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Category Archives: Endovascular abdominal aortic aneurysm repair

Silent killer on the rise > Adults need to know > Older adults may be at risk > Abdominal aortic aneurysms AAA > Ultrasound scan of the aorta can reveal AAA > Risk factors include being a male > Over the age of 60 > Having high blood pressure > History of smoking

Are aneurysms increasing in incidence and becoming more common? Is the danger of not knowing you have an aneurysm that as the vessel weakens and continues to enlarge, it can burst or rupture and cause internal bleeding? Will we be seeing more of them, now that Medicare has approved funding for screening of these aneurysms?

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Stent-graft > EVAR > New findings on abdominal aortic aneurysm AAA > Mortality > Endovascular technology > Hospital volume > Proportion of AAA repaired with EVAR > Increased from 27% to 39%

Did the introduction of endovascular (EVAR) technology change the relationship of hospital volume to mortality with abdominal aortic aneurysm repair?Are higher-volume hospitals are more likely to use the endovascular approach? Is the greater use of the endovascular procedure at high-volume hospitals accounting for the difference in mortality between high-and low-volume hospitals?

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Endovascular abdominal aortic aneurysm repair > Under severe regulatory body scrutiny > Cost effectiveness as a function of cost and clinical benefit > National Institute of Clinical Excellence NICE > Unfit for open repair and not high risk > Endovascular Aneurysm Repair EVAR Trials > Dutch Randomized Endovascular Aneurysm Management DREAM > Open Versus Endovascular Repair OVER trial > Multi-center experience > Cook > Medtronic > Gore

Are there two populations of patients considered for EVAR, those fit for open repair and those unfit? Is there ever more evidence that the fitness of the patient is of crucial importance in the decision-making? Are trial results pointing toward EVAR being of poor or even no benefit in the very sick patients?

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