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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 therapeutic measure against concomitant intraabdominal aneurysm and colorectal carcinoma is still a dilemma. Here we report the clinical courses of three cases of colorectal carcinoma coincidental with moderate-sized abdominal aortic or iliac artery aneurysm in those who underwent operations during a recent three-year period. Resection of malignant lesion and wrapping of aneurysm were carried out in all three patients simultaneously. Carcinoma was staged by Dukes classification as A in one patient and B in two patients. All tolerated surgery well without any signs of complications. Two-year or three-year follow-up shows that they have continued to do well, with no further symptoms of abdominal aortic aneurysm, peripheral vascular disease, or recurrence of colorectal carcinoma. We conclude that, if the aneurysm is not about to rupture and the carcinoma is in an advanced stage, then the carcinoma should be resected, associated with interim aneurysmal wrapping. However, both lesions need to be resected eventually for long-term survival.
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PMID:Role of wrapping in concomitant intra-abdominal aneurysm and colorectal carcinoma. Report of three cases. 139 89

Over a 1-year period, 242 patients with peripheral vascular disease underwent abdominal ultrasonography to detect the presence of an abdominal aortic aneurysm. In 34 (14 per cent) an abdominal aortic aneurysm was found; half of these aneurysms were greater than 4 cm in diameter. In addition, 16 patients had ectatic aortas. Abdominal aortic aneurysms were more common in men than in women (17 versus 8 per cent). Patients with claudication were as likely to have an abdominal aortic aneurysm as those with rest pain or gangrene. The presence of aortoiliac occlusive disease increased the chance of an aneurysm being present (P less than 0.02). Patients with occlusive peripheral vascular disease are a high-risk group with regard to the development of an abdominal aortic aneurysm. Patients with proximal occlusive disease represent a subgroup at even higher risk.
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PMID:Prevalence of abdominal aortic aneurysm in patients with occlusive peripheral vascular disease. 195 1

The rapidly rising incidence of abdominal aortic aneurysm (AAA) and the grave prognosis in cases of rupture call for early detection and operative intervention. However, there is as yet no consensus on which groups in the population should be selected for screening. Some Authors have suggested the screening of populations at risk by virtue of their age, sex and/or the presence of arterial hypertension, and report the incidence of AAA in these populations as 5.3%, 3.4% and 0.25%, respectively. In this study we screened a group of patients with atherosclerotic peripheral vascular disease. Within this group the incidence of aneurysms was found to be 5.9%, which is at least twice the estimated incidence in the general population. Three of the six patients discovered, successfully underwent surgery. We conclude that screening of this specific population group is considerably more cost-effective than universal screening.
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PMID:Ultrasound screening for abdominal aortic aneurysms in patients with atherosclerotic peripheral vascular disease. 218 82

Seven patients with severe aortic stenosis underwent percutaneous aortic balloon valvuloplasty in preparation for major noncardiac surgery. There were four men and three women (mean age 82 +/- 1.3 years, range 78 to 88). A significant reduction in the transaortic pressure gradient from 77 +/- 7.8 to 31 +/- 6.2 mm Hg (p = 0.002) and increase in calculated aortic valve area from 0.5 +/- 0.1 to 1.0 +/- 0.3 cm2 (p = 0.05) was noted. Three of the seven procedures were performed anterograde with use of transseptal puncture: two of the three because of abdominal aortic aneurysm and one because of peripheral vascular disease. All seven patients underwent uncomplicated noncardiac surgery under general anesthesia 10 +/- 4.3 days (range 0 to 29) after aortic valvuloplasty. One patient had exploratory laparotomy, one underwent stabilization of a hip fracture and two underwent resection of an abdominal aortic aneurysm. Of the three other patients who underwent colectomy, one had repeat aortic valvuloplasty and repair of a hip fracture 7 months later and one required exploratory laparotomy without repeat valvuloplasty 7 weeks later. Percutaneous aortic balloon valvuloplasty is an effective and safe procedure that may reduce the risk of general anesthesia and major noncardiac surgery in elderly patients with aortic stenosis.
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PMID:Percutaneous aortic balloon valvuloplasty: its role in the management of patients with aortic stenosis requiring major noncardiac surgery. 292 53

The pattern of vascular surgery at Westmead Hospital from 1979 to 1985 has been reviewed. There has been an upward trend in the number of patients having repair of abdominal aortic aneurysm and carotid endarterectomy. However, the number of operations for peripheral vascular disease has not increased. This may be due to the increasing use of percutaneous transluminal angioplasty (PTA), but it may also be associated with the increasing difficulty in obtaining hospital admission for patients with conditions not immediately life or limb threatening.
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PMID:The changing pattern of vascular surgery: the effect of percutaneous transluminal angioplasty. 295 88

Combined repair of peripheral vascular disease and myocardial revascularization has become accepted treatment in selected patients. Two of our patients underwent such a procedure. One patient suffered an intraoperative dissection of the ascending aorta following myocardial revascularization. Ascending aortic replacement and vein graft reimplantation was accomplished as well as repair of the abdominal aortic aneurysm. Because of this experience we recommend that following myocardial revascularization, aortic cannulation be maintained during repair of the abdominal aortic aneurysm. This allows immediate access to cardiopulmonary bypass should untoward cardiovascular events occur during aneurysm repair.
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PMID:Surgical approach to combined coronary revascularization and abdominal aortic aneurysmectomy. 325 68

A study was carried out to see if an ultrasonic examination of the abdominal aorta was indicated in every patient who attended an outpatient clinic with peripheral vascular disease (PVD). One hundred consecutive patients were studied and compared with a control group. The incidence of abdominal aortic aneurysm (AAA) in the control group was 2 per cent. In the study group, the male patients had an incidence of 20 per cent of aneurysm and ectasia, while the female patients had an incidence of 12 per cent. Of all the abnormal aortas found by ultrasound, only 31 per cent were palpable clinically. Two aneurysms that required operation were found, while the remainder are to be followed by regular ultrasound assessment. Further studies are necessary to conclude if screening of a high risk group, such as patients with PVD, is worthwhile.
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PMID:High prevalence of abdominal aortic aneurysm in men with peripheral vascular disease: screening by ultrasonography. 328 95

In a review of the records of 74 patients who had undergone repair of an abdominal aortic aneurysm at a community hospital between 1977 and 1983 we found that the aneurysm had been undiagnosed before rupture in 35%; these patients had an operative death rate of 50%, whereas elective repair carried a death rate of 4%. The characteristic patient was an obese man over the age of 55 years with hypertension, coronary artery disease, cerebrovascular disease or peripheral vascular disease. Ultrasound examination was performed in 45 patients with these characteristics, and six aneurysms were diagnosed. Either surgery or computed tomography confirmed the diagnosis. The rate of false-negative results was estimated by review of the charts of 100 men over the age of 55 years who had undergone abdominal ultrasonography for other indications: no undetected aneurysms were discovered over 3 years of follow-up. Routine screening in this high-risk group would improve the rate of diagnosis of this potentially fatal condition before rupture and offer the patient the lower mortality rate associated with elective surgery.
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PMID:Ultrasound screening for clinically occult abdominal aortic aneurysm. 328 38

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

Life expectancy after aneurysm surgery was analyzed for male patients over the age of 60 years with known risk factors classified by the Goldman cardiac risk index, which has previously been utilized for prediction of immediate perioperative risks of surgery and anesthesia. The preoperative risk factors, Goldman cardiac risk index, and long-term survival rates were tabulated for each of 96 male patients over the age of 60 years who had elective repair of infrarenal abdominal aortic aneurysm. Follow-up data of up to 14 years (mean 4.2 years) was entered into a SurvPak-PC biostatistical software program for construction of Kaplan-Meier survival curves and actuarial life tables to measure differences in survival between groups and for performance of nonparametric analysis (by log rank test) of the influence of preoperative risk factors. The operative mortality rate was 3.1 percent and the 5 year survival rate for the whole group was 61 percent, with a median survival of 8.7 years. Five year survival rates for patients in three age groups (60 to 70 years, 71 to 80 years, and greater than 80 years), when compared with age-matched populations, were 67 percent versus 88 percent, 50 percent versus 73 percent, and 35 percent versus 39 percent, respectively. Patients in Goldman class 1, 2, and 3 or 4 had 5 year survival rates of 79 percent, 53 percent, and 41 percent, respectively. Factors that adversely affected long-term survival were Goldman classes 3 or 4 (median survival 2.1 +/- 0.4 years, p = 0.001), cerebrovascular disease (median survival 1.9 +/- 0.6 years, p = 0.004), history of cardiac disease (median survival 3.2 +/- 0.6 years, p = 0.012), and creatinine concentration greater than 3 mg/100 ml (median survival 3.1 +/- 1.6 years, p = 0.034), whereas Goldman class 2 or the presence of hypertension, pulmonary disease, diabetes mellitus, peripheral vascular disease, and size of the aneurysm, although associated with a shortened length of survival, as independent variables did not reach statistical significance. A combination of any three of these risk factors, however, shortened the survival time markedly (median 1.9 +/- 0.7 years, p = 0.003). We believe that the Goldman cardiac risk index classification correlates with long-term survival in patients undergoing elective aortic surgery.
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PMID:Cardiac risk index as a predictor of long-term survival after repair of abdominal aortic aneurysm. 340 Aug 5


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