Aortic aneurysm trials in octogenarians: Are we really measuring the outcomes that matter?

Vascular ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 435-445 ◽  
Author(s):  
SJ Aitken ◽  
V Naganathan ◽  
FM Blyth
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Surgery ◽  
Outcome Data ◽  
80 And Over ◽  
Patient Centered ◽  
Aged 80 And Over ◽  
Abdominal Aortic ◽  
Procedural Complication ◽  
Short Term Mortality ◽  
Health Quality

Purpose This study is a systematic review to determine the types of outcomes reported in abdominal aortic aneurysm (AAA) studies of patients aged 80 and over. Specifically, it determines the types of patient-centered outcomes reported. Method MEDLINE and EMBASE were searched from 2000 to 2014 for studies on AAA surgery with outcome data on patients aged 80 and over. Outcomes were categorized according to Donabedian’s framework for health quality indicators, with further classification as procedural, complication, resource or patient-centered outcome indicators. Findings Forty studies were reviewed. Patient-centered outcomes were infrequently reported (13%, n=5), with limited outcomes specifically relevant to older patients. No studies reported physical function, activities of daily living or cognition using validated assessment methods. Short-term mortality (95%, n=38) and complications (85%, n=34) were reported most frequently. Conclusion Reporting of aortic surgery outcomes in patients aged 80 and over requires a focus upon outcomes of primary importance to people of this age.

scholarly journals Prior Cardiac and Thoracic Aortic Surgery as a Complication Risk Factor for Abdominal Aortic Aneurysm Repair

2012 ◽  
Vol 76 (6) ◽  
pp. 1380-1384 ◽  
Author(s):  
Kota Yamamoto ◽  
Toshihiro Fukui ◽  
Shigefumi Matsuyama ◽  
Minoru Tabata ◽  
Haruo Aramoto ◽  
...  
Keyword(s):  
Risk Factor ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Aortic Surgery ◽  
Abdominal Aortic Aneurysm Repair ◽  
Thoracic Aortic Surgery ◽  
Complication Risk ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

scholarly journals Changes in Abdominal Aortic Aneurysm Rupture and Short-Term Mortality, 1995–2008

2012 ◽  
Vol 256 (4) ◽  
pp. 651-658 ◽  
Author(s):  
Marc L. Schermerhorn ◽  
Rodney P. Bensley ◽  
Kristina A. Giles ◽  
Rob Hurks ◽  
A. James OʼMalley ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Aneurysm Rupture ◽  
Short Term ◽  
Abdominal Aortic Aneurysm Rupture ◽  
Abdominal Aortic ◽  
Short Term Mortality

Open and endovascular treatment options in thoracic aortic surgery

2018 ◽  
pp. 111-134
Author(s):  
Ourania Preventza ◽  
Joseph S. Coselli
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aorta ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Surgery ◽  
Treatment Options ◽  
Median Sternotomy ◽  
Aortic Disease ◽  
Transverse Arch ◽  
Abdominal Aortic ◽  
Thoracoabdominal Approach

Open endovascular and hybrid repairs have recently emerged as a method for treating the different segments of the thoracic aorta. A full or upper-mini median sternotomy is the usual approach for proximal aortic disease and proximal and transverse arch repairs. Other approaches, such as minimally invasive right thoracotomy, have also emerged. Until recently, a left thoracotomy and thoracoabdominal approach has been the sole approach for treating lesions of the descending and thoracoabdominal thoracic aorta. In the 1980s, the first aortic repair with a self-fixing endoprosthesis was performed. In subsequent years, the technique of using a stent graft to treat an abdominal aortic aneurysm, and subsequently thoracic aortic aneurysm, was popularized, followed by extensive development of this technology. The different techniques and modalities for treatment are discussed in this chapter.

scholarly journals What matters to people aged 80 and over regarding ambulatory care? A systematic review and meta-synthesis of qualitative studies

2021 ◽  
Author(s):  
Angélique Herrler ◽  
Helena Kukla ◽  
Vera Vennedey ◽  
Stephanie Stock
Keyword(s):  
Nursing Care ◽  
Qualitative Studies ◽  
Human Being ◽  
Age Group ◽  
Health Issues ◽  
80 And Over ◽  
Patient Centered ◽  
Aged 80 And Over ◽  
Younger Age ◽  
Care Relationships

AbstractThe growing percentage of the population aged 80 and over is challenging for healthcare systems, as frailty and other complex health issues are common in this age group. In order to provide patient-centered ambulatory healthcare, their preferences and expectations need to be explored. Therefore, the aim of this study was to systematically search for and synthesize qualitative evidence on how people aged 80 and over believe ambulatory healthcare (medical and nursing care) should be delivered to them. Medline, PsycINFO, CINAHL, Web of Science Core Collection and Google Scholar were searched for full research reports of qualitative studies focusing on the preferences, wishes, needs, expectations and experiences of people aged 80 and over regarding ambulatory medical and nursing care. The results were screened by two independent reviewers using a two-step approach. The included studies were meta-synthesized using Thomas and Harden’s ‘thematic synthesis’ approach in order to gain a new, second-order interpretation of the findings of the primary studies. In the intermediate synthesis step, 14 aspects of healthcare structures and care relationships were identified as relevant. Based on these, three underlying wishes were found: feeling safe, feeling like a meaningful human being, and maintaining control and independence. The results of this review are in line with other research, such as reviews focusing on the preferences of the younger age group (65–80). However, the importance of aspects of care relationships as an integral part of favorable ambulatory healthcare and the wish to be strengthened as a meaningful human being are emphasized more strongly.

Endoleaks after endovascular abdominal aortic aneurysm repair

2017 ◽  
Vol 86 (1) ◽  
pp. 73
Author(s):  
Jakub Tomasz Kramek ◽  
Hubert Stępak ◽  
Grzegorz Oszkinis
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Treatment Options ◽  
Abdominal Aortic Aneurysm Repair ◽  
Duplex Sonography ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Short Term Mortality ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Traditional surgical repair and endovascular repair (EVAR) are the treatment options for abdominal aortic aneurysm repair. EVAR as less invasive becomes a significant and widely accepted way of treatment aortic aneurysms with expanding number of procedures. This technique has a lover short‑term mortality and a shorter hospital stay but is not free from complications. The most common complication after EVAR are endoleaks. For the first time summarised and assessed in 1997. Although it is often asymptomatic but may cause aneurysm expanding and rupture. Endoleak is defined as persistent blood flow into the aneurysm sac. It can be revealed intra‑operatively or during the follow up – CT; arteriography, angio‑MRI enables endoleak diagnosis. Usage of duplex sonography is questionable. In this mini‑review we summarise endolek diagnostic, classification and treatment options.

scholarly journals Ambulatory Care Preferences of Older People Age 80 and Over: A Systematic Review of Qualitative Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 198-198
Author(s):  
Angélique Herrler ◽  
Helena Kukla ◽  
Vera Vennedey ◽  
Stephanie Stock
Keyword(s):  
Older People ◽  
Ambulatory Care ◽  
Patient Centered Care ◽  
Qualitative Studies ◽  
80 And Over ◽  
Coordinated Care ◽  
Patient Centered ◽  
Aged 80 And Over ◽  
Eligibility Criteria ◽  
Centered Care

Abstract According to the United Nations, the number of people aged 80 and over is expected to treble by 2050 globally. But research on the preferences for care of this age group grows slowly. To achieve high-quality patient-centered care, we need to understand the oldest people’s specific living circumstances, care preferences and goals. The aim of the study was to synthesize findings about ambulatory care preferences, experiences and expectations of people aged 80 and over. We systematically searched Medline, CINAHL, PsycInfo, Web of Science Core Collection and Google Scholar for qualitative studies published until October 2019 and additionally conducted forward and backward citation search for included studies. Two independent reviewers assessed studies for eligibility criteria and quality. We performed a thematic synthesis of study findings as developed by Thomas and Harden using MAXQDA-20 content analysis software. Twenty-three studies were included. They were mainly conducted in Europe, used face-to-face interviews, reported on ambulatory home care and used qualitative content or thematic analysis. The meta-synthesis revealed two fundamental themes from the perspective of older people: feeling safe and feeling valued in their relationships with caregivers and in their care environment. This was shown, for instance, in preferences for coordinated care, high continuity of caregivers, personal attention and interactions based on trust and respect. In practice, the older persons’ preferences should be integrated into care planning and policies to ensure patient-centered care.

scholarly journals Stent graft infection after endovascular repair of abdominal aortic aneurysm: a case report and literature review

2020 ◽  
Vol 7 (10) ◽  
pp. 3449
Author(s):  
Alaa Sedik ◽  
Meriem Touahria ◽  
Ahmed Wahdan ◽  
Nader Twfeek ◽  
Alaa Osman
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortic Surgery ◽  
Late Complication ◽  
Graft Infection ◽  
Endovascular Aneurysm Repair ◽  
Emergency Laparotomy ◽  
Management Problem ◽  
Abdominal Aortic

Aortic end graft (EVAR) infection isa challenging management problem in aortic surgery with 0.2% to 0.7% incidence, which is similar to aortic graft infection after open abdominal aortic aneurysm (AAA) repair. Although much attention has been given to the more common problem of endo leak management, yet only sporadic case reports have been reported about the late complication of endograft infection. We reported a case of elderly Saudi male, known to have multiple medical problems presented to our emergency department with severe progressive abdominal pain, vomiting, and fever over the last 7 days. He was evaluated and diagnosed as septic shock due to and infected stent graft following Endovascular Aneurysm Repair of abdominal aortic aneurysm, 4 years ago, with peritonitis. He underwent emergency laparotomy and a left paraaortic abscess was drained and a part of exposed metals of the stent graft found. Other intraperitoneal abcesses were drained and abdomen closed over drains. Patient remained under ICU care, but unfortunately deteriorated and died 3 days postoperatively.

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