The risk of rupture in untreated aneurysms: The impact of size, gender, and expansion rate

Brown, Peter; Zelt, David; Sobolev, Boris

doi:10.1067/mva.2003.119

Cited by 295 publications

(239 citation statements)

References 23 publications

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“…23,26 In addition, AAAs in women occur nearly a decade later than they do in men, although they are more often juxtarenal compared with infrarenal AAAs. 27 Nonetheless, women have up to 4 times the risk of rupture and death compared with men, 28,29 and have nearly 3-times the complication rate after AAA repair compared with men. 30 Thus, whereas AAAs occur more frequently in men, the clinical sequelae of this disease in women are more disastrous.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Experimental Aortic Aneurysm Formation

Ailawadi

Eliason

Roelofs

et al. 2004

ATVB

165

147

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Objective-It is hypothesized that a male predominance, similar to that in humans, persists in a rodent model of experimental abdominal aortic aneurysm (AAA) via alterations in matrix metalloproteinases (MMPs). Methods and Results-Group I experiments were as follows: elastase perfusion of the infrarenal aorta was performed in male (M) and female (F) rats. At 14 days, aortas were harvested for immunohistochemistry, real-time polymerase chain reaction (PCR), and zymography. Group II experiments were the following: abdominal aorta was transplanted from F or M donors into F or M recipients. At 14 days, rodents that had undergone transplantation underwent elastase perfusion. In group III, male rats were given estradiol or sham 5 days before elastase perfusion. In group I, M rats had larger AAAs with higher frequency than did F rats. M rat aortas had more significant macrophage infiltrates and increased matrix metalloproteinase (MMP)-9 production and activity. In group II, M-to-M aortic transplants uniformly developed aneurysms after elastase perfusion, whereas F-to-F aortic transplants remained resistant to aneurysm formation. F aortas transplanted into M recipients, however, lost aneurysm resistance. In group III, estradiol-treated rats demonstrated smaller aneurysms and less macrophage infiltrate and MMP-9 compared with M controls after elastase. Conclusions-These data provide evidence of gender-related differences in AAA development, which may reflect an estrogen-mediated reduction in macrophage MMP-9 production.

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Section: Discussionmentioning

confidence: 99%

Gender Differences in Experimental Aortic Aneurysm Formation

Ailawadi

Eliason

Roelofs

et al. 2004

ATVB

165

147

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“…Only five of the studies had aneurysm rupture as a primary outcome measure 23,41,43,45,46 and even in these studies the diagnostic criteria for aneurysm rupture were not reported. Overall, 9779 patients (8662 men, and 1117 women) were included, with study size ranging from 176 to 2257 patients and average length of follow-up ranging from 1.6 to 4.6 years.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The 14 included studies 22,23,29,32,36,37,[40][41][42][43][44][45][46][47] were published from 1991 to 2008 (with patients enrolled from 1976 to 2006); 11 of these were prospective studies 22,23,29,32,36,37,40,41,[43][44][45] (including four randomised trials), whereas the remaining three studies 42,46,47 had both retrospective and prospective contributions. Only five of the studies had aneurysm rupture as a primary outcome measure 23,41,43,45,46 and even in these studies the diagnostic criteria for aneurysm rupture were not reported.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

184

177

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This report should be referenced as follows:Thompson SG, Brown LC, Sweeting MJ, Bown MJ, Kim LG, Glover MJ, et al. Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Technol Assess 2013;17(41). Health Technology Assessment is indexed in MEDLINE, CINAHL, EMBASE, The Cochrane Library and the ISI Science Citation Index and is assessed for inclusion in the Database of Abstracts of Reviews of Effects. Health Technology Assessment is indexed and abstracted inThis journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/30/02. The contractual start date was in November 2009. The draft report began editorial review in July 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research...

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“…Общая летальность по-прежнему остается крайне высокой -80-90%. Прак-тически не изменилась операционная летальность, варьи-руя от 32 до 80% при экстренном вмешательстве [1,3]. Не-смотря на широкое применение методов ультразвуковой диагностики, разрыв аневризмы является первым клини-ческим проявлением заболевания у 2 / 3 больных [9].…”

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