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European Journal of Vascular and... Dec 2022
Topics: Humans; Aortic Aneurysm, Abdominal; Aortic Rupture
PubMed: 36216233
DOI: 10.1016/j.ejvs.2022.10.009 -
The Journal of Thoracic and... Oct 2015
Topics: Aortic Aneurysm, Thoracic; Aortic Rupture; Female; Humans; Male
PubMed: 26277470
DOI: 10.1016/j.jtcvs.2015.07.044 -
The Journal of Thoracic and... Feb 2016
Topics: Aortic Dissection; Aortic Aneurysm; Aortic Diseases; Aortic Rupture; Female; Hematoma; Humans; Male; Ulcer
PubMed: 26521967
DOI: 10.1016/j.jtcvs.2015.10.011 -
Current Drug Targets 2018Abdominal aortic aneurysm (AAA), a common disease involving the segmental expansion and rupture of the aorta, has a high mortality rate. Therapeutic options for AAA are... (Review)
Review
BACKGROUND
Abdominal aortic aneurysm (AAA), a common disease involving the segmental expansion and rupture of the aorta, has a high mortality rate. Therapeutic options for AAA are currently limited to surgical repair to prevent catastrophic rupture. Non-surgical approaches, particularly pharmacotherapy, are lacking for the treatment of AAA.
OBJECTIVE
We review both basic and clinical studies and discuss the current challenges to developing medical therapy that reduces AAA progression.
RESULTS
Studies using animal models of AAA progression and human AAA explant cultures have identified several potential targets for preventing AAA growth. However, no clinical studies have convincingly confirmed the efficacy of any pharmacologic treatment against the growth of AAA. Thus, there is as yet no strong recommendation regarding pharmacotherapy to reduce the risk of AAA progression and rupture.
CONCLUSION
This review identifies concerns that need to be addressed for the field to progress and discusses the challenges that must be overcome in order to develop effective pharmacotherapy to reduce AAA progression in the future.
Topics: Animals; Aortic Aneurysm, Abdominal; Aortic Rupture; Clinical Trials as Topic; Disease Models, Animal; Disease Progression; Humans; Molecular Targeted Therapy; Risk Factors; Signal Transduction
PubMed: 29284386
DOI: 10.2174/1389450119666171227223331 -
Journal of Zoo and Wildlife Medicine :... Sep 2018Across China and Southeast Asia, over 17,000 bears are currently farmed for bile, predominantly for traditional Chinese medicines. Bears on farms in China are cage...
Across China and Southeast Asia, over 17,000 bears are currently farmed for bile, predominantly for traditional Chinese medicines. Bears on farms in China are cage confined and undergo repeated daily bile extraction facilitated by surgically implanted catheters or gallbladder fistulas. Numerous health problems have been reported in bile-farmed bears including peritonitis, abdominal hernias, and extraction site abscessation. Between 2009 and 2014, five Asiatic black bears ( Ursus thibetanus) and one Asiatic black/Eurasian brown bear ( Ursus arctos arctos) hybrid, rescued from the bear bile industry in China, died from ruptured and/or dissecting aortic aneurysm. Medical records were reviewed and two bears exhibited no clinical signs prior to death. In four bears, clinical findings varied and included increased stereotypic behavior prior to death, epistaxis, retinal lesions, dysphagia, weight loss, and acute onset of hyporexia. On postmortem examination, hemopericardium with dissection and/or rupture of the ascending aorta and left ventricular wall hypertrophy were present in all cases. No evidence of infectious disease, connective tissue disorders, or congenital cardiac disease was identified. Based on these observations screening thoracic radiography was performed on all bears at the rescue center and aortic dilation was identified in 73 of 134 (54.5%) bile-extracted bears. To the authors' knowledge, aortic aneurysm, rupture, and/or dissection have not been previously reported in any bear species and the high prevalence in this population of bears suggests an association with bile-farming practices. Future studies are needed to investigate the etiopathogenesis of this condition to aid in early diagnosis and improved management of bears being rescued from bile farms across Asia.
Topics: Aortic Dissection; Animals; Aortic Aneurysm; Aortic Rupture; Ursidae
PubMed: 30212334
DOI: 10.1638/2018-0018.1 -
Diabetes & Vascular Disease Research Sep 2016To summarize the association of diabetes with abdominal aortic aneurysm rupture, we reviewed currently available studies with a systematic literature search and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To summarize the association of diabetes with abdominal aortic aneurysm rupture, we reviewed currently available studies with a systematic literature search and meta-analytic evaluation.
METHODS
To identify all studies reporting the association of diabetes with abdominal aortic aneurysm rupture, MEDLINE and EMBASE were searched through July 2015. For each study, data regarding diabetes prevalence in both the ruptured and non-ruptured groups were used to generate an unadjusted odds ratio for abdominal aortic aneurysm rupture and 95% confidence intervals. Alternatively, an unadjusted or adjusted odds ratio, or hazard ratio for abdominal aortic aneurysm rupture with 95% confidence interval was directly abstracted (as available) from each individual study.
RESULTS
Our search identified 11 eligible studies. A primary meta-analysis of nine studies reporting data on ruptured (not including non-ruptured symptomatic) abdominal aortic aneurysm demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.71; 95% confidence interval, 0.56 to 0.89; p = 0.003). A secondary meta-analysis of all 11 studies (adding two studies in which non-ruptured symptomatic abdominal aortic aneurysm was included in the rupture group) also demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.77; 95% confidence interval, 0.63 to 0.95; p = 0.01).
CONCLUSION
Diabetes is negatively associated with abdominal aortic aneurysm rupture.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Chi-Square Distribution; Diabetes Mellitus; Humans; Incidence; Odds Ratio; Prevalence; Protective Factors; Risk Assessment; Risk Factors
PubMed: 27334484
DOI: 10.1177/1479164116651389 -
Blood Dec 2018Abdominal aortic aneurysm (AAA) is a degenerative vascular pathology resulting in significant morbidity and mortality in older adults due to rupture and sudden death.... (Review)
Review
Abdominal aortic aneurysm (AAA) is a degenerative vascular pathology resulting in significant morbidity and mortality in older adults due to rupture and sudden death. Despite 150 000 new cases and nearly 15 000 deaths annually, the only approved treatment of AAA is surgical or endovascular intervention when the risk for aortic rupture is increased. The goal of the scientific community is to develop novel pharmaceutical treatment strategies to reduce the need for surgical intervention. Because most clinically relevant AAAs contain a complex structure of fibrin, inflammatory cells, platelets, and red blood cells in the aneurysmal sac known as an intraluminal thrombus (ILT), antithrombotic therapies have emerged as potential pharmaceutical agents for the treatment of AAA progression. However, the efficacy of these treatments has not been shown, and the effects of shrinking the ILT may be as detrimental as they are beneficial. This review discusses the prospect of anticoagulant and antiplatelet (termed collectively as antithrombotic) therapies in AAA. Herein, we discuss the role of the coagulation cascade and platelet activation in human and animal models of AAA, the composition of ILT in AAA, a possible role of the ILT in aneurysm stabilization, and the implications of antithrombotic drugs in AAA treatment.
Topics: Animals; Aortic Aneurysm, Abdominal; Aortic Rupture; Blood Coagulation; Fibrinolytic Agents; Humans; Platelet Aggregation Inhibitors; Thrombosis
PubMed: 30228233
DOI: 10.1182/blood-2017-08-743237 -
The Journal of Thoracic and... Feb 2016
Topics: Aortic Dissection; Aortic Aneurysm; Aortic Diseases; Aortic Rupture; Female; Hematoma; Humans; Male; Ulcer
PubMed: 26496807
DOI: 10.1016/j.jtcvs.2015.09.019 -
Vascular Pharmacology Dec 2021Abdominal aortic aneurysm (AAA) is associated with increased plasma levels of microRNA (miR) -10b. 5 nmols of miR-10b or miR control was administrated to Apolipoprotein...
Abdominal aortic aneurysm (AAA) is associated with increased plasma levels of microRNA (miR) -10b. 5 nmols of miR-10b or miR control was administrated to Apolipoprotein E-deficient mice three days prior implantation of osmotic mini-pumps containing angiotensin II, and for three additional times once a week, which increased expression of miR-10b in plasma. Animals receiving miR-10b had a mortality rate due to aortic rupture of 61% compared to 11% in the miR controls (p < 0.05). Further, miR- 10b resulted in an increased aneurysm formation and growth (p < 0.05), which was accompanied by increased elastin degradation, neutrophil and mast cell markers (p < 0.05). In conclusion, miR-10b is functionally affecting aneurysm development and rupture and not only a marker of AAA. More mechanistic studies are required to better understand miR-10b's role in AAA formation.
Topics: Angiotensin II; Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortic Rupture; Disease Models, Animal; Mice; Mice, Inbred C57BL; Mice, Knockout, ApoE; MicroRNAs
PubMed: 34715373
DOI: 10.1016/j.vph.2021.106927 -
Radiology and Oncology Apr 2022Endovascular abdominal aortic aneurysm repair (EVAR) has become a mainstay of abdominal aorta aneurysm treatment. Long term follow-up on specific stent grafts is needed.
BACKGROUND
Endovascular abdominal aortic aneurysm repair (EVAR) has become a mainstay of abdominal aorta aneurysm treatment. Long term follow-up on specific stent grafts is needed.
PATIENTS AND METHODS
This study included 123 patients (104 men; mean age 73.0 years, range 51-89) with abdominal aorta aneurysm, treated with Excluder stent graft between October 2002 and June 2008. Periprocedural and follow-up data were retrieved by reviewing the records of our institution, while time and cause of death were retrieved from the National Institute of Public Health. If an abdominal aortic aneurysm rupture was listed as the cause of death, records were retrieved from the institution that issued the death certificate. Our primary goal was to assess the primary technical success rate, type 1 and type 2 endoleak, reintervention free survival, 30-day mortality, the overall survival and aneurysm rupture-free survival.
RESULTS
The median follow-up was 9.7 years (interquartile range, 4.6-13.8). The primary technical success was 98.4% and the 30-day mortality accounted for 0.8%. Secondary procedures were performed in 29 (23.6%) patients during the follow-up period. The one-, five-, ten-, fifteen- and seventeen-year overall survival accounted for 94.3%, 74.0%, 47.2%, 35.8% and 35.8%, while the aneurysm-related survival was 98.4%, 96.3%, 92.6%, 92.6%, 92.6%. In seven (5.7%) patients, abdominal aortic rupture was found as the primary cause of death during follow-up.
CONCLUSIONS
Our data showed that EVAR with Excluder stent graft offers good long-term results. More than 75% of patients can be treated completely percutaneously. Late ruptures do occur in the first ten years, raising awareness about regular medical controls.
Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Aortic Rupture; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Humans; Male; Middle Aged; Stents
PubMed: 35417109
DOI: 10.2478/raon-2022-0008