Pulmonary Function Testing for Patients with Abdominal Aortic Aneurysm: A Combined Decision

2021 ◽  
Author(s):  
Mohamed Elsharkawi ◽  
Wael Tawfick ◽  
Muhammad Tubassam ◽  
Stewart Walsh
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Pulmonary Function ◽  
Pulmonary Function Testing ◽  
Abdominal Aortic ◽  
Function Testing

TP5.2.13 Perceived risk of pre-operative abdominal aortic aneurysm rupture due to pulmonary function testing: all blown out of proportion?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ayman Badawy ◽  
Weronika Stupalkowska ◽  
Arindam Chaudhuri
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Pulmonary Function ◽  
Operative Mortality ◽  
Preoperative Assessment ◽  
Aneurysm Rupture ◽  
Rupture Risk ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Elective Repair

Abstract Aim Though contraindicated in some respiratory laboratories due to a perceived increased risk of aneurysm rupture, pulmonary function tests (PFT) and cardiopulmonary exercise tests (CPET) are used commonly in preoperative assessment of patients with abdominal aortic aneurysm (AAA) considered for elective repair. We examine whether preoperative PFT/CPET are associated with increased AAA rupture risk. Methods A retrospective analysis of a prospective database of patients with AAA ≥50mm who had PFT/CPET/both as part of their preoperative assessment from November 2012 to December 2020 in a single vascular hub before elective AAA repair (open/endovascular). Patients with AAA <50mm, or those who did not have PFT/CPET preoperatively were excluded from analysis. Baseline demographics, AAA size, type of repair, time from PFT/CPET to repair, rupture rate and 30-day post-operative mortality are presented. Results A total of 410 patients (mean age 74 ± 8 years, 361 (88%) male) were included in the analysis. The mean AAA size was 63 ±11mm. 350 (85%) patients underwent endovascular repair. 220 (53%) patients had PFT, 69 (17%) had CPET and the remaining 121 (30%) had both PFT/CPET preoperatively. The median time from PFT/CPET to repair was 36 days (IQR 48 days), with no preoperative AAA rupture in this cohort. 30-day post-operative mortality was 3%. Conclusions This study strongly suggests that PFT and CPET are not associated with increased risk of AAA rupture and are therefore safe for assessing respiratory function in patients considered for AAA repair without adding to pre-operative rupture risk.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

Influence of preoperative statins and aspirin administration on biological and magnetic resonance imaging properties in patients with abdominal aortic aneurysm

VASA ◽  
2020 ◽  
pp. 1-9
Author(s):  
Milos Sladojevic ◽  
Petar Zlatanovic ◽  
Zeljka Stanojevic ◽  
Igor Koncar ◽  
Sasenka Vidicevic ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Abdominal Aortic Aneurysm ◽  
Magnetic Resonance ◽  
Aortic Aneurysm ◽  
Signal Intensity ◽  
Psoas Muscle ◽  
Resonance Imaging ◽  
Maximal Diameter ◽  
Aneurysm Wall ◽  
Abdominal Aortic

Summary: Background: Main objective of this study was to evaluate the influence of statins and/or acetylsalicylic acid on biochemical characteristics of abdominal aortic aneurysm (AAA) wall and intraluminal thrombus (ILT). Patients and methods: Fifty patients with asymptomatic infrarenal AAA were analyzed using magnetic resonance imaging on T1w sequence. Relative ILT signal intensity (SI) was determined as a ratio between ILT and psoas muscle SI. Samples containing the full ILT thickness and aneurysm wall were harvested from the anterior surface at the level of the maximal diameter. The concentration of enzymes such as matrix metalloproteinase (MMP) 9, MMP2 and neutrophil elastase (NE/ELA) were analyzed in ILT and AAA wall; while collagen type III, elastin and proteoglycan 4 were analyzed in harvested AAA wall. Oxidative stress in the AAA wall was assessed by catalase and malondialdehyde activity in tissue samples. Results: Relative ILT signal intensity (1.09 ± 0.41 vs 0.89 ± 0.21, p = 0.013) were higher in non-statin than in statin group. Patients who were taking aspirin had lower relative ILT area (0.89 ± 0.19 vs 1.13. ± 0.44, p = 0.016), and lower relative ILT signal intensity (0.85 [0.73–1.07] vs 1.01 [0.84–1.19], p = 0.021) compared to non-aspirin group. There were higher concentrations of elastin in AAA wall among patients taking both of aspirin and statins (1.21 [0.77–3.02] vs 0.78 (0.49–1.05) ng/ml, p = 0.044) than in patients who did not take both of these drugs. Conclusions: Relative ILT SI was lower in patients taking statin and aspirin. Combination of antiplatelet therapy and statins was associated with higher elastin concentrations in AAA wall.

Associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm – a grin without a cat!

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Hisato Takagi ◽  
Takuya Umemoto
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Peripheral Artery Disease ◽  
Literature Search ◽  
Systematic Literature Search ◽  
Peripheral Artery ◽  
Epidemiological Evidence ◽  
Abdominal Aortic ◽  
Artery Disease ◽  
Meta Analyses

Abstract. Both coronary and peripheral artery disease are representative atherosclerotic diseases, which are also known to be positively associated with presence of abdominal aortic aneurysm. It is still controversial, however, whether coronary and peripheral artery disease are positively associated with expansion and rupture as well as presence of abdominal aortic aneurysm. In the present article, we overviewed epidemiological evidence, i. e. meta-analyses, regarding the associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm through a systematic literature search. Our exhaustive search identified seven meta-analyses, which suggest that both coronary and peripheral artery disease are positively associated with presence of abdominal aortic aneurysm, may be negatively associated with expansion of abdominal aortic aneurysm, and might be unassociated with rupture of abdominal aortic aneurysm.

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