Re: “Proposed NICE Abdominal Aortic Aneurysm Repair Guidelines: Swinging the Pendulum too Far?”

I read the editorial by Llapis et  al.1 with great interest. The title is absolutely correct with the NICE guidelines swinging the pendulum too far. However, I was left disappointed with some of the arguments in the editorial as they swung the pendulum too far the other way.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Correspondence Source Type: research

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We report an unusual case of a 65-year-old male patient with horseshoe kidney, who underwent a successful open repair for abdominal aortic aneurysm. The accessory renal arteries were perfused with histidine-tryptophan-ketoglutarate (HTK) solution (Custodiol ®; Dr. Franz-Kohler Chemie GmbH, Bensheim, Germany) during the vascular reconstruction. There were no creatinine and eGFR modifications in the postoperative time. In the literature, only two cases of Custodiol solution for kidney protection during aortic surgery are reported.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
We report a case of an infrarenal abdominal aortic aneurysm (AAA) with unrecognized primary aortoduodenal fistula (ADF), treated by endovascular aortic repair (EVAR). Endograft infection was diagnosed 12 months thereafter. The associated ADF was uncovered during open surgery, which included endograft extraction, in-situ aortic reconstruction with a cryopreserved homograft (CHG) and duodenal repair. The patient was urgently reoperated in early postoperative course, due to CHG rupture and subsequent hemorrhagic shock.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
Endovascular aortic aneurysm repair (EVR) has a major financial impact on health care systems. We characterized reimbursement for index EVR hospitalizations among Medicare beneficiaries having surgery at Vascular Quality Initiative (VQI) centers.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research
PMID: 31589486 [PubMed - in process]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
CONCLUSIONS: Prophylactic prosthetic wrapping of vascular anastomosis in patients with Behçet's AAA in resource-challenged settings, where the proximal anastomoses were all end-to- end with wrapping, is an affordable, simple, reliable, and feasible technique, and commonly associated with a lower incidence of anastomotic site false aneurysms and different complications related to the implanted graft, where endovascular procedures might not be applicable. Moreover, the proper preoperative medical preparation for controlling the activity of Behçet's disease, with the administration of immunosuppressive agents, f...
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
Abstract BACKGROUND: The aim of this study was to examine the value preoperative AT as predictor of postoperative survival in patients who underwent elective EVAR for repair of asymptomatic AAA. METHODS: Consecutive patients who underwent elective EVAR between 2008 and 2018 were analysed. Cardiopulmonary exercise testing was performed. Perioperative/30 day mortality was compared between patients who had AT ≥8 ml kg-1 min-1 and those with AT
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Authors: Bonfill X, Quintana MJ, Bellmunt S, Suclupe S, Gómez E, Fernández de Valderrama I, Castejón B, Miralles M, Pérez E, Escudero JR, AAA Spanish study group Abstract BACKGROUND: To assess potential variability in the clinical characteristics and treatment of patients undergoing elective surgery for abdominal aortic aneurysm (AAA) across five hospitals in Spain. METHODS: Multicenter, retrospective cohort study of patients diagnosed with AAA and treated with open surgical repair (OSR) or endovascular aneurysm repair (EVAR). We evaluated clinical and demographic variables, includin...
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
CONCLUSIONS: Different applications of the use of 3D printing and digital imaging in vascular surgery have been experimented with a different maturity level. Whilst the technology has increased its potential in the latest years, the number of studies documented in the literature is still quite narrow. Further research is necessary to fully test the potential of 3D printing, also in combination with other technologies (e.g. 3D imaging and CNC cutting). Early experimentations show that these technologies have the potential to radically change the vascular surgery practice in the near future, in particular in treatment like E...
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
Abstract In recent years, the prevalence of invasive Streptococcus dysgalactiae subsp. equisimilis (SDSE) infections has increased gradually throughout the world, including Japan. Here, we report the case of an abdominal aortic graft infection caused by stG485.0, ST29 SDSE in an elderly patient with diabetes. An 86-year-old man who had undergone an abdominal aortic aneurysm (not infected) repair with a bifurcated graft 10 years ago was referred to our hospital after being suspected of having abdominal aortic graft infection through computed tomography. He underwent surgery, and the pus developed between the aneury...
Source: Japanese Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Jpn J Infect Dis Source Type: research
In the past decade, treatment of abdominal aortic aneurysm (AAA) has dramatically shifted from open repair to an endovascular approach. The decreasing number of open AAA repairs (OAR) has raised concerns regarding future vascular surgeons' competence to perform this complex and high-risk procedure. Prior work has documented decreasing open aortic volume among surgical residents. However, these studies report average national case volume with a limited understanding of the variation in OAR exposure among training programs and trainees.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
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