scholarly journals Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine

2021 ◽  
Vol 41 (6) ◽  
pp. 376-382
Author(s):  
Abdulrahman M. Alfuraih ◽  
Abdulaziz I. Alrashed ◽  
Saleh O. Almazyad ◽  
Mohammed J. Alsaadi
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Large Scale ◽  
Care Hospital ◽  
Ultrasound Machine ◽  
Abdominal Aortic ◽  
Conventional Ultrasound ◽  
Handheld Ultrasound ◽  
The Mean ◽  
Operator Reproducibility

BACKGROUND: Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines. OBJECTIVES: Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening. DESIGN: Analytical, cross-sectional. SETTING: Ultrasound department at a large tertiary care hospital in Riyadh. PATIENTS AND METHODS: Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility. MAIN OUTCOME MEASURE: Inter-system and intra- and inter-operator ICCs. SAMPLE SIZE: 114 males with repeated measurements by second operator on a subset of 35 participants. RESULTS: The median age (interquartile range) of participants was 68 years (62–74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, P =.007) and the Butterfly device (ICC=0.467, P =.037). The inter-system ICCs (95% CI) were 0.818 (0.736–0.874) and 0.879 (0.799–0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD ( P =.34). CONCLUSIONS: Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening. LIMITATIONS: No cases of abdominal aortic aneurysm in the sample and lack of blinding. CONFLICT OF INTEREST: None.

Diet and the content of selenium and lead in patients with abdominal aortic aneurysm

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 381-389 ◽  
Author(s):  
Socha ◽  
Borawska ◽  
Gacko ◽  
Guzowski
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Healthy Volunteers ◽  
Arterial Wall ◽  
Aortic Wall ◽  
Dietary Habits ◽  
Absorption Spectrometry ◽  
Control Group ◽  
Abdominal Aortic ◽  
The Mean

Background: To evaluate the content of selenium (Se) and lead (Pb) and the influence of dietary habits and smoking in patients with abdominal aortic aneurysm (AAA). Patients and methods: Forty-nine patients with AAA prior to surgical procedures aged 42 - 81 years and a control group of 22 healthy volunteers aged 31 - 72 years and 17 aortic wall samples from deceased were included in the study. Food-frequency questionnaires were implemented in AAA patients to collect the dietary data. Se and Pb concentrations in the serum and blood, respectively, and in arterial wall and parietal thrombus samples were determined by the atomic absorption spectrometry method. Results: The mean Se level in serum of patients with AAA (60.37 ± 21.2 microg/L) was significantly (p < 0.008) lower than in healthy volunteers (75.87 ± 22.4 microg/L). We observed a significant correlation (r = 0.69, p < 0.0001) between the content of Se in serum and the parietal thrombus of examined patients. Se concentration in aortic wall was inversely correlated to the concentration of Pb (r = - 0.38, p < 0.02). We observed significantly lower (p < 0.05) concentrations of Se (39.14 ± 37.1 microg/g) and significantly higher (p < 0.05) concentrations of Pb (202.69 ± 180.6 microg/g) in aortic wall samples of smoking patients than in non-smoking patients (77.56 ± 70.0 microg/g, 73.09 ± 49.8 microg/g; respectively). Conclusions: Se serum level is lower in patients with AAA than in healthy volunteers. In aortic wall, Se concentration is inversely correlated with Pb concentration. Dietary habits and smoking have an influence on the Se and Pb status in patients with AAA.

scholarly journals Update on Abdominal Aortic Aneurysm Research: From Clinical to Genetic Studies

Scientifica ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
Helena Kuivaniemi ◽  
Evan J. Ryer ◽  
James R. Elmore ◽  
Irene Hinterseher ◽  
Diane T. Smelser ◽  
...  
Keyword(s):  
Risk Factor ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Large Scale ◽  
Protective Factor ◽  
Positive Family History ◽  
Large Data ◽  
Medical Emergency ◽  
European Ancestry ◽  
Abdominal Aortic

An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta with a diameter of at least 3.0 cm. AAAs are often asymptomatic and are discovered as incidental findings in imaging studies or when the AAA ruptures leading to a medical emergency. AAAs are more common in males than females, in individuals of European ancestry, and in those over 65 years of age. Smoking is the most important environmental risk factor. In addition, a positive family history of AAA increases the person’s risk for AAA. Interestingly, diabetes has been shown to be a protective factor for AAA in many large studies. Hallmarks of AAA pathogenesis include inflammation, vascular smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. Autoimmunity may also play a role in AAA development and progression. In this Outlook paper, we summarize our recent studies on AAA including clinical studies related to surgical repair of AAA and genetic risk factor and large-scale gene expression studies. We conclude with a discussion on our research projects using large data sets available through electronic medical records and biobanks.

scholarly journals 3 Years Expeimental Study on Abdominal Aortic Aneurysm Patients Who were Treated with Endovascular Aneurysm Repair at Dr. Mohammad Hoesin Hospital Palembang During 1st of January 2018 – 31st of December 2020

2021 ◽  
Vol 4 (2) ◽  
pp. 286-304
Author(s):  
Muhammad Febriandi Djunaidi ◽  
Kemas Muhammad Dahlan ◽  
Fahmi Jaka Yusuf
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Femoral Artery ◽  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic ◽  
Mean Diameter ◽  
History Of ◽  
The Mean ◽  
The Right

Abdominal aortic aneurysm (AAA) is a focal dilatation of the aortic segment with an increase of 1.5 times the normal value or ≥3 cm. The risk increases in old age and requires alternative surgery such as EVAR. EVAR is more useful in AAA therapy than surgery with wide incisions. This research was descriptive in RSMH Palembang for 5 years in 1st of January 2018 - 31st of December 2020 with variables of patient clinical characteristics and patient CTA results. The results showed that AAA was more common in men, aged 60-69 years with high school education, risk factors such as a history of CHF, hypertension, CAD, and smoking habits. Angiographic CT result showed proximal diameter > 2 cm, PAU, calcification, iliac aneurysm, and lowest renal artery on the left side. All AAA patients had inferior limb thrombus and angulation > 600. The average of aneurysm is 5.8 cm in diameter and 9.23 cm in length. The mean diameter of the right iliac artery differs from the mean diameter of the left iliac artery. The diameter of the right femoral artery also differs from the diameter of the left femoral artery. AAA patients mostly had no history of CKD, COPD, and DM. The patients were hospitalized for an average of 7 days, especially in the ICU for 2 days.

scholarly journals An Algorithm to Analyze Cost Heterogeneity using Counterfactual Scenarios in Endovascular versus Open Repair of Abdominal Aortic Aneurysm: Predicting Costs for Subsequent Patients

10.36469/9876 ◽  
2014 ◽  
Vol 1 (3) ◽  
pp. 308-321 ◽  
Author(s):  
Christopher A. Jones ◽  
Peter W. Callas ◽  
Robert W. Everett ◽  
Richard A. Galbraith ◽  
Richie Spitsberg ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Bypass Graft ◽  
Receiver Operating Curve ◽  
Patient Specific ◽  
Chronic Obstructive ◽  
Efficient Treatment ◽  
Abdominal Aortic ◽  
The Mean

Objectives: We examined patient-specific predictors of high cost for endovascular (EVAR) and open (OPEN) repair of abdominal aortic aneurysm (AAA). Methods: Vascular Study Group of Northern New England data specific to Fletcher Allen Health Care were merged with cost data from the same source. We retrospectively analyzed 389 elective AAA repairs (230 EVAR, 159 OPEN) between 2003 and 2011 to determine clinical characteristics that contribute to membership in the upper quartile of cost (UQC) versus the remaining three quartiles. For the purpose of this exercise, it was assumed that clinical outcomes were equally good with EVAR versus OPEN repair. Results: Significant predictors of UQC for OPEN repair procedures were: history of treated chronic obstructive pulmonary disease (COPD), previous bypass surgery, transfer from hospital and age &gt;70 (area under receiver operating curve [ROC] = 0.726). Predictors of UQC for EVAR were: presence of iliac aneurysm(s), coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty within the past 5 years, ejection fraction ≤30%, absence of beta blockers, creatinine ≥1.5mg/dL, and current use of tobacco (area under ROC = 0.784). The mean length of stay for EVAR and OPEN repair were 2.22 and 8.55 days, respectively. Costs for EVAR and OPEN repair were $32,656 (standard error of the mean [SEM] $591) and $28,183 (SEM $1,571), respectively. Conclusions: Certain risk factors at the individual patient level are predictive of UQC. Under such circumstances, it is our expectation that such algorithms may be used to select the most cost-efficient treatment.

P5601High pulse wave velocity is associated with poor shrinkage of abdominal aortic aneurysm in endovascular aneurysm repair patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Kanamoto ◽  
H Otsuka ◽  
T Anegawa ◽  
T Takaseya ◽  
Y Shintani ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cardiovascular Event ◽  
Aortic Stiffness ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic ◽  
The Mean ◽  
Aneurysm Repair ◽  
Changing Rate

Abstract Background Endovascular aneurysm repair (EVAR) has widely spread for treatment of abdominal aortic aneurysm (AAA). However, the effects of EVAR on vascular function remain to be clarified. According to several reports, changes in aortic stiffness after EVAR reflect badly on future cardiovascular events. Recently, brachial-ankle pulse wave velocity (baPWV) is accepted as the most simple and reproducible method to determine the aortic stiffness. Purpose We aimed to evaluate the change of baPWV following EVAR and investigate the relationship between the aortic stiffness and the long-term outcomes following EVAR. Methods We enrolled 172 patients who underwent primary EVAR between January 2009 and December 2017 in our University hospital. Patients with saccular aneurysm, iliac aneurysm and pseudo aneurysm were excluded from the analysis. PWV data were collected before and 1 week after EVAR. PWV was measured as the mean baPWV values of both lower limbs. The long-term outcomes were evaluated with the cardiovascular event and AAA changing rate (mm/year) which was calculated by computed tomographic scanning at the preoperative and latest imaging studies. The cardiovascular event was defined as the expansion of thoracic or abdominal aortic aneurysm (>10 mm or >5 mm/year), central nervous system disorder, acute heart failure, new arrhythmia, peripheral arterial disease. Receiver operating characteristic (ROC) curve analysis was used to evaluate the cut off values of preoperative baPWV (pre-PWV) and postoperative baPWV (post-PWV) for the risk factor of cardiovascular event. Results The mean age was 76.6±7.5 years and 149 patients (86.7%) were male. The mean follow-up period was 41.6±27.0 months. The mean AAA changing rate was −1.84±4.72 mm/year. Post-PWV was significantly increased compared to pre-PWV (pre-PWV v.s. post-PWV; 1885±382 cm/s vs. 2060±528 cm/s, p<0.0001). The optimal cut-off values of the pre and post PWV for predicting cardiovascular events were 1900 cm/s and 2100 cm/s, respectively. The Kaplan-Meier curves indicate that 5 year-cardiovascular event free rates were 45.9% in the patients with pre PWV ≥1900 cm/s and 73.2% in the patients with pre PWV <1900 cm/s (p=0.0185). Similarly, 5 year-cardiovascular event free rates were 46.6% in the patients with post-PWV ≥2100cm/s and 73.4% in the patients with post PWV <2100 cm/s (p=0.0162). Furthermore, the linear regression analysis indicated that post-PWV values correlated positively with the AAA changing rate (r=0.1811, p=0.0195) while pre-PWV was not associated with AAA changing rate (r=0.1211, p=0.1201). Conclusions Our results show that EVAR increase aortic stiffness in the acute phases and high post-baPWV is associated with poor shrinkage of abdominal aortic aneurysm in EVAR patients. This is the first study to demonstrate the association between high PWV and poor long-term outcome in endovascular aneurysm repair patients.

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.

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