scholarly journals Background and Proposed Design for a Metformin Abdominal Aortic Aneurysm Suppression Trial

2020 ◽  
Vol 3 ◽  
Author(s):  
Ronald L Dalman ◽  
Ying Lu ◽  
Kenneth W Mahaffey ◽  
Amanda J Chase ◽  
Jordan R Stern ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Controlled Clinical Trial ◽  
Rupture Risk ◽  
Double Blind ◽  
Abdominal Aortic ◽  
Patients With Diabetes ◽  
Risk Patients ◽  
Toxic Potential ◽  
Small Aneurysms

Abdominal aortic aneurysm (AAA) may lead to rupture and death if left untreated. While endovascular or surgical repair is generally recommended for AAA greater than 5–5.5 cm, the vast majority of aneurysms detected by screening modalities are smaller than this threshold. Once discovered, there would be a significant potential benefit in suppressing the growth of these small aneurysms in order to obviate the need for repair and mitigate rupture risk. Patients with diabetes, in particular those taking the oral hypoglycaemic medication metformin, have been shown to have lower incidence, growth rate, and rupture risk of AAA. Metformin therefore represents a widely available, non-toxic, potential inhibitor of AAA growth, but thus far no prospective clinical studies have evaluated this. Here, we present the background, rationale, and design for a randomised, double-blind, placebo-controlled clinical trial of metformin for growth suppression in patients with small AAA.

scholarly journals Fenofibrate in the management of AbdoMinal aortic aneurysm (FAME)-2: the study protocol for a multi-centre, randomised, placebo-controlled trial

2016 ◽  
Vol 3 (4) ◽  
pp. 217 ◽  
Author(s):  
Sophie E. Rowbotham ◽  
Bernie Bourke ◽  
Michael Bourke ◽  
Rene Jaeggi ◽  
Jason S. Jenkins ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Outcome Measures ◽  
Medical Therapy ◽  
Controlled Trial ◽  
Aortic Aneurysms ◽  
Secondary Outcome ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Abdominal Aortic

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Abdominal aortic aneurysms (AAAs) are a leading cause of mortality worldwide but have no recognised medical therapy. Pre-clinical studies indicate that osteopontin plays an important role in the pathogenesis of AAA via a number of mechanisms. This trial aims to assess the potential of fenofibrate to favourably alter biomarkers associated with AAA pathology. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Fenofibrate in the management of AbdoMinal aortic anEurysm (FAME)-2 is a multi-centre, prospective, randomised, double-blind, placebo-controlled clinical trial to assess the effect of 24 weeks of oral therapy with 145 mg of fenofibrate on key pathological markers of AAA. A total of 140 participants with an AAA measuring between 35-49 mm will be randomly assigned to either 145 mg of fenofibrate once per day or identical placebo for a period of 24 weeks. Primary outcome measures will be serum concentrations of osteopontin and kallistatin. Secondary outcome measures will include serum levels of resistin, lipids, matrix metalloproteinases and pro-inflammatory cytokines, circulating concentrations of AAA biomarkers, and AAA diameter as assessed by ultrasound.</span></p><p class="abstract"><strong>Conclusions:</strong> This study represents the next step in the assessment of a potential novel medical therapy for AAA.</p>

scholarly journals Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography

Aorta ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 47-55 ◽  
Author(s):  
Caroline Mora ◽  
Claude Marcus ◽  
Coralie Barbe ◽  
Fiona Ecarnot ◽  
Anne Long
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Weighted Kappa ◽  
Maximum Diameter ◽  
Clinical Decisions ◽  
Diameter Measurement ◽  
Double Blind ◽  
Automated Method ◽  
Abdominal Aortic

Background: Computed tomography angiography (CTA) is the reference technique for the measurement of native maximum abdominal aortic aneurysm (AAA) diameter when surgery is being considered. However, there is a wide choice available for the methodology of maximum AAA diameter measurement on CTA, and to date, no consensus has been reached on which method is best. We analyzed clinical decisions based on these various measures of native maximum AAA diameter with CTA, then analyzed their reproducibility and identified the method of measurement yielding the highest agreement in terms of patient management. Materials and Methods: Three sets of measures in 46 native AAA were obtained, double-blind by three radiologists (J, S, V) on orthogonal planes, curved multiplanar reconstructions, and semi-automated-software, based on the AAA-lumen centerline. From each set, the clinical decision was recorded as follows: "Follow-up" (if all diameters <50 mm), "ambiguous" (if at least one diameter <50 mm AND at least one ≥50 mm) or "Surgery " (if all diameters ≥50 mm). Intra- and interobserver agreements in clinical decisions were compared using the weighted Kappa coefficient. Results: Clinical decisions varied according to the measurement sets used by each observer, and according to intra and interobserver (lecture#1) reproducibility. Based on the first reading of each observer, the number of AAA proposed for surgery ranged from 11 to 24 for J, 5 to 20 for S, and 15 to 23 for V. The rate of AAAs classified as "ambiguous" varied from 11% (5/46) to 37% (17/46).The semi-automated method yielded very good intraand interobserver agreements in clinical decisions in all comparisons (Kappa range 0.83–1.00). Conclusion: The semi-automated method seems to be appropriate for native AAA maximum diameter measurement on CTA. In the absence of AAA outer-wallbased software more robust for complex AAA, clinical decisions might best be made with diameter values obtained using this technique.

scholarly journals Grading Abdominal Aortic Aneurysm Rupture Risk

2013 ◽  
Vol 57 (5) ◽  
pp. 43S
Author(s):  
Emiliano Chisci ◽  
Neri Alamanni ◽  
Francesca Iacoponi ◽  
Stefano Michelagnoli ◽  
Setacci Carlo
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Aneurysm Rupture ◽  
Rupture Risk ◽  
Abdominal Aortic Aneurysm Rupture ◽  
Abdominal Aortic
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