Dedication These guidelines are dedicated to Paola De Rango, University of Perugia, Italy. She participated very actively in the process of developing these guidelines, in particular the important ...chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. Dr Paola De Rango, July 28, 1966 – February 21, 2016
To study the growth rate and factors influencing progression of small infrarenal abdominal aortic aneurysms (AAA).
Observational, longitudinal, prospective study.
We followed patients with AAA <5
cm ...in diameter in two groups. Group I (AAA 3–3.9
cm,
n=246) underwent annual ultrasound scans. Group II (AAA 4–4.9
cm,
n=106) underwent 6-monthly CT scans.
We included 352 patients (333 men and 19 women) followed for a mean of 55.2±37.4 months (6.3–199.8). The mean growth rate was significantly greater in group II (4.72±5.93
vs. 2.07±3.23
mm/year;
p<0.0001). Group II had a greater percentage of patients with rapid aneurysm expansion (>4
mm/year) (36.8
vs. 13.8%;
p<0.0001). The classical cardiovascular risk factors did not influence the AAA growth rate in group I. Chronic limb ischemia was associated with slower expansion (≤4
mm/year) (OR 0.47; CI 95% 0.22–0.99;
p=0.045). Diabetic patients in group II had a significantly smaller mean AAA growth rate than non-diabetics (1.69±3.51
vs. 5.22±6.11
mm/year;
p=0.032).
The expansion rate of small AAA increases with the AAA size. AAA with a diameter of 3–3.9
cm expand slowly, and they are very unlikely to require surgical repair in 5 years. Many 4–4.9
cm AAA can be expected to reach a surgical size in the first 2 years of follow-up. Chronic limb ischemia and diabetes are associated with reduced aneurysm growth rates.
Abstract Objectives Diminished soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) concentrations are associated with cardiovascular diseases. We have analyzed sTWEAK levels and its ...relation with expansion rate in subjects with abdominal aortic aneurysm (AAA). Methods sTWEAK levels were measured by ELISA. Results sTWEAK concentrations were diminished in small AAA (≤5 cm; 353 ± 12 pg/mL; n = 25, p = 0.03) and large AAA (>5 cm; 315 ± 21 pg/mL; n = 18, p = 0.004) compared with healthy subjects (411 ± 22 pg/mL; n = 27). Moreover, sTWEAK concentrations were negatively associated with AAA size ( r = −0.4; p = 0.008). sTWEAK was also negatively associated with AAA expansion rate with 5 years of follow-up ( n = 79, r = −0.263; p = 0.031). Multivariate regression analysis revealed that sTWEAK levels were independently associated with AAA growth rate ( β = −0.208; p = 0.046). Conclusions sTWEAK plasma levels were decreased in subjects with AAA and were independently related with AAA expansion rate indicating that this protein could be a novel diagnostic and prognostic biomarker of AAA.
Abstract Introduction Anaemia can compromise muscle and organ function. Related iron and vitamin body stores have seldom been assessed in patients with peripheral arterial disease. Report We ...retrospectively analysed basal prevalence of anaemia, iron, B12 -vitamin and folic acid deficits in 420 patients with claudication and 204 patients with critical limb ischaemia (CLI). The prevalence of the evaluated parameters was 9.8%, 6.7%, 6.7% and 2.9% among patients with claudication but 49.5%, 31.9%, 15.7% and 6.4% among CLI patients, respectively ( p < 0.05 for all). Discussion Anaemia, iron and vitamin deficits are uncommon among patients with ischemic claudication but very prevalent among patients with CLI.
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