Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair
Frank A. Lederle,Gary R. Johnson,Samuel E. Wilson,David J. Ballard,William D. Jordan,John Blebea,Fred N. Littooy,Julie A. Freischlag,Dennis F. Bandyk,Joseph H. Rapp,Atef Salam +10 more
TLDR
The rupture rate is substantial in high-operative-risk patients with abdominal aortic aneurysm of at least 5.5 cm in diameter and increases with larger diameter.Abstract:
ContextAmong patients with abdominal aortic aneurysm (AAA) who have high operative
risk, repair is usually deferred until the AAA reaches a diameter at which
rupture risk is thought to outweigh operative risk, but few data exist on
rupture risk of large AAA.ObjectiveTo determine the incidence of rupture in patients with large AAA.Design and SettingProspective cohort study in 47 Veterans Affairs medical centers.PatientsVeterans (n = 198) with AAA of at least 5.5 cm for whom elective AAA
repair was not planned because of medical contraindication or patient refusal.
Patients were enrolled between April 1995 and April 2000 and followed up through
July 2000 (mean, 1.52 years).Main Outcome MeasureIncidence of AAA rupture by strata of initial and attained diameter.ResultsOutcome ascertainment was complete for all patients. There were 112
deaths (57%) and the autopsy rate was 46%. Forty-five patients had probable
AAA rupture. The 1-year incidence of probable rupture by initial AAA diameter
was 9.4% for AAA of 5.5 to 5.9 cm, 10.2% for AAA of 6.0 to 6.9 cm (19.1% for
the subgroup of 6.5-6.9 cm), and 32.5% for AAA of 7.0 cm or more. Much of
the increased risk of rupture associated with initial AAA diameters of 6.5-7.9
cm was related to the likelihood that the AAA diameter would reach 8.0 cm
during follow-up, after which 25.7% ruptured within 6 months.ConclusionThe rupture rate is substantial in high-operative-risk patients with
AAA of at least 5.5 cm in diameter and increases with larger diameter.read more
Citations
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ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)
Alan T. Hirsch,Ziv J. Haskal,Norman R. Hertzer,Curtis W. Bakal,Mark A. Creager,Jonathan L. Halperin,Loren F. Hiratzka,William R.C. Murphy,Jeffrey W. Olin,Jules B. Puschett,Kenneth Rosenfield,David B. Sacks,James C. Stanley,Lloyd M. Taylor,Christopher J. White,John White,Rodney A. White,Elliott M. Antman,Sidney C. Smith,Cynthia D. Adams,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Raymond J. Gibbons,Sharon A. Hunt,Alice K. Jacobs,Rick A. Nishimura,Joseph P. Ornato,Richard L. Page,Barbara Riegel +29 more
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Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.
Salim S. Virani,Alvaro Alonso,Hugo J. Aparicio,Emelia J. Benjamin,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Susan Cheng,Francesca N. Delling,Mitchell S.V. Elkind,Kelly R. Evenson,Jane F. Ferguson,Deepak K. Gupta,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Chong D. Lee,Tené T. Lewis,Junxiu Liu,Matthew Shane Loop,Pamela L. Lutsey,Jun Ma,Jason Mackey,Seth S. Martin,David B. Matchar,Michael E. Mussolino,Sankar D. Navaneethan,Amanda M. Perak,Gregory A. Roth,Zainab Samad,Gary Satou,Emily B. Schroeder,Svati H. Shah,Christina M. Shay,Andrew Stokes,Lisa B. VanWagner,Nae Yuh Wang,Connie W. Tsao +38 more
TL;DR: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...
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The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm
Elliot L. Chaikof,Ronald L. Dalman,Mark K. Eskandari,Benjamin M. Jackson,W. Anthony Lee,M. Ashraf Mansour,Tara M. Mastracci,Matthew W. Mell,M. Hassan Murad,Louis L. Nguyen,Gustavo S. Oderich,Madhukar S. Patel,Marc L. Schermerhorn,Benjamin W. Starnes +13 more
TL;DR: A door‐to‐intervention time of <90 minutes is suggested, based on a framework of 30‐30‐30 minutes, for the management of the patient with a ruptured aneurysm, and the Vascular Quality Initiative mortality risk score is suggested for mutual decision‐making with patients considering aneurYSm repair.
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Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery.
Fl Moll,Jt Powell,Gustav Fraedrich,Fabio Verzini,Stéphan Haulon,Matthew Waltham,van Herwaarden Ja,Pj Holt,van Keulen Jw,van Keulen Jw,B Rantner,Fj Schlösser,Francesco Setacci,J.-B. Ricco +13 more
TL;DR: This poster presents a poster presented at the 2016 International Congress of the American College of Vascular Surgery (ICS) entitled “Cardiology and Vascular Surgeons: Foundations of Cardiac Rhythm Management, 2nd Ed.”
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Frank A. Lederle,Samuel E. Wilson,Gary R. Johnson,Donovan B. Reinke,Fred N. Littooy,Charles W. Acher,David J. Ballard,Louis M. Messina,Ian L. Gordon,Edmund P. Chute,William C. Krupski,Steven J. Busuttil,Gary W. Barone,Steven Sparks,Linda M. Graham,Joseph H. Rapp,Michel S. Makaroun,Gregory L. Moneta,Robert A. Cambria,Raymond G. Makhoul,Darwin Eton,Howard J. Ansel,Julie A. Freischlag,Dennis F. Bandyk +23 more
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Journal Article
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Frank A. Lederle,Gary R. Johnson,Samuel E. Wilson,Edmund P. Chute,Fred N. Littooy,Dennis F. Bandyk,William C. Krupski,Gary W. Barone,Charles W. Acher,David J. Ballard +9 more
TL;DR: The Aneurysm Detection and Management (ADAM) study is an ongoing randomized clinical trial comparing two strategies for the management of AAA in patients 50 to 79 years of age with asymptomatic AAAs.
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