miR-29c-3p is an Effective Biomarker of Abdominal Aortic Aneurysm in Patients Undergoing Elective Surgery

MicroRNA ◽  
2016 ◽  
Vol 5 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Sabina Licholai ◽  
Wojciech Szczeklik ◽  
Marek Sanak
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Elective Surgery ◽  
Abdominal Aortic

Compensated activation of coagulation in patients with abdominal aortic aneurysm: effects of heparin treatment prior to elective surgery

2004 ◽  
Vol 92 (11) ◽  
pp. 997-1002 ◽  
Author(s):  
Jacek Szmidt ◽  
Krzystof Bojakowski ◽  
Tomasz Grzela ◽  
Magorzata Palester-Chlebowczyk ◽  
Maria Jelenska
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Reference Group ◽  
Elective Surgery ◽  
Operation Time ◽  
Fibrinogen Concentration ◽  
Excessive Bleeding ◽  
Prothrombin Fragment ◽  
Abdominal Aortic ◽  
D Dimer

SummaryElective surgery of abdominal aortic aneurysm (AAA) sometimes leads to excessive bleeding and disseminated intravascular coagulation (DIC), even in patients with normal preoperative coagulation parameters. Coagulation screen, performed routinely before surgery is of limited value in the assessment of compensated activation of the haemostatic system. In this study, we used a number of additional tests (D-dimer, prothrombin fragment 1+2, antithrombin, and activation of fibrinolysis in the platelet poor plasma) for the diagnosis of compensated activation of the haemostatic system in AAA-patients. Ddimer and marker of thrombin generation (prothrombin fragment 1+2) positively correlated with each other (r = 0.768, P < 0.001). Out of 71 AAA patients, 15 patients had normal global coagulation times, but those with a Ddimer concentration above 3000 ng/ml were selected for preoperative low molecular weight heparin (LMWH) treatment. Administration of LMWH diminished coagulation abnormalities (D-dimer and prothrombin fragment 1+2 decreased significantly) and resulted in the increase of platelet number and fibrinogen concentration, indicating their previous consumption. Despite differences in aneurysm diameters between the groups of 15 LMWH treated patients (mean 70.9 ± 16 mm) and the reference group of 20 untreated AAA patients (mean 52.3 ± 8.0 mm), intraoperative parameters (operation time, blood loss and transfusion demands) were similar.

scholarly journals Modelling the impact of changes to abdominal aortic aneurysm screening and treatment services in England during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253327
Author(s):  
Lois G. Kim ◽  
Michael J. Sweeting ◽  
Morag Armer ◽  
Jo Jacomelli ◽  
Akhtar Nasim ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Screening Programme ◽  
Elective Surgery ◽  
Discrete Event ◽  
Drop Out ◽  
Abdominal Aortic ◽  
Related Service ◽  
The Impact ◽  
Related Mortality

Background The National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) in England screens 65-year-old men. The programme monitors those with an aneurysm, and early intervention for large aneurysms reduces ruptures and AAA-related mortality. AAA screening services have been disrupted following COVID-19 but it is not known how this may impact AAA-related mortality, or where efforts should be focussed as services resume. Methods We repurposed a previously validated discrete event simulation model to investigate the impact of COVID-19-related service disruption on key outcomes. This model was used to explore the impact of delayed invitation and reduced attendance in men invited to screening. Additionally, we investigated the impact of temporarily suspending scans, increasing the threshold for elective surgery to 7cm and increasing drop-out in the AAA cohort under surveillance, using data from NAAASP to inform the population. Findings Delaying invitation to primary screening up to two years had little impact on key outcomes whereas a 10% reduction in attendance could lead to a 2% lifetime increase in AAA-related deaths. In surveillance patients, a 1-year suspension of surveillance or increase in the elective threshold resulted in a 0.4% increase in excess AAA-related deaths (8% in those 5–5.4cm at the start). Longer suspensions or a doubling of drop-out from surveillance would have a pronounced impact on outcomes. Interpretation Efforts should be directed towards encouraging men to attend AAA screening service appointments post-COVID-19. Those with AAAs on surveillance should be prioritised as the screening programme resumes, as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality.

Influence of Respiratory Disease on Perioperative Cardiac Risk in Patients Undergoing Elective Surgery for Abdominal Aortic Aneurysm

2000 ◽  
Vol 14 (5) ◽  
pp. 490-495 ◽  
Author(s):  
Jean-Christophe Pillet ◽  
Philippe Chaillou ◽  
Philippe Bizouarn ◽  
Paul Pittaluga ◽  
Philippe Patra ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Respiratory Disease ◽  
Elective Surgery ◽  
Cardiac Risk ◽  
Abdominal Aortic

scholarly journals Are Periods of Low Atmospheric Pressure Associated with an Increased Risk of Abdominal Aortic Aneurysm Rupture?

2008 ◽  
Vol 90 (5) ◽  
pp. 389-393 ◽  
Author(s):  
RA Smith ◽  
PR Edwards ◽  
AF da Silva
Keyword(s):  
Logistic Regression ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Atmospheric Pressure ◽  
Elective Surgery ◽  
Meteorological Data ◽  
Multiple Logistic Regression ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Low Atmospheric Pressure

INTRODUCTION Seasonal variation in rates of abdominal aortic aneurysm (AAA) rupture has previously been described. However, only two studies, to date, have suggested that periods of low atmospheric pressure may account for this observation and both returned apparently contradictory findings. The objective of this study was to demonstrate whether periods of low atmospheric pressure are indeed associated with an increased likelihood of AAA rupture presentation. PATIENTS AND METHODS A total of 182 cases of ruptured AAA were identified retrospectively from two centres over a 6-year period from January 2000 to December 2005. Local meteorological data for the corresponding period was obtained from the UK Meteorological Office which was recorded daily at a local weather station. Statistical analysis using Student's t-test, ANOVA (Kruskal–Wallis), linear regression and multiple logistic regression was conducted to identify significant relationships from the data. RESULTS Days of rupture presentation were associated with a significantly lower daily mean atmospheric pressure when compared with days when no rupture occurred (P = 0.025). Multiple logistic regression demonstrated a significant association between low daily atmospheric pressure and rupture incidence (P = 0.033) which appeared to be independent of temperature. A significant seasonal trough in atmospheric pressure was observed in October and November (Kruskal–Wallis, P < 0.001); however, there was no corresponding autumnal peak in rupture incidence (P = 0.232). CONCLUSIONS The findings of this study appear to confirm the assertion that low atmospheric pressure is associated with an increased risk of AAA rupture on a day-to-day basis; however, no evidence was identified to support a change in policy regarding prioritising elective surgery based on seasonal risk.

Changes in Referral Practice, Workload, and Operative Mortality after Establishment of an Endovascular Abdominal Aortic Aneurysm Program

1998 ◽  
Vol 5 (3) ◽  
pp. 201-205 ◽  
Author(s):  
Jonathan R. Boyle ◽  
Matthew M. Thompson ◽  
Robert D. Sayers ◽  
Ahktar Nasim ◽  
Patricia Healey ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Elective Surgery ◽  
Endovascular Aneurysm Repair ◽  
Prospective Audit ◽  
Abdominal Aortic ◽  
Risk Patients ◽  
Aneurysm Repair ◽  
Referral Practice ◽  
Overall Mortality

Purpose: To determine the change in referral practice following establishment of an endovascular abdominal aortic aneurysm (AAA) program. Methods: A prospective audit of all elective admissions for AAA was established in January 1994 at the initiation of an endovascular AAA program. A comparison was made between this cohort and the elective AAA repairs performed between 1981 and 1993. Results: Since January 1994, 213 AAA patients (177 men; median age 73 years, range 54 to 88) have been referred for potential endovascular aneurysm repair. To date, 142 patients have undergone elective surgery (41 endovascular and 101 conventional). Between 1981 and 1993, 304 patients (255 men; median age 69 years, range 45 to 86) had elective aneurysm repair. Comparison of the two time periods has revealed significant increases in the number of tertiary referrals (41.8% versus 9.5%, p < 0.01), annual operations (50 versus 23, p < 0.05), and overall mortality (12% versus 6.7%, p < 0.05), the latter attended by a significant increase in cardiorespiratory comorbidity. Conclusions: The higher elective AAA mortality rate since the establishment of an endovascular program reflects a change in referral practice and may be directly attributable to an increase in the number of high-risk patients. An endovascular AAA program has clinical and financial implications for the hospital concerned.

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