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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

O2 and CO2 tensions were measured in the gastrocnemius muscles of patients submitted for reconstructive arterial surgery due to obstructive arteriosclerosis (37) or abdominal aortic aneurysm (5). Four patients without signs of arterial ischaemia served as controls. Measurements were carried out by means of implanted silastic tonometers during breathing of air and 100% O2 and immediately after walking on a treadmill. Peripheral blood pressures in the ankles were recorded with a Doppler apparatus. Baseline tissue gas tensions showed no essential differences between the various groups of patients: intermittent claudication, pain at rest, praegangrene, abdominal aortic aneurysm and controls. In contrast, baseline ankle pressures correlated well with the severity of the disease. During breathing of oxygen, the smallest increases of muscle PO2 were observed in extremities with pain at rest or praegangrene and the highest responses were recorded in controls and aneurysm patients. Muscle PCO2 values showed no alterations during oxygen breathing. In physical exercise, muscle PO2 and PCO2 levels as well as ankle blood pressures remained unchanged in controls and patients with aneurysm but no claudication. However, in all groups with arterial ischaemia, the exercise test resulted in a profound fall of muscle PO2 and ankle blood pressure and an increase of muscle PCO2.
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PMID:Tissue gas tensions in the calf muscles of patients with lower limb arterial ischaemia. 43 76

A mathematic model is created to determine the economic cost per year of anticipated prolongation of life that would result from a program of abdominal ultrasonographic (US) screening for abdominal aortic aneurysm. The protocol involves US screening at age 60, 67, and 74 years with additional annual follow-up US and examination if an aneurysm of less than 40 mm is detected. Larger aneurysms are assumed to be sent for early elective resection. The benefits and risks for a subset of men with symptoms of intermittent claudication (IC) as an additional risk factor of atherosclerosis is calculated for comparison. Many of the factors on which these calculated costs and benefits are based are approximations and inferences. These include operative mortality for elective and emergent cases, charges for each such condition, cost of US, and anticipated survival following successful aneurysmectomy both with and without concomitant IC. Sensitivity analysis is performed to show how variations in the major parameters alter the outcome of the calculated cost per year of anticipated extension of life.
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PMID:Ultrasonographic screening for abdominal aortic aneurysm: analysis of surgical decisions for cost-effectiveness. 250 Jul 80

Intermittent claudication from peripheral vascular disease is sometimes difficult to distinguish from neurogenic claudication secondary to lumbar spinal stenosis. Of 172 patients with symptoms of claudication and lumbar spinal stenosis proved by myelography or computed tomography (CT), nine had peripheral vascular disease identified with ultrasonography and arteriography. All of the nine patients had a laminectomy performed to decompress the narrow spinal canal, and two had an additional posterolateral fusion. Two patients were treated with an excision of their abdominal aortic aneurysm, while one of those patients later required a bypass graft for iliac stenosis. One patient had had an aortofemoral bypass graft, one a femoropopliteal graft, and one a lumbar sympathectomy. Follow-up study ranged from three to eight years, with an average of five years after their last surgical procedure. Paresthesias generally dissipated after the spinal surgery. The cramping-type discomfort associated with walking was not easily attributed either to vascular or a neurogenic etiology. Five patients had initial weakness, which invariably improved. A secondary etiology contributing to claudication must be excluded in those patients with persistent discomfort following previous lumbar spinal or vascular surgery for arterial insufficiency.
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PMID:Concurrent lumbar spinal stenosis and peripheral vascular disease. A report of nine patients. 336 86

A preoperative and postoperative hemodynamic study was performed in 20 consecutive patients undergoing elective resection of abdominal aortic aneurysm. Screening for venous thrombosis and pulmonary embolism with 125I uptake test, measurements of maximal venous emptying and pulmonary perfusion scintigraphy were also done before and after the operation. Only five patients complained of intermittent claudication preoperatively, but the laboratory investigations revealed signs of peripheral arterial insufficiency in 15 cases. Maximal venous emptying from the legs was markedly decreased on the first postoperative day and remained significantly below normal on the sixth day. Signs of postoperative thromboembolism appeared in eight patients. These patients did not differ from the others in regard to the pattern of maximal venous emptying. In the three-year follow-up period, the calf blood flow and the ratio of systolic toe pressure to systemic systolic blood pressure were further decreased, despite significant rise in systemic blood pressure.
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PMID:Hemodynamic findings before and after resection of abdominal aortic aneurysm. 649 75

The operative treatment of chronic contained rupture of a saccular abdominal aortic aneurysm (AAA) with retroperitoneal haematoma is reported. A 62-year-old man presented with a painless abdominal mass and intermittent claudication. He had an episode of severe abdominal pain about 2 years before admission. A giant retroperitoneal neoplasm was initially suspected, based on computed tomography. However, magnetic resonance imaging, angiography and colour Doppler sonography demonstrated chronic contained rupture of an AAA. A punched-out oval defect (width 3.5 cm x length 4.5 cm) that was thought to connect the thrombosed aneurysm to an organized retroperitoneal haematoma was discovered in the posterior wall of the bifurcation of the aorta at laparotomy. An infrarenal aortobiexternal iliac Y-graft with bypass to the left femoral artery was placed without removing the aneurysm or haematoma. Recovery was uneventful. The retroperitoneal haematoma appeared smaller on computed tomography about 1 year after operation. This case fulfilled the criteria for chronic contained rupture of an AAA proposed by Jones and associates.
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PMID:Chronic contained rupture of an abdominal aortic aneurysm. 760 13

A 55 year old male with a history of intermittent claudication presented with an abdominal mass, and was diagnosed by abdominal computed tomography (CT) with an abdominal aortic aneurysm accompanying horseshoe kidney. The horseshoe kidney configuration and governing vessels, urinary duct course, and right common iliac arterial stenosis were shown by methods such as angiogram, spiral CT, and intravenous pyelogram before operation. At the operation, the abdomen was opened by a median incision and, using a staple exclusion technique, the abnormal renal artery was reconstructed using 189 mm knitted Y shaped dacron graft replacement and the great saphenous vein. The isthmus was not resected. There were no post operative complications, nor was there any large decrease in renal function. Good results were obtained, and we herein report our results together with a discussion of the literature.
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PMID:A case report of nonresective staple exclusion of abdominal aortic aneurysm associated with horseshoe kidney. 1089 93

Two simultaneous operations for off-pump CABG (OPCAB) and abdominal vascular surgery were performed safely and effectively. [Case 1] A 52-year-old man was admitted with the right intermittent claudication and angina pectoris. Coronary angiography and aortography showed 90% stenosis of left anterior descending coronary artery (LAD) and the right external iliac artery. The patient underwent 1 CABG using left internal thoracic artery (ITA) without cardiopulmonary bypass and abdominal aorta--the right external iliac bypass simultaneously. Bleeding volume during the operation was only 150 ml. The operation time was 3 hours 50 minutes. [Case 2] A 57-year-old man was referred from the other hospital with complaints of abdominal aortic aneurysm. He had the history of 4 stroke attacks caused by idiopathic aldosteronism. Preoperative coronary angiography and aortography showed severe 3 vessels disease and abdominal aortic aneurysm. First, we harvested bilateral ITAs, the right gastroepiploic artery (GEA) and saphenous vein (SV). The complete revascularization (left ITA-LAD, right ITA-1st diagonal branch, GEA-seg. 4 posterodescending branch, SV graft-posterolateral branch) was performed on the beating heart. Then we repaired the abdominal aortic aneurysm (56 mm in diameter) using a Gelsealed Y-graft. The operative course was uneventful. The operation time was 6 hours 15 minutes. These cases suggested that OPCAB technique combined with abdominal vascular surgery reduced operation time and prevented complication in the patient with the risk of brain trouble.
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PMID:[Combined off-pump CABG (OPCAB) and abdominal vascular surgery]. 1176 1

A 79-year old man was admitted to our department with complaints of bilateral foot coldness, numbness and intermittent claudication. He underwent endovascular repair for abdominal aortic aneurysm three years before. An abdominal X-ray showed highly kinked endovascular stent-graft which indicated graft migration, and aortography showed occlusion of stent-graft and infrarenal aorta. An axillo-bifemoral bypass was performed and blood flow to the lower extremities was restored. Endovascular repair for AAA has been established worldwide as a less invasive treatment. Endovascular repair can be performed with low mortality and morbidity in the short period, however, in the long-term follow-up series, several late complications, such as late endoleaks, graft occlusion, AAA expansion, and even AAA rupture were encountered. Indication for endovascular repair for AAA still remains controversial because of these late complications, therefore, great attention must be paid for patient selection for endovascular repair.
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PMID:[Occlusion of endovascular stent-graft for abdominal aortic aneurysm three years after surgery]. 1238 15

Using statins to treat older men and women with coronary artery disease (CAD) and hypercholesterolemia reduces the risk of all-cause mortality, cardiovascular mortality, coronary events, coronary revascularization, stroke, Intermittent claudication, and congestive heart failure. The target serum low-density lipoprotein (LDL) cholesterol level is < 100 mg in older patients with CAD, prior stroke, peripheral arterial disease, extracranial carotid arterial disease, abdominal aortic aneurysm, diabetes meilitus, and the metabolic syndrome. Statins are also effective in reducing cardiovascular events in older persons with hypercholesterolemia without cardiovascular disease. Consider using statins in older persons without cardiovascular disease but with a serum LDL cholesterol > or = 130 mg/dL, or a serum high-density lipoprotein cholesterol < 50 mg/dL. Data from the Heart Protection Study favor treating patients at high risk for vascular events with statins regardless of age or initial serum lipids.
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PMID:Hypercholesterolemia. The evidence supports use of statins. 1293 49

We report the case of an isolated atherosclerotic aneurysm of the superficial femoral artery (SFA). The patient was a 76-year-old man who presented with intermittent claudication and muscle weakness in his right leg. Angiography showed an aneurysm in the lower portion of the right SFA, but no abdominal aortic aneurysm or any other peripheral aneurysms were detected. The patient had not suffered any major complications such as rupture, thrombosis, or distal emboli by the time of presentation. Thus, we resected the aneurysm and replaced it with a Dacron graft. Pathological examination revealed typical atherosclerotic changes and no evidence of infection, previous injury, or connective tissue disorders. While isolated atherosclerotic aneurysms of the SFA are rare, with only about 30 cases documented, patients frequently present with major complications and therefore, making an early diagnosis and initiating appropriate surgical treatment are essential.
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PMID:Surgical treatment for an atherosclerotic aneurysm of the superficial femoral artery: report of a case. 1474 27


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