Family history of atherosclerotic vascular disease is associated with the presence of abdominal aortic aneurysm

Introduction The efficacy of preclinical ultrasound at providing a quantitative assessment of mouse models of vascular disease is relatively unknown. In this study, preclinical ultrasound was used in combination with a semi-automatic image processing method to track arterial distension alterations in mouse models of abdominal aortic aneurysm and atherosclerosis. Methods Longitudinal B-mode ultrasound images of the abdominal aorta were acquired using a preclinical ultrasound scanner. Arterial distension was assessed using a semi-automatic image processing algorithm to track vessel wall motion over the cardiac cycle. A standard, manual analysis method was applied for comparison. Results Mean arterial distension was significantly lower in abdominal aortic aneurysm mice between day 0 and day 7 post-onset of disease (p < 0.01) and between day 0 and day 14 (p < 0.001), while no difference was observed in sham control mice. Manual analysis detected a significant decrease (p < 0.05) between day 0 and day 14 only. Atherosclerotic mice showed alterations in arterial distension relating to genetic modification and diet. Arterial distension was significantly lower (p < 0.05) in Ldlr−/− (++/−−) mice fed high-fat western diet when compared with both wild type (++/++) mice and Ldlr−/− (++/−−) mice fed chow diet. The manual method did not detect a significant difference between these groups. Conclusions Arterial distension can be used as an early marker for the detection of arterial disease in murine models. The semi-automatic analysis method provided increased sensitivity to differences between experimental groups when compared to the manual analysis method.

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Isolated right testicular pain for six days: an unusual presentation of occult abdominal aortic aneurysm leak

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x569406 ◽

2011 ◽

Vol 93 (4) ◽

pp. e1-e2 ◽

Cited By ~ 3

Author(s):

Rachael O Forsythe ◽

Victoria Lavin ◽

Simon CA Fraser ◽

Alan McNeill

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Case Reports ◽

Haemodynamic Instability ◽

Older Patient ◽

Testicular Pain ◽

Lower Back ◽

Abdominal Aortic ◽

History Of ◽

The Right

Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain; however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. On examination, a painless AAA was detected. The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.

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High prevalence of abdominal aortic aneurysm in men with peripheral vascular disease: Screening by ultrasonography

British Journal of Surgery ◽

10.1002/bjs.1800750318 ◽

1988 ◽

Vol 75 (3) ◽

pp. 240-242 ◽

Cited By ~ 100

Author(s):

J. T. Allardice ◽

G. J. Allwright ◽

J. M. C. Wafula ◽

A. P. Wyatt

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Disease Screening ◽

Peripheral Vascular ◽

Abdominal Aortic ◽

High Prevalence

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Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair

Journal of Vascular Surgery ◽

10.1067/mva.1984.avs0010429 ◽

1984 ◽

Vol 01 (3) ◽

pp. 429-433 ◽

Cited By ~ 1

Author(s):

Patrick J. O'Hara ◽

Gregory P. Borkowski ◽

Norman R. Hertzer ◽

Peter B. O'Donovan ◽

Susan L. Brigham ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Natural History ◽

Abdominal Aortic Aneurysm Repair ◽

Abdominal Aortic ◽

History Of ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

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Retrospective review of abdominal aortic aneurysm deaths in New Zealand: what proportion of deaths is potentially preventable by a screening programme in the contemporary setting?

BMJ Open ◽

10.1136/bmjopen-2018-027291 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027291

Author(s):

Wing Cheuk Chan ◽

Dean Papaconstantinou ◽

Doone Winnard ◽

Gary Jackson

Keyword(s):

Abdominal Aortic Aneurysm ◽

New Zealand ◽

Aortic Aneurysm ◽

Screening Programme ◽

Population Based ◽

Cross Sectional ◽

The People ◽

Abdominal Aortic ◽

High Prevalence ◽

History Of

ObjectivesTo describe the proportions of people dying from abdominal aortic aneurysm (AAA) who might have benefited from a formal screening programme for AAA.DesignRetrospective cross-sectional review of deaths.Setting and study populationsAll AAA deaths registered in New Zealand from 2010 to 2014 in the absence of a national AAA screening programme.Main outcome measuresKnown history of AAA prior to the acute event leading to AAA death, prognosis limiting comorbidities, history of prior abdominal imaging and a validated multimorbidity measure (M3-index scores).Results1094 AAA deaths were registered in the 5 years between 2010 and 2014 in New Zealand. Prior to the acute AAA event resulting in death, 31.3% of the cohort had a known AAA diagnosis, and 10.9% had a previous AAA procedure. On average, the AAA diagnosis was known 3.7 years prior to death. At least 77% of the people dying from AAA also had one or more other prognosis limiting diagnosis. The hazard of 1-year mortality associated with the non-AAA related comorbidities for the AAA cohort aged 65 or above were 1.5–2.6 times higher than to the age matched general population based on M3-index scores. In 2014, overall AAA deaths accounted for only 0.7% of total deaths, and 1.0% of deaths among men aged 65 or above in New Zealand. At most, 20% of people dying from AAA in New Zealand between 2010 and 2014 might have had the potential to derive full benefit from a screening programme. About 51% of cases would have derived no or very limited benefit from a screening programme.ConclusionFalling AAA mortality, and high prevalence of competing comorbidities and/or prior AAA diagnosis and procedure raises the question about the likely value of a national AAA screening programme in a country such as New Zealand.

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Prevalence of abdominal aortic aneurysm and associated lower extremity artery aneurysm in men hospitalized for suspected or known cardiopulmonary disease

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1265-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Anna Hohneck ◽

Michael Keese ◽

Gerhard Ruemenapf ◽

Klaus Amendt ◽

Hannelore Muertz ◽

...

Keyword(s):

Diabetes Mellitus ◽

Abdominal Aortic Aneurysm ◽

High Risk ◽

Aortic Aneurysm ◽

Lower Extremity ◽

Leading Edge ◽

Screening Programs ◽

Cardiopulmonary Disease ◽

Abdominal Aortic ◽

History Of

Abstract Background AAA is a disease affecting predominantly male patients ≥65 years and its dreaded complications such as rupture led to population-based screening programs as preventive measure. Nonetheless, the supposed prevalence may have been overestimated, so that targeted screening of high risk populations may be more effective. This study was performed to evaluate the prevalence of abdominal aortic aneurysm (AAA) of an inpatient high-risk cohort and to estimate the co-prevalence of lower extremity arterial aneurysms. Methods Participants: 566 male inpatients, ≥ 65 years of age, hospitalized for suspected or known cardiopulmonary disease. Primary and secondary outcome measures: Maximal infrarenal aortic diameters using abdominal ultrasound (leading edge to leading edge method). Upon detection of an AAA (diameter ≥ 30 mm), the lower extremity arteries were examined with regard to associated aneurysms. Results In 40 of 566 patients (7.1%) AAAs were detectable. Fourteen patients (2.5%) had a first diagnosis of AAA, none of which was large (> 55 mm), the remaining 26 patients were either already diagnosed (14 patients, 2.5%) or previously repaired (12 patients, 2.1%). The three most common main diagnoses at discharge were acute coronary syndrome (43.3%), congestive heart failure (32.2%), and chronic obstructive pulmonary disease (12%). The cohort showed a distinct cardiovascular risk profile comprising arterial hypertension (82.9%), diabetes mellitus (44.4%), and a history of smoking (57.6%). In multivariate analysis, three-vessel coronary artery disease (Odds ratio (OR): 4.5, 95% confidence interval (CI): 2.3–8.9, p < 0.0001) and history of smoking (OR: 3.7, CI: 1.6–8.6, p < 0.01) were positively associated with AAA, while diabetes mellitus (OR: 0.5, CI: 0.2–0.9, p = 0.0295) showed a negative association with AAA. Among the subjects with AAA, we found two large iliac and two large popliteal aneurysms. Conclusion Ultrasound screening in male inpatients, hospitalized for suspected or known cardiopulmonary disease, revealed a high AAA prevalence in comparison to the present epidemiological screening programs. There was a moderate proportion of newly-screen detected AAA and additional screening of the lower extremity arteries yielded some associated aneurysms with indication for possible intervention.

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