Relevant bibliographies by topics / Adominal aortic aneurysms (AAAs)

Academic literature on the topic 'Adominal aortic aneurysms (AAAs)'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Adominal aortic aneurysms (AAAs)"

1

Salmon, Morgan. "NADPH Oxidases in Aortic Aneurysms." Antioxidants 11, no. 9 (September 16, 2022): 1830. http://dx.doi.org/10.3390/antiox11091830.

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Abdominal aortic aneurysms (AAAs) are a progressive dilation of the infrarenal aorta and are characterized by inflammatory cell infiltration, smooth muscle cell migration and proliferation, and degradation of the extracellular matrix. Oxidative stress and the production of reactive oxygen species (ROS) have been shown to play roles in inflammatory cell infiltration, and smooth muscle cell migration and apoptosis in AAAs. In this review, we discuss the principles of nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase/NOX) signaling and activation. We also discuss the effects of some of the major mediators of NOX signaling in AAAs. Separately, we also discuss the influence of genetic or pharmacologic inhibitors of NADPH oxidases on experimental pre-clinical AAAs. Experimental evidence suggests that NADPH oxidases may be a promising future therapeutic target for developing pharmacologic treatment strategies for halting AAA progression or rupture prevention in the management of clinical AAAs.
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Lu, Hong, Debra L. Rateri, Dennis Bruemmer, Lisa A. Cassis, and Alan Daugherty. "Involvement of the renin–angiotensin system in abdominal and thoracic aortic aneurysms." Clinical Science 123, no. 9 (July 13, 2012): 531–43. http://dx.doi.org/10.1042/cs20120097.

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Aortic aneurysms are relatively common maladies that may lead to the devastating consequence of aortic rupture. AAAs (abdominal aortic aneurysms) and TAAs (thoracic aortic aneurysms) are two common forms of aneurysmal diseases in humans that appear to have distinct pathologies and mechanisms. Despite this divergence, there are numerous and consistent demonstrations that overactivation of the RAS (renin–angiotensin system) promotes both AAAs and TAAs in animal models. For example, in mice, both AAAs and TAAs are formed during infusion of AngII (angiotensin II), the major bioactive peptide in the RAS. There are many proposed mechanisms by which the RAS initiates and perpetuates aortic aneurysms, including effects of AngII on a diverse array of cell types and mediators. These experimental findings are complemented in humans by genetic association studies and retrospective analyses of clinical data that generally support a role of the RAS in both AAAs and TAAs. Given the lack of a validated pharmacological therapy for any form of aortic aneurysm, there is a pressing need to determine whether the consistent findings on the role of the RAS in animal models are translatable to humans afflicted with these diseases. The present review compiles the recent literature that has shown the RAS as a critical component in the pathogenesis of aortic aneurysms.
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3

Fairman, Alexander S., and Grace J. Wang. "Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms." Seminars in Interventional Radiology 37, no. 04 (October 2020): 382–88. http://dx.doi.org/10.1055/s-0040-1715872.

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AbstractSince its inception in the 1990s, endovascular aortic repair has quickly replaced traditional open aortic repair (OAR) as the most common method for elective treatment of abdominal aortic aneurysms (AAA). After numerous iterations and failures of different endografts, the technology has undergone dramatic improvements with evidence pointing to this technology serving as a safe and durable modality, albeit with the requirement of routine surveillance. Not surprisingly, the ability to treat patients with AAAs with minimally invasive technology that could theoretically mitigate some of the risks associated with OAR, such as aortic cross clamping and significant blood loss, was also adopted in patients with ruptured AAAs and is now the preferred treatment method if anatomically feasible.
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Siika, Antti, Moritz Lindquist Liljeqvist, Rebecka Hultgren, T. Christian Gasser, and Joy Roy. "Aortic Lumen Area Is Increased in Ruptured Abdominal Aortic Aneurysms and Correlates to Biomechanical Rupture Risk." Journal of Endovascular Therapy 25, no. 6 (October 24, 2018): 750–56. http://dx.doi.org/10.1177/1526602818808292.

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Purpose: To investigate how 2-dimensional geometric parameters differ between ruptured and asymptomatic abdominal aortic aneurysms (AAAs) and provide a biomechanical explanation for the findings. Methods: The computed tomography angiography (CTA) scans of 30 patients (mean age 77±10 years; 23 men) with ruptured AAAs and 60 patients (mean age 76±8 years; 46 men) with asymptomatic AAAs were used to measure maximum sac diameter along the center lumen line, the cross-sectional lumen area, the total vessel area, the intraluminal thrombus (ILT) area, and corresponding volumes. The CTA data were segmented to create 3-dimensional patient-specific models for finite element analysis to compute peak wall stress (PWS) and the peak wall rupture index (PWRI). To reduce confounding from the maximum diameter, 2 diameter-matched groups were selected from the initial patient cohorts: 28 ruptured AAAs and another with 15 intact AAAs (diameters 74±12 vs 73±11, p=0.67). A multivariate model including the maximum diameter, the lumen area, and the ILT area of the 60 intact aneurysms was employed to predict biomechanical rupture risk parameters. Results: In the diameter-matched subgroup comparison, ruptured AAAs had a significantly larger cross-sectional lumen area (1954±1254 vs 1120±623 mm2, p=0.023) and lower ILT area ratio (55±24 vs 68±24, p=0.037). The ILT area (2836±1462 vs 2385±1364 mm2, p=0.282) and the total vessel area (3956±1170 vs 4338±1388 mm2, p=0.384) did not differ statistically between ruptured and intact aneurysms. The PWRI was increased in ruptured AAAs (0.80 vs 0.48, p<0.001), but the PWS was similar (249 vs 284 kPa, p=0.194). In multivariate regression analysis, lumen area was significantly positively associated with both PWS (p<0.001) and PWRI (p<0.01). The ILT area was also significantly positively associated with PWS (p<0.001) but only weakly with PWRI (p<0.01). The lumen area conferred a higher risk increase in both PWS and PWRI when compared with the ILT area. Conclusion: The lumen area is increased in ruptured AAAs compared to diameter-matched asymptomatic AAAs. Furthermore, this finding may in part be explained by a relationship with biomechanical rupture risk parameters, in which lumen area, irrespective of maximum diameter, increases PWS and PWRI. These observations thus suggest a possible method to improve prediction of rupture risk in AAAs by measuring the lumen area without the use of computational modeling.
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Paraskevas, Kosmas I., Dimitri P. Mikhailidis, and Athanasios D. Giannoukas. "Additional Issues on Screening, Prevention, and Treatment of Abdominal Aortic Aneurysms." American Journal of Men's Health 7, no. 6 (March 28, 2013): 472–74. http://dx.doi.org/10.1177/1557988313483306.

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The prevalence of abdominal aortic aneurysms (AAAs) and AAA-related deaths are steadily declining in some countries as a result of the reduction in smoking rates. It was thus suggested that screening programs that do not target high-risk populations are likely to have very low AAA detection rates. However, this may not apply to other countries that do not exhibit similar reductions in smoking rates. It was assumed that by using the U.S. Preventive Services Task Force screening criteria (men 65-75 years with smoking history) less than 30% of AAAs would be captured. A more extensive scoring system that includes additional risk factors such as the presence of carotid artery or peripheral arterial disease, obesity, hypertension, and so on, may identify almost 90% of AAAs. This article discusses this and other issues on screening, prevention, and treatment of AAAs.
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Zarins, Christopher K., and E. John Harris. "Operative Repair for Aortic Aneurysms: The Gold Standard." Journal of Endovascular Therapy 4, no. 3 (August 1997): 232–41. http://dx.doi.org/10.1177/152660289700400302.

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Surgical treatment of abdominal aortic aneurysm (AAA) is being challenged by newer, minimally invasive therapies. Such new treatment strategies will need to prove themselves against concurrent results of standard operative AAA repair, within defined medical risk and aneurysm morphological categories. We review the natural history of AAAs, the medical risk levels for elective AAA repair, aneurysm morphology and its impact on operative mortality, the issue of high-risk patient treatment, and the current standard of care for AAAs based on single-center, multicenter, and population-based statistics. In good-risk patients, aneurysms > 5 cm in diameter are best treated by replacement with a prosthetic graft. Operative mortality should be < 5% and 1-year survival > 90%. Aortic endograft techniques must meet or exceed these standards if they are to supplant standard surgical repair.
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Liu, Haole, Panpan Wei, Weilai Fu, Congcong Xia, Yankui Li, Kangli Tian, Yafeng Li, et al. "Dapagliflozin Ameliorates the Formation and Progression of Experimental Abdominal Aortic Aneurysms by Reducing Aortic Inflammation in Mice." Oxidative Medicine and Cellular Longevity 2022 (January 28, 2022): 1–11. http://dx.doi.org/10.1155/2022/8502059.

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Background. Dapagliflozin, a sodium glucose transporter protein-2 (SGLT-2) inhibitor, reduces the risk for cardiovascular diseases. However, the influence of dapagliflozin on nondissecting abdominal aortic aneurysms (AAAs) remains unclear. Methods. AAAs were created in male C57BL/6 mice via intra-aortic porcine pancreatic elastase (PPE) infusion. Mice were daily treated with dapagliflozin (1 or 5 mg/kg body weight) or an equal volume of vehicle through oral gavage beginning one day prior to PPE infusion for 14 days. To investigate its translational value, dapagliflozin or vehicle was also administered to mice with existing AAAs in another cohort. Aortic diameters were measured prior to (day 0 for baseline) and 14 days after PPE infusion. After sacrifice, mice aortae were collected, and following histological analyses were performed. Results. Dapagliflozin treatment significantly reduced aneurysmal aortic expansion following PPE infusion as compared to vehicle treatment especially at 5 mg/kg body weight (approximately 21% and 33% decreases in 1 and 5 mg/kg treatment groups, respectively). The dose-dependent attenuation of AAAs by dapagliflozin was also confirmed on histological analyses. Dapagliflozin remarkably reduced aortic accumulation of macrophages, CD4+ T cells, and B cells particularly following dapagliflozin treatment at 5 mg/kg. Dapagliflozin treatment also markedly attenuated medial SMC loss. Though the difference was not significant, dapagliflozin treatment tended to attenuate CD8+ T cells and elastin degradation. Dapagliflozin treatment at 5 mg/kg caused a 53% reduction in neovessel density. Furthermore, dapagliflozin treatment mitigated further progress of existing AAAs. Conclusion. Dapagliflozin treatment ameliorated PPE-induced AAAs by inhibiting aortic leukocytes infiltration and angiogenesis.
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Li, Zong-Zhuang, and Qiu-Yan Dai. "Pathogenesis of Abdominal Aortic Aneurysms: Role of Nicotine and Nicotinic Acetylcholine Receptors." Mediators of Inflammation 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/103120.

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Inflammation, proteolysis, smooth muscle cell apoptosis, and angiogenesis have been implicated in the pathogenesis of abdominal aortic aneurysms (AAAs), although the well-defined initiating mechanism is not fully understood. Matrix metalloproteinases (MMPs) such as MMP-2 and -9 and other proteinases degrading elastin and extracellular matrix are the critical pathogenesis of AAAs. Among the risk factors of AAAs, cigarette smoking is an irrefutable one. Cigarette smoke is practically involved in various aspects of the AAA pathogenesis. Nicotine, a major alkaloid in tobacco leaves and a primary component in cigarette smoke, can stimulate the MMPs expression by vascular SMCs, endothelial cells, and inflammatory cells in vascular wall and induce angiogenesis in the aneurysmal tissues. However, for the inflammatory and apoptotic processes in the pathogenesis of AAAs, nicotine seems to be moving in just the opposite direction. Additionally, the effects of nicotine are probably dose dependent or associated with the exposure duration and may be partly exerted by its receptors—nicotinic acetylcholine receptors (nAChRs). In this paper, we will mainly discuss the pathogenesis of AAAs involving inflammation, proteolysis, smooth muscle cell apoptosis and angiogenesis, and the roles of nicotine and nAChRs.
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Romary, Daniel J., Alycia G. Berman, and Craig J. Goergen. "High-frequency murine ultrasound provides enhanced metrics of BAPN-induced AAA growth." American Journal of Physiology-Heart and Circulatory Physiology 317, no. 5 (November 1, 2019): H981—H990. http://dx.doi.org/10.1152/ajpheart.00300.2019.

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An abdominal aortic aneurysm (AAA), defined as a pathological expansion of the largest artery in the abdomen, is a common vascular disease that frequently leads to death if rupture occurs. Once diagnosed, clinicians typically evaluate the rupture risk based on maximum diameter of the aneurysm, a limited metric that is not accurate for all patients. In this study, we worked to evaluate additional distinguishing factors between growing and stable murine aneurysms toward the aim of eventually improving clinical rupture risk assessment. With the use of a relatively new mouse model that combines surgical application of topical elastase to cause initial aortic expansion and a lysyl oxidase inhibitor, β-aminopropionitrile (BAPN), in the drinking water, we were able to create large AAAs that expanded over 28 days. We further sought to develop and demonstrate applications of advanced imaging approaches, including four-dimensional ultrasound (4DUS), to evaluate alternative geometric and biomechanical parameters between 1) growing AAAs, 2) stable AAAs, and 3) nonaneurysmal control mice. Our study confirmed the reproducibility of this murine model and found reduced circumferential strain values, greater tortuosity, and increased elastin degradation in mice with aneurysms. We also found that expanding murine AAAs had increased peak wall stress and surface area per length compared with stable aneurysms. The results from this work provide clear growth patterns associated with BAPN-elastase murine aneurysms and demonstrate the capabilities of high-frequency ultrasound. These data could help lay the groundwork for improving insight into clinical prediction of AAA expansion. NEW & NOTEWORTHY This work characterizes a relatively new murine model of abdominal aortic aneurysms (AAAs) by quantifying vascular strain, stress, and geometry. Furthermore, Green-Lagrange strain was calculated with a novel mapping approach using four-dimensional ultrasound. We also compared growing and stable AAAs, finding peak wall stress and surface area per length to be most indicative of growth. In all AAAs, strain and elastin health declined, whereas tortuosity increased.
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Han, Yanshuo, Hao Zhang, Ce Bian, Chen Chen, Simei Tu, Jiahui Guo, Yihao Wu, Dittmar Böckler, and Jian Zhang. "Circular RNA Expression: Its Potential Regulation and Function in Abdominal Aortic Aneurysms." Oxidative Medicine and Cellular Longevity 2021 (June 29, 2021): 1–21. http://dx.doi.org/10.1155/2021/9934951.

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Abdominal aortic aneurysms (AAAs) have posed a great threat to human life, and the necessity of its monitoring and treatment is decided by symptomatology and/or the aneurysm size. Accumulating evidence suggests that circular RNAs (circRNAs) contribute a part to the pathogenesis of AAAs. circRNAs are novel single-stranded RNAs with a closed loop structure and high stability, having become the candidate biomarkers for numerous kinds of human disorders. Besides, circRNAs act as molecular “sponge” in organisms, capable of regulating the transcription level. Here, we characterize that the molecular mechanisms underlying the role of circRNAs in AAA development were further elucidated. In the present work, studies on the biosynthesis, bibliometrics, and mechanisms of action of circRNAs were aims comprehensively reviewed, the role of circRNAs in the AAA pathogenic mechanism was illustrated, and their potential in diagnosing AAAs was examined. Moreover, the current evidence about the effects of circRNAs on AAA development through modulating endothelial cells (ECs), macrophages, and vascular smooth muscle cells (VSMCs) was summarized. Through thorough investigation, the molecular mechanisms underlying the role of circRNAs in AAA development were further elucidated. The results demonstrated that circRNAs had the application potential in the diagnosis and prevention of AAAs in clinical practice. The study of circRNA regulatory pathways would be of great assistance to the etiologic research of AAAs.
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Dissertations / Theses on the topic "Adominal aortic aneurysms (AAAs)"

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Dahal, Shataakshi. "Stem Cells Based Elastic Matrix Regeneration for Small Abdominal Aortic Aneurysms (AAAs) Repair." Cleveland State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=csu1599137475237285.

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Dahal, Shataakshi. "Stem Cells Based Elastic Matrix Regeneration for Small Abdominal Aortic Aneurysms (AAAs) Repair." Cleveland State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=csu1599137475237285.

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Books on the topic "Adominal aortic aneurysms (AAAs)"

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Lee, Christoph I. Abdominal Aortic Aneurysm Screening. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190223700.003.0024.

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This chapter, found in the abdominal and pelvic pain section of the book, provides a succinct synopsis of a key study examining the use of ultrasound for screening asymptomatic patients for abdominal aortic aneurysms (AAAs). This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study showed that screening for AAAs can decrease aneurysm-related mortality rates. However, since AAAs contribute to less than 3% of all deaths, screening provides no significant decrease in all-cause mortality. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.
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Reinecke, Holger. Epidemiology and global burden of peripheral arterial disease and aortic aneurysms. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0068.

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Peripheral artery disease (PAD) and aortic aneurysms are common diseases which show an increasing prevalence and incidence. From community-based trials assessing ankle–brachial indices, 2–4% of the general population have been shown to be affected by PAD, which increases up to 15% in those above 70 years of age. About 30–40% of the in-hospital cases with PAD have critical limb ischaemia and suffer from a 1-year mortality of 20–40%. Abdominal aortic aneurysms (AAAs) also show a relatively high prevalence of about 1–2% in the general population as found by large-scale, systematic duplex screening. Of these, about 5% come to hospital admittance with a ruptured AAA which is still associated with an in-hospital mortality of up to 50%. The prevalence of thoracic aortic aneurysms (TAAs) was reported to be at about 0.16–0.34% in selected subgroups of the general population. The incident cases of TAAs have risen from 10/100,000 cases in the late 1980s up to about 17/100,000 cases in the first decade of this millennium. It is noteworthy that PAD and aortic aneurysms as well as their associated co-morbidities remain in many cases underdiagnosed and undertreated. This leads to a high cardiovascular morbidity and mortality which could not be obviously markedly reduced in the recent decades. Since nearly all vascular disorders are systemic diseases, not only the specific vessel bed which leads to a presentation should be assessed but also all other possible vascular manifestations should be thoroughly examined to reduce adverse events.
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Kahn, S. Lowell. Creation of a Flow-Modulating Stent Using Multilayered Wallstents for Aneurysm Exclusion. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0011.

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Abdominal aortic aneurysms (AAAs) are a common pathology that is found in 4–9% of patients in the developed world. Risk factors for AAAs include age, male sex, family history, comorbid cardiovascular disease, and smoking. Despite the male predominance of the disease, rupture occurs at a smaller diameter in females, and the outcomes are poorer in this subgroup. Flow-modulating stents are a relatively new development and consist of multilayered bare-metal self-expanding stents. Despite the inherent porosity of the stents, the interconnected stent matrix features flow-diverting properties that preserve luminal and branch vessel flow while simultaneously depressurizing the aneurysm sac, resulting in shrinkage and thrombosis. Flow-modulating stents are unavailable in the United States. This chapter discusses in vivo construction of a flow-modulating stent and its potential applications and complications.
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Book chapters on the topic "Adominal aortic aneurysms (AAAs)"

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von Allmen, Regula S. "Aortic aneurysm: abdominal aortic aneurysm—therapeutic options." In ESC CardioMed, edited by Raimund Erbel, 2579–82. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0611.

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For uncomplicated abdominal aortic aneurysms (AAAs), small ones (<55 mm in diameter) are generally subject to surveillance, while larger ones (≥55 mm in diameter) should be considered for aneurysm repair. There is no benefit of a timely repair for small AAAs, regardless of repair method and patient age. Aortic aneurysm, however, is a surrogate for cardiovascular morbidity, thus risk factor management and secondary preventive drug treatment is essential in all AAA patients. Several studies have attempted to address the optimal pace for ultrasound surveillance of small aneurysms and based on a recent large meta-analysis, intervals of 3 years, 1 year, and 6 months were proposed for AAAs measuring 30–39, 40–49, and 50–54 mm, respectively. In patients with a large aneurysm, open or endovascular aortic repair (EVAR) is the primary treatment option. The goals for both repair techniques are identical, although the treatment strategy is completely different. During EVAR, the aneurysm is left intact, and the blood flow is excluded from the aneurysm by catheter-based deployment of a stent graft; thus, successful EVAR procedures are bound to specific anatomical conditions. In cases that are anatomically and physiologically eligible for both conventional EVAR and open repair, EVAR was associated with a substantial early survival advantage; this benefit, however, was lost over time. The rate of late rupture was significantly higher after endovascular repair than after open repair. In patients with a ruptured AAA, an individual patient data meta-analysis from three randomized controlled trials reported similar survival to 90 days following an endovascular or open repair strategy.
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von Allmen, Regula S. "Aortic aneurysm: abdominal aortic aneurysm—diagnostic approach." In ESC CardioMed, edited by Raimund Erbel, 2577–79. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0610.

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Abdominal aortic aneurysms (AAAs) account for three-quarters of aortic aneurysms and affect 2–4% of men older than 65 years. Prevalence is three to six times higher in men and atherosclerosis is the main underlying cause of AAA development. Generally, an aortic diameter of 30 mm or greater constitutes an AAA. Aortic aneurysms are usually asymptomatic until rupture, being associated with a mortality of almost 80–90%. This has raised interest in nationwide AAA screening programmes and trials have demonstrated that ultrasound-based screening of at-risk populations is effective in reducing AAA-related mortality. In the absence of screening, diagnosis is usually incidental during imaging for unrelated medical problems. If an AAA is diagnosed, the entire aorta needs to be assessed including iliac arteries for concomitant aneurysms. Peripheral aneurysms at femoral and popliteal locations may be coexisting in up to 14% of patients. Contrast-enhanced computed tomography (CT) or magnetic resonance imaging is used for a more refined AAA assessment. Enhanced spiral CT with curved multiplanar reconstruction allows exact characterization of the aortic anatomy, which is relevant if aortic repair is considered, the optimal treatment method is to be determined, and the procedure is to be planned. Symptomatic AAA patients should have immediate imaging to make a diagnosis before catastrophic rupture, and in patients with a presumed rupture, swift diagnosis and treatment is life-saving. The choice of the imaging modality is guided by the haemodynamic status of the patient, considering that CT is the required tool to determine and plan the appropriate life-saving procedure.
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Robinson, Albert R., Thomas R. Powell, and Yi Deng. "Open Abdominal and Thoracoabdominal Aortic Aneurysm Repair." In Vascular Anesthesia Procedures, 107–26. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506073.003.0009.

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This chapter describes the challenges that anesthesiologists face in the surgical repair of abdominal aortic aneurysms (AAAs) and thoracoabdominal aortic aneurysms (TAAAs). The anesthetic management of these patients includes caring for acutely sick patients who typically also present with some combination of hypertension, diabetes, hypercholesterolemia, and cardiac, pulmonary, and renal comorbidities. The aorta must be cross clamped and unclamped in AAA and TAAA repair, leading to hemodynamic instability as well as absolute and/or relative hypovolemia. Lung isolation is desirable in TAAA repair to facilitate access to the descending aorta. Techniques such as cerebrospinal spinal fluid drainage and hypothermia are used in at-risk cases to afford enhanced spinal cord protection. An understanding of a patient’s coagulation status and epidural anesthesia is important intraoperatively to decrease general anesthetic requirements as well as for postoperative pain management. Postoperatively, patients require continuous monitoring for bleeding and fluid management.
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Reinecke, Holger, and Nasser Malyar. "Epidemiology and global burden of peripheral arterial disease and aortic aneurysms." In ESC CardioMed, 328–34. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0068_update_001.

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Peripheral artery disease (PAD) and aortic aneurysms are common diseases in older populations, sharing common aetiological risk factors. From community-based trials assessing ankle–brachial indices, 2–4% of the general population have been shown to be affected by PAD, which increases up to 15% in those above 70 years of age. About 30–40% of the in-hospital cases with PAD have critical limb ischaemia and suffer from a 1-year mortality of 20–40%. Abdominal aortic aneurysms (AAAs) also show a relatively high prevalence of about 1–2% in the general population as found by large-scale, systematic duplex screening. Of these, about 5% come to hospital admittance with a ruptured AAA which is still associated with an in-hospital mortality of up to 50%. The prevalence of thoracic aortic aneurysms (TAAs) was reported to be at about 0.16–0.34% in selected subgroups of the general population. The incident cases of TAAs have risen from 10/100,000 cases in the late 1980s up to about 17/100,000 cases in the first decade of this millennium. It is noteworthy that PAD and aortic aneurysms as well as their associated co-morbidities remain in many cases underdiagnosed and undertreated. This leads to a high cardiovascular morbidity and mortality which could not be obviously markedly reduced in the recent decades. Since nearly all vascular disorders are systemic diseases, not only the specific vessel bed which leads to a presentation should be assessed but also all other possible vascular manifestations should be thoroughly examined to reduce the high rates of adverse events and the persistent poor outcome.
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Sankova, Susan K., and Jeongae Yoon. "Endovascular Procedures of the Abdomen/Lower Extremities." In Vascular Anesthesia Procedures, 145–54. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506073.003.0011.

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This chapter continues an overview of endovascular procedures, focusing on interventions below the diaphragm. Endovascular intervention has become the major technique for management of abdominal aortic aneurysms (AAAs), both ruptured and unruptured. Advancements in endovascular techniques have shortened AAA operative and recovery times and permitted intervention on patients previously felt too tenuous for an open surgical approach. Peripheral artery disease (PAD) can also be treated with a variety of endovascular techniques, including angioplasty, atherectomy, and stenting. Endovascular interventions in PAD have similarly reduced the recovery burden for patients and provide similar outcomes to open procedures. The minimally invasive nature of the endovascular approach often allows greater flexibility in anesthetic technique compared to open procedures. In conjunction with the procedural approach, the patient’s health status, preferences, and anesthesiologist preferences permit a choice of anesthesia care that may lie along a spectrum ranging from local anesthesia with minimal sedation to full general endotracheal anesthesia. The endovascular approach does, however, present specific anesthesia management concerns in both the intra- and postoperative period, which are reviewed in this chapter.
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Conference papers on the topic "Adominal aortic aneurysms (AAAs)"

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Les, Andrea S., Christopher P. Cheng, Mary T. Draney Blomme, C. Alberto Figueroa, John F. LaDisa, Jinha M. Park, Robert J. Herfkens, Ronald L. Dalman, and Charles A. Taylor. "Hemodynamics in Human Abdominal Aortic Aneurysms During Rest and Simulated Exercise." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176209.

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Abdominal Aortic Aneurysms (AAAs) — the localized enlargement of the abdominal aorta — represent the 13th leading cause of death in the United States. The natural progression of small (3–5 cm) AAAs is 2–6% growth per year until rupture or surgical repair [1]. As AAAs enlarge, adverse hemodynamic conditions (including regions of low mean wall shear stress and high particle residence time) are exacerbated under normal resting conditions.
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Ayyalasomayajula, Avinash, Bruce R. Simon, and Jonathan P. Vande Geest. "Porohyperelastic Simulation of Abdominal Aortic Aneurysms." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-193147.

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Abdominal aortic aneurysm (AAA) is a progressive dilation of the infrarenal aorta and results in a significant alteration in local hemodynamic environment [1]. While an aneurysmal diameter of 5.5cm is typically classified as being of high risk, recent studies have demonstrated that maximum wall stress could be a better indicator of an AAA rupture than maximum diameter [2]. The wall stress is greatly influenced by the blood pressure, aneurysm diameter, shape, wall thickness and the presence of thrombus. The work done by Finol et al. suggested that hemodynamic pressure variations have an insignificant effect on AAA wall stress and that primarily the shape of the aneurysm determines the stress distribution. They noted that for peak wall stress studies the static pressure conditions would suffice as the in vivo conditions. Wang et al have developed an isotropic hyperelastic constitutive model for the intraluminal thrombus (ILT). Such models have been used to study the stress distributions in patient specific AAAs [3, 4].
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Kinkaid, Jeffrey N., Steven P. Marra, Francis E. Kennedy, and Mark F. Fillinger. "Inflation Testing as a Means of Measuring Failure Strength of Aortic Tissue." In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-43102.

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Abdominal Aortic Aneurysms (AAAs) are localized enlargements of the aorta. If untreated, AAAs will grow irreversibly until rupture occurs. Ruptured AAAs are usually fatal and are a leading cause of death in the United States, killing 15,000 per year (National Center for Health Statistics, 2001). Surgery to repair AAAs also carries mortality risks, so surgeons desire a reliable tool to evaluate the risk of rupture versus the risk of surgery.
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4

Ashton, John H., and Jonathan P. Vande Geest. "Development of a Thrombus Mimic in Abdominal Aortic Aneurysms." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176625.

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Abdominal aortic aneurysms (AAAs) represent a significant disease in the western world as rupture of AAA is currently the 15th leading cause of death in the United States [1,2]. The rate of incidence of this disease is also thought to be increasing given the aging population. While AAA rupture is attributed to the gradual weakening of the wall, the mechanisms of aneurysm initiation, growth, and development remain relatively unclear. The role of biomechanics in the diagnosis and prevention of AAA rupture has been reported [3].
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Basciano, Christopher A., Julie H. Y. Ng, Ender A. Finol, and Clement Kleinstreuer. "A Relation Between Particle Hemodynamics and Intraluminal Thrombus Formation in Abdominal Aortic Aneurysms." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-204721.

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Abdominal aortic aneurysms (AAAs) are local dilations of the aorta below the renal arteries where the lumen diameter is ≥ 1.5 times the normal diameter of the healthy blood vessel. Ruptured aneurysms are the 13th leading cause of death in the US [1]. In approximately 75% of all AAAs, a particle-deposition layer forms adjacent to the arterial wall within the lumen called the intra-luminal thrombus (ILT). The thrombus composition has been shown to be a fibrin structure composed of blood cells, platelets, blood proteins, and other cellular debris [2]. Additionally, Yamazumi et al. [3] have presented data that suggest AAA morphology is associated with an elevated state of blood coagulation and fibrinolysis within the aneurysm.
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Finol, Ender A., Shoreh Hajiloo, Keyvan Keyhani, David A. Vorp, and Cristina H. Amon. "Flow-Induced Wall Pressure Under Average Resting Hemodynamic Conditions for Patient-Specific Abdominal Aortic Aneurysms." In ASME 2002 International Mechanical Engineering Congress and Exposition. ASMEDC, 2002. http://dx.doi.org/10.1115/imece2002-32326.

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Abdominal Aortic Aneurysms (AAAs) are characterized by a continuous dilation of the infrarenal segment of the abdominal aorta. Despite significant improvements in surgical procedures and imaging techniques, the mortality and morbidity rates associated with untreated ruptured AAAs are still outrageously high. AAA disease is a health risk of significant importance since this kind of aneurysm is mostly asymptomatic until its rupture, which is frequently a lethal event with an overall mortality rate in the 80% to 90% range. From a purely biomechanical viewpoint, aneurysm rupture is a phenomenon that occurs when the mechanical stress acting on the dilating inner wall exceeds its failure strength. Since the internal mechanical forces are maintained by the dynamic action of blood flowing in the aorta, the quantification of the hemodynamics of AAAs is essential for the characterization of their biomechanical environment.
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Shum, Judy, Elena Di Martino, Satish Muluk, and Ender A. Finol. "Geometry Quantification of Abdominal Aortic Aneurysms." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19682.

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Recent studies have shown that the maximum transverse diameter of an abdominal aortic aneurysm (AAA) and expansion rate are not entirely reliable indicators of rupture potential. We hypothesize that aneurysm morphology and wall thickness can be quantified in a systematic approach leading to accurate differentiation of the geometric characteristics of aneurysm population subsets. A non-invasive, image-based evaluation of AAA shape was implemented on a retrospective study of sixty-six subjects who underwent elective repair and twenty-eight subjects who suffered AAA rupture within 1 month of their last pre-operative follow-up. The contrast-enhanced computed tomography (CT) scans of these patients were used to generate three-dimensional models from the segmented images. Twenty-eight geometry-based indices were calculated to characterize the size and shape of the AAA sac, and regional variations in wall thickness were estimated based on a novel segmentation algorithm. A multivariate analysis of variance using a maximum AAA diameter of 5.5 cm as a factor was performed for all indices as dependent variables, for the electively repaired group. Box and Whisker plots and ROC curves were generated to determine the indices’ potential as predictors of rupture risk. Listed from highest to lowest area under the ROC curve (AUC), the following six indices were found statistically significant (p < 0.05): volume (V, p < 0.0001), surface area (S, p < 0.0001), intraluminal thrombus volume (VILT, p < 0.0001), diameter-to-diameter ratio (DDr, p < 0.0001), diameter-to-height ratio (DHr, p = 0.015), and centroid distance of the maximum diameter (dc, p = 0.008). Given that individual AAAs have complex, tortuous and asymmetric shapes with local changes in surface curvature and wall thickness, the assessment of AAA rupture risk should require the accurate characterization of aneurysmal sac shape.
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Consolini, Michelle, Tiziano Passerini, Marina Piccinelli, Brandon Fornwalt, Nick G. Willett, Robert C. Long, Alessandro Veneziani, John N. Oshinski, and W. Robert Taylor. "Shear Stress and Angiotensin II in the Development and Localization of Abdominal Aortic Aneurysms." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-205071.

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Abdominal aortic aneurysms (AAAs) develop in the infrarenal aorta of humans and in the suprarenal aorta of apoE−/− mice infused with angiotensin II (AngII). Oscillatory wall shear stress in the infrarenal human abdominal aorta is driven by the flow to the gastric arteries, the lumbar curvature and the capacitance of the lower extremities [1]. Two of these factors, the lumbar curvature and the capacitance of the lower extremities, are significantly different in mice than in humans. Therefore, we hypothesized that the differences in localization of AAAs between species is explained by differences in the pattern of wall shear stress via the shear-regulated modulation of inflammatory pathways involving AngII.
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Vande Geest, Jonathan, Ajay Bohra, Wei Sun, Elena Di Martino, Michael S. Sacks, and David A. Vorp. "Development and 3D Finite Element Implementation of a Multiaxial Constitutive Relation for Abdominal Aortic Aneurysms." In ASME 2004 International Mechanical Engineering Congress and Exposition. ASMEDC, 2004. http://dx.doi.org/10.1115/imece2004-59643.

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Abdominal aortic aneurysm (AAA), a localized dilation of the infrarenal aorta, represents a significant disease in the western population. There are approximately 200,000 patients in the US and 500,000 patients worldwide diagnosed with AAAs every year (Bosch, et al. 2001), and rupture of AAAs currently ranks as the 13th leading cause of death in the US. (Silverberg and Lubera 1987) In the past 30 years, the diagnosis of AAA has tripled in the Western world, and this will likely increase in the coming years as the average age of the population is increasing. (Bosch, et al. 2001)
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Speelman, Lambert, E. Marielle H. Bosboom, Geert Willem H. Schurink, Jaap Buth, Marcel Breeuwer, Michael J. Jacobs, and Frans N. van de Vosse. "Effect of Intraluminal Thrombus on Wall Stress and Growth Rate of Abdominal Aneurysms." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19222.

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In the decision for surgical repair of abdominal aortic aneurysms (AAAs), the risk of rupture is weighed carefully against the risk of the surgical procedure. Currently, AAA diameter is the main factor that determines the decision for surgery. However, in rupture risk estimation AAA wall stress has higher sensitivity and specificity than maximum diameter [1]. Moreover, peak wall stress was higher for ruptured than for non-ruptured or asymptomatic AAAs [2, 3].
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