Surgonomics: The Costs of Ruptured Abdominal Aortic Aneurysm

Muñoz, Eric; Kassan, Martin; Chang, John B.

doi:10.1177/000331978803900907

Cited by 10 publications

(3 citation statements)

References 13 publications

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“…In recent years, endoscopic therapy has gradually become the primary prophylaxis against bleeding of gastric varices. Endoscopic variceal ligation [ 20 ] and endoscopic sclerotherapy [ 21 ] have been widely used in variceal bleeding. However, both of them are prone to rebleeding and recurrence after the treatment.…”

Section: Discussionmentioning

confidence: 99%

Additional Benefits Conferred by Endoscopic Sclerotherapy to Liver Cirrhosis Patients Receiving Endoscopic Variceal Ligation

Chen

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. Gastroesophageal varices are a direct consequence of portal hypertension in cirrhosis. The management of gastroesophageal varices has evolved over the last decade resulting in reduced mortality and morbidity rates. The study was aimed to analyze the short-term and long-term efficacy of different endoscopic methods in the treatment of gastric varices in cirrhotic patients. Methods. From January 2016 to December 2019, 135 patients with liver cirrhosis and gastric varices undergoing different endoscopic treatment protocols were retrospectively analyzed. The patients were divided into three groups according to endoscopic variceal ligation, endoscopic sclerotherapy, and a combination of both, respectively. Main outcomes including the overall response rate, hemostasis, short- and long-term rebleeding (3 months before and after treatment), complication, blood pressure, heart rate, portal venous pressure (PVP), portal vein diameter (PVD), portal vein velocity (PVV), portal vein blood flow (PVF) detected by ultrasound, recurrence rate, and mortality were analyzed after treatments. Results. The overall response rate in the combined group was higher than that in the ligation group and the sclerotherapy group ( P < 0.05 ). The incidence rate of complications in the combined group and the ligation group was lower than that in the sclerotherapy group ( P < 0.05 ). After treatment, the PVP, PVD, and PVF were reduced in the combined group compared with the ligation group and the sclerotherapy group, while the PVV was not ( P < 0.05 ). Lower rates of long-term rebleeding, recurrence, and mortality were noted in the combined group compared to the ligation group and the sclerotherapy group ( P < 0.05 ). Conclusion. Endoscopic variceal ligation combined with endoscopic sclerotherapy is more effective than both alone in treating liver cirrhosis and gastric varices. The combined therapy contributed to reduced short-term and long-term rebleeding rate, decreased long-term recurrence rate, and mortality.

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Section: Discussionmentioning

confidence: 99%

Additional Benefits Conferred by Endoscopic Sclerotherapy to Liver Cirrhosis Patients Receiving Endoscopic Variceal Ligation

Chen

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…This observation notwithstanding, the current study supports an aggressive surgical approach toward the elderly patient who presents with an rAAA. 22 Although the mortality rate is higher than that in younger patients, survival occurs frequently. Furthermore, recent studies have demonstrated that elderly survivors of rAAA repair are just as likely to resume their premorbid quality of life as are younger rAAA survivors or elderly patients who undergo elective aneurysm surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases

Dardik

Burleyson

Bowman

et al. 1998

Journal of Vascular Surgery

155

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“…In 1988, 39,000 AAA repairs were performed in the United States for a total health cost of approximately $933 million ($23,931 per patient). 2,3 AAAs are always associated with significant aortic atherosclerosis and because of this association have been classically described as random variants of atherosclerosis that occur at a weakened site in the arterial wall. The aneurysm is , thought to grow according to Laplace's law until eventually it ruptures.…”

mentioning

confidence: 99%

Current Concepts for the Pathogenesis of Abdominal Aortic Aneurysms

Cohen¹

1990

Perspectives in Vascular Surgery and Endovascular Therapy

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Abdominal aortic aneurysms (AAAs) occur in approximately 2% of the elderly population. In 1988, 39,000 AAA repairs were performed in the United States for a total health cost of approximately $933 million ($23,931 per patient). 2,3AAAs are always associated with significant aortic atherosclerosis and because of this association have been classically described as random variants of atherosclerosis that occur at a weakened site in the arterial wall. The aneurysm is , thought to grow according to Laplace's law until eventually it ruptures. This description of AAAs is now being challenged by an increasing amount of data from recent clinical, genetic, and biochemical studies that suggest that aneurysmal pathogenesis is more likely related to an alteration in systemic connective tissue metabolism. CLINICAL OBSERVATIONSIf aneurysmal degeneration is considered to be a common manifestation of atherosclerosis, then distal aneurysms and aortic aneurysms should be commonplace in the patient with diffuse arterial disease. This, however, is not the case. It is unusual, if not rare, for a patient with superficial femoral artery disease, distal arterial disease, or aortoiliac obstructive disease to have distal arterial aneurysms. However, AAAs commonly occur along with peripheral aneurysms, and patients with peripheral aneurysms frequently have associated aneurysms at other locations. In a study of 1488 patients with AAAs, 4% of the patients had associated peripheral aneurysms, and multiple aneurysms occurred in 83% of patients who had at least one peripheral aneurysm.4 In patients with a common femoral artery aneurysm, 95% had a second aneurysm, 92% had an aortoiliac aneurysm, and 59% had bilateral femoral aneurysms. Among patients with popliteal artery aneurysms, 78% had a second aneurysm, 64% had an aortic aneurysm, and 47% had a popliteal artery aneurysm on the contralateral . side.' In one study of 100 consecutive femoral aneurysms,' all patients were men and 85% of these patients had an AAA.Inguinal herniation is significantly higher in patients with AAAs (26%) as compared to patients with aortic occlusive disease ( 15 % ) .6 In addition, patients with AAAs have more severe herniation in terms of direct hernias, bilateral hernias, recurrent hernias, and early onset, suggesting that a systemic connective tissue disorder causes weakening of both the abdominal wall and the aorta and results in formation of both hernia and AAA in the same patient.6 Tortuous carotid arteries are associated with AAAs in up to 44% of cases, whereas only at UNIV REGINA LIBRARY on June 4, 2016 pvs.sagepub.com Downloaded from

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Surgonomics: The Costs of Ruptured Abdominal Aortic Aneurysm

Cited by 10 publications

References 13 publications

Additional Benefits Conferred by Endoscopic Sclerotherapy to Liver Cirrhosis Patients Receiving Endoscopic Variceal Ligation

Additional Benefits Conferred by Endoscopic Sclerotherapy to Liver Cirrhosis Patients Receiving Endoscopic Variceal Ligation

Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases

Current Concepts for the Pathogenesis of Abdominal Aortic Aneurysms

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