To return to the home page, click here
AAA Papers of the Month often features papers published in the
Journal of Vascular Surgery. I have recently noticed that the
publisher, Mosby, may change the URL for a paper, so my links
no longer work. Accordingly, I am going back to the old method
of giving the full citation. If the reader wishes to find full text of the
quoted paper, it is still a simple matter. Use the PubMed link at
the bottom of the AIP homepage and search for the name of one
of the authors and/or some keywords from the title of the paper.
#1. Loftus IM, et al. Prevalence of true vein graft aneurysms:
Implications for aneurysm pathogenesis. J Vasc Surg 1999; 29: 403-8.
Brief summary: The authors found that aneurysms formed in 42% of
grafts performed for popliteal artery aneurysms, versus only 2% of
grafts performed for atherosclerotic occlusive disease. They
conclude that the finding not only has clinical implications, but also
suggests that aneurysmal disease is a systemic process.
Comment by mdt: Yes, I agree. I made similar comments about five
years ago in a letter to the editor of JVS.
#2. Moore G et al (incl Rob Thompson). Suppression of experimental
AAA's by systemic treatment with a hydroxamte-based MMP inhibitor
(RS 132908).
Brief summary: Using the Anidjar/Dobrin model, the authors found that
AAA's developed in all control animals, with a diameter of 5.98 +/- 1.02
mm at day 14. In contrast, only 63% of control animals developed
AAA's, with a mean diameter of 3.59 +/- .34 (p < .05). They further
show that the MMP inhibitor RS 132908 appears to promote
preservation of aortic elastin and to enhance a profibrotic response
in the aortic wall.
Comment by mdt: The St. Louis group under the leadership of
Rob Thompson continues to contribute steadily to the literature on
experimental aortic aneurysms. They and others have suggested the
efficacy of several pharmacological interventions. It may be appropriate
now to test the efficacies of different agents in the same experiments,
to lay a background of choosing an intervention for trials in man.
#3. Quinones-Baldrich WJ, et al (incl Wesley Moore). Endovascular (EV),
transperitoneal (TA), and retroperitoneal (RP) AAA repair: Results and costs.
J Vasc Surg 1999; 30: 59-67.
Comment by mdt: The UCLA group was the first in the States to
implant the so-called EVT device in 1993. Accordingly, when they speak,
we listen. Here they report that there were no statistically significant
differences in operative mortality among the 3 approaches, but the
EV group had fewer respiratory complications than TA and fewer wound
complications than RP. EV also had overall less morbidity and a shorter
hospital stay. Costs are initially lower with EV, but comparisons are
difficult because EV requires more preoperative imaging and longer
surveillance.
Yep... EV is maturing as expected. We should also have an answer to
the durability question within several more years.