Editor's Choice – Trend-break in Abdominal Aortic Aneurysm Repair With Decreasing Surgical Workload

Lilja, Fredrik; Mani, Kevin; Wanhainen, Anders

doi:10.1016/j.ejvs.2017.02.031

Cited by 65 publications

(55 citation statements)

References 43 publications

(30 reference statements)

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“…The lower survival may be as result of poor local socioeconomic demographics which cannot be accounted for. EVAR has increasingly been used in the frail and elderly population during the last 15 years, 21 and this study, along with the long-term EVAR 2 results, may add to a growing body of evidence questioning its use and influence on survival.…”

Section: Discussionmentioning

confidence: 89%

Outcome after Turndown for Elective Abdominal Aortic Aneurysm Surgery

Whittaker

Meecham

Summerour

et al. 2017

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 89%

Outcome after Turndown for Elective Abdominal Aortic Aneurysm Surgery

Whittaker

Meecham

Summerour

et al. 2017

European Journal of Vascular and Endovascular Surgery

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“…However, the incidence of intact AAA repair remains consistent (Lilja et al. ). Additionally, the 30‐day mortality after ruptured AAA repair remains high (28%) (Lilja et al.…”

Section: Introductionmentioning

confidence: 91%

“…Additionally, the 30‐day mortality after ruptured AAA repair remains high (28%) (Lilja et al. ). Therefore, a pharmacological strategy to inhibit or slow AAA progression is desired.…”

Section: Introductionmentioning

confidence: 99%

“…Previously, early detection by screening with ultrasound, increased the number of elective open repairs and endovascular aneurysm repairs, which improved the short-and long-term outcome of patients with AAA (Lilja et al 2017). However, the incidence of intact AAA repair remains consistent (Lilja et al 2017). Additionally, the 30-day mortality after ruptured AAA repair remains high (28%) (Lilja et al 2017).…”

Section: Introductionmentioning

confidence: 99%

“…However, the incidence of intact AAA repair remains consistent (Lilja et al 2017). Additionally, the 30-day mortality after ruptured AAA repair remains high (28%) (Lilja et al 2017). Therefore, a pharmacological strategy to inhibit or slow AAA progression is desired.…”

Section: Introductionmentioning

confidence: 99%

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A selective antagonist of prostaglandin E receptor subtype 4 attenuates abdominal aortic aneurysm

Yokoyama

Saito

et al. 2018

Physiol Rep

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Abdominal aortic aneurysm (AAA) is a progressive disease that has an increasing prevalence with aging, but no effective pharmacological therapy to attenuate AAA progression is currently available. We reported that the prostaglandin E receptor EP4 plays roles in AAA progression. Here, we show the effect of CJ‐42794, a selective EP4 antagonist, on AAA using two mouse models (angiotensin II‐ and CaCl2‐induced AAAs) and human aortic smooth muscle cells isolated from AAA tissue. Oral administration of CJ‐42794 (0.2 mg/kg per day) for 4 weeks significantly decreased AAA formation in ApoE−/− mice infused with angiotensin II (1 μg/kg per min), in which elastic fiber degradation and activations of matrix metalloproteinase (MMP)‐2 and MMP‐9 were attenuated. Interleukin‐6 (IL‐6) proteins were highly expressed in the medial layer of angiotensin II‐induced mouse AAA tissues, whereas this expression was significantly decreased in mice treated with CJ‐42794. AAA formation induced by periaortic CaCl2 application in wild‐type mice was also reduced by oral administration of CJ‐42794 for 4 weeks. After oral administration of CJ‐42794 beginning 2 weeks after periaortic CaCl2 application and continuing for an additional 4 weeks, the aortic diameter and elastic fiber degradation grade were significantly smaller in CJ‐42794‐treated mice than in untreated mice. Additionally, in smooth muscle cells isolated from human AAA tissues, stimulation of CJ‐42794 inhibited PGE 2‐induced IL‐6 secretion in a dose‐dependent manner and decreased PGE 2‐induced MMP‐2 activity. These data suggest that inhibition of EP4 has the potential to be a pharmacological strategy for attenuation of AAA progression.

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Treatment of aortic aneurysms registered in Swedvasc

et al. 2018

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Swedvasc is a registry for vascular surgical procedures, both open and endovascular. It was started in 1987 and since 1994 the whole population of Sweden is covered, at present around 10 million inhabitants. In a recent external validation, it was found to be highly accurate with abdominal aortic aneurysm surgery correctly reported in >96%. In this paper various factors explaining the almost 100% coverage are discussed, one important being that the registry has been developed and maintained within the profession of vascular surgery and not dictated by authorities. Another factor of importance is the possibility to use data in various research projects and so far 15 PhD theses have used Swedvasc data. To exemplify the practical use of the registry, the treatment of abdominal aortic aneurysms is scrutinized and among the various complications abdominal compartment syndrome is analyzed. Several significant temporal changes have been observed over the almost 25 years of Swedvasc: increasing use of endovascular surgery, treatment of aneurysms detected by screening , decreasing treatment for rupture, improved outcome, increasing treatment of older patients and patients with comorbid conditions. In conclusion, a high quality national vascular registry can be valid with high compliance and can be used to study population-based development of treatment and outcome. It can also be used to perform international comparisons with other registries, thereby getting an indication of the quality of care.

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Editor's Choice – Trend-break in Abdominal Aortic Aneurysm Repair With Decreasing Surgical Workload

Cited by 65 publications

References 43 publications

Outcome after Turndown for Elective Abdominal Aortic Aneurysm Surgery

Outcome after Turndown for Elective Abdominal Aortic Aneurysm Surgery

A selective antagonist of prostaglandin E receptor subtype 4 attenuates abdominal aortic aneurysm

Treatment of aortic aneurysms registered in Swedvasc

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