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

The effect of surgery for combined abdominal aortic aneurysm (AAA) and internal iliac artery aneurysm (IIAA) on postoperative intestinal ischemia and sexual dysfunction was studied. Nineteen men and three women, aged 51 to 79 years, were included in this study. The IIAA was unilateral in 13 cases and bilateral in 9. The maximum diameter of the IIAAs ranged from 3.0 to 7.5 cm. Seven cases underwent emergent surgery for aneurysmal rupture. A bifurcated graft was implanted in all cases. Among cases with unilateral IIAA, aneurysmectomy and IIA reconstruction was performed in 2 cases, and ligation of the IIA was performed in the remaining 11. Among cases with bilateral IIAAs, IIA reconstruction was performed on one side and IIA ligation on the another side in 1 case. Bilateral ligation was performed in 4 and exclusion of the AAA and both IIAAs were performed in 4. The inferior mesenteric artery was reconstructed in 10 cases. The average postoperative follow-up period was 6.2 years. Postoperatively 2 cases experienced bowel necrosis and 4 had diarrhea and/or mucous stool. An erectile disturbance occurred postoperatively in 33.3% of cases which had undergone unilateral and 50% of cases which had undergone bilateral IIA ligation.
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PMID:[Effect of surgery for combined abdominal aortic and internal iliac artery aneurysm on postoperative intestinal ischemia and sexual dysfunction]. 180 81

Male sexual dysfunction after aortoiliac operations can be a distressing complication. Since previous studies dealing with this problem have not excluded other causes of sexual dysfunction, the true incidence of this complication has been difficult to ascertain. We assessed preoperative and postoperative sexual function in a group of patients with no identifiable organic or functional etiology of sexual dysfunction other than aortoiliac operations or arterial occlusive disease. Seventy-six male patients had no evidence of sexual dysfunction of ambiguous etiology before or after operation. Preoperatively, 33% of patients with abdominal aortic aneurysm and 22% of those with aortoiliac occlusive disease were functionally impotent. Conventional dissection techniques rendered an additional 30% of each group functionally impotent. Postoperative impotence was twice as common in those with minor dysfunction preoperatively.
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PMID:Aortoiliac operations and sexual dysfunction. 720 49

Open abdominal aortic aneurysm repair has been reported to be associated with impairment of sexual function in men, most likely because of autonomic nerve injury and pelvic blood flow changes. Endovascular aneurysm repair does not involve dissection in the area of the iliac bifurcation and therefore may be associated with lower incidence of sexual dysfunction as compared to open repair. We conducted a retrospective study of males after open and endovascular abdominal aortic aneurysm repair to determine if there is a significant difference in the incidence of sexual dysfunction between the two procedures. A modified International Index of Erectile Function Questionnaire was used to access sexual function before and after aneurysm repair. The questionnaire was mailed to all male patients who underwent abdominal aortic aneurysm repair from January 1, 1999 to July 15, 2002. The questionnaire asked patients questions regarding their sexual function before and 3 months after the repair. Questionnaire scores for domains of sexual function (erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction) as well as the total questionnaire score were analyzed. The chi-square and Wilcoxon's signed ranks test were used for statistical comparisons, with p < 0.05 considered significant. Logistic regression was used to examine association. Two hundred ninety-three questionnaires were mailed and 90 were returned completed. There was no difference for the total questionnaire score or the erectile function score before the procedure. Based on the questionnaire score, erectile function worsened after open AAA repair ( p = 0.002). Orgasmic function also deteriorated after open AAA repair ( p = 0.001). Endovascular repair was not accompanied by decreased erectile or orgasmic function ( p = 0.057 and p = 0.068, respectively). Impairment of erectile function was not associated with age, diabetes, or the number of patent hypogastric arteries after aneurysm repair, but there was a significant association between impaired erectile function and open aneurysm repair ( p = 0.036). Endovascular repair of abdominal aortic aneurysms is associated with significantly less impairment of erectile and orgasmic function than that with open repair. Preservation of sexual function after endovascular as compared to open repair should be among the factors considered when weighing treatment options for an abdominal aortic aneurysm in a sexually active male.
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PMID:Erectile function after open or endovascular abdominal aortic aneurysm repair. 1450 65

Few studies have thoroughly investigated the incidence and detailed the degree of sexual disability after aortic aneurysm surgery. Reports prior to 1990 vary greatly in the incidence of postoperative dysfunction mostly because of nonstandardized methods of assessment. In this article, we compare the incidence of reported sexual dysfunction after aortic reconstruction, open and endovascular abdominal aortic aneurysm repair. Pertinent studies on sexual dysfunction following open and endovascular aortic aneurysm repair were identified from a MEDLINE search of English-language publications since 1966. Newer standardized methods of assessment have identified relatively high rates of sexual dysfunction prior to and after intervention. Aortic aneurysm patients have a baseline incidence of sexual dysfunction of approximately 30%, which doubles over the next 7 years. Patients who had open aortic operations reported significantly increased sexual dysfunction during the first postoperative year. Endovascular repair with unilateral internal iliac occlusion results in new sexual dysfunction in approximately 10% of patients, but this increases significantly with bilateral internal iliac occlusion. When compared with open operation, the incidence of sexual dysfunction is lower overall in patients with endovascular aortic aneurysm repairs, which includes those who have internal iliac artery occlusion, but it is increased with bilateral iliac occlusion. Surgeons should be aware of the preoperative prevalence of sexual dysfunction in patients undergoing aortic procedures.
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PMID:Sexual dysfunction in men after open or endovascular repair of abdominal aortic aneurysms. 1558 27

The combination of Trans-Atlantic Intersociety Consensus (TASC) D aortoiliac occlusive disease as well as a symptomatic abdominal aortic aneurysm (AAA) is not a common occurrence. Extensive calcified atherosclerotic disease, occlusions, and small iliofemoral segmental arteries make transfemoral access difficult, if not impossible, for endovascular aneurysm repair (EVAR) in these patients. We present a case in which "controlled rupture" of the external iliac artery with a covered stent allowed transfemoral delivery of an aortouni-iliac stent graft with a completion femoral-to-femoral bypass. The patient is a 60-year-old male with a 5.3 cm symptomatic infrarenal AAA and a history of one block right leg claudication. Preoperative computed tomography angiography revealed the patient to have occlusion of the right common iliac artery, extensive calcified stenoses of his aortoiliac segments, and a prohibitively small left external iliac artery, which measured 4.5 mm at its narrowest diameter. The patient, despite discussions concerning the suitability of his iliac arteries as conduits for the delivery of the stent graft, insisted on an endovascular approach to lessen his chances of postoperative sexual dysfunction as well as minimize his length of stay. Access was obtained through bilateral femoral artery cutdowns, and attempts at dilating the left external iliac artery using 16-French dilators were performed without success. An 8 mm x 5 cm covered self-expanding stent was deployed in the diseased 4.5 mm left external iliac artery, followed by angioplasty performed with an 8 mm noncompliant balloon to disrupt the vessel. This endoconduit now allowed accommodation of our 18-French introducer for the aortouni-iliac stent graft. The operation was completed with a femoral-femoral bypass. Flow to both hypogastric arteries was preserved. We believe use of such techniques will ultimately expand the number of patients eligible for EVAR and avoid devastating access-related complications.
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PMID:Use of internal endoconduits as an adjunct to endovascular aneurysm repair in the setting of challenging aortoiliac anatomy. 1974 13

Preservation of one or both internal iliac arteries (IIA) during endovascular repair of an abdominal aortic aneurysm (AAA) reduces the risk of buttock claudication, sexual dysfunction, and pelvic ischemia. Various techniques have been reported for this purpose. We report a case involving the proximal migration of a bell-bottom limb of a previous endovascular aneurysm repair (EVAR), leading to a type I distal endoleak. On reconstruction, the stent graft resembled a person running and was subsequently named a "running stent"; this had no particular clinical relevance. The patient was successfully treated endovascularly using a branched iliac device. To our knowledge, this is the first reported case of the use of an iliac branched device to treat a type 1b endoleak.
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PMID:From the "bell-bottom" to a migrated "running stent" and then a successful conversion to hypogastric branched endograft. 2380 32