We have located links that may give you full text access.
Journal Article
Review
Screening, diagnosis and advances in aortic aneurysm surgery.
Gerontology 2004
BACKGROUND: Aortic aneurysms are common in the elderly and a frequent cause of sudden death. As elective aneurysm repair has a mortality drastically lower than that associated with rupture, the emphasis must be on early detection and repair free from complications. Recent advances include ultrasound screening for asymptomatic abdominal aortic aneurysm (AAA) and clinical trials on the size of AAA that require repair. Pre-operative assessment, management of cardiac risk, autologous blood transfusion strategies, and endovascular stent graft technology to avoid major open surgery are all issues to be addressed.
METHODS: Following a computerized Medline search for publications on the detection and treatment of abdominal and thoracic aortic aneurysm, the publications identified were then read and the references within those publications examined for further publications on this topic. We have reviewed these publications without attempting a meta-analysis.
RESULTS: Randomized population studies have addressed ultrasound screening for AAA. Attendance for screening was good and AAA detection inexpensive. Screening men from 65 years reduces the mortality from rupture and is cost-effective. Open thoracic and abdominal aneurysm repair has a mortality of around 8%, with myocardial infarction being a frequent cause of death. Pre-operative reduction of cardiac risk by cardiac investigations and beta-blockade may reduce this mortality. Autologous transfusion techniques such as acute normovolaemic haemodilution and interoperative cell salvage reduce the need for allogeneic blood and the complications associated with open surgery. Minimally invasive endovascular repair is now possible for 40% of the AAA and an increasing proportion of thoracic aneurysms.
CONCLUSIONS: The combination of screening, reduced pre-operative risk, and new minimally invasive techniques extends aortic aneurysm treatment into an increasingly elderly population. The combination of these techniques will reduce mortality from ruptured aortic aneurysm in the elderly and also reduce the stress associated with aneurysm surgery.
METHODS: Following a computerized Medline search for publications on the detection and treatment of abdominal and thoracic aortic aneurysm, the publications identified were then read and the references within those publications examined for further publications on this topic. We have reviewed these publications without attempting a meta-analysis.
RESULTS: Randomized population studies have addressed ultrasound screening for AAA. Attendance for screening was good and AAA detection inexpensive. Screening men from 65 years reduces the mortality from rupture and is cost-effective. Open thoracic and abdominal aneurysm repair has a mortality of around 8%, with myocardial infarction being a frequent cause of death. Pre-operative reduction of cardiac risk by cardiac investigations and beta-blockade may reduce this mortality. Autologous transfusion techniques such as acute normovolaemic haemodilution and interoperative cell salvage reduce the need for allogeneic blood and the complications associated with open surgery. Minimally invasive endovascular repair is now possible for 40% of the AAA and an increasing proportion of thoracic aneurysms.
CONCLUSIONS: The combination of screening, reduced pre-operative risk, and new minimally invasive techniques extends aortic aneurysm treatment into an increasingly elderly population. The combination of these techniques will reduce mortality from ruptured aortic aneurysm in the elderly and also reduce the stress associated with aneurysm surgery.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app