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

Primary aorto-enteric fistulae are rare. Preoperative diagnosis is important but is difficult and cannot usually be confirmed by upper gastrointestinal series, aortography and endoscopy. Computed tomography demonstrating an abdominal aortic aneurysm with air bubbles in its wall and "soft tissue" mass posteriorly should raise the possibility of penetration of the aneurysm into the lumen of the bowel and related consequences (hematoma, sepsis, infected operating field).
Clin Imaging 1989 Sep
PMID:Computed tomography diagnosis of primary aorto-enteric fistula. 281 86

824 men aged 65 to 74 were invited for ultrasound screening of the aorta and 426 (51.7%) attended. An abdominal aortic aneurysm was discovered in 23 (5.4%), and in 10 (2.3%) the aneurysm was 4.0 cm or more in diameter. 2 other patients had a common iliac artery aneurysm. The 36 men who had objective evidence of occlusive arterial disease of the lower limbs were twice as likely to be tobacco smokers and accounted for 5 (20%) of the aneurysms discovered. Extension of this screening programme to England and Wales could be expected to identify 52,500 men with an abdominal aortic aneurysm. If elective surgical replacement of the aneurysm were to be accepted by 60% of those with aneurysms 4 cm or more in diameter, 6000 unnecessary deaths from aortic aneurysm rupture could be prevented.
Lancet 1988 Sep 10
PMID:Oxford screening programme for abdominal aortic aneurysm in men aged 65 to 74 years. 290 Sep 88

A mutation in Escherichia coli leads to the loss of ribosomal protein L24, severely impaired growth, and a temperature-sensitive phenotype. The mutation was shown to be in rplX, the gene for protein L24, and was due to the alteration of an AAA codon to a TAA stop codon at position 61 in rplX that resulted in a 20-amino acid peptide instead of the 104 amino acids of wild-type L24 protein. rplX genes from three temperature-resistant and fast growing pseudorevertants of the mutant were cloned and sequenced. They were found to have different base substitutions in the TAA codon, resulting in the reappearance of a full-sized protein L24 moiety. Complementation of the slow growth in trans could be achieved with several plasmids containing at least the spc promoter and intact L14 and L24 genes. Plasmids containing genes distal to rplX could further stimulate growth, and the wild type arose when the entire spc operon and the alpha operon were present. In all cases, protein L24 was expressed by the plasmids. Therefore, slow growth could be explained by polarity extending to the alpha operon. However, temperature sensitivity could not be complemented by any of the plasmids in trans, although we found that this phenotype was caused by the mutation in the rplX gene.
J Bacteriol 1985 Sep
PMID:DNA sequence and complementation analysis of a mutation in the rplX gene from Escherichia coli leading to loss of ribosomal protein L24. 299 50

Twenty-four cases of abdominal aortic aneurysm were studied by means of MR Imaging, Computed Tomography (CT), Ultrasound (US) and Angiography. MR Imaging gave detailed information on the site and extension of the aneurysm. The extent of branches involvement, the presence of thrombosis, and the adjacent structures were also demonstrated. Major limitations of angiography were its morbility, and the difficult/impossible demonstration of eventual thrombi, and of the adjacent structures. CT, although extremely valuable in emergency cases and in the detection of calcifications, provided insufficient information on the involvement of the vessels originating from the aorta. US proved useful in the screening of abdominal aortic aneurysms, but lacked both the accuracy and the reliability necessary to a complete preoperative evaluation. MR Imaging proves thus to be a good investigation technique for a complete assessment of aneurysmatic lesions. Its major limitation is its inability to detect calcifications, while its major advantages are the accurate demonstration of both blood flow and eventual thrombi, and the multiplanarity and non-invasiveness of the methodology.
Radiol Med 1988 Sep
PMID:[Abdominal aortic aneurysms. Comparison of magnetic resonance, ultrasound, CT x-ray and angiography]. 305 Nov 46

Surgical care costs continue to rise at a rate greater than overall U.S. economic growth. Government and industry have vowed to slow the growth of health care spending. Prospective payment systems using the Diagnostic Related Group (DRG) mechanism are being phased in for payment of in-patient hospital care. One expected effect of the DRG payment scheme is a more careful financial analysis of the components of surgical care. The purposes of this study were to examine a vascular procedure, ruptured abdominal aortic aneurysm (RAAA), performed at a large teaching hospital during a ten-year period; to characterize patients by cost (hospital charges exclusive of physician fees) and outcome; and to test the hypothesis that an IDENTIFIER, here the presence or absence and duration of hypotension (less than 90 mm Hg systolic), could predict differences in cost and outcome. The results, in conjunction with historic data, were used to quantify aggregate hospital expenditures for this condition by survivor and the identifier. The results indicate: (1) mortality is higher for the hypotensive patient than for the normotensive patient (p less than 0.05) and is related to the duration of hypotension; (2) lowest mean charges per patient were in the hypotensive more than thirty minutes group ($5,587) followed by normotensive ($28,298), then hypotensive less than thirty minutes ($43,876); and (3) the mean charges for each survivor were $42,447 for normotensive patients versus $107,572 for hypotensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Angiology 1988 Sep
PMID:Surgonomics: the costs of ruptured abdominal aortic aneurysm. 313 26

Suprarenal extension of abdominal aortic aneurysms (AAAs) has been reported to be present in less than 10% of patients. Its preoperative demonstration is of value in planning the aneurysm repair; however, the most appropriate radiologic method of assessment remains controversial. Although many practitioners advocate angiography, recent advances in noninvasive techniques challenge this approach. To determine the optimal method of assessment, a retrospective study of CT, ultrasonography, and angiography was undertaken in a group of 101 patients with AAA. Conventional CT was used in all patients and high-resolution CT through the region of the renal vein was used in 45 of these patients. Ultrasonography was used in 27 patients and angiography in 23. Conventional CT detected the renal artery origins in 76% of the cases--results that improved to 98% when thin-section high-resolution CT was used. These improvements in CT make the delineation of the relationship of the renal arteries to the aortic aneurysms almost as accurate as angiography at approximately half the cost. Its accuracy, safety, and cost effectiveness make CT the modality of choice in the preoperative assessment of suprarenal aortic aneurysms.
J Vasc Surg 1987 Sep
PMID:Improved identification of renal arteries in patients with aortic aneurysms by means of high-resolution computed tomography. 330 96

We describe the technique of intraoperative angioscopy for delineation of peripheral vascular anatomy. Angioscopes with outer diameters of 0.85-2.9 mm have been used during 86 peripheral vascular procedures. Angioscopic inspections were performed during 68 femoral popliteal bypasses, four aortofemoral bypass grafts, one abdominal aortic aneurysm, two extra anatomic axillary femoral bypass grafts, and 11 other vascular procedures. We obtained useful images in 73 of 86 procedures (85%), thereby yielding 118 angioscopic inspections (53 arteries, 37 anastomoses, and 28 vein grafts). Changes in intraoperative management based on angioscopic findings included revision of five of 37 (14%) anastomoses, deletion of four of 31 (13%) completion angiograms, revision of eight of 17 (47%) in situ venous valves, and repetition of thrombectomy in six of seven (86%) cases. In 22 of 73 (30%) peripheral angioscopies, potential causes of graft occlusion were recognized. Complications from intraoperative angioscopy have included one anastomotic flap from intimal disruption that required anastomotic revision. Three small flaps, possibly resulting from angioscopic trauma, were recognized but appeared to have no clinical significance. In conclusion, intraoperative angioscopy provides visual assessment of luminal patency and anastomotic anatomy. This assessment alters intraoperative procedures in some cases and cannot be obtained by angiography.
Circulation 1988 Sep
PMID:Intraoperative decisions based on angioscopy in peripheral vascular surgery. 340 14

We report a case of duodenal obstruction caused by an abdominal aortic aneurysm. The duodenum was firmly attached to the lateral wall of the aneurysm by a tough, fibrous band. Duodenal obstruction is a rare presenting complaint in a patient with an abdominal aortic aneurysm. Anatomic features have not been routinely described in previous patients. We propose a mechanism for the cause of this entity and a review of the literature. The treatment of choice is resection of the aneurysm with graft replacement of the aorta.
Am J Gastroenterol 1988 Sep
PMID:Duodenal obstruction by abdominal aortic aneurysms. 341 51

An 8-year experience with treatment of 58 patients with ruptured abdominal aortic aneurysm (RAAA) is reviewed with hospital mortality of 25.9 per cent. Added to a previously reported experience, 115 patients have been treated over 25 years with 33 per cent mortality. Preoperative hypotension, free rupture, venous injury, and massive transfusion were found to be associated with mortality. Interhospital transfer, preexisting coronary or pulmonary disease, known aneurysm, anemia, delay in surgery, and operative time were not found to predict outcome. Some patients are normotensive at presentation, providing an excellent chance for survival when expeditious diagnosis and treatment are carried out. Optimal operative management, complications, and causes of death are discussed. The role of computed tomography (CT) in diagnosis is considered. Elective resection of known aneurysms is the most important factor in reducing deaths from RAAA. The role of regionalization of care is unclear, since some patients cannot be safely transported. However, some evidence for optimal results in specialized centers is presented.
Am Surg 1988 Sep
PMID:Ruptured abdominal aortic aneurysm: a 25-year experience and analysis of recent cases. 341 95

To assess the intraoperative and postoperative hemodynamic effects of beta-blockade and its benefits in limiting myocardial ischemia and infarction, a group of 32 patients scheduled for abdominal aortic aneurysm (AAA) surgery (group 1) was treated with oral metoprolol immediately before surgery and with intravenous metoprolol during the postoperative period. Mean age was 71 years, and mean ejection fraction was 56% (range 36% to 83%). Eight patients had a preoperative history of angina, 13 had a history of myocardial infarction, and five had electrocardiographic evidence of prior myocardial infarction. A group of 51 closely matched patients with AAA who did not receive metoprolol served as controls (group 2). In group 1, overall hemodynamic tolerance of metoprolol intraoperatively and postoperatively was good, and there was no incidence of congestive heart failure, hypotension, or asthma. Furthermore, in group 1 significant reduction of systolic blood pressure and heart rate was consistently noted at frequent intraoperative intervals and for 48 hr after surgery, with only a transient reduction of cardiac index. In group 1, only one patient (3%) suffered an acute myocardial infarction. In contrast, nine group 2 patients (18%; p less than .05) suffered perioperative myocardial infarction. Furthermore, only four (12.5%) group 1 patients developed significant cardiac arrhythmias as opposed to 29 group 2 patients (56.9%; p less than .001). These data demonstrate that beta-blockade with metoprolol is effective in controlling systolic blood pressure and heart rate both intraoperatively and postoperatively in patients undergoing repair of AAA and can significantly reduce the incidence of perioperative myocardial infarction and arrhythmias.
Circulation 1987 Sep
PMID:The hemodynamics of beta-blockade in patients undergoing abdominal aortic aneurysm repair. 362 32


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