Abdominal Aortic Aneurysm

2012 ◽  
Vol 7 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Ken Tillman ◽  
O. Danny Lee ◽  
Kristin Whitty
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Treatment Guidelines ◽  
Smoking Status ◽  
Current Evidence ◽  
Ultrasound Screening ◽  
Comprehensive Overview ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

Men are more likely than women to develop an abdominal aortic aneurysm (AAA), a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. What many men do not know is that an AAA can easily be identified through an ultrasound screening, and if the aneurysm is >5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Although current AAA screening recommendations focus on men between the ages of 65 and 75 years, who have ever smoked, recent evidence suggest many men of ages 50 to 80 years, regardless of smoking status, may also be at risk for developing an AAA. This article presents a comprehensive overview of AAA disease and summarizes current evidence-based diagnostic and treatment guidelines, the importance of educating men about this health issue, and the need for more widespread AAA ultrasound screening opportunities.

ASCENDING AORTIC ANEURYSM – A CASE REPORT

2020 ◽  
Vol 1 (3) ◽  
pp. 54-55
Author(s):  
Prathap Kumar. J.
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Leg Pain ◽  
Ultrasound Screening ◽  
Ascending Aortic Aneurysm ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.

scholarly journals Novel Biomarkers of Abdominal Aortic Aneurysm Disease: Identifying Gaps and Dispelling Misperceptions

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Demetrios Moris ◽  
Eleftherios Mantonakis ◽  
Efthymios Avgerinos ◽  
Marinos Makris ◽  
Chris Bakoyiannis ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cost Effective ◽  
Aneurysm Rupture ◽  
Screening Programs ◽  
Results Of Treatment ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Novel Biomarkers

Abdominal aortic aneurysm (AAA) is a prevalent and potentially life-threatening disease. Early detection by screening programs and subsequent surveillance has been shown to be effective at reducing the risk of mortality due to aneurysm rupture. The aim of this review is to summarize the developments in the literature concerning the latest biomarkers (from 2008 to date) and their potential screening and therapeutic values. Our search included human studies in English and found numerous novel biomarkers under research, which were categorized in 6 groups. Most of these studies are either experimental or hampered by their low numbers of patients. We concluded that currently no specific laboratory markers allow screeing for the disease and monitoring its progression or the results of treatment. Further studies and studies in larger patient groups are required in order to validate biomarkers as cost-effective tools in the AAA disease.

scholarly journals Derivation and Validation of a 10-Year Risk Score for Symptomatic Abdominal Aortic Aneurysm: A Cohort Study of Nearly 500,000 Individuals

Circulation ◽  
2021 ◽  
Author(s):  
Paul Welsh ◽  
Claire E. Welsh ◽  
Pardeep S. Jhund ◽  
Mark Woodward ◽  
Rosemary Brown ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Risk Score ◽  
Validation Cohort ◽  
Smoking Status ◽  
Hospital Inpatient ◽  
Ultrasound Screening ◽  
Derivation Cohort ◽  
Abdominal Aortic

Background: Abdominal aortic aneurysm (AAA) can occur in patients who are ineligible for routine ultrasound screening. A simple AAA risk score was derived and compared to current guidelines used for ultrasound screening of AAA. Methods: UK Biobank participants without previous AAA were split into a derivation cohort (n=401,820, 54.6% women, mean age 56.4 years, 95.5% white race) and validation cohort (n=83,816). Incident AAA was defined as first hospital inpatient diagnosis of AAA, death from AAA, or an AAA-related surgical procedure. A multivariable Cox model was developed in the derivation cohort into an AAA risk score that did not require blood biomarkers. To illustrate the sensitivity and specificity of the risk score for AAA, a theoretical threshold to refer patients for ultrasound at 0.25% 10-year risk was modelled. Discrimination of the risk score was compared to a model of US Preventive Services Task Force (USPSTF) AAA screening guidelines. Results: In the derivation cohort there were 1,570 (0.40%) cases of AAA over a median 11.3 years of follow-up. Components of the AAA risk score were age (stratified by smoking status), weight (stratified by smoking status), antihypertensive and cholesterol lowering medication use, height, diastolic blood pressure, baseline cardiovascular disease, and diabetes. In the validation cohort, over ten years of follow-up, the C-index for the model of the USPSTF guidelines was 0.705 (95% CI 0.678, 0.733). The C-index of the risk score as a continuous variable was 0.856 (95%CI 0.837-0.878). In the validation cohort, the USPSTF model yielded sensitivity 63.9% and specificity 71.3%. At the 0.25% 10-year risk threshold, the risk score yielded sensitivity 82.1% and specificity 70.7%, while also improving the net reclassification index (NRI) compared to the USPSTF model +0.176 (95%CI 0.120, 0.232). A combined model, whereby risk scoring was combined with the USPSTF model, also improved prediction compared to USPSTF alone (NRI +0.101, 95%CI 0.055, 0.147). Conclusions: In an asymptomatic general population, a risk score based on patient age, height, weight and medical history may improve identification of asymptomatic patients at risk for clinical events from AAA. Further development and validation of risk scores to detect asymptomatic AAA is needed.

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.

scholarly journals Rolipram Prevents the Formation of Abdominal Aortic Aneurysm (AAA) in Mice: PDE4B as a Target in AAA

Antioxidants ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 460
Author(s):  
Saray Varona ◽  
Lídia Puertas ◽  
María Galán ◽  
Mar Orriols ◽  
Laia Cañes ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Inflammatory Cells ◽  
Progressive Increase ◽  
Phosphodiesterase 4 ◽  
Inflammatory Conditions ◽  
Abdominal Aortic ◽  
Threatening Condition ◽  
Life Threatening ◽  
Effective Therapeutic Strategy

Abdominal aortic aneurysm (AAA) is a common life-threatening condition characterized by exacerbated inflammation and the generation of reactive oxygen species. Pharmacological treatments to slow AAA progression or to prevent its rupture remain a challenge. Targeting phosphodiesterase 4 (PDE4) has been verified as an effective therapeutic strategy for an array of inflammatory conditions; however, no studies have assessed yet PDE4 in AAA. Here, we used angiotensin II (AngII)-infused apolipoprotein E deficient mice to study the involvement of the PDE4 subfamily in aneurysmal disease. PDE4B but not PDE4D was upregulated in inflammatory cells from both experimental and human AAA. The administration of the PDE4 selective inhibitor rolipram (3 mg/kg/day) to AngII-challenged mice (1000 ng/kg bodyweight/min) protected against AAA formation, limiting the progressive increase in the aortic diameter without affecting the blood pressure. The drug strongly attenuated the rise in vascular oxidative stress (superoxide anion) induced by AngII, and decreased the expression of inflammatory markers, as well as the recruitment of macrophages (MAC3+), lymphocytes (CD3+), and neutrophils (ELANE+) into the vessel wall. Rolipram also normalized the vascular MMP2 expression and MMP activity, preserving the elastin integrity and improving the vascular remodelling. These results point to PDE4B as a new therapeutic target for AAA.

Life-Threatening Upper Gastrointestinal Bleeding Secondary to Aortoenteric Fistula

2008 ◽  
Vol 2 ◽  
pp. CCRPM.S376
Author(s):  
Tasbirul Islam ◽  
George Hines ◽  
Douglas S. Katz ◽  
William Purtil ◽  
Francis Castiller
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Gastrointestinal Bleeding ◽  
Surgical Repair ◽  
Upper Gastrointestinal Bleeding ◽  
Aortoduodenal Fistula ◽  
Open Surgical Repair ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Upper Gastrointestinal

We present a patient with gastrointestinal bleeding secondary to an aortoduodenal fistula. The patient had undergone an open surgical repair of an abdominal aortic aneurysm five years prior to admission.

Aortoduodenal Fistula After Endovascular Abdominal Aortic Aneurysm Repair

2020 ◽  
Vol 54 (5) ◽  
pp. 445-448
Author(s):  
Akihiro Hosaka ◽  
Masaru Nemoto ◽  
Manabu Motoki ◽  
Atsushi Akai ◽  
Masaaki Kato
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Primary Repair ◽  
Recurrent Infection ◽  
Abdominal Aortic Aneurysm Repair ◽  
Duodenal Wall ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Aneurysm Repair

Aortoduodenal fistula after endovascular treatment of abdominal aortic aneurysm is a very rare but life-threatening complication. Herein, we describe 4 cases of aortoduodenal fistula diagnosed at 15 to 78 months after the index aortic intervention, all successfully treated by surgery. All patients underwent primary repair of the duodenal wall, creation of tube duodenostomy, stent graft removal, and in situ reconstruction using a rifampicin-soaked prosthesis. Patients received prolonged antibiotic treatment for at least 2 months postoperatively, and all were free of recurrent infection at follow-up. Prompt and appropriate surgical intervention is required to effectively manage this condition.

scholarly journals Is local anaesthesia superior to general anaesthesia in endovascular repair of abdominal aortic aneurysm?

2019 ◽  
Vol 29 (4) ◽  
pp. 599-603
Author(s):  
Amer Harky ◽  
Ciaran Grafton-Clarke ◽  
Jeremy Chan
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Statistical Significance ◽  
Current Evidence ◽  
Perioperative Outcomes ◽  
General Anaesthetic ◽  
Abdominal Aortic ◽  
Meta Analyses ◽  
Study Type

Summary A best evidence topic in cardiovascular surgery was written in accordance to a structured protocol. The question addressed was: in patients undergoing endovascular repair of abdominal aortic aneurysm (EVAR), is local anaesthetic (LA) superior to general anaesthetic in terms of perioperative outcomes? Altogether, 630 publications were found using the reported search protocol, of which 3 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type and primary outcomes were tabulated. The 3 included studies are systematic reviews with meta-analyses, with no randomized trials identified. Within the studies, there is a degree of heterogeneity in terms of surgical case-mix (elective or emergency EVAR or both) and anaesthetic technique (LA, regional anaesthetic, local-regional anaesthetic and general anaesthetic). With 1 study not providing pooled estimates, the second study demonstrated statistical significance in favour of local-regional anaesthetic within the elective setting in terms of mortality [pooled odds ratio (OR) 0.70, 95% confidence interval (CI) 0.52–0.95; P = 0.02], morbidity (pooled OR 0.73, 95% CI 0.55–0.96; P = 0.0006) and total length of hospital admission (pooled mean difference: −1.53, 95% CI −2.53 to −0.53; P = 0.00001). The third study failed to demonstrate a statistically significant mortality benefit with LA (pooled OR 0.54, 95% CI 0.21–1.41; P = 0.211). While the results of these studies fail to provide a clear answer to a complex surgical problem, it would be appropriate, in the light of current evidence, to recommend LA as non-inferior to general anaesthetic in both emergency and elective settings.

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