Abdominal aortic aneurysms (AAA) are those of >3 cm aortic diameter. They run the risk of rupture and ensuing death by bleeding. In consequence, they are treated to repair the aneurysm before it ruptures. In this regard, the most relevant predictor of rupture is aneurysm diameter. That is, the greater the aneurysm, the greater the…
Abdominal Aortic Aneurysm during the Pandemic: Should They Be Operated or Deferred?
Some European societies have recommended deferring the treatment of infrarenal abdominal aortic aneurysm (AAA) ≥5.5 cm during the COVID-19 pandemic. However, these documents have also suggested optimal deferral times, and everything must be adjusted according to the transmission risk/risk of rupture balance. Annual risk of rupture can be estimated based on a prospective cohort published by…
SOLACI PERIPHERAL | 2nd Clinical Case: Juxtarenal Abdominal Aortic Aneurysm
SOLACI’s Department of Peripheral Endovascular Interventions brings a new challenging clinical case for the whole Latin American medical community so as to continue fostering and sharing scientific knowledge and experience among peers. Tell us what you think about this case and its resolution using the comments section in this post, and answer the questions featured…
¿Metformin to Treat Abdominal Aortic Aneurysms?
Currently, there are no drugs to treat abdominal aortic aneurysms (AAA) outside those indicated as secondary prevention drugs. What this study shows is that diabetic patients treated with metformin had lower AAA incidence than diabetic patients treated without metformin, and even lower incidence than non- diabetic patients, as if metformin per se were a…
Surveillance after EVAR: When and How Long
It has been suggested that surveillance after endovascular abdominal aorta aneurysm repair (EVAR) should be for life, seeing as on one hand we are not sure how long these devices last (and they keep coming out), and on the other hand, there could be late complications, such as type 2 leaks. This is why the…
Safety in Abdominal Aortic Aneurysm Surveillance Programs
Abdominal Aortic Aneurysm (AAA) rupture rate in the UK justifies the current surveillance programs and bring ease to some physicians that at some point have cast a shadow on their efficacy. This study also endorses reference thresholds to intervene patients. In 2009, the UK National Health Service (NHS) implemented a AAA national surveillance scheme where…
Vascular Surgeons of the Future in the Endovascular Era
The use of endovascular aneurysm repair (EVAR) for the treatment of infrarenal abdominal aortic aneurysms is widely spread, due to its minimally invasive approach, rapid recovery, and better short-term survival. Approximately 60% of all infrarenal abdominal aortic aneurysms (AAAs) repairs in Europe and 85% in the United States are by EVAR. A decade ago, we believed…
Are Abdominal Aortic Aneurysm Screening Programs Overstated?
With the remarkable drop in tobacco use across the world, also dropped mortality associated to abdominal aorta aneurysm rupture (AAA). All AAA screening programs have been designed decades ago, when the risk was higher. This is why we might need to rethink these programs, or at least design new randomized controlled studies to pave the…
Post EVAR Contrast Enhanced Ultrasound Based Follow Up Reduces CT by 90%. Is It Safe Though?
This four-year retrospective analyzis has shown that contrast enhanced ultrasound based follow up protocol post endovascular aortic repair is safe and effective. Aneurysm related mortality, reintervention rate, sac retraction and endoleak detection resulted similar to that of CT based follow up protocols. In this study, doppler and enhanced contrast ultrasound were the main follow up…
Risk of Colonic Ischemia after Abdominal Aortic Aneurysm Repair
This is the largest and most recent analyzis to show colonic ischemia is more frequent after open abdominal aortic aneurysm repair (2.1% a 3.6%), compared against endovascular repair (0.5% a 1%), especially in elective patients. Most cases presented within the first 7 days. The evidence is not enough to determine the cause behind the different…
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