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1. Shared Genetic Risk Factors of Intracranial, Abdominal, and Thoracic Aneurysms

Author

Femke N. G. van ’t Hof, Ynte M. Ruigrok, Cue Hyunkyu Lee, Stephan Ripke, Graig Anderson, Mariza de Andrade, Annette F. Baas, Jan D. Blankensteijn, Erwin P. Böttinger, Matthew J. Bown, Joseph Broderick, Philippe Bijlenga, David S. Carrell, Dana C. Crawford, David R. Crosslin, Christian Ebeling, Johan G. Eriksson, Myriam Fornage, Tatiana Foroud, Mikael von und zu Fraunberg, Christoph M. Friedrich, Emília I. Gaál, Omri Gottesman, Dong‐Chuan Guo, Seamus C. Harrison, Juha Hernesniemi, Albert Hofman, Ituro Inoue, Juha E. Jääskeläinen, Gregory T. Jones, Lambertus A. L. M. Kiemeney, Riku Kivisaari, Nerissa Ko, Seppo Koskinen, Michiaki Kubo, Iftikhar J. Kullo, Helena Kuivaniemi, Mitja I. Kurki, Aki Laakso, Dongbing Lai, Suzanne M. Leal, Hanna Lehto, Scott A. LeMaire, Siew‐Kee Low, Jennifer Malinowski, Catherine A. McCarty, Dianna M. Milewicz, Thomas H. Mosley, Yusuke Nakamura, Hirofumi Nakaoka, Mika Niemelä, Jennifer Pacheco, Peggy L. Peissig, Joanna Pera, Laura Rasmussen‐Torvik, Marylyn D. Ritchie, Fernando Rivadeneira, Andre M. van Rij, Regie Lyn P. Santos‐Cortez, Athanasios Saratzis, Agnieszka Slowik, Atsushi Takahashi, Gerard Tromp, André G. Uitterlinden, Shefali S. Verma, Sita H. Vermeulen, Gao T. Wang, Buhm Han, Gabriël J. E. Rinkel, Paul I. W. de Bakker, Ana Verissimo, Benjamin J. Wright, Suzannah Bumpstead, Solveig Gretarsdottir, Stephen A. Badger, Anne H. Child, Rachel E. Clough, Gillian Cockerill, Hany Hafez, D. Julian A. Scott, Simon Futers, Soroush Sohrabi, Alberto Smith, Matthew M. Thompson, Frank M. van Bockxmeer, Stefan E. Matthiasson, Gudmar Thorleifsson, Unnur Thorsteinsdottir, Joep A. W. Teijink, Cisca Wijmenga, Jacqueline de Graaf, Lambertus A. Kiemeney, Jutta Palmen, Andrew J. Smith, Jes S. Lindholt, Declan T. Bradley, Matthew Waltham, Sarah Edkins, Rhian Gwilliam, Sarah E. Hunt, Simon Potter, Jonathan Golledge, Per Eriksson, Paul E. Norman, Janet T. Powell, Kari Stefansson, John R. Thompson, Steve E. Humphries, Robert D. Sayers, Panos Deloukas, Nilesh J. Samani, L. Victoria Phillip, Geraldine B. Hill, Michael J. A. Williams, Ian A. Thomson, Jo Krysa, Gerard T. Wilkins, Tony R. Merriman, Thodor M. Vasudevan, David R. Lewis, Ross D. Blair, and Andrew A. Hill

Subjects
abdominal aortic aneurysm, genome wide association study, intracranial aneurysm, thoracic aortic aneurysm, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

BackgroundIntracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co‐occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs. Methods and ResultsWe performed a mega‐analysis of 1000 Genomes Project‐imputed genome‐wide association study (GWAS) data of 4 previously published aneurysm cohorts: 2 IA cohorts (in total 1516 cases, 4305 controls), 1 AAA cohort (818 cases, 3004 controls), and 1 TAA cohort (760 cases, 2212 controls), and observed associations of 4 known IA, AAA, and/or TAA risk loci (9p21, 18q11, 15q21, and 2q33) with consistent effect directions in all 4 cohorts. We calculated polygenic scores based on IA‐, AAA‐, and TAA‐associated SNPs and tested these scores for association to case‐control status in the other aneurysm cohorts; this revealed no shared polygenic effects. Similarly, linkage disequilibrium–score regression analyses did not show significant correlations between any pair of aneurysm subtypes. Last, we evaluated the evidence for 14 previously published aneurysm risk single‐nucleotide polymorphisms through collaboration in extended aneurysm cohorts, with a total of 6548 cases and 16 843 controls (IA) and 4391 cases and 37 904 controls (AAA), and found nominally significant associations for IA risk locus 18q11 near RBBP8 to AAA (odds ratio [OR]=1.11; P=4.1×10−5) and for TAA risk locus 15q21 near FBN1 to AAA (OR=1.07; P=1.1×10−3). ConclusionsAlthough there was no evidence for polygenic overlap between IAs, AAAs, and TAAs, we found nominally significant effects of two established risk loci for IAs and TAAs in AAAs. These two loci will require further replication.

Published
2016
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2. Emergency EVAR for ruptured abdominal aortic aneurysms: New Zealand experience

Author

Sam, Taylor, Ian, Thomson, and Jo, Krysa

Subjects
Male, Aortic Rupture, Endovascular Procedures, Length of Stay, Risk Assessment, Postoperative Complications, Treatment Outcome, Humans, Female, Hospital Mortality, Emergency Treatment, Aged, Aortic Aneurysm, Abdominal, New Zealand
Abstract

A ruptured abdominal aortic aneurysm (rAAA) remains a significant threat to life, with a 30-50% in-hospital mortality rate. The recent introduction of emergency endovascular aneurysm repair (rEVAR) in New Zealand presents an alternative to open repair for rAAAs. The aim of this paper is to review the current experience in New Zealand in the repair of rAAAs.Data from the Australasian Vascular Audit (AVA) was reviewed, with data pertaining to rAAAs collected for the five-year period from January 2010 to December 2014.Two hundred and eighty-five rAAAs were reported over the five-year period, with an overall mortality rate of 34.0%. There was no significant difference in in-hospital mortality rates alone after rEVAR vs open repair (rOR) (OR 0.39, 95% CI 0.14-1.06, P=0.065). Significant reductions in length of hospital stay (9.710.2 days vs 16.812.9 days, P=0.0125) and the combined in-hospital mortality/post-operative complication rate (35.7% vs 63.6%, OR 0.3, 95% CI 0.1-0.7, P=0.005) were observed after rEVAR vs rOR.A primary rEVAR approach is appropriate in selected patients and may represent a paradigm shift in the management of ruptured AAAs in New Zealand.

Published
2016

3. Mobilised to Iraq: a surgical trainee's tale

Author

Jo Krysa

Subjects
Officer, Medical education, Political science, World War II, General Medicine, Specialist registrar, Surgical training
Abstract

Mobilisation papers to go to Iraq arrived on my desk during the first year of my specialist registrar training in surgery. I have been in the territorial army for over four years, but the unit had not been deployed since the second world war and so compulsory mobilisation was a bit of a shock. At that time I did not know how my training would be affected, and to be honest the idea of spending six months in Iraq scared me. I was given two weeks to organise my life and present myself at the army unit. My deployment was fully supported by my family and the programme director of the higher surgical training committee, for which I am grateful. I completed the predeployment training and arrived in Iraq at the beginning of July. We spent five days acclimatising in Kuwait. We then moved on to our respective posts. I was a medical officer …

Published
2004
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