scholarly journals Comparison of Clinical Effects of Abdominal Aortic Aneurysm Treatment with Open and Endovascular Techniques

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Ning Dou ◽  
Jing-jing Tan ◽  
Jian Zuo

Objective: To compare the therapeutic effects of endovascular and open surgery on abdominal aortic aneurysms.  Methods: From June 2019 to May 2020, 60 cases of abdominal aortic aneurysms (AAA) were divided into observation group (30 cases in endovascular technique group) and control group (30 cases in open technique group). Results: The blood loss, operative time and blood transfusion of the observation group were significantly lower than those of the control group (P<0.05). The incidence of postoperative complications is low, and the incidence of long-term complications is relatively high.  Conclusion: In the treatment of abdominal aortic aneurysm, endovascular technology has the advantages of low risk, less trauma, and quick recovery after surgery. Open surgery is suitable for patients who cannot receive endovascular treatment. In order to achieve good treatment effects, it is necessary to choose an appropriate treatment method according to the actual situation of the patient.

Author(s):  
O. Karaarslan Cengiz ◽  
G. Nergizoglu

The risk of cardiovascular disease begins to increase from the early stages of chronic kidney disease (CKD). Abdominal aortic aneurysms are the most common arterial aneurysms of peripheral arterial diseases. The frequency of abdominal aortic aneurysm varies according to the population studied. This study aimed to determine the prevalence of abdominal aortic aneurysm in patients with stage 3-4  CKD and investigate  CKD is a risk factor for abdominal aortic aneurysm formation. Methods. Patients aged 55 years and older who were followed up in the internal medicine outpatient clinics were enrolled. Two hundred CKD patients with glomerular filtration rates between 15-59 mL/min per 1.73 m2 were included in the study group, and 110 patients with glomerular filtration rates of 60 mL/min per 1.73 m2 or above were assigned to the control group. An ultrasonography device with a 3.5 MHz probe was used for screening. Abdominal aortic diameters of 3 cm and above were accepted as abdominal aortic aneurysms. Results. Eighteen patients in the study group (9%) and four in the control group (3.6%) had an abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysms was higher in the  CKD  group. However, the difference was not statistically significant (p=0.078). Moreover, the median aortic diameter was 21.8 mm (14-44 mm) in the study group, compared to 21.0 mm (14-46 mm) in the control group. The prevalence of the abdominal aortic aneurysm was 14.9% in stage 4  CKD patients and 6% in stage 3  CKD patients (p=0.038). Conclusion. An abdominal aortic aneurysm is more common in patients with  CKD although it does not reach statistical significance. The median aortic diameter was significantly wider in CKD patients compared to the control group . The prevalence of abdominal aortic aneurysm increased with an increase in the CKD stage .


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Konstantinos Filis ◽  
Vasilios Martinakis ◽  
George Galyfos ◽  
Fragiska Sigala ◽  
Dimitris Theodorou ◽  
...  

Aim. Although osteopontin (OPN) and osteoprotegerin (OPG) have been associated with abdominal aortic aneurysms (AAAs), no association of these two biomarkers with AAA surgical or endovascular treatment has been reported. Material and Methods. Seventy-four AAA patients were prospectively selected for open or endovascular repair. All aneurysms were classified (Types A–E) according to aneurysmal extent in CT imaging (EUROSTAR criteria). All patients had preoperative serum OPN and OPG values measurements and 1 week after the procedure. Preoperative and postoperative values were compared with a control group of twenty patients (inguinal hernia repair). Results. Preoperative OPN values in patients with any type of aneurysm were higher than in the control group, while OPG values showed no difference. Postoperative OPN values in AAA patients were higher than in the control group. OPN values increased after open surgery and after EVAR. OPG values increased after open surgery but not after EVAR. There was no difference in OPN/OPG values between EVAR and open surgery postoperatively. Conclusions. OPN values are associated with aneurysm presence but not with aneurysm extent. OPG values are not associated either with aneurysm presence or with aneurysm extent. OPN values increase after AAA repair, independently of the type of repair.


2020 ◽  
pp. 145749692091726
Author(s):  
A. Sonetto ◽  
S. Laukontaus ◽  
L. Vikatmaa ◽  
P. Aho ◽  
M. Venermo

Introduction: Endovascular aneurysm sealing represents an alternative to advanced technology devices for compromised patients with abdominal aortic aneurysms. We report our results of 15 fragile patients with very low-quality infrarenal necks treated with endovascular aneurysm sealing. Material and methods: All patients treated with Nellix device in our hospital between June 2015 and October 2016 were retrospectively reviewed. The primary endpoints are the following: overall survival and freedom from reintervention rates. The secondary endpoints are the following: technical success; 30-day mortality; abdominal aortic aneurysm–related mortality; and freedom from endoleak rate, complications, and surgical conversion rate. Results: Nellix was used in 15 patients, median age 75.5 years, of which 67% were unfit for open surgery. Mean aneurysm diameter was 60 mm. One-third (5/15) of the patients were inside the Nellix instructions for use. Technical success rate was 93.3%. No perioperative complications existed, and 30-day mortality was 0%. Median follow-up was 35 (interquartile range: 11–37) months. Survival rates at 1 and 3 years were 80% and 59.3%. Abdominal aortic aneurysm–related mortality occurred in 3 of 15 cases. Freedom from rupture rates at 1 and 3 years were 92.9% and 66%. Freedom from endoleak rates at 1 and 3 years were 92.9% and 74.5%. Freedom from reintervention rates at 1 and 3 years were 86.7% and 70.6%, with a dramatic drop to 37.1% at 4 years of follow-up. Three open surgery conversions were needed. There were no statistically significant differences in results between patients treated inside and outside instructions for use. Conclusion: The endovascular aneurysm sealing has shown encouraging short-term results, but its safety and effectiveness during time is questionable, because this system still carries high rates of reintervention, conversions for type IA endoleaks, and secondary aneurysm ruptures.


VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Yohei Kawatani ◽  
Yoshitsugu Nakamura ◽  
Yujiro Hayashi ◽  
Tetsuyoshi Taneichi ◽  
Yujiro Ito ◽  
...  

Infectious abdominal aortic aneurysms often present with abdominal and lower back pain, but prolonged fever may be the only symptom. Infectious abdominal aortic aneurysms initially presenting with meningitis are extremely rare; there are no reports of their successful treatment. Cases withStreptococcus pneumoniaeas the causative bacteria are even rarer with a higher mortality rate than those caused by other bacteria. We present the case of a 65-year-old man with lower limb weakness and back pain. Examination revealed fever and neck stiffness. Cerebrospinal fluid showed leukocytosis and low glucose levels. The patient was diagnosed with meningitis and bacteremia caused byStreptococcus pneumoniaeand treated with antibiotics. Fever, inflammatory response, and neurologic findings showed improvement. However, abdominal computed tomography revealed an aneurysm not present on admission. Antibiotics were continued, and a rifampicin soaked artificial vascular graft was implanted. Tissue cultures showed no bacteria, and histological findings indicated inflammation with high leukocyte levels. There were no postoperative complications or neurologic abnormalities. Physical examination, blood tests, and computed tomography confirmed there was no relapse over the following 13 months. This is the first reported case of survival of a patient with an infectious abdominal aortic aneurysm initially presenting with meningitis caused byStreptococcus pneumoniae.


2019 ◽  
Vol 13 (9) ◽  
pp. 430-434
Author(s):  
Ian Peate

This is the second article in a series of articles regarding screening programmes. In this article, an overview of the abdominal aorta is provided. The article also considers the abdominal aortic aneurysm screening programme. Aortic abdominal aneurysm is described. The majority of abdominal aortic aneurysms are asymptomatic; however, if there are any symptoms, these are explained. All four UK countries offer men aged 65 years and over a screening opportunity using an ultrasound scan, the fundamental aspects of abdominal aortic aneurysm screening programmes is offered. It is emphasised that screening is not mandatory in the UK; the man has a right to decline the invitation to attend any screening programme.


Vascular ◽  
2014 ◽  
Vol 23 (4) ◽  
pp. 411-418 ◽  
Author(s):  
Erasmo S da Silva ◽  
Vitor C Gornati ◽  
Ivan B Casella ◽  
Ricardo Aun ◽  
Andre EV Estenssoro ◽  
...  

Objective To analyze the characteristics of patients with abdominal aortic aneurysms referred to a tertiary center and to compare with individuals with abdominal aortic aneurysm found at necropsy. Methods We have retrospectively analyzed the medical records of 556 patients with abdominal aortic aneurysm and 102 cases abdominal aortic aneurysm found at necropsy. Results At univariated analysis, hypertension, tobacco use and maximum diameter were significant risk factors for symptomatic aneurysm, while diabetes tended to be a protective factor for rupture. By logistic regression analysis, the largest transverse diameter was the only one significantly associated with abdominal aortic aneurysm rupture ( p < .0001, odds ratio 1.7, 95% confidence interval 1.481–1.951). Intact abdominal aortic aneurysm found at necropsy showed similarities with outpatients in relation to abdominal aortic aneurysm diameter and risk factors. Conclusion Intact abdominal aortic aneurysm at necropsy and at outpatients setting showed similarities that confirmed that abdominal aortic aneurysm repair is less offered to women, and they died more frequently with intact abdominal aortic aneurysm from other causes.


2021 ◽  
pp. 153857442110226
Author(s):  
Dorota Studzińska ◽  
Mateusz Kózka ◽  
Kamil Polok ◽  
Katarzyna Gronostaj ◽  
Maciej Chwała ◽  
...  

Objective: The aim of our study was to assess the prevalence of renal masses suspected of malignancy and adrenal incidentalomas in patients with abdominal aortic aneurysm based on the computed tomography angiography (CTA). Methods: In the retrospective cross-sectional study, the CTA scans of patients with abdominal aortic aneurysms and thoraco-abdominal aortic aneurysms type II-IV were assessed. Patients with thoraco-abdominal aortic aneurysms type I and V and history of abdominal aortic surgery were excluded from the study. Results: Study group comprised 937 patients with a median age of 73.0 years, 83.8% of whom were male. CTA revealed renal tumors in 11 patients (1.2% of the study population) with a median size of 26 mm (interquartile range 20-50). Adrenal incidentalomas were found in 61 patients (6.5% of the study population). In 20 patients (2.1%) adrenal lesions were found bilaterally. Conclusion: In the described cohort, the renal and adrenal tumors were relatively common findings among patients with abdominal aortic aneurysm and thoraco-abdominal aortic aneurysms type II-IV. Both anaesthesiologists and surgeons should be vigilant about the possibility of such coexistence in order to provide the patients with the best possible perioperative care and an optimal surgical modality.


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