the association between ILT and risk of AAA rupture, particularly in small aneurysms. Methods: Patients were retrospectively identified and categorized by maximum aneurysm diameter and rupture status: small (,60 mm) or large (≥60 mm) and ruptured (rAAA) ...
First generation aortic endovascular stent-grafts (EVG) had low applicability and were associated with a significant incidence of peri-procedural complications. With time, a number of EVG systems perished (some predictably) in a "survival of the fittest". Improvements in design have been made as a result of these failures. Current designs have low peri-procedural morbidity and mortality and improving durability. This paper sets out to discuss the use of a variety of EVG for abdominal aortic aneurysm repair. The ideal properties of an EVG will be outlined along with some of the advantages and limitations of current, and, where appropriate, historical, commercially available stent-graft systems.. ...
When trumpeter, Peter Cripps had a CT scan for a kidney stone it was discovered he also had an abdominal aortic aneurysm.. "Just before Christmas I had the most horrendous pain in my abdomen. I had a CT scan, which revealed I had a kidney stone. Thankfully, that was quite small but, more worryingly, the nurse told me I also had an abdominal aortic aneurysm. The surgeon came to see me straight away and recommended an open AAA operation which was done on January 16 2007. "Id had a four-way heart bypass four years earlier and five years before that a heart attack and I was convinced I was not going to make it. But the operation went really well and I was out of hospital a week later. "I felt weak and tired and I was quite insecure when I first got home. But I tried to do a little more each day and was soon back on my feet. In fact, I was able to go back to my part-time job fitting insulation mats on yacht engines within just three weeks. I play trumpet in a band and was able to start blowing again ...
Introduction: Endovascular aneurysm repair (EVAR) has been an established treatment for abdominal aortic aneurysm (AAA). Although statin use has been shown associated with better long-term survival following open AAA surgery, its impact on EVAR has not been systematically explored.. Methods: We retrospectively analyzed a multicenter database of 368 consecutive patients (age, 76 ± 8 years; 84% male) undergoing EVAR for AAA between November 2006 and December 2013. The outcome measure was overall survival following EVAR. Independent predictor associated with the outcome was assessed by Cox proportional hazard regression model. Furthermore, the association between the statin use and the outcome was assessed.. Results: During the follow-up of 30 ± 20 months, 38 patients died from cardiovascular disease (33%), cancer (23%) or infection (23%). Survival rate was 96% and 81% at 1 and 5 years, respectively. In Cox regression analysis, statin use (in 213 AAA patients, 58%) was negatively associated with ...
We thank Dr Han and colleagues, and Dr Murakami and colleagues, as well, for their interest in our study1 and for discussing our proposed pathomechanism of segmental aortic stiffness in the context of experimental and clinical aortic coarctation.. We read with great interest the report of an alternative rabbit model that combines external elastase application with proximal aortic coarctation to model accelerated abdominal aortic aneurysm development.2 Although poststenotic turbulent flow caused by experimental aortic constriction may critically contribute to aortic dilation in this model, aortic coarctation also results in segmental aortic stiffness and may therefore generate substantial axial wall stress during systolic aortic expansion that we believe is a critical driver of early abdominal aortic aneurysm development.. In our study, mild aortic infusion of porcine pancreatic elastase (1.5 U/mL for 5 minutes) was sufficient to induce initial elastin damage and aortic stiffening that eventually ...
TY - JOUR. T1 - Endovascular aortic aneurysm repair with carbon dioxide-guided angiography in patients with renal insufficiency. AU - Criado, Enrique. AU - Upchurch, Gilbert R.. AU - Young, Kate. AU - Rectenwald, John E.. AU - Coleman, Dawn M.. AU - Eliason, Jonathon L.. AU - Escobar, Guillermo A.. PY - 2012/6/1. Y1 - 2012/6/1. N2 - Objective: Renal dysfunction following endovascular abdominal aortic aneurysm repair (EVAR) remains a significant source of morbidity and mortality. We studied the use of carbon dioxide (CO 2) as a non-nephrotoxic contrast agent for EVAR. Methods: Recorded data from 114 consecutive patients who underwent EVAR with CO 2 as the contrast agent over 44 months were retrospectively analyzed. CO 2 was used exclusively in 72 patients and in an additional 42 patients iodinated contrast (IC) was given (mean, 37 mL). Renal and hypogastric artery localization and completion angiography were done with CO 2 in all patients, including additional arterial embolization in 16 cases. ...
An aortic aneurysm is a dilation of a segment of the aorta where the wall of the vessel becomes thin and weak. The most common site involves the abdominal aorta below the arteries to the kidneys. The main risk of an aortic aneurysm is rupture. If the aneurysm ruptures, the chance for survival is very low. If the aneurysm is repaired before rupture, the chance of survival is very good. In general, an abdominal aortic aneurysm should be repaired when it reaches a size of 5 centimeters in diameter. On average, an aortic aneurysm will increase in size 0.5 centimeters per year. A more rapid rate of enlargement might lead us to recommend repair before the aneurysm reaches 5 centimeters. There are currently two acceptable methods used to repair an abdominal aortic aneurysm. The most common method involves making an incision in the abdomen and directly exposing the aneurysm. The involved section of aorta is completely replaced with a prosthetic fabric tube. This operation is highly effective at reducing ...
TY - JOUR. T1 - Comparison of transmitted pressure across percutaneous abdominal aorta aneurysm conduits. T2 - A new in vitro model. AU - Thorpe, P. E.. AU - Hunter, D. W.. AU - Chouinard, P.. AU - Agrawal, Devendra K.. AU - Zhan, X. X.. PY - 1996. Y1 - 1996. N2 - The treatment of abdominal aorta aneurysm is aimed at decreasing pressure on the arterial wall which is thought to cause growth and eventual rupture of the aneurysm. If significant pressure is transmitted across percutaneously placed stem-grafts, they may prove unacceptable for abdominal aorta aneurysm repair. Therefore, we developed an in mm model to study transmission of pressure across various materials implanted in an aneurysmal lumen. A pinch roller model producing pulsatile flow through an aneurysm fashioned from heated polyethylene was used with H2O, glycerol and heparinized bovine blood. Continuous pressure readings obtained from 3 sites (above, below and mid aneurysm) were compared between different materials including bare ...
I write a lot pregnabcy yahoo answers and some abdominal aortic aneurysm after pregnancy the things that young people think will stop them becoming pregnant are incredibly naпve - its scary how uninformed they are. Women need to measure their body temperature every morning, before arising. Read this article to learn why French women are encouraged to give birth and what are the anurysm in giving birth. What I like abdominal aortic aneurysm after pregnancy this calendar is that it shows how the days repeat. However, hair loss during pregnancy is completely normal and is said to occur due to fluctuating hormones in the body. Family history: Women with a aortkc history aorttic ovarian cancer, or breast cancer are aneuryysm prone to the chance of developing ovarian cancer compared to other women. Apparently, Dutch fathers have been in the scene of aneuryzm abdominal aortic aneurysm after pregnancy a long time as can be observed in paintings from the 17th and 18th centuries. Or, evening sickness. ...
Long-term outcome of ruptured abdominal aortic aneurysm: impact of treatment and age Jelle W Raats,1 Hans C Flu,1 Gwan H Ho,1 Eelco J Veen,1 Louwerens D Vos,2 Ewout W Steyerberg,3 Lijckle van der Laan1 1Department of Surgery, Amphia Hospital, Breda, 2Department of Radiology, Amphia Hospital, Breda, 3Department of Public Health, Erasmus MC, Rotterdam, the Netherlands Background: Despite advances in operative repair, ruptured abdominal aortic aneurysm (rAAA) remains associated with high mortality and morbidity rates, especially in elderly patients. The purpose of this study was to evaluate the outcomes of emergency endovascular aneurysm repair (eEVAR), conventional open repair (OPEN), and conservative treatment in elderly patients with rAAA.Methods: We conducted a retrospective study of all rAAA patients treated with OPEN or eEVAR between January 2005 and December 2011 in the vascular surgery department at Amphia Hospital, the Netherlands. The outcome in patients treated for rAAA by eEVAR or OPEN repair
Abdominal aortic aneurysm (AAA) is a potentially fatal disease and survival rate is very low when rupture occurs. Experimental models related with abdominal aortic aneurysm are performed on intact and ruptured aneurysm (RAAA) models. By using AAA models; complex mechanisms of aneurysm formation, aneurysm progression, chance of rupture, preventative and treating methods are researched. Most commonly used methods for creating aneurysm are utilization of transgenic or knockout animals; intra/extraluminal pharmacologic treatments such as elastase, calcium chloride or angiotensin II; hyperlipidemic diet application and surgical interventions such as xenograft, stenosis or graft. Pathogenesis of aneurysm is predominantly examined on rodents whereas studies aimed at development of treatment modalities such as surgical or endovascular interventions are predominantly performed on large animals like rabbit, porcine or dog. Experimental studies modeling aneurysm rupture (RAAA) simulate shock (total hypoperfusion)
Desgranges P, Kobeiter H, Katsahian S, et al. Editors choice - ECAR (endovasculaire ou chirurgie dans les anévrysmes aorto-iliaques rompus): a French randomized controlled trial of endovascular versus open surgical repair of ruptured aorto-iliac aneurysms. Eur J Vasc Endovasc Surg. 2015;50(3):303-310. PMID: 26001320 www.ncbi.nlm.nih.gov/pubmed/26001320.. Glebova NO, Malas MB. The management of ruptured abdominal aortic aneurysm. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:788-791.. Holt PJE, Thompson MM. Abdominal aortic aneurysm. In: Cronenwett JL, Johnston KW, eds. Rutherfords Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 130. ...
The pathology of the human abdominal aortic aneurysm (AAA) and its relationship to the later complication of intraluminal thrombus (ILT) formation remains unclear. The hemodynamics in the diseased abdominal aorta are hypothesized to be a key contributor to the formation and growth of ILT. The objective of this investigation is to establish a reliable 3D flow visualization method with corresponding validation tests with high confidence in order to provide insight into the basic hemodynamic features for a better understanding of hemodynamics in AAA pathology and seek potential treatment for AAA diseases. A stereoscopic particle image velocity (PIV) experiment was conducted using transparent patient-specific experimental AAA models (with and without ILT) at three axial planes. Results show that before ILT formation, a 3D vortex was generated in the AAA phantom. This geometry-related vortex was not observed after the formation of ILT, indicating its possible role in the subsequent appearance of ILT ...
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A new landmark study by researchers at the University of Maryland School of Medicine (UMSOM) found that patients with a vascular condition, called abdominal aortic aneurysm, received no benefits from taking a common antibiotic drug to reduce inflammation. Patients who took the antibiotic doxycycline experienced no reduction in the growth of their aneurysm over two years compared to those who took a placebo, according to the study published today in the Journal of the American Medical Association (JAMA). The finding could lead doctors to stop prescribing the drug as a way to prevent small aneurysms from growing larger and bursting.. "This study provides strong evidence that doxycycline is of no benefit for patients with small abdominal aortic aneurysms in terms of preventing their growth. Health care providers should take note of the finding and stop using this as a prophylactic treatment," said corresponding author Michael Terrin, MDCM, MPH, Professor of Epidemiology and Public Health at UMSOM. ...
Management of ruptured abdominal aortic aneurysms. The latest evidence on the best way to manage a ruptured aneurysm will be presented including the one-year results of the IMPROVE trial and the IPD 3 trial. In the same session, the controversy as to whether many patients with ruptured abdominal aortic aneurysms are denied intervention will be discussed. Greenhalgh comments: "Perhaps doctors are becoming more concerned about operating for fear of having poor mortality figures. We need to find evidence whether indeed patients are denied intervention.". Janet Powell (Imperial College, London, UK), member of the CX Programme Organising Board, considers that a few patients are offered repair of ruptured aortic aneurysm because perhaps "not all centres have an endovascular team and facilities available at all times; additionally, there are financial stringencies on healthcare systems and many of these patients may need intervention out of hours." Holden adds that many questions on this subject remain ...
In many countries the gold standard for treating abdominal aortic aneurysms is still open surgery with a long incision. In patients with suitable anatomy alternatively an endovascular approach can be chosen. Since open surgery is more durable in many countries a laparoscopic procedure using key hole surgery has gained wider acceptance. The current study wants to prove that laparoscopic aortic aneurysm procedures are less invasive than open surgery with reduced recovery times.. Study design: Multi center prospective randomized study including patients with infra or juxtarenal aortic aneurysms ( AAA).. In group I the AAA is resected using a conventional long incision and standard procedures for resecting the AAA. A Dacron graft is used in inlay technique to restore blood flow.. In group II a total laparoscopic approach is chosen to exclude the AAA. Identical to open surgery a dacron graft is laparoscopically sawn in to exclude the AAA and to restore blood flow.. In a subgroup II a the ...
Searchers launched a study of more than three million people-by far the largest ever-to uncover what. St ascending aortic aneurysms are diagnosed in. Eurysm was noted during workup for back pain, and CT was ordered after AAA was identified on. aneurysm anu rizm a sac formed by the localized dilatation of the wall of an artery, a vein, or the heart. ThodsWe examined differences between England and the United. Dications for surgical treatment of thoracic aortic aneurysms (TAAs) are based on size or growth rate and symptoms. CT demonstrates abdominal aortic aneurysm (AAA). Thoracic aortic aneurysm (TAA) can be due to one of several etiologies. Historical perspective. 9 out of 10 Cardiovascular Doctors Support Preventive Health Screenings For People At Risk. E natural history of TAA is one of progressive expansion, the rate of which depending upon! Abdominal aortic aneurysm; Synonyms: triple a: CT reconstruction image of an abdominal aortic aneurysm (white arrows) Classification and external ...
Angiotensin IV (Ang IV), as an effector peptide of the rennin-angiotensin system, possesses many biological properties yet not completely known. In this study, we aimed to investigate the role of Ang IV in the development of Ang II-induced abdominal aortic aneurysm (AAA) in apolipoprotein E-knockout mice. We used Ang II infusion to induce AAA, and animals were treated with Ang II (1.44 mg/kg per day) plus no treatment, Ang II (1.44 mg/kg per day) plus low-, medium-, and high-dose Ang IV (0.72, 1.44, and 2.88 mg/kg per day, respectively). The incidence of AAA was 87.5%, 66.7%, 37.5%, and 83.3% in the no treatment, the low-, medium-, or high-dose Ang IV group, respectively. Compared with the no treatment group, medium-dose Ang IV treatment markedly reduced macrophage infiltration; levels of proinflammatory cytokines, including monocyte chemoattractant protein 1, interleukin 6, and intercellular adhesion molecule 1; the expression and activity of metalloproteinases 2 and 9; but increased smooth ...
January 20, 2016-Online in the Journal of Vascular Surgery (JVS), Diogo Silveira, MD, et al published findings for the late 3-year performance of total endovascular treatment of juxtarenal aortic aneurysms in octogenarians using the chimney/snorkel technique.. Between January 2009 and December 2014, endovascular aortic aneurysm repair was performed using the chimney/snorkel technique at one center in 35 high-risk octogenarian patients with juxtarenal aortic aneurysms who were unfit for open repair. Twenty-five patients (71.4%) were asymptomatic, and 10 patients were treated in an urgent care setting. The median follow-up was 36 months (range, 1-69 months). The primary endpoint was the survival rate.. As summarized in JVS, the investigators reported that the technical success rate was 100%. A single chimney graft placement was performed in 22 patients (62.9%), double chimneys were performed in 10 patients (28.6%), and triple chimneys were performed in three (8.5%) patients. Overall, 51 ...
To present the combined 14-year experience of 2 university centers performing endovascular aneurysm repair (EVAR) on 100% of noninfected ruptured abdominal aortic aneurysms (RAAA) over the last 32 months. Endovascular aneurysm repair for RAAA f
Introduction. Collagen is the most abundant protein in mammals and gives mechanical strength, stiffness and toughness to biological tissues like skin, tendon, bone, and vasculature [1]. Collagen fibrils of about 0.1 micrometers in diameters are the basic building blocks of fibrous collagenous tissues and their organization into suprafibrilar structures determines the tissues macroscopic mechanical properties. For example, detailed data regarding the organization of strong bundles of collagen might be critical to predict the onset of tissue failure, as it is clinically motivated by a rupture risk assessment of Abdominal Aortic Aneurysm (AAA). Previously proposed structural constitutive models for soft biological tissues [2, 3] integrated information regarding the collagen orientation, and regardless of their popularity, the requested microstructural information is not yet available in the open literature.. Method and Materials. The present study investigated the collagen formation in 12 AAA wall ...
Introduction. Collagen is the most abundant protein in mammals and gives mechanical strength, stiffness and toughness to biological tissues like skin, tendon, bone, and vasculature [1]. Collagen fibrils of about 0.1 micrometers in diameters are the basic building blocks of fibrous collagenous tissues and their organization into suprafibrilar structures determines the tissues macroscopic mechanical properties. For example, detailed data regarding the organization of strong bundles of collagen might be critical to predict the onset of tissue failure, as it is clinically motivated by a rupture risk assessment of Abdominal Aortic Aneurysm (AAA). Previously proposed structural constitutive models for soft biological tissues [2, 3] integrated information regarding the collagen orientation, and regardless of their popularity, the requested microstructural information is not yet available in the open literature.. Method and Materials. The present study investigated the collagen formation in 12 AAA wall ...
SCVS 2018 Abstracts: Statin Therapy is Associated with Higher Long-term, but not Perioperative Survival after Abdominal Aortic Aneurysm Repair
Learn more about Abdominal Aortic Aneurysm Repair at Sky Ridge Medical Center DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall Your Doctorrevision ...
Abdomen Aortic Aneurysm AAA Endovascular repair in Bangkok Thailand. Abdominal aortic aneurysm may not be noticeable, but deadly illness that is waiting to burst. We are fortuned to be living in a time where advanced medical technology and medical expertise can reduce the risk of death. Statistics have shown that 50 - 90% of patients overcome the disease. Our expert vascular surgeon shared with us his experience the treatment of abdominal aortic aneurysm. The aorta sends blood to each organ in the body, driven by the heart. Blood is supplied through the pulmonary artery, to the abdomen where the main artery splits into two just below the belly to supply the legs and pelvis. If there is any damage in this part of the blood vessel, the blood will seep out and will not be able to reach any other organ in the body, resulting in death. Abdominal aortic aneurysm is a condition where the blood vessel dilates to more than 1.5 - 2 cm in diameter. The cause is unclear; risk factors are smoking, ...
BACKGROUND: Open abdomen treatment (OAT) is considered a lifesaving procedure in patients with abdominal compartment syndrome (ACS) after endovascular or open intervention for ruptured abdominal aortic aneurysms (RAAA). Standardized treatment methods and algorithms for its use are still lacking. The high, published mortality rates may reflect difficulties in detecting and treating ACS, especially in patients treated by emergency endovascular aneurysm repair (eEVAR). Presented are standardized algorithms for OAT, including a new technique using the vacuum-assisted closure (VAC) system developed during 10 years of experience with eEVAR for RAAA. METHODS: We retrospectively analyzed 102 patients with RAAA treated by eEVAR from January 1998 to April 2008. Abdominal decompression was done when intravesical pressure ,20 mm Hg or when abdominal perfusion pressure was ,50 to 60 mm Hg and concomitant organ deterioration occurred. OAT was initially done with a subcutaneously sutured plastic bag or with a ...
An aneurysm occurs when a blood vessel becomes abnormally large or balloons outward. The abdominal aorta is a large blood vessel that supplies blood to your abdomen, the pelvis, and legs. When a weak area of the abdominal aorta grows, it is called an abdominal aortic aneurysm (AAA). AAA can develop in anyone, but it is primarily seen in men over 60 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture which can cause massive internal bleeding and can be fatal. When diagnosed early, abdominal aortic aneurysms can be treated, or even cured, with highly effective and safe treatments ...
Objective To assess the incidence and risk factors for proximal aneurysm neck related complications with a late generation device for endovascular abdominal aneurysm repair (EVAR). Methods Data were retrieved from a prospective registry (Endurant Stent Graft Natural Selection Global Postmarket Registry) involving 79 institutions worldwide. The risk factors tested were ... read more age, gender, surgical risk profile, proximal neck length (30 mm), supra- and infrarenal angulation (,60° and 75°), mural thrombus/calcification (,50%) and taper (,10%), and AAA diameter (,65 mm). Two neck related composite endpoints were used, for intra-operative (type-1a endoleak, conversion, deployment/retrieval complication or unintentional renal coverage) and post-operative (type-1a endoleak or migration) adverse events. Independent risk factors were identified using multivariable backwards modeling. Results The study included 1263 patients (mean age 73, 10.3% female) from March 2009 to May 2011. Twenty three ...
Remote ischaemic preconditioning may confer the cytoprotection in critical organs. We hypothesized that limb remote ischemic preconditioning (RIPC) would reduce intestinal and pulmonary injury in patients undergoing open infrarenal abdominal aortic aneurysm (AAA) repair.The primary outcomes included the biomarkers reflecting intestinal injury (serum intestinal fatty acid binding protein, endotoxin levels and diamine oxidase activity) and the variables reflecting pulmonary injury (arterial-alveolar oxygen tension ratio, alveolar-arterial oxygen tension difference and respiratory index). In addition, the severity of intestinal and pulmonary injury was assessed with different scoring methods, respectively. Markers of oxidative stress and systemic inflammation were measured as well ...
Approach and Results-We report that administration of deoxycorticosterone acetate (DOCA) and salt or aldosterone and salt, but not DOCA or salt alone, to C57BL/6 male mice induced abdominal and thoracic aortic aneurysm formation and rupture in an age-dependent manner. DOCA and salt- or aldosterone and salt-induced aortic aneurysm mimicked human aortic aneurysm with respect to elastin degradation, inflammatory cell infiltration, smooth muscle cell degeneration and apoptosis, and oxidative stress. Aortic aneurysm formation did not correlate with the increase in blood pressure induced by DOCA and salt. Systemic administration of the angiotensin-converting enzyme inhibitor, enalapril, or angiotensin type 1 receptor antagonist, losartan, did not affect DOCA and salt-induced aortic aneurysm. In contrast, the mineralocorticoid receptor antagonists, spironolactone or eplerenone, significantly attenuated DOCA and salt- or aldosterone and salt-induced aortic aneurysm.. ...
An abdominal aortic aneurysm (AAA) is when the lower part of the aorta becomes enlarged, like a balloon. The aorta is the largest artery in the body. It carries blood from the heart down along the backbone where it splits into many smaller arteries that bring blood to all of the organs. Aneurysm is a general term that describes an enlargement of any blood vessel in the body. Aneurysms usually develop slowly over time and may not cause problems until they become so enlarged that they can rupture.. Smaller AAAs generally do not cause symptoms. Larger AAAs can cause symptoms such as a pulsating feeling near the belly button, deep and constant abdominal pain, or back pain. Rupture of an aortic aneurysm is a medical emergency. If an aortic aneurysm ruptures, symptoms include vomiting, intense pain, excessive sweating, a drop in blood pressure, fainting, and shortness of breath.. AAAs can be caused by stiffening of the artery walls due to plaque build up (atherosclerosis), infection of the aorta, or ...
Alternative treatments for abdominal aortic aneurysm - Are there effective natural treatments for abdominal aortic aneurysm? No. Basically, trying to prevent the AAA from rupturing or leaking. This can be done with surgery (open vs. Placed via blood vessel) or with medical management and follow-up. The most "natural" thing is to do nothing, but this has a much higher death rate than surgical repair or blood pressure control with meds. Avoiding stress, tobacco, etc. May help keep BP down when used in conjunction with meds.
Endothelial dysfunction is observed in patients with abdominal aortic aneurysm (AAA), who have increased risk of cardiovascular events and mortality. This study aimed to assess the acute effects of moderate and higher-intensity exercise on endothelial function, as assessed by flow-mediated-dilation (FMD), in AAA patients (n=22; 74±6 y) and healthy adults (n=22; 72±5y). Participants undertook three randomised visits, including moderate-intensity continuous exercise (40% peak power output, PPO), higher-intensity interval exercise (70% PPO), and a no-exercise control. Brachial artery FMD was assessed at baseline, 10- and 60-min after each condition. Baseline FMD was lower in AAA patients compared to healthy adults [by 1.10%, (95% CI, 0.72 to 1.81), P=0.044]. There were no group differences in the FMD responses after each condition (P=0.397). FMD did not change after the control condition, but increased by 1.21% (95% CI, 0.69 to 1.73, P|0.001) 10 min after moderate-intensity continuous exercise in both
Hey, guys and gals, another thing you need to be vigilant for is an abdominal aortic aneurysm. Though anyone can get them, they seem to be more prevalent in men than women and are a leading cause of death in older men. An abdominal aortic aneurysm, or AAA, is a weak spot in an artery wall in the stomach and can be hereditary and is also more common in smokers. You can and should get a screening to make sure youre not going to have one of these. Should something be found, modern medicine has a much easier way of treating it now than in the past. Nowadays, this can be repaired under local anesthetic (if you have the stomach for it!) and only takes about five days for recovery. ...
European Heart Journal - Cardiovascular Imaging (2012) 13, 574-578 doi:10.1093/ejechocard/jer260 Screening for abdominal aortic aneurysm in coronary care unit patients with acute myocardial infarction using portable transthoracic echocardiography 1 Cardiology Department, AP-HP, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France; 2INSERM U698, Paris, France; and 3University Paris 7, Paris, France Received 30 August 2011; accepted after revision 31 October 2011; online publish-ahead-of-print 29 November 2011 Aims Patients with acute myocardial infarction (AMI) represent a high-risk population in which screening for abdominal aortic aneurysm (AAA) is recommended but only occasionally performed. Transthoracic echocardiography (TTE) may offer the unique opportunity to evaluate the cardiac function and to screen for AAA during the same examination. We aimed to evaluate the feasibility of AAA screening at bedside using a portable cardiac ultrasound (US) echo machine and to determine the ...
Typically contrast images are not necessary in the case of an acute abdominal aortic aneurysm rupture. This was acquired and shows a very dramatic rupture with a huge amount of active contrast extravasation in keeping with acute haemorrhage.
To provide the most rigorous possible test of the utility of screening, we designed the trial as a population based study with the primary end point, mortality from abdominal aortic aneurysm, to be analysed on an intention to treat basis. We planned to have 90% power to detect and declare significant (two sided α = 0.05) a relative reduction of 50% in mortality among men invited for screening over five years from the start of screening. Using available pilot data, we estimated that the control group would need to contain about 20 000 men to experience 55 deaths from abdominal aortic aneurysm.3. Men were identified from an electronic copy of the electoral roll, enrolment to vote being compulsory for all Australian adults. The ideal target age range for screening is 65-74 years, but the electoral roll listed fewer than 40 000 men in this age group in the main metropolitan area of Perth (the capital city of Western Australia) and satellite towns. The addition of men aged 75-79 years increased the ...
Abdominal Aortic Aneurism is a condition when large blood vessels responsible for supplying blood to the abdomen, legs and pelvis become unusually large or inflates in an outward direction. Aneurism has been particularly categorized into three groups, viz. genetically inherited diseases, enzyme destruction, and lifestyle-influenced conditions.The risk factors of an abdominal aortic aneurism include smoking, obesity, high cholesterol, high blood pressure, emphysema and genetic factors. It generally develops in males over the age of 60 experiencing any of these risk factors. The symptoms mostly include severe abdomen or back pain, nausea, vomiting, clammy skin, rapid heart rate and shock.. ...
Title: MedicineNet Abdominal Aortic Aneurysm Specialty, Description: MedicineNet Abdominal Aortic Aneurysm Specialty, By: Feedage Forager, ID: 330969, Grade: 91, Type: RSS20
Elective EVAR using the Cook Zenith endograft provides excellent results through a mean follow-up of |5 years. There is a low aneurysm-related mortality and an acceptable rate of postoperative complications and reinterventions. The occurrence of late complications throughout the follow-up period …
Approach and Results-AAA was induced in low-density lipoprotein receptor-null (Ldlr-/-) mice by infusing angiotensin II. Nox2 expression was elevated in the abdominal aortae of these mice during infusion of angiotensin II, with enhanced Nox2 expression mainly because of the recruitment of NOX2-enriched macrophages into AAA lesions. Unexpectedly, systemic Nox2 deficiency promoted AAA development but reduced the level of reactive oxygen species in AAA lesions. Nox2 deficiency stimulated macrophage conversion toward the M1 subset, enhancing expression of interleukin (IL)-1β and matrix metalloproteinase-9/12 mRNA. Administration of neutralizing antibody against IL-1β abolished AAA development in Nox2-deficient mice. Bone marrow transplantation experiments revealed that AAA aggravation by Nox2 deficiency is because of bone marrow-derived cells. Isolated bone marrow-derived macrophages from Nox2-null mice could not generate reactive oxygen species. In contrast, IL-1β expression in peritoneal and ...
Highlighted review Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair available now ...
TWENTY YEARS LATER WE REMEMBER DECEMBER 3RD, 1999, AS THE LAUNCH OF THE NEW ERA OF ENDOVASCULAR ANEURYSM REPAIR IN EAST TENNESSEE. Open surgical repair was the standard method of aneurysm repair for five decades. Dr. Juan Parodi, Dr. Julio Palmaz and Dr. Nicholas Volodos are recognized as pioneers of endovascular aneurysm repair. Dr. Parodi […]. Read More » Tags: AAA repair, abdominal aortic aneurysm, Dr. George Pliagas, Premier Surgical Associates, Premier Surgical Associates of Knoxville, surgery in Knoxville, surgery in Tennessee, vascular surgeon. ...
RADIOLOGY: AORTA: Case# 27: LEAKING ABDOMINAL AORTIC ANEURYSM. 84-year-old male with a known abdominal aortic aneurysm who presents with severe abdominal pain. There is a very large abdominal aortic aneurysm which begins between the origin of the superior mesenteric artery and the renal artery and extends into the aortic bifurcation to involve the right common iliac artery. At its greatest dimensions, it measures 15.0 cm x 10.0 cm and contains a large amount of intramural thrombus. The aortic aneurysm is eccentric in location, residing more in the right side of the retroperitoneum. There is a moderate amount of hemorrhage within the right side of the retroperitoneum surrounding the aneurysm consistent with subacute hemorrhage. No active arterial extravasation is identified at this time. Abdominal aortic aneurysms usually occur in the setting of atherosclerotic disease but may be caused by syphilis, by extension of a dissection from above, or by connective tissue disorders such as Takayasus arteritis
RADIOLOGY: AORTA: Case# 27: LEAKING ABDOMINAL AORTIC ANEURYSM. 84-year-old male with a known abdominal aortic aneurysm who presents with severe abdominal pain. There is a very large abdominal aortic aneurysm which begins between the origin of the superior mesenteric artery and the renal artery and extends into the aortic bifurcation to involve the right common iliac artery. At its greatest dimensions, it measures 15.0 cm x 10.0 cm and contains a large amount of intramural thrombus. The aortic aneurysm is eccentric in location, residing more in the right side of the retroperitoneum. There is a moderate amount of hemorrhage within the right side of the retroperitoneum surrounding the aneurysm consistent with subacute hemorrhage. No active arterial extravasation is identified at this time. Abdominal aortic aneurysms usually occur in the setting of atherosclerotic disease but may be caused by syphilis, by extension of a dissection from above, or by connective tissue disorders such as Takayasus ...
Introduction Prevalence of abdominal aortic aneurysm is 2-6%. Aneurysm is on the leading possitions in death cause. Lot of patients die do to ruptured aneurysm. The etiology of abdominal aortic aneurysm remains unknown. Current treatment(resection or endovascular)is not indicated for everyone. We don´t know the right conservative (pharmacological) treatment. Aims With our study, we would like to confirm the impact of atorvastatin on experimental abdominal aortic aneurysm. We would like to evaluate and quantified changes in the composition of an aneurysmatic wall under the effect of atorvastatin. Other aim is to make a summary of known knowledge of this disorder. These knowledges can help in searching for new treatment options. Methods Comparison of 2 groups of pigs with experimental abdominal aortic aneurysm. Group treated with atorvastatin and group without any pharmacological influencing. Comparing of aneurysmal growth rate. Evaluation of changes of the wall structure in both groups using a ...
Epidemiologic research has shown a correlation between cigarette smoke and the risk of developing atherosclerosis and associated pathological processes including abdominal aortic aneurysms (AAA). Hyperlipidemia and hypertension are additional risk factors for atherosclerosis. The hyperlipideamic apolipoprotein e-knockout (ApoE-/-) mouse is a well-established animal model system for studying the mechanisms of the atherosclerotic process. In this study, we examined the mechanistic effects occurring as three risk factors interact in the atherosclerotic process. Hypertension was induced in hyperlipidemic apolipoprotein-e-knockout (ApoE-/-) mice by application of angiotensin-II and the mice were exposed to mainstream smoke from the reference cigarette 2R4F (University of Kentucky) for 30 days. AAA formation was seen only in angiotensin-ii treated ApoE-/--mice. The incidence and severity of AAA were further increased by smoke exposure. Expression of matrix metalloproteinases-(MMP)-2, -3, -8, -9, and ...
Abdominal Aortic Aneurysm (AAA) Screening is now available in MPHC The 4th Practice in conjuction with Affidea. What is an AAA?. The aorta is the main vessel carrying blood around your body. In some people, especially older men, the wall of the aorta gradually weakens and starts to expand. See diagrammatic illustration below.. Is an AAA serious?. Large AAA are rare, but can be very serious. As the aorta expands it can burst, and the person usually dies. Small/medium sized AAA are not as dangerous, and your consultant vascular surgeon will arrange ultrasound monitoring to see if it gets bigger.. Is Screening for AAA important, and why are you invited?. Most people with AAA have no symptoms. A simple painless ultrasound scan of your tummy will tell if you have an AAA. We are inviting men only, as AAA are six times more common in men than women. Ruptured AAA mostly happens to men. You also are more likely to have an AAA if you you smoke, have high blood pressure or your parent, brother or sister ...
The Relationship between Patent Vessels that Arise from the Aneurysmal Sac and Early Endoleak Purpose: To determine the association of patent sac branch vessels (lumbar and inferior mesenteric arteries [IMAs]) with early endoleak rate after stent-graft repair of abdominal aortic aneurysm (AAA). Materials And Methods: Pre- and postoperative computed tomographic (CT) angiograms in 158 patients…
Abdominal aortic aneurysm (AAA) repair is done to treat an aneurysm. An aneurysm is a bulging, weak spot in the aorta that may be at risk for rupturing. In this case, the aneurysm is in part of the aorta that is in the abdomen.
Abdominal aortic aneurysm (AAA) repair is done to treat an aneurysm. An aneurysm is a bulging, weak spot in the aorta that may be at risk for rupturing. In this case, the aneurysm is in part of the aorta that is in the abdomen.
An abdominal aortic aneurysm (AAA) is a bulge formed in the large blood vessels that supply blood to the abdomen, pelvis, and legs. A fluid structure interaction model was developed in a 3D aortic aneurysm model, which was constructed from abdominal CT scan images. Combining medical imaging and computational fluid dynamics (CFD) in a time dependent study allowed the determination of wall stress, deformation, and fluid flow dynamic over a period of time. The model estimated the time to rupture based on the effects of hypertensive blood pressure and degradation of the diseased aortic wall mechanical properties.. ...
Coronary artery disease (CAD) was evaluated by noninvasive examination in abdominal aortic aneurysm (AAA) patients. A simultaneous operation or a 2-staged operation was performed depending on the seriousness of the condition when both diseases were combined. A total of 36 patients underwent elective repair of AAA between 1996 and 2001. Coronary angiography (CAG) was performed only in patients with suspected CAD by dipyridamole myocardial scintigraphy. Significant CAD was found in 8 patients. Simultaneous operation was performed in 4 patients, and off-pump coronary artery bypass grafting (OPCAB) was performed in all cases of simultaneous operation. In 4 patients receiving 2-staged operations, 1 standard coronary artery bypass grafting (CABG), 1 OPCAB and 2 percutaneous transluminal coronary angioplasties (PTCA) were performed prior to AAA surgery. Twenty-eight patients underwent only AAA operation. Though there were no incidents of perioperative myocardial infarction or cardiac related deaths in ...
Background Research: The definition of an aneurysm is permanent, localised dilatation of a blood vessel or heart chamber. The abdominal aorta is the largest blood vessel in the human body and usually has a diameter of 1.8 -2.0 centimetres (cm), dependant on age, sex and body habitus. Aortic dilatation is generally classed as an aneurysm when dilation of the vessel is 1.5 times the normal size. An abdominal aortic aneurysm (AAA) affects any part of the aorta below the diaphragm with 80 % typically being found between the renal artery and aortic bifurcation. Risk Factors There are many factors that relate to the development of AAA. Gender is one of the biggest non-modifiable risk factors, as an AAA is four to six times more likely in males compared with females. Furthermore, the development of AAA in females occurs approximately ten years later than males. The risk of AAA also increases if there is family history of the disease, especially if the relative is first degree. There is also ...
Abdominal aortic aneurysm (AAA) rupture represents a major cardiovascular risk, combining complex vascular mechanisms weakening the abdominal artery wall coupled with hemodynamic forces exerted on the arterial wall. At present, a reliable method to predict AAA rupture is not available. Recent studies have introduced fluid structure interaction (FSI) simulations using isotropic wall properties to map regions of stress concentrations developing in the aneurismal wall as a much better alternative to the current clinical criterion, which is based on the AAA diameter alone. A new anisotropic material model of AAA that closely matches observed biomechanical AAA material properties was applied to FSI simulations of patient-specific AAA geometries in order to develop a more reliable predictor for its risk of rupture. Each patient-specific geometry was studied with and without an intraluminal thrombus (ILT) using two material models-the more commonly used isotropic material model and an anisotropic ...
The US Preventative Services Task Force (USPSTF)have recommended that men aged 65 to 75 who have ever smoked should get an ultrasound to screen for Abdominal Aortic Aneurysm (AAA).. Why is screening important? Most AAAs are "silent" until they rupture and AAA ruptures are often fatal.. The Mayo Clinic defines an AAA as "An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the bodys main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding". Screening for an AAA is an easy procedure - its simply an ultrasound of your abdomen, concentrating on the aorta. Canada Diagnostic Centres has been providing AAA screening since 2007 and patients often combine this screening test with our other screening exams for early detection of disease.. What ...
Stent graft devices for the treatment of abdominal aortic aneurysms (AAAs) are being in-creasingly used worldwide. Yet, during modelling and optimization of these devices, as well as in clinical practice, vascular sections are idealized, possibly compromising the effective-ness of the intervention. In this study, we challenge the commonly used approximation of the circular cross-section of the aorta and identify the implications of this approximation to the mechanical assessment of stent grafts. Using computed tomography angiography (CTA) data from 258 AAA patients, the lumen of the aneurysmal neck was analysed. The cross-section of the aortic neck was found to be an independent variable, uncorrelated to other geometrical aspects of the region, and its shape was non-circular reaching elliptical ratios as low as 0.77. These results were used to design a finite element analysis (FEA) study for the assessment of a ring stent bundle deployed under a variety of aortic cross-sections. Re-sults showed ...
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An endovascular stent graft is placed inside the abdominal aortic aneurysm to help prevent rupture. Medtronic is a leading developer of endovascular stent grafts.
Primary among the mechanical factors linked with abdominal aortic aneurysm (AAA) rupture is peak wall stress, frequently quantified as either the maximum principal or Von Mises stress exerted along the diseased arterial wall. Intraluminal pressure, as an impinging normal force on the wall, has been hypothesized as the dominant influence on this stress and thus the majority of numerical modeling studies of AAA mechanics have focused on static computational solid stress (CSS) predictions [1,2]. Unfortunately, retrospective studies comparing the magnitude of wall stress with the failure strength of the aneurysmal wall have yet to consistently predict the outcome for patient-specific AAAs [3,4]. Previous studies have shown that hemodynamics also plays a significant role in both the biological and mechanical factors that exist within AAAs. In the present investigation, partially and fully coupled fluid-structure interaction (p-FSI and f-FSI, respectively) computations of patient-specific AAA models ...
Many asymptomatic patients with a small abdominal aortic aneurysm (AAA) are diagnosed incidentally during routine abdominal screening. However, there is no effective treatment option for small AAA despite their gradual expansion. Angiotensin II is thought to induce and perpetuate inflammation in the aortic wall, and previous studies reported the inhibitory effects of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in experimental studies. However, there is no evidence for a beneficial effect of these medicines on AAA progression in clinical trials. Therefore, we focused on direct renin inhibition, because inhibition of multiple steps of the renin-angiotensin system might be required for treating AAA. The present study reported the inhibitory effect of direct renin inhibition on experimental AAA expansion associated with a significant reduction of excess renin-angiotensin system activation in the aneurysm wall. In addition, significant inhibition of activation of ...
TY - JOUR. T1 - Operative and Midterm Outcomes of the Fenestrated Anaconda Stent-Graft in the Endovascular Treatment of Juxtarenal, Suprarenal, and Type IV Thoracoabdominal Aortic Aneurysms. AU - Kotelis, Drosos. AU - Schleimer, Karina. AU - Foldenauer, Christina. AU - Jalaie, Houman. AU - Grommes, Jochen. AU - Jacobs, Michael J.. AU - Kalder, Johannes. PY - 2016/12. Y1 - 2016/12. KW - abdominal aortic aneurysm. KW - endoleak. KW - endovascular aneurysm repair. KW - fenestrated stent-graft. KW - juxtarenal aneurysm. KW - mortality. KW - reintervention. KW - suprarenal aneurysm. KW - thoracoabdominal aortic aneurysm. U2 - 10.1177/1526602816667281. DO - 10.1177/1526602816667281. M3 - Article. VL - 23. SP - 930. EP - 935. JO - Journal of Endovascular Therapy. JF - Journal of Endovascular Therapy. SN - 1526-6028. IS - 6. ER - ...
SCVS 2018 Abstracts: Impact of Secondary Interventions on Mortality after Fenestrated Branched Endovascular Aortic Aneurysm Repair
Learn more about Endovascular Repair of Abdominal Aortic Aneurysm at Medical City Dallas DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall ...
Several studies have demonstrated that AngII infusion leads to the formation of AAAs in mice.12,13,50 AngII exerts its diverse bioactive effects primarily by activating the AT1a receptor in mice, which plays a critical role in AngII-induced AAA development.17 In addition to mediating traditional G-protein-dependent signaling, the AT1a receptor is involved in G-protein-independent signaling by forming a complex with the multifunctional scaffolding protein βarr2.19,24 In the present study, we investigated a role for βarr2 in AngII-induced AAA formation and found that βarr2 deficiency significantly attenuates AAA formation in mice both on a hyperlipidemic apoE background and on a normolipidemic C57BL/6 background (Figure 1). These studies suggest that G-protein-independent, βarr2-dependent signaling for the AT1a receptor plays a major role in AngII-induced AAA formation.. Although our present studies showed that βarr2 deficiency attenuated AngII-induced AAA formation in mice on the ...
Desgranges P, Kobeiter H, Katsahian S, et al. Editors choice - ECAR (endovasculaire ou chirurgie dans les anévrysmes aorto-iliaques rompus): a French randomized controlled trial of endovascular versus open surgical repair of ruptured aorto-iliac aneurysms. Eur J Vasc Endovasc Surg. 2015;50(3):303-310. PMID: 26001320 www.ncbi.nlm.nih.gov/pubmed/26001320.. Holt PJE, Thompson MM. Abdominal aortic aneurysms: evaluation and decision making. In: Cronenwett JL, Johnston KW, eds. Rutherfords Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 130.. Lal BK, Zhou W, Li Z, et al. Predictors and outcomes of endoleaks in the veterans affairs open versus endovascular repair (OVER) trial of abdominal aortic aneurysms. J Vasc Surg. 2015;62(6):1394-1404. PMID: 26598115 www.ncbi.nlm.nih.gov/pubmed/26598115.. Tracci MC, Cherry KJ. The aorta. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 61. ...
1. Marshall G. Screening for abdominal aortic aneurysm - does it fulfill the criteria for mass screening? Radiography. 1996; 2:3-9. http://dx.doi.org/10.1016/S1078-8174(96)90029-2.. 2. Scott R, Vardulaki K, Walker N, Day N, Duffy S, Ashton H. The long-term benefits of a single scan for abdominal aortic aneurysm (AAA) at age 65. Eur J Vasc Endovasc. 2001; 21:535-40. http://dx.doi.org/10.1053/ejvs.2001.1368.. 3. Scott R, Bridgewater S, Ashton H. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Brit J Surg. 2002; 89:283-5. http://dx.doi.org/10.1046/j.0007-1323.2001.02014.x.. 4. Heronm M, Hoyert D, Murphy S, Xu J, Kochanek K,Tejada-Vera B. Deaths: final data for 2006. Natl Vital Stat Rep. 2009; 57(14):34-86. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. 5. Bown M, Sutton A, Bell P, Sayers R. A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Brit J Surg. 2002; 89:714-30. http://dx.doi.org/10.1046/j.1365-2168.2002.02122.x.. 6. UK Small ...
Some abdominal aortic aneurysms can be repaired using endovascular stent grafting. Medtronic AneuRx AAAdvantage and Talent Abdominal Stent Grafts are used for this procedure.
A role of ACE I/D polymorphism in the pathogenesis of abdominal aortic aneurysm (AAA) has been demonstrated, possibly due to the effect of angiotensin II on vascular tissue remodelling. Angiotensin II exerts profibrogenic effects through the local induction of TGF-. Dysregulated TGF- signalling may result from mutations in TGFBR1 and TGFBR2 genes, thus resulting in degenerative changes in the vessel wall. We performed a case-control study in order to investigate the role of TGFBR1 9A6A polymorphism as predisposing factor to AAA per se, and in the presence of ACE DD and AT1R 1166 CC genotypes in 201 AAA patients (mean age ± S.D., 71.5 ± 6.9) referred to the Unit of Vascular Surgery of the University of Florence, compared with 252 healthy controls (mean age ± S.D., 70.6 ± 8.6). A significant difference in genotype distribution and allele frequency between patients and controls was found for ACE, but not for AT1R and TGFBR1 polymorphisms. At univariate analysis a significant association between ...
Even though multiple etiological, genetic, and environmental factors contributing to AAA have been identified in the past decade, the mechanisms leading to terminal aorta weakening and ultimate rupture are still incompletely understood. Gene expression array analyses provide a comprehensive, global view of disease‐related genes, as well as of activated or inactivated pathways.. There have been a few earlier investigations with different study designs using gene expression array analyses from AAA patients,20, 21, 22, 23, 24, 25 but this is the first study using whole genome microarrays to compare relative mRNA expression patterns between stable and ruptured AAAs in order to identify processes associated with AAA progression and rupture. With our approach we were able to identified and validate 2 gene sets. The first gene set relates to AAA growth and rupture (terminal progression-associated genes). A second set of 5 candidate genes (STC1, ADAMTS9, GFPT2, GAL3ST4, and CCL4L1) showed no ...
April 1, 2009 - Endovascular aortic repair (EVAR) used to repair ruptured abdominal aortic aneurysms (RAAAs) had a significant mortality benefit, according to five-year study published in the April issue of the Journal of Vascular Surgery.. The study, conducted by researchers from the University of Massachusetts Memorial Medical Centers division of vascular and endovascular surgery in Worcester, examined the national frequency, predictors, outcomes, and the effect of institutional volume metrics in cases where endovascular aortic repair (EVAR) was used to repair ruptured abdominal aortic aneurysms (RAAAs) between 2001 and 2006.. Over the years EVAR has gained wide acceptance for the elective treatment of abdominal aortic aneurysms (AAA). This success has led to increased interest in similar treatment of RAAAs, because most patients who suffer a RAAA do not survive long enough to obtain medical care. The mortality rate for patients who do survive and undergo traditional open surgical repair ...
Most aortic aneurysms occur in the part of your aorta thats in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number
Is the rupture rate falling? Janet Powell, London,UK, told delegates that the rate and volume of aneurysm rupture is declining. She made the point that smoking prevalence had decreased, and use of lipid-lowering and antihypertensive drugs had increased in those who were 65+ years. "The small aneurysm rupture rate is decreasing and deaths from (and hospital admissions for) large ruptured aneurysm are decreasing. Since selection for repair and its mortality are unchanged, have cardiovascular risk prevention programmes pre-empted national aneurysm screening programmes?" she asked. Martin Bjorck, Uppsala, Sweden, told delegates that an aneurysm screening programme should include a smoking cessation programme, promotion of exercise and healthy diet and statin treatment prior to surgery. There should also be hypertension treatment, according to standard of care, he said. "As we all know, screening elderly men for abdominal aortic aneurysm, and repair of those who have or later develop large aneurysms, ...
Degradation of the elastic media is a hallmark of abdominal aortic aneurysms (AAAs). We examined the expression of 2 elastolytic matrix metalloproteinases (MMPs), MMP-2 and MMP-9, in AAA aortic tissues compared with those from atherosclerotic occlusive disease (AOD) and nondiseased control tissues. Quantitative competitive reverse transcription-polymerase chain reaction and gelatin zymography showed increased MMP-9 mRNA and protein in both AAA and AOD tissues compared with those in control tissue, but there was no significant difference between AAA and AOD. In contrast, MMP-2 mRNA and protein levels were significantly higher in AAA than in AOD or control tissues. Sequential extraction of the MMPs from the aortic tissue with a physiological salt solution, 2% dimethylsulfoxide (DMSO), and 10 mol/L urea showed that large amounts of MMP-2 and MMP-9 were bound to the matrix. The most conspicuous finding was that the levels of MMP-2 were significantly elevated in the DMSO fraction in AAA tissues compared with
Abdominal aortic aneurysm (AAA) is an inflammatory disease associated with macrophage accumulation in the adventitia, oxidative stress, medial elastin degradation and aortic dilation. Progression of AAA is linked to increased risk of rupture, which carries a high mortality rate. Drug therapies trialled to date lack efficacy and although aneurysm repair is available for patients with large aneurysm, peri-surgical morbidity and mortality have been widely reported. Recent studies using rodent models of AAA suggest that long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs) and their metabolites can moderate inflammation and oxidative stress perpetuated by infiltrating macrophages and intervene in the destruction of medial elastin. This review examines evidence from these animal studies and related reports of inhibition of inflammation and arrest of aneurysm development following prophylactic supplementation with LC n-3 PUFAs. The efficacy of LC n-3 PUFAs for management of existing aneurysm is
BACKGROUND: The aim of this study was to investigate trends in population-based mortality, hospital admission and case fatality rates for abdominal aortic aneurysm (AAA) from 1979 to 1999. METHODS: This was an analysis of routine statistics from 79 495 death certificates in England and Wales and 3217 hospital inpatient admissions in the Oxford Region. RESULTS: Mortality rates for all AAAs increased between 1979 and 1999 from 13 to 25 per million in women and from 80 to 115 per million in men. Admission rates increased in the same time interval from three to 22 admissions per million per year in women, and from 52 to 149 per million per year in men. Case fatality rates for all non-ruptured AAAs that were operated on decreased from 25.8 to 9.0 per cent and for all ruptured AAAs from 69.9 to 54.4 per cent. CONCLUSION: Mortality rates and hospital admission rates for AAA rose in men and even more so in women between 1979 and 1999. Perioperative mortality for ruptured AAA declined a little during the study
Cinà CS, Devereaux PJ. Endovascular and open repair did not differ for mortality rates at 2 years in abdominal aortic aneurysm. ACP J Club. 2005;143:64. doi: 10.7326/ACPJC-2005-143-3-064. Download citation file:. ...
This study was designed to evaluate the optimal surgical treatment strategy for abdominal aortic aneurysm (AAA) coexisting with coronary artery disease (CAD). Twenty-six patients (21 men and 5 women with a mean age of 72.6 }3.7years old) who required surgical treatment of both conditions were examined. Eleven patients underwent a one-stage operation. Four of them had on-pump CABG and 7, including 3 high-risk-patients, underwent off-pump CABG. There were no operative mortalities, but 3 patients had severe morbidity (respiratory failure, acute renal failure, pneumonia). Fifteen patients underwent a two-stage operation. None of them had rupture of the AAA during the interval between the two operations, but 2 patients with large AAA (more than 6cm in diameter) required emergency operation due to impending rupture of the AAA. There was no operative mortality, but one patient suffered acute renal failure. One-stage operation for low-risk patients seems to be a safe and reasonable strategy. One-stage ...
Although we successfully excluded aneurysmal segments immediately in all cases in which the homemade device functioned appropriately, our experience should be qualified. We used a model of AAA in healthy, nonatherosclerotic swine. Even after balloon overstretch injury, the course of the infrarenal aorta remained essentially unchanged. This and more complicated surgical models cannot represent the complex 3D anatomy and tortuosity encountered clinically in degenerative arterial segments in patients with AAA, in whom the expected benefits of detailed soft tissue contrast and 3D representation by MRI may be more dramatic. In particular, safe traversal of tortuous iliac artery segments, one of the procedural challenges of AAA endografting, might be simplified by using rtMRI to visualize device-related anatomic distortion and to guide operator adjustments. Furthermore, we used a simple tubular endograft, although most clinical devices are bifurcated to cover the aorta and both iliac limbs.. Our ...
Abdominal aortic aneurysm (AAA) is a common disease for which mechanisms of formation are still not well understood. Despite a strong genetic component to AAA risk, specific risk alleles are still largely unidentified. AAA is also a localized disease with a majority occurring in the infrarenal abdominal aorta and is six times more common than aneurysms of the thoracic aorta. To determine whether risk alleles are present in functional positional candidate genes. we: 1. performed a genetic association study using DNA from AAA cases and controls in ten candidate genes and 2. performed exon sequencing on three genes with evidence of nominal association. To identify genes with regional expression in the aorta of potential relevance to AAA: 1. Illumina microarrays were used to perform a gene expression profiling of entire baboon aortas and 2. protein expression of one candidate gene, HOXA4, was examined in further detail. Single nucleotide polymorphisms in three positional candidate genes, CEBPG, PEPD and
An abdominal aortic aneurysm (AAA) is a potentially fatal cardiovascular disease with multifactorial development and progression. Two preclinical models of the disease (elastase perfusion and angiotensin II infusion in apolipoprotein-E-deficient animals) have been developed to study the disease during its initiation and progression. To date, most studies have used |i|ex vivo|/i| methods to examine disease characteristics such as expanded aortic diameter or analytic methods to look at circulating biomarkers. Herein, we provide evidence from |i|in vivo|/i| ultrasound studies of the temporal changes occurring in biomechanical parameters and macromolecules of the aortic wall in each model. We present findings from 28-day studies in elastase-perfused rats and AngII |i|apoE|sup|−/−|/sup||/i| mice. While each model develops AAAs specific to their induction method, they both share characteristics with human aneurysms, such as marked changes in vessel strain and blood flow velocity. Histology and
Friedrichshafen Clinic in Germany offers top-end surgical treatment for abdominal aortic aneurism. The department of general, visceral and vascular surgery, guided by Prof. Dr. Thorsten Lehmann, uses a wide range of traditional and new methods for abdominal aneurism treatment: open surgery; endovascular therapy, laparoscopic surgery, endovascular implants etc.
In an attempt to chart the changing rates of open, EVAR and branched/fenestrated EVAR repairs over the past decade, Suckow and colleagues used a query of Medicare claims data from 2003-2013 involving abdominal aortic aneurysm repairs (excluding open repairs with any thoracic component but including juxta-/pararenal procedures).. The data gathered showed a 20% decline in all forms of abdominal aortic aneurysm repair to approximately 24,000 repairs in 2013 following a peak of approximately 30,000 in 2005. Breaking these figures down by procedure type, the number of EVAR procedures grew by 74% from 2003-2008 before falling by 13% to 2013. Open repair saw a prolonged and significant decline from 2003 to 2013, falling by 78%. Less than 4,000 open repair Medicare procedures were completed in 2013, Suckow said. Branched/fenestrated EVAR-first coded by Medicare in 2011-has since increased by 504% and by 2013 was as common as open repair.. As well as looking at the total number of repairs, the team also ...
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