Portal de Periódicos da CAPES

Abdominal Aortic Aneurysm

2009; American College of Physicians; Volume: 150; Issue: 9 Linguagem: Inglês

10.7326/0003-4819-150-9-200905050-01005

1539-3704

Frank A. Lederle,

Aortic aneurysm repair treatments

In the Clinic5 May 2009Abdominal Aortic AneurysmFrank A. Lederle, MD, Christine Laine, MD, MPH, David R. Goldmann, MD, and Harold C. Sox, MDFrank A. Lederle, MD, Christine Laine, MD, MPH, David R. Goldmann, MD, and Harold C. Sox, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-9-200905050-01005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An aneurysm is a failure of the arterial wall that results in a balloon-like dilatation of a segment of the artery. Aortic aneurysms constitute the 14th leading cause of death in the United States and the 10th leading cause of death in older men, who are the principal victims (1). Diagnosis of abdominal aortic aneurysm (AAA) is important because the natural history is that of continued enlargement with potentially catastrophic consequences. Because the condition may be entirely asymptomatic, and when symptoms are present, they may be nonspecific, the internist is often the first to evaluate the patient. Thus, understanding the ...References1. Silverberg E, Boring CC, Squires TS. Cancer statistics, 1990. CA Cancer J Clin. 1990;40:9-26. [PMID: 2104569] Google Scholar2. McPhee JT, Hill JS, Eslami MH. The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001-2004. J Vasc Surg. 2007;45:891-9. [PMID: 17391899] Google Scholar3. Lederle FA, Johnson GR, Wilson SE, et al. The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators. Arch Intern Med. 2000;160:1425-30. [PMID: 10826454] Google Scholar4. The UK Small Aneurysm Trial Participants. Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 1998;352:1649-55. [PMID: 9853436] Google Scholar5. Aneurysm Detection and Management Veterans Affairs Cooperative Study Group. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002;346:1437-44. [PMID: 12000813] Google Scholar6. Santilli SM, Littooy FN, Cambria RA, et al. Expansion rates and outcomes for the 3.0-cm to the 3.9-cm infrarenal abdominal aortic aneurysm. J Vasc Surg. 2002;35:666-71. [PMID: 11932660] Google Scholar7. Veterans Affairs Cooperative Study #417 Investigators. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002;287:2968-72. [PMID: 12052126] Google Scholar8. Adam DJ, Mohan IV, Stuart WP, et al. Community and hospital outcome from ruptured abdominal aortic aneurysm within the catchment area of a regional vascular surgical service. J Vasc Surg. 1999;30:922-8. [PMID: 10550191] Google Scholar9. Brown LC, Powell JT. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. UK Small Aneurysm Trial Participants. Ann Surg. 1999;230:289-96; discussion 296-7. [PMID: 10493476] Google Scholar10. Powell JT, Brown LC, Greenhalgh RM, et al. The rupture rate of large abdominal aortic aneurysms: is this modified by anatomical suitability for endovascular repair? Ann Surg. 2008;247:173-9. [PMID: 18156938] Google Scholar11. U.S. Preventive Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med. 2005;142:198-202. [PMID: 15684208] Google Scholar12. Fleming C, Whitlock EP, Beil TL, et al. Screening for abdominal aortic aneurysm: a best-evidence systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2005;142:203-11. [PMID: 15684209] Google Scholar13. Multicentre Aneurysm Screening Study Group. A sustained mortality benefit from screening for abdominal aortic aneurysm. Ann Intern Med. 2007;146:699-706. [PMID: 17502630] Google Scholar14. Lindholt JS, Norman P. Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and long-term effects of screening for abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008;36:167-71, response to comment, 621-2. [PMID: 18485756] Google Scholar15. Scott RA, Bridgewater SG, Ashton HA. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg. 2002;89:283-5. [PMID: 11872050] Google Scholar16. Lederle FA, Johnson GR, Wilson SE, et al. Yield of repeated screening for abdominal aortic aneurysm after a 4-year interval. Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators. Arch Intern Med. 2000;160:1117-21. [PMID: 10789604] Google Scholar17. Hafez H, Druce PS, Ashton HA. Abdominal aortic aneurysm development in men following a "normal" aortic ultrasound scan. Eur J Vasc Endovasc Surg. 2008;36:553-8. [PMID: 18718773] Google Scholar18. Thomas AC, Knapman PA, Krikler DM, et al. Community study of the causes of "natural" sudden death. BMJ. 1988;297:1453-6. [PMID: 3147014] Google Scholar19. Lederle FA, Parenti CM, Chute EP. Ruptured abdominal aortic aneurysm: the internist as diagnostician. Am J Med. 1994;96:163-7. [PMID: 8109601] Google Scholar20. Lederle FA, Simel DL. The rational clinical examination. Does this patient have abdominal aortic aneurysm? JAMA. 1999;281:77-82. [PMID: 9892455] Google Scholar21. Lederle FA, Wilson SE, Johnson GR, et al. Variability in measurement of abdominal aortic aneurysms. Abdominal Aortic Aneurysm Detection and Management Veterans Administration Cooperative Study Group. J Vasc Surg. 1995;21:945-52. [PMID: 7776474] Google Scholar22. Barnett SB, Ter Haar GR, Ziskin MC, et al. International recommendations and guidelines for the safe use of diagnostic ultrasound in medicine. Ultrasound Med Biol. 2000;26:355-66. [PMID: 10773365] Google Scholar23. Lindholt JS, Vammen S, Juul S, et al. The validity of ultrasonographic scanning as screening method for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 1999;17:472-5. [PMID: 10375481] Google Scholar24. Adam DJ, Bradbury AW, Stuart WP, et al. The value of computed tomography in the assessment of suspected ruptured abdominal aortic aneurysm. J Vasc Surg. 1998;27:431-7. [PMID: 9546228] Google Scholar25. Gloviczki P, Pairolero PC, Mucha P Jr, Farnell MB, Hallett JW Jr, Ilstrup DM, et al. Ruptured abdominal aortic aneurysms: repair should not be denied. J Vasc Surg. 1992;15:851-7; discussion 857-9. [PMID: 1578541] Google Scholar26. Shuman WP, Hastrup W Jr, Kohler TR, et al. Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room. Radiology. 1988;168:117-9. [PMID: 3289085] Google Scholar27. Nusbaum JW, Freimanis AK, Thomford NR. Echography in the diagnosis of abdominal aortic aneurysm. Arch Surg. 1971;102:385-8. [PMID: 5553311] Google Scholar28. Carro C, Camilleri L, Garcier JM, et al. Periaortic lymphoma mimicking aortic aneurysm. Eur J Cardiothorac Surg. 2004;25:1126. [PMID: 15145022] Google Scholar29. Valentine RJ, Barth MJ, Myers SI, et al. Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms. Surgery. 1993;113:286-9. [PMID: 8441963] Google Scholar30. UK Small Aneurysm Trial Participants. Abdominal aortic aneurysm expansion: risk factors and time intervals for surveillance. Circulation. 2004;110:16-21. [PMID: 15210603] Google Scholar31. Smoking, lung function and the prognosis of abdominal aortic aneurysm. The UK Small Aneurysm Trial Participants. Eur J Vasc Endovasc Surg. 2000;19:636-42. [PMID: 10873733] Google Scholar32. Propanolol Aneurysm Trial Investigators. Propranolol for small abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg. 2002;35:72-9. [PMID: 11802135] Google Scholar33. Wilmink ABM, Hubbard CSFF, Day NE, et al. Effect of propranolol on the expansion of abdominal aortic aneurysms: a randomized study [Abstract]. Br J Surg. 2000;87:499. Google Scholar34. Vammen S, Lindholt JS, Ostergaard L, et al. Randomized double-blind controlled trial of roxithromycin for prevention of abdominal aortic aneurysm expansion. Br J Surg. 2001;88:1066-72. [PMID: 11488791] Google Scholar35. Mosorin M, Juvonen J, Biancari F, et al. Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: a randomized, double-blind, placebo-controlled pilot study. J Vasc Surg. 2001;34:606-10. [PMID: 11668312] Google Scholar36. ACES Investigators. Azithromycin for the secondary prevention of coronary events. N Engl J Med. 2005;352:1637-45. [PMID: 15843666] Google Scholar37. Pravastatin or Atorvastatin Evaluation and Infection Therapy Thrombolysis in Myocardial Infarction 22 Investigators. Antiobiotic treatment of Chlamydia pneumoniae after acute coronary syndrome. N Engl J Med. 2005;352:1646-54. [PMID: 15843667] Google Scholar38. Velicer CM, Heckbert SR, Lampe JW, et al. Antibiotic use in relation to the risk of breast cancer. JAMA. 2004;291:827-35. [PMID: 14970061] Google Scholar39. Powell JT, Brown LC, Forbes JF, et al. Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial. Br J Surg. 2007;94:702-8. [PMID: 17514693] Google Scholar40. EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet. 2005;365:2179-86. [PMID: 15978925] Google Scholar41. Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2005;352:2398-405. [PMID: 15944424] Google Scholar42. EVAR trial participants. Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet. 2005;365:2187-92. [PMID: 15978926] Google Scholar43. Brown LC, Greenhalgh RM, Howell S, et al. Patient fitness and survival after abdominal aortic aneurysm repair in patients from the UK EVAR trials. Br J Surg. 2007;94:709-16. [PMID: 17514695] Google Scholar44. Killeen SD, Andrews EJ, Redmond HP, et al. Provider volume and outcomes for abdominal aortic aneurysm repair, carotid endarterectomy, and lower extremity revascularization procedures. J Vasc Surg. 2007;45:615-26. [PMID: 17321352] Google Scholar45. Dimick JB, Upchurch GR Jr. Endovascular technology, hospital volume, and mortality with abdominal aortic aneurysm surgery. J Vasc Surg. 2008;47:1150-4. [PMID: 18440178] Google Scholar46. American College of Cardiology. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery—-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). J Am Coll Cardiol. 2002;39:542-53. [PMID: 11823097] Google Scholar47. Samain E, Farah E, Lesèche G, et al. Guidelines for perioperative cardiac evaluation from the American College of Cardiology/American Heart Association task force are effective for stratifying cardiac risk before aortic surgery. J Vasc Surg. 2000;31:971-9. [PMID: 10805888] Google Scholar48. McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351:2795-804. [PMID: 15625331] Google Scholar49. American Association for Vascular Surgery. ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease) endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. J Am Coll Cardiol. 2006;47:1239-312. [PMID: 16545667] Google Scholar50. Grimshaw GM, Thompson JM, Hamer JD. A statistical analysis of the growth of small abdominal aortic aneurysms. Eur J Vasc Surg. 1994;8:741-6. [PMID: 7828753] Google Scholar51. McCarthy RJ, Shaw E, Whyman MR, et al. Recommendations for screening intervals for small aortic aneurysms. Br J Surg. 2003;90:821-6. [PMID: 12854107] Google Scholar52. Hallett JW Jr, Marshall DM, Petterson TM, et al. Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience. J Vasc Surg. 1997;25:277-84; discussion 285-6. [PMID: 9052562] Google Scholar53. Johnston KW. Nonruptured abdominal aortic aneurysm: six-year follow-up results from the multicenter prospective Canadian aneurysm study. Canadian Society for Vascular Surgery Aneurysm Study Group. J Vasc Surg. 1994;20:163-70. [PMID: 8040938] Google Scholar54. Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. Guidelines for the treatment of abdominal aortic aneurysms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg. 2003;37:1106-17. [PMID: 12756363] Google Scholar55. Lederle FA, Powell JT, Greenhalgh RM. Repair of small abdominal aortic aneurysms [Letter]. N Engl J Med. 2006;354:1537-8. [PMID: 16598058] Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Hyperlipidemia in Patients With Abdominal Aortic Aneurysm Ankur Sethi Management of Hyperlipidemia in Patients With Abdominal Aortic Aneurysm Frank A. Lederle Metrics Cited byRecommendations on Emergency/Urgent Ultrasound Scans from the Italian College of Emergency Radiology by SIRMAutomatic Detection and Segmentation of Thrombi in Abdominal Aortic Aneurysms Using a Mask Region-Based Convolutional Neural Network with Optimized Loss FunctionsRed Flags in Geriatric Medicine: Assessing Risk and Managing It in Primary CareAneurysms of the aorta: ascending, thoracic, and abdominal and their managementMolecular Pathogenesis and the Possible Role of Mitochondrial Heteroplasmy in Thoracic Aortic AneurysmA Simple Target Will Save the Day and the Kidney: This Is How We Perform Our Endovascular Fenestrated Graft ProcedureHeart Disease and Stroke Statistics—2021 UpdateAortic Aneurysms, Chronic Kidney Disease and MetalloproteinasesLow Back Pain EmergenciesHeart Disease and Stroke Statistics—2020 Update: A Report From the American Heart AssociationUpdated Guidelines on Screening for Abdominal Aortic AneurysmsHeart Disease and Stroke Statistics—2019 Update: A Report From the American Heart AssociationGenetics of Thoracic and Abdominal Aortic DiseasesChronic kidney disease measures and the risk of abdominal aortic aneurysmHeart Disease and Stroke Statistics—2018 Update: A Report From the American Heart AssociationDual-Energy CT of Aortic DiseaseHeart Disease and Stroke Statistics—2017 Update: A Report From the American Heart AssociationDOLOR ABDOMINAL AGUDO EN EL ADULTO MAYORMeta-Analysis of Genome-Wide Association Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk LociVascular diseases: aortitis, aortic aneurysms, and vascular calcificationAbdominal aortic aneurysmAneurysms of the AortaImmunohistochemical Analysis of the Natural Killer Cell Cytotoxicity Pathway in Human Abdominal Aortic AneurysmsThe Potential Role of DNA Methylation in Abdominal Aortic AneurysmsPatients with familial abdominal aortic aneurysms are at increased risk for endoleak and secondary intervention following elective endovascular aneurysm repairPotential Interactions Between Genetic Polymorphisms of the Transforming Growth Factor-β Pathway and Environmental Factors in Abdominal Aortic AneurysmsThe biaxial mechanical behaviour of abdominal aortic aneurysm intraluminal thrombus: Classification of morphology and the determination of layer and region specific propertiesSystematic Review: Emergency Department Bedside Ultrasonography for Diagnosing Suspected Abdominal Aortic AneurysmUse of a Web-based clinical decision support system to improve abdominal aortic aneurysm screening in a primary care practiceLow Back Pain EmergenciesBiodegradable Shape‐Memory PolymersAcute Abdominal Pain in the Older AdultDiseases of the AortaVascular Emergencies of the RetroperitoneumAbdominal Aortic AneurysmRoutine Screening for Abdominal Aortic Aneurysm during Clinical Transthoracic Echocardiography in a Korean PopulationShape-memory polymers as a technology platform for biomedical applicationsUpdate on Multidetector Computed Tomography Angiography of the Abdominal AortaAneurysm: Epidemiology Aetiology and Pathophysiology 5 May 2009Volume 150, Issue 9Page: ITC5-1KeywordsAbdominal aortic aneurysmAneurysmsAntibioticsAortaComputed axial tomographyDeath ratesMortalityRandomized trialsSurgeryUltrasound imaging ePublished: 5 May 2009 Issue Published: 5 May 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...