Search

To determine whether an association of peripheral artery disease (PAD) with abdominal aortic aneurysm (AAA) growth is positive, none, or negative, a meta-analysis of all available studies was performed through a systematic literature search.MEDLINE and Embase databases were searched until July 2015 by the use of PubMed and Ovid Web-based search engines. The search terms were enlargement, expansion, growth, or progression; and abdominal aortic aneurysm. Studies that fulfilled the following criteria were included: (1) AAA patients with PAD and those without PAD as the population and (2) data of AAA growth as the outcomes. By means of growth rates in patients with and without PAD for each study, we generated standardized mean differences (SMDs) and their 95% confidence intervals (CIs).Of 612 initially screened publications that were potentially relevant, 11 eligible studies that reported the correlation between PAD and AAA growth were identified, and a total of 4573 patients with AAA were included. A pooled analysis of the 11 studies demonstrated a statistically significant association of PAD with lower growth rates of AAA (SMD, -0.18; 95% CI, -0.25 to -0.11; P .00001). In addition, separately combining seven adjusted effect estimates did not substantively alter the pooled estimate (SMD, -0.17; 95% CI, -0.25 to -0.09; P .0001). No significant publication bias was observed.PAD is likely negatively associated with AAA growth. Further research is required to explain why PAD negatively correlates with AAA growth despite a positive correlation with AAA presence.

Background The present study provides a contemporary and comprehensive summation of midterm patency rates of polyester (Dacron) or polytetrafluoroethylene (PTFE) grafts in femoropopliteal bypass grafting based on a meta-analysis consisting only of randomized controlled trials. Methods MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify all randomized controlled trials of Dacron vs PTFE grafts in femoropopliteal bypass grafting. Seven trials were found. Survival data were combined to yield the pooled cumulative primary patency. We estimated the log hazard ratio (HR) for each 1-month interval and then combined the HRs in a stratified way across intervals to obtain an overall log HR for each trial. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic HRs in fixed-effects and random-effects models. Results The pooled cumulative primary patency of Dacron and PTFE grafts was, respectively, 60.2% (95% confidence interval [CI], 56.4%-64.0%) and 53.8% (95% CI, 46.8%-60.9%) at 3 years, and 49.2% (95% CI, 45.6%-52.7%) and 38.4% (95% CI, 32.2%-44.6%) at 5 years. Pooled analysis of the seven trials demonstrated no difference in HR for graft occlusion with Dacron relative to PTFE grafts (random-effects HR, 0.87; 95% CI, 0.67-1.12; P = .27 for effect; P = .03 for heterogeneity). Conclusion Either Dacron or PTFE grafts can be used in femoropopliteal bypass grafting with no significant differences in midterm graft patency at 5 years (49.2% vs 38.4%) when the autologous saphenous vein is unavailable.

Objective To summarize the association of simple renal cyst (SRC) with abdominal aortic aneurysm (AAA), we reviewed currently available clinical studies with a systematic literature search and meta-analytic evaluation. Methods To identify all case-control studies evaluating the association of SRC with AAA, databases including MEDLINE and Embase were searched through April 2015 using web-based search engines (PubMed and Ovid). For each study, data regarding SRC prevalence in both the AAA and control groups were used to generate unadjusted odds ratios (ORs) and 95% confidence intervals. When an adjusted OR (by the use of multivariable logistic regression) was available, we preferentially abstracted the adjusted OR rather than an unadjusted OR. Results Of 139 potentially relevant articles screened initially, 5 eligible case-control studies enrolling a total of 2897 participants were identified and included. A pooled analysis of seven estimates from the five studies demonstrated a statistically significant 2.54-fold prevalence of SRC in patients with AAA relative to subjects without AAA (OR, 2.54; 95% confidence interval, 1.93-3.34; P Conclusions Our meta-analytic evaluation demonstrated 2.5-fold prevalence of SRC in patients with AAA relative to subjects without AAA, which suggests that SRC is associated with AAA.

We describe a dorsalis pedis artery true aneurysm due to atherosclerosis. A 61-year-old woman had a pulsatile and painful tumor on the right dorsal part of the foot, and magnetic resonance imaging revealed an aneurysm of the dorsalis pedis artery. Resection of the aneurysm was completed without complications. Pathologic analysis showed true aneurysm due to atherosclerosis. We review the literature on true aneurysm of the infrapopliteal arteries, including the dorsalis pedis artery, and discuss the clinical presentation and surgical management.

Proximal ulnar artery aneurysms, including pseudoaneurysms, have not been described in the English literature. We report a nontraumatic pseudoaneurysm of the proximal ulnar artery with eosinophilia in a 54-year-old man. Radial, coronary, and hepatic artery aneurysms associated with eosinophilia in idiopathic hypereosinophilic syndrome or allergic granulomatous angiitis (Churg Strauss syndrome) have been reported. Although it is unclear in the present case whether eosinophilia was associated with the pseudoaneurysm of the ulnar artery, eosinophil infiltration into the aneurysmal wall may have influenced vascular injury as the cause of the pseudoaneurysm formation.

Purpose It remains unclear whether population-based screening for abdominal aortic aneurysm (AAA) in men reduces all-cause long-term mortality. We performed an updated meta-analysis of randomized controlled trials of AAA screening for prevention of long-term mortality in men. Methods To identify all randomized controlled trials of population-based AAA screening with long-term (≥10 year) follow-up in men, MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched through June 2009. Data regarding AAA-related and all-cause mortality (including Cox regression hazard ratios [HRs] and 95% confidence intervals [CIs]) were abstracted from each individual study. For each study, data regarding mortality in both the screening and control groups were used to generate odds ratios (ORs) and 95% CIs. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs or HRs (or risk ratios where no HR was reported) in both fixed- and random-effects models. Results Our search identified four randomized controlled trials of population-based AAA screening with long-term follow-up in men aged ≥65 years. Pooled analysis demonstrated a statistically significant reduction in AAA-related mortality (random-effects OR, 0.55; 95% CI, 0.36 to 0.86; P = .008; P for heterogeneity=.01; absolute risk reduction [ARR], 4 per 1000; number needed to screen [NNS], 238; random-effects HR, 0.55; 95% CI, 0.35 to 0.86; P = .009; P for heterogeneity=.009) and revealed a statistically nonsignificant reduction (but a strong trend toward a significant reduction) in all-cause mortality (fixed-effects OR, 0.98; 95% CI, 0.95 to 1.00 [1.001]; P = .06; P for heterogeneity=.93; ARR, 5 per 1000; NNS, 217; fixed-effects HR, 0.98; 95% CI, 0.96 to 1.00 [1.0001]; P ≥ .05 [ P = .052]; P for heterogeneity=.74) with AAA screening relative to control. Conclusion The results of our analysis suggest that population-based screening for AAA reduces AAA-related long-term mortality by 4 per 1000 over control in men aged ≥65 years. Whereas, screening for AAA shows a strong trend toward a significant reduction in all-cause long-term mortality by 5 per 1000, which does not narrowly reach statistical significance.

Intercostal artery pseudoaneurysm is extremely rare, and only six cases have been reported in the English literature. We describe a case of intercostal artery pseudoaneurysm due to a stab wound, review the literature, and discuss therapeutic modalities. Intercostal artery pseudoaneurysm is at risk for early rupture, and diagnosis before rupture is mandatory. Although embolization is considered to be a feasible therapeutic method, we would emphasize the significance of the anatomic features of the intercostal arteries: multiple blood supplies into the pseudoaneurysm, such as the anterior and posterior intercostal arteries, and musculophrenic artery.