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Ann Vasc Surg 2021 Apr 6. Epub 2021 Apr 6.

Division of Vascular Surgery, University of Missouri, Columbia, MO, USA. Electronic address:

We present a ruptured pararenal abdominal aortic aneurysm (AAA) repaired with a complex three-vessel chimney EVAR (ChEVAR). This technique allows for rapid sealing of the aneurysm with branch preservation and avoids complex open aortic surgery. This case report highlights techniques and pitfalls from ChEVAR repair in the emergency setting. Read More

Ann Vasc Surg 2021 Apr 5. Epub 2021 Apr 5.

The George Washington University Department of Surgery, Washington, District of Columbia.

Type Of Research: Retrospective NSQIP database review KEY FINDINGS:: Comparison of FEVAR vs OSR for juxtarenal abdominal aortic aneurysms in patients with renal disease showed similar 30-day mortality. However, FEVAR was associated with fewer renal and pulmonary complications compared to OSR.

Take Home Message: FEVAR is better for patients with chronic renal insufficiency due to decreased renal and pulmonary complications. Read More

Prog Cardiovasc Dis 2021 Apr 5. Epub 2021 Apr 5.

Center for Vascular Research, University of Maryland, United States of America; University of Maryland, United States of America; Endovascular Surgery, University of Maryland Medical Center, United States of America; Baltimore VA Medical Center, United States of America. Electronic address:

Abdominal aortic aneurysms (AAA) are prevalent among older adults and can cause significant morbidity and mortality if not addressed in a timely fashion. Their etiology remains the topic of continued investigation. Known causes include trauma, infection, and inflammatory disorders. Read More

Sci Prog 2021 Apr-Jun;104(2):368504211003785

International Center for Numerical Methods in Engineering (CIMNE), Technical University of Catalonia, Barcelona, Catalunya, Spain.

The morphometry of abdominal aortic aneurysms (AAA) has been recognized as one of the main factors that may predispose them to rupture. The need to quantify the morphometry of AAA on a patient-specific basis constitutes a valuable tool for assisting in rupture risk prediction. Previous results of this research group have determined the correlations between hemodynamic stresses and aneurysm morphometry by means of the Pearson coefficient. Read More

Ann Vasc Surg 2021 Apr 4. Epub 2021 Apr 4.

Dept of Surgery, 4(th) Military Teaching Hospital, 5 Weigla street, 50-981 Wroclaw, Poland; Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland. Electronic address:

Introduction: . Metformin is a commonly used drug in diabetes mellitus treatment. Recently it has been suggested that the use of metformin on diabetes mellitus patients may lower the prevalence and slow the progression of AAA (abdominal aortic aneurysm) as well as the risk of rupture related mortality. Read More

Ann Vasc Surg 2021 Apr 3. Epub 2021 Apr 3.

Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.

Introduction: Persistent type II endoleaks (ELIIp) occur in 8% to 23% of patients submitted to endovascular aneurysm repair (EVAR) and may lead to aneurysm progression and rupture. Intraoperative embolization of the abdominal aortic aneurysm (AAA) sac is effective to prevent their occurrence, however a method to achieve complete sac thrombosis has not been standardized yet. Aim of our study was to identify factors associated with prevention of ELIIp after intraoperative embolization, in order to optimize technical details. Read More

Ann Vasc Surg 2021 Apr 3. Epub 2021 Apr 3.

Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Background: Although randomized studies have revealed the long-term outcomes of the endovascular repair (ER) of abdominal aortic aneurysm (AAA) compared to open repair (OR), there is controversy surrounding chronic renal decline (CRD) after ER. This study reviewed our propensity-matched cohorts of ER and OR to compare CRD rates using a time-to-event analysis. The ER groups undergoing suprarenal (SR) or infrarenal (IR) proximal fixation were also compared with the OR group. Read More

Ann Vasc Surg 2021 Apr 2. Epub 2021 Apr 2.

Department of Surgery - Vascular Surgery Unit, School of Medicine, University of Ioannina, Ioannina, Greece.

Preservation of the hypogastric circulation is of major clinical importance in cases of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA). Pelvic ischemia can be detrimental and significantly increase post-operative morbidity and mortality. However, the application of a side branch device or a bell-bottom graft is not possible in ruptured aortoiliac aneurysms (due to off-the-shelf unavailability and/or prolonged operative time) and in most cases pelvic circulation may have to be sacrificed. Read More

Antioxidants (Basel) 2021 Mar 16;10(3). Epub 2021 Mar 16.

CIBER de Enfermedades Cardiovasculares, ISCIII, 28029 Madrid, Spain.

Abdominal aortic aneurysm (AAA) is a common life-threatening condition characterized by exacerbated inflammation and the generation of reactive oxygen species. Pharmacological treatments to slow AAA progression or to prevent its rupture remain a challenge. Targeting phosphodiesterase 4 (PDE4) has been verified as an effective therapeutic strategy for an array of inflammatory conditions; however, no studies have assessed yet PDE4 in AAA. Read More

Heart Surg Forum 2021 04 2;24(2):E351-E358. Epub 2021 Apr 2.

Department of Emergency Medicine, Changsha Central Hospital, University of South China, Hengyand, Hunan, China.

Background: Aortic aneurysm (AA) is an aortic disorder prone to sudden, life-threatening aortic dissection or rupture, with poor clinical outcomes. In this study, we aimed to analyze the clinical characteristics of AA in MIMIC-III to explore implications for management.

Methods: All patients with AA, including abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA), in the MIMIC-III database were included. Read More

Front Endocrinol (Lausanne) 2021 15;12:618434. Epub 2021 Mar 15.

The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Improved understanding of abdominal aortic aneurysms (AAA) pathogenesis is required to identify treatment targets. This systematic review summarized evidence from animal studies and clinical research examining the role of adipokines and perivascular adipose tissue (PVAT) in AAA pathogenesis. Meta-analyses suggested that leptin (Standardized mean difference [SMD]: 0. Read More

Int J Mol Med 2021 May 31;47(5). Epub 2021 Mar 31.

Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.

Abdominal aortic aneurysm (AAA) is a pathological state with permanent dilation, which indicates a fatal potential for aortic rupture. It has been reported that dexmedetomidine (Dex) and microRNA (miR)‑21 are involved in the progression of AAA. Thus, the present study aimed to investigate the joint effects of these factors on AAA treatment. Read More

J Trauma Acute Care Surg 2021 Mar 27. Epub 2021 Mar 27.

University of Colorado School of Medicine University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine Denver Health Medical Center University of Colorado School of Medicine University of Colorado School of Medicine University of Colorado School of Medicine Denver Health Medical Center, University of Colorado School of Medicine.

Background: The rationale for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is to control life-threatening sub-diaphragmatic bleeding and facilitate resuscitation, however, incorporating this into the resuscitative practices of a trauma service remains challenging. The objective of this study is to describe the process of successful implementation of REBOA use in an academic urban level I trauma center. All REBOA procedures from April 2014 through December 2019 were evaluated; REBOA was implemented after surgical faculty attended a required and internally developed Advanced Endovascular Strategies for Trauma Surgeons course (AESTS). Read More

J Vasc Res 2021 Mar 29:1-8. Epub 2021 Mar 29.

Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.

Computational fluid dynamics were used to assess hemodynamic changes in an actively rupturing abdominal aortic aneurysm (AAA) over a 9-day period. Active migration of contrast from the lumen into the thickest region of intraluminal thrombus (ILT) was demonstrated until it ultimately breached the adventitial layer. Four days after symptom onset, there was a discrete disruption of adventitial calcium with bleb formation at the site of future rupture. Read More

J Exp Med 2021 Jun;218(6)

Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.

Abdominal aortic aneurysms (AAAs) are a life-threatening disease for which there is a lack of effective therapy preventing aortic rupture. During AAA formation, pathological vascular remodeling is driven by macrophage infiltration, and the mechanisms regulating macrophage-mediated inflammation remain undefined. Recent evidence suggests that an epigenetic enzyme, JMJD3, plays a critical role in establishing macrophage phenotype. Read More

Exp Mech 2021 Jan 15;61(1):203-216. Epub 2020 Sep 15.

Biomedical Engineering Program, University of South Carolina, Columbia, SC, USA.

Background: Mouse models of abdominal aortic aneurysm (AAA) and dissection have proven to be invaluable in the advancement of diagnostics and therapeutics by providing a platform to decipher response variables that are elusive in human populations. One such model involves systemic Angiotensin II (Ang-II) infusion into low density-lipoprotein receptor-deficient (LDLr-/-) mice leading to intramural thrombus formation, inflammation, matrix degradation, dilation, and dissection. Despite its effectiveness, considerable experimental variability has been observed in AAAs taken from our Ang-II infused LDLr-/- mice (n=12) with obvious dissection occurring in 3 samples, outer bulge radii ranging from 0. Read More

Arterioscler Thromb Vasc Biol 2021 Mar 25:ATVBAHA120315546. Epub 2021 Mar 25.

Saha Cardiovascular Research Center, University of Kentucky, Lexington. (L.M., M.O., A.J., D.T., W.J., J.J.M., L.Y., A.B., D.A.H., V.S.).

Objective: Cytoskeletal structural proteins maintain cell structural integrity by bridging extracellular matrix with contractile filaments. During abdominal aortic aneurysm (AAA) development, (1) aortic medial degeneration is associated with loss of smooth muscle cell integrity and (2) fibrogenic mesenchymal cells mediate extracellular matrix remodeling. Calpains cleave cytoskeletal proteins that maintain cell structural integrity. Read More

Arterioscler Thromb Vasc Biol 2021 Mar 25:ATVBAHA120315812. Epub 2021 Mar 25.

Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, United Kingdom.

Abdominal aortic aneurysm (AAA) is a focal dilation of the aorta associated with high mortality through rupture. Most of our understanding of the biology that drives AAA progression originates from surgical samples acquired in cases of elective open repair. These markers, which include macrophage infiltration and angiogenesis, have led to the exploration of novel radiopharmaceuticals to study AAA in preclinical models and human patients. Read More

Semin Vasc Surg 2021 Mar 6;34(1):29-37. Epub 2021 Feb 6.

Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 110 Francis Street, Suite 5B, Boston, MA 02215. Electronic address:

Abdominal aortic aneurysm (AAA) disease remains a major source of morbidity in developed countries and can progress to life-threatening rupture if left untreated, with exceedingly high mortality. The goal of AAA management is to identify and electively repair AAAs before rupture. AAA disease burden and outcomes have improved over time with declining tobacco use and advancements in care across patients' disease course. Read More

Eur J Vasc Endovasc Surg 2021 Mar 16. Epub 2021 Mar 16.

Department of Surgery & Cancer, Imperial College London, London, UK. Electronic address:

Objective: To encompass the needs of all stakeholders and allow effective data synthesis from trials, registries, and other studies; a core outcome set for infrarenal abdominal aortic aneurysm (AAA) repair is needed. In this first stage, the aim was to report the range, frequency, and time of pre-specified outcomes reported following AAA repair.

Data Sources: Medline, Embase, and CENTRAL databases 2010 - 2019 were searched using ProQuest Dialog™. Read More

Int Angiol 2021 Mar 19. Epub 2021 Mar 19.

Vascular Surgery Department, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.

Introduction: Endovascular aneurysm repair (EVAR) has become the treatment of choice for abdominal aortic aneurysm (AAA), demonstrating excellent early outcomes. However, EVAR durability has been questioned in the long-term period. The aim of this study was to assess EVAR outcomes in terms of survival and freedom from re-intervention during a long-term period. Read More

Am J Mens Health 2021 Mar-Apr;15(2):15579883211001204

School of Nursing, University of British Columbia, Vancouver, BC, Canada.

Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western countries including the UK and Sweden. Read More

Eur J Vasc Endovasc Surg 2021 Mar 12. Epub 2021 Mar 12.

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Objective: As open abdominal aortic aneurysm (AAA) repair (OAR) rates decline in the endovascular era, the endorsement of minimum volume thresholds for OAR is increasingly controversial, as this may affect credentialing and training. The purpose of this analysis was to identify an optimal centre volume threshold that is associated with the most significant mortality reduction after OAR, and to determine how this reflects contemporary practice.

Methods: This was an observational study of OARs performed in 11 countries (2010 - 2016) within the International Consortium of Vascular Registry database (n = 178 302). Read More

Vasc Endovascular Surg 2021 Mar 15:15385744211000572. Epub 2021 Mar 15.

22606MercyOne Medical Center, Des Moines, IA, USA.

Objective: The purpose of this study was to identify the effect of abdominal aortic aneurysm (AAA) size on endoleak development and secondary intervention after endovascular repair (EVAR), as well as to examine the effect on overall survival and cause of mortality.

Methods: Retrospective analysis was performed on all non-ruptured AAA treated by elective EVAR using FDA-approved endografts in our facility from July 2004 to December 2017. Patients were grouped into 3 cohorts based on preoperative aneurysm size: Group I (<5. Read More

J Vasc Surg Cases Innov Tech 2021 Mar 27;7(1):117-119. Epub 2020 Dec 27.

Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, Conn.

Abdominal aortic aneurysm rupture after endovascular aneurysm repair (EVAR) is rare, but remains a significant limitation of endovascular technology. Preservation of the endograft during open conversion of a post-EVAR rupture has been shown to be associated with improved perioperative outcomes. An interposition Dacron graft with felt pledgets is a novel bail-out option for the open reconstruction of a type III endoleak with total endograft preservation. Read More

J Vasc Surg 2021 Mar 6. Epub 2021 Mar 6.

Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, Mass. Electronic address:

Objective: The risk of aortic abdominal aneurysm (AAA) rupture increases with an increasing aneurysm diameter. However, the effect of the AAA diameter on late outcomes after aneurysm repair is unclear. Therefore, we assessed the association of a large AAA diameter with late outcomes for patients undergoing open and endovascular AAA repair. Read More

Redox Biol 2021 Feb 20;41:101903. Epub 2021 Feb 20.

Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA; Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA. Electronic address:

Abdominal aortic aneurysm (AAA) is a catastrophic disease with little effective therapy. Myocardin related transcription factor A (MRTFA, MKL1) is a multifaceted transcription factor, regulating diverse biological processes. However, a detailed understanding of the mechanistic role of MKL1 in AAA has yet to be elucidated. Read More

Front Cardiovasc Med 2021 15;8:631790. Epub 2021 Feb 15.

Biomedical Engineering, University of Calgary, Calgary, AB, Canada.

Current clinical practice for the assessment of abdominal aortic aneurysms (AAA) is based on vessel diameter and does not account for the multifactorial, heterogeneous remodeling that results in the regional weakening of the aortic wall leading to aortic growth and rupture. The present study was conducted to determine correlations between a novel non-invasive surrogate measure of regional aortic weakening and the results from invasive analyses performed on corresponding aortic samples. Tissue samples were evaluated to classify local wall weakening and the likelihood of further degeneration based on non-invasive indices. Read More

Exp Biol Med (Maywood) 2021 Feb 27:1535370221992530. Epub 2021 Feb 27.

Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing 100730, China.

As a prevalent potentially life-threatening condition, abdominal aortic aneurysm (AAA) presents increasing risk of rupture as its diameter grows. However, rapid progression and rupture may occasionally occur in smaller AAAs. Earlier surgery for patients with high risk of disease progression may improve the outcome. Read More