Abdominal Aortic Aneurysm Screening: A Systematic Review and Meta-analysis of Efficacy and Cost

Ying, Andrew; Affan, Eshan T.

doi:10.1016/j.avsg.2018.05.044

Cited by 39 publications

(13 citation statements)

References 39 publications

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“…Aortic aneurysm and dissection are a major cause of cardiovascular morbidity and mortality worldwide. The prevalence of the most common type, the abdominal aortic aneurysm (AAA), is 3.3-7.7% in screened populations, 1 and there are approximately 45,000 AAA repairs annually in the United States. 2 The morbidity of AAA derives from the risk of fatal rupture.…”

Section: Introductionmentioning

confidence: 99%

Adventitial recruitment of Lyve-1− macrophages drives aortic aneurysm in an angiotensin-2-based murine model

Ulndreaj

Chen

et al. 2021

Clinical Science

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Objective: Aortic macrophage accumulation is characteristic of the pathogenesis of abdominal aortic aneurysm (AAA) but the mechanisms of macrophage accumulation and their phenotype are poorly understood. Lyve-1+ resident aortic macrophages independently self-renew and are functionally distinct from monocyte-derived macrophages recruited during inflammation. We hypothesized that Lyve-1+ and Lyve-1- macrophages differentially contribute to aortic aneurysm. Approach and Results: Angiotensin-2 and beta-aminopropionitrile (AT2/BAPN) were administered to induce AAA in C57BL/6J mice. Using immunohistochemistry, we demonstrated primarily adventitial accumulation of aortic macrophages, and in association with areas of elastin fragmentation and aortic dissection. Compared to controls, AAA was associated with a relative percent depletion of Lyve-1+ resident aortic macrophages and accumulation of Lyve-1- macrophages. Using CD45.1/CD45.2 parabiosis, we demonstrated aortic macrophage recruitment in AAA. Depletion of aortic macrophages in CCR2-/- mice was associated with reduced aortic dilatation indicating the functional role of recruitment from the bone marrow. Depletion of aortic macrophages using anti- Macrophage Colony Stimulating Factor 1 Receptor (MCSF1R)-neutralizing antibody reduced the incidence of AAA. Conditional depletion of Lyve-1+ aortic macrophages was achieved by generating Lyve-1 wt/cre Csf1rfl/fl mice. Selective depletion of Lyve-1+ aortic macrophages had no protective effects following AT2/BAPN administration and resulted in increased aortic dilatation in the suprarenal aorta. Conclusions: Aortic macrophage accumulation in AAA derives from adventitial recruitment of Lyve-1- macrophages, with relative percent depletion of Lyve-1+ macrophages. Selective targeting of macrophage subtypes represents a potential novel therapeutic avenue for the medical treatment of AAA.

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Section: Introductionmentioning

confidence: 99%

Adventitial recruitment of Lyve-1− macrophages drives aortic aneurysm in an angiotensin-2-based murine model

Ulndreaj

Chen

et al. 2021

Clinical Science

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“…AAA is usually diagnosed by physical examination, abdominal ultrasound, or computer tomography (CT). However, the speed of growing is individual, and also, the risk of rupture is not just dependent on the size of the aneurysm [6,7]. Rupture even in small AAA was reported, while large aneurysms remain stable.…”

Section: Introductionmentioning

confidence: 99%

Blood biomarker panel recommended for personalized prediction, prognosis, and prevention of complications associated with abdominal aortic aneurysm

Moláček¹,

Třeška²,

Zeithaml³

et al. 2019

EPMA Journal

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The aim of the study was to evaluate the ability of following biomarkers as diagnostic tools and risk predictors of AAA: Creactive protein, interleukin-6, pentraxin-3, galectin-3, procollagen type III N-terminal peptide, C-terminal telopeptide of type I collagen, high-sensitive troponin I, and brain natriuretic peptide. Seventy-two patients with an AAA and 100 healthy individuals were enrolled into the study. We assessed individual biomarker performance and correlation between the AAA diameter and biomarker levels, and also, a multivariate logistic regression was used to design a possible predictive model of AAA growth and rupture risk. We identified following four parameters with the highest potential to find a useful place in AAA diagnostics: galectin-3, pentraxin-3, interleukin-6, and C-terminal telopeptide of type I. The best biomarkers in our evaluation (galectin-3 and pentraxin-3) were AAA diameter-independent. With the high AUC and AAA diameter correlation, the high-sensitive troponin I can be used as an independent prognostic biomarker of the upcoming heart complications in AAA patients. Authors recommend to add biomarkers as additional parameters to the current AAA patient management. Main addition value of biomarkers is in the assessment of the AAA with the smaller diameter. Elevated biomarkers can change the treatment decision, which would be done only based on AAA diameter size. The best way how to manage the AAA patients is to create a reliable predictive model of AAA growth and rupture risk. A created multiparameter model gives very promising results with the significantly higher efficiency compared with the use of the individual biomarkers.

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“…Screening tests for abdominal aortic aneurysms are performed on patients fulfilling at least three of the following criteria: (1) age above 65 years, (2) male, (3) hypertension, (4) coronary artery disease, (5) hyperlipidemia, (6) smoking or (7) negative family history [14][15][16]. According to recent reports, the risk of developing AAA is higher in the first degree relatives of AAA patients, regardless of sex, in comparison to those without a family history of AAA [17]. This suggests that patients of both sexes above the age of 65 with a positive family history of AAA should be screened.…”

Section: Discussionmentioning

confidence: 99%

Abdominal aorta aneurysm screening program in Swietokrzyskie Voivodeship: early results

et al. 2019

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Introduction: The prevalence of abdominal aorta aneurysms (AAA) is estimated to be between 1.3-12.5% in men and 5.2% in women, which poses a serious public health issue. Ruptured aorta aneurysm most often causes internal bleeding and ultimately leads to death. The cause of high mortality is the asymptomatic occurrence of AAA. Usually, the first symptom is its rupture The aim of our paper is to provide a relationship between the percentage of the population reporting to the vascular surgeon and the type of residence based on the analysis of data from screening studies carried out in one of the regions of Poland. Material and methods: Patients previously informed about the free diagnostics in the Provincial Hospital in Kielce were examined by qualified physicians with ESAOTE MyLab Seven ultrasound device. Prior to that, patients were asked to fill a questionnaire to acquire data about their risk factors, demography, and medical history. Results: A total of 22 (7.3%) aneurysms were found in a group of 301 patients, of which 20 (6.6%) were found in men and 2 (0.66%) in women. Conclusions: Screening tests are an effective method to significantly improve early detection of AAAs. However, it is necessary to provide easier access to health professionals qualified to perform ultrasound examinations. It is especially important for the population of men with a family history of AAA, because they are at a higher risk of developing this pathology. The incidence rate of AAA observed in our study is consistent with the data published in worldwide literature.

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Abdominal Aortic Aneurysm Screening: A Systematic Review and Meta-analysis of Efficacy and Cost

Cited by 39 publications

References 39 publications

Adventitial recruitment of Lyve-1− macrophages drives aortic aneurysm in an angiotensin-2-based murine model

Adventitial recruitment of Lyve-1− macrophages drives aortic aneurysm in an angiotensin-2-based murine model

Blood biomarker panel recommended for personalized prediction, prognosis, and prevention of complications associated with abdominal aortic aneurysm

Abdominal aorta aneurysm screening program in Swietokrzyskie Voivodeship: early results

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