Article
Surgery
Shirli Tay, Mohamed S. Zaghloul, Mehreen Shafqat, Chao Yang, Kshitij A. Desai, Gayan De Silva, Luis A. Sanchez, Mohamed A. Zayed
Summary: This study compared the outcomes of emergency PEVAR (rPEVAR) and open femoral exposure (rEVAR) in patients with ruptured AAA, and found no difference in perioperative outcomes and 30-day major adverse events rate between the two groups.
FRONTIERS IN SURGERY
(2022)
Article
Surgery
Eric Galloway Jernigan, Nhan Nguyen Tran, Khalil Qato, Gary Giangola, Alfio Carroccio, Allan Marc Conway
Summary: This retrospective study analyzed the outcomes of symptomatic and ruptured abdominal aortic aneurysms treated with chimney or snorkel technique, demonstrating acceptable rates of morbidity and mortality with ChEVAR, but long-term data are needed to determine durability.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Samuel Ersryd, Hassan Baderkhan, Khatereh Djavani Gidlund, Martin Bjorck, Peter Gillgren, Linda Bilos, Anders Wanhainen
Summary: The study found that abdominal compartment syndrome after ruptured abdominal aortic aneurysms repair is mainly associated with physiological factors, such as pre-operative hypotension, use of aortic balloon occlusion, or intraoperative transfusions. Treatment outside the instructions for use or any other morphological factors were not associated with a risk of ACS.
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
(2021)
Review
Surgery
Jianqing Deng, Jie Liu, Dan Rong, Yangyang Ge, Hongpeng Zhang, Xiaoping Liu, Wei Guo
Summary: This meta-analysis found that local anesthesia (LA) in endovascular repair of ruptured abdominal aortic aneurysms (REVAR) is associated with a significantly lower 30-day/in-hospital mortality rate compared to general anesthesia (GA). However, further randomized controlled trials are needed to validate these findings due to potential observation bias in the included studies.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Melissa Jones, Hannah Koury, Peter Faris, Randy Moore
Summary: This study characterizes the impact of an emergency endovascular aneurysm repair (EVAR) protocol on the mortality rate of patients with ruptured abdominal aortic aneurysm (rAAA). The findings suggest that the protocol has led to improved 30-day mortality for unstable patients with rAAA and has demonstrated stable surgical performance over a 17-year period.
JOURNAL OF VASCULAR SURGERY
(2022)
Article
Surgery
David T. McGreevy, Artai Pirouzram, Khatereh Djavani Gidlund, Kristofer F. Nilsson, Tal M. Horer
Summary: A study conducted in a Swedish hospital found that for patients without prior aneurysm surgery experience, endovascular aneurysm repair (EVAR) can replace open aortic surgery and effectively reduce mortality rates.
JOURNAL OF VASCULAR SURGERY
(2023)
Review
Surgery
Nikolaos Kontopodis, Nikolaos Galanakis, Christos V. Ioannou, Dimitrios Tsetis, Jean-Pierre Becquemin, George A. Antoniou
Summary: The study found that there were significant differences in all-cause mortality during the perioperative and postoperative period between EVAR and open repair. However, no significant difference was observed in aneurysm-related mortality. Recent studies and treated patients showed a more pronounced advantage for EVAR. The certainty for the body of evidence for overall and postdischarge all-cause mortality was judged to be low, while that for aneurysm-related mortality was high.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Medicine, General & Internal
Claire van der Riet, Richte C. L. Schuurmann, Angelos Karelis, Mehmet A. Suludere, Meike J. van Harten, Bjoern Sonesson, Nuno V. Dias, Jean-Paul P. M. de Vries, Martijn L. Dijkstra
Summary: This study investigates the changes in supra- and infra-renal aortic neck diameters before and after endovascular aortic aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) and the possible association with endograft apposition. The results show that the post-operative aortic diameter is significantly larger than the preoperative diameter, with a more significant increase in the aortic diameter at the supra- and infra-renal levels in patients with low preoperative systolic blood pressure. A shorter apposition length is associated with a higher aortic diameter increase.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Gang Fang, Jianing Yue, Tao Shuai, Tong Yuan, Bichen Ren, Yuan Fang, Tianyue Pan, Zhenjie Liu, Zhihui Dong, Weiguo Fu
Summary: This study reviewed the clinical experience of using an EVAR-only strategy for the management of ruptured abdominal aortic aneurysms (RAAAs) and discussed its feasibility. The results showed that the EVAR-only strategy allowed rEVAR to be used in almost all RAAAs with similar mortality compared to the EVAR-selected strategy. The EVAR-only strategy was associated with a simplified algorithm, less impact on hemodynamics, and shorter operation and recovery time.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, General & Internal
Nicola Troisi, Giulia Bertagna, Lorenzo Torri, Francesco Canovaro, Mario D'Oria, Daniele Adami, Raffaella Berchiolli
Summary: Despite improvements in diagnosis and treatment, ruptured abdominal aortic aneurysms (RAAAs) still cause a significant number of deaths. This study aims to provide an overview of the contemporary management of RAAA patients, focusing on preoperative and intraoperative factors that could aid in decision-making for surgeons. The importance of the English summary: 8 points.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Boonying Siribumrungwong, Jiro Kurita, Tatsuo Ueda, Daisuke Yasui, Ken-ichiro Takahashi, Takashi Sasaki, Yasuo Miyagi, Shun-ichiro Sakamoto, Yosuke Ishii, Tetsuro Morota, Takashi Nitta
Summary: Operative mortality rates did not significantly differ between EVAR and OSR, with EVAR showing less blood loss, shorter operative times, and shorter length of hospital stay but with higher re-intervention rates.
ASIAN JOURNAL OF SURGERY
(2022)
Article
Medicine, General & Internal
Abdulhakim Ibrahim, Miroslav Dimitrov Yordanov, Mohammad Hasso, Benjamin Heine, Alexander Oberhuber
Summary: The aim of this study was to analyze the outcomes and complications in patients who underwent open surgical treatment for AAA in the endovascular era. The study found that open aneurysm repair is safe and effective when performed in specialized high-volume centers.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Matthew J. Eagleton, Michael Stoner, John Henretta, Maciej Dryjski, Jean Panneton, Apostolos Tassiopoulos, Manish Mehta, Benjamin Pearce, Mel J. Sharafuddin
Summary: The study evaluated the safety and effectiveness of the latest generation TREO stent graft for endovascular repair of abdominal aortic aneurysms, with 93.1% successful aneurysm treatment at 1 year and 54.3% of patients experiencing aneurysm sac shrinkage >5 mm at 3 years. Long-term follow-up is ongoing to determine the sustainability of these favorable outcomes.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Katherine M. Reitz, Amanda R. Phillips, Edith Tzeng, Michel S. Makaroun, Christine M. Leeper, Nathan L. Liang
Summary: This study compares immediate and early mortality among patients undergoing ruptured abdominal aortic aneurysm (RAAA) repair and finds that immediate deaths are predominantly related to shock from massive hemorrhage, while early deaths are mainly associated with comorbid conditions leading to multisystem organ failure.
JOURNAL OF VASCULAR SURGERY
(2022)
Review
Polymer Science
Gianmarco de Donato, Edoardo Pasqui, Claudia Panzano, Brenda Brancaccio, Gaia Grottola, Giuseppe Galzerano, Domenico Benevento, Giancarlo Palasciano
Summary: Abdominal aortic aneurysm (AAA) is a condition where the abdominal aorta dilates and grows until it ruptures. EVAR is a minimally invasive procedure using stent grafts to treat this condition. Recent advancements have introduced polymer-based technology as a safe and effective alternative to seal AAA.
Article
Surgery
Lois G. Kim, Michael J. Sweeting, David Epstein, Maarit Venermo, Fiona E. Rohlffs, Roger M. Greenhalgh
Summary: Compared with the outcomes of the EVAR-1 trial, adherence to the EVAR-1 scan protocol in simulation models reduced AAA deaths and increased elective re-interventions. The European Society re-intervention guidelines provided the most clinically effective strategy, but with an increase in re-intervention rates. Annual ultrasound in primary care was the cheapest and most cost-effective strategy that reduced AAA-related deaths.
Letter
Cardiac & Cardiovascular Systems
Michail Katsoulis, Manuel Gomes, Alvina G. Lai, Albert Henry, Spiros Denaxas, Pagona Lagiou, Vahe Nafilyan, Ben Humberstone, Amitava Banerjee, Harry Hemingway, R. Thomas Lumbers
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
(2021)
Article
Economics
Allan Wailoo, Monica Hernandez Alava, Stephen Pudney, Garry Barton, John O'Dwyer, Manuel Gomes, Lisa Irvine, David Meads, Zia Sadique
Summary: In these six countries, using EQ5D-5L compared to EQ5D-3L has a significant impact on cost-effectiveness analyses, with differences in results being large and the direction of change potentially unpredictable.
Article
Multidisciplinary Sciences
Lois G. Kim, Michael J. Sweeting, Morag Armer, Jo Jacomelli, Akhtar Nasim, Seamus C. Harrison
Summary: Efforts should be focused on encouraging men to attend AAA screening appointments post-COVID-19, and prioritizing those with AAAs on surveillance as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality. Delaying primary screening invitations or reducing attendance could have significant negative effects on AAA-related mortality, while longer suspensions or increased drop-out rates from surveillance could greatly impact outcomes.
Letter
Public, Environmental & Occupational Health
Michail Katsoulis, Bianca De Stavola, Alvina G. Lai, Manuel Gomes, Karla Diaz-Ordaz
Article
Economics
Manuel Gomes, Elizabeth Murray, James Raftery
Summary: Digital health interventions present unique challenges for economic evaluations, requiring consideration of their distinct features in study design, measurement, analysis, and reporting. Traditional methodological standpoints may not be appropriate for digital health interventions, highlighting the need for further methodological research.
Article
Medicine, General & Internal
Elizabeth Ingram, Silvie Cooper, Sarah Beardon, Katherine Korner, Helen McDonald, Sue Hogarth, Manuel Gomes, Jessica Sheringham
Summary: This study investigates the challenges and opportunities senior leaders face when using analytics to inform healthcare decision-making. The results suggest that organizational fragmentation and concerns about data quality hinder the use of analytics, while trusted relationships and collaboration facilitate its use.
Article
Economics
Manuel Gomes, Nick Latimer, Marta Soares, Sofia Dias, Gianluca Baio, Nick Freemantle, Dalia Dawoud, Allan Wailoo, Richard Grieve
Summary: Target trial emulation (TTE) is a method used in non-randomised studies using real-world data to reduce biases, by applying design principles from randomised controlled trials (RCTs) to mimic RCT data. It helps avoid common design flaws and optimize analysis methods, providing a transparent and accessible framework to minimize confounding and assess potential limitations of real-world data in HTA decision-making.
Review
Economics
Keyi Li, Paula Lorgelly, Sarah Jasim, Tiyi Morris, Manuel Gomes
Summary: The impact of unemployment on health and social care utilization varies across different care settings, with a stronger association found in mental health services. Unemployed individuals are about 30% more likely to use health services compared to those employed, mainly driven by mental health service use. Factors such as financial pressure, health insurance, social network, disposable time, and depression/anxiety play a role in this association.
EUROPEAN JOURNAL OF HEALTH ECONOMICS
(2023)
Article
Primary Health Care
Helen Strongman, Emily Herrett, Rod Jackson, Michael Sweeting, Alexander R. Lyon, Susannah Stanway, Claire Lawson, Umesh Kadam, Liam Smeeth, Krishnan Bhaskaran
Summary: This study aimed to assess whether cancer diagnosis should be included in cardiovascular risk scores. The results showed that including a 1-year cancer survivorship variable in a QRISK3-based model met the threshold for inclusion for males, but not females. When considering cancer type, the threshold was met for both sexes with a history of haematological cancer, and for males but not females with a history of solid cancers. Developers should consider including cancer history variables in future cardiovascular risk models.
BRITISH JOURNAL OF GENERAL PRACTICE
(2023)
Article
Multidisciplinary Sciences
Christina M. van der Feltz-Cornelis, Jennifer Sweetman, Gail Allsopp, Emily Attree, Michael G. Crooks, Daniel J. Cuthbertson, Denise Forshaw, Mark Gabbay, Angela Green, Melissa Heightman, Toby Hillman, Lyth Hishmeh, Kamlesh Khunti, Gregory Y. H. Lip, Paula Lorgelly, Hugh Montgomery, W. David Strain, Emma Wall, Caroline Watkins, Nefyn Williams, Dan G. Wootton, Amitava Banerjee, STIMULATE-ICP Consortium
Summary: As mortality rates from COVID-19 decline, the prevalence of long-term sequelae (Long COVID) is increasing and posing challenges to healthcare systems worldwide. Traditional disease-specific care pathways have been ineffective for patients with multi-morbidity, highlighting the need for a more holistic and integrated care model for the multi-system nature of Long COVID. The evolution of integrated care systems in the UK presents an important opportunity to explore areas of mutual benefit to Long COVID, multi-morbidity, and other long-term conditions.
Review
Economics
Tiyi Morris, Fiona Aspinal, Jean Ledger, Keyi Li, Manuel Gomes
Summary: This study critically reviews existing literature on the impact of digital health interventions for the management of type 2 diabetes on health and social care utilization and costs. The review shows no clear evidence of an impact of digital health interventions on health and social care utilization or costs, with mixed findings reported in the included studies.
PHARMACOECONOMICS-OPEN
(2023)
Article
Substance Abuse
Beatrice C. Downing, Matthew Hickman, Nicola R. Jones, Sarah Larney, Michael J. Sweeting, Yixin Xu, Michael Farrell, Louisa Degenhardt, Hayley E. Jones
Summary: This study aims to estimate the prevalence of opioid dependence in New South Wales, Australia, and found that the prevalence in 2016 was 0.92%, higher than previous estimates. Approximately one-third of the patients had no record of opioid agonist treatment in the last 4 years.
Article
Mathematical & Computational Biology
Juan Segura-Buisan, Clemence Leyrat, Manuel Gomes
Summary: This article assesses the relative advantages of multiple imputation (MI) and inverse probability weighting (IPW) to address missing data in both outcomes and confounders measured over time. Through a comprehensive simulation study, MI consistently provided low bias and more precise estimates compared to IPW across a wide range of scenarios.
STATISTICS IN MEDICINE
(2023)
Review
Public, Environmental & Occupational Health
Elizabeth Ingram, Sarah Ledden, Sarah Beardon, Manuel Gomes, Sue Hogarth, Helen McDonald, David P. Osborn, Jessica Sheringham
Summary: This study systematically reviewed the associations between household and area-level social determinants of health and multimorbidity prevalence or incidence in the general population. The findings suggest that household income and area-level deprivation are significant factors associated with multimorbidity.
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
(2021)