A5055921602- Aortic aneurysm repair treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Aortic Disease and Treatment Approaches
- Peripheral Artery Disease Management
- Cerebrovascular and Carotid Artery Diseases
- Vascular Procedures and Complications
- Infectious Aortic and Vascular Conditions
- Renal and Vascular Pathologies
- Cardiovascular Health and Disease Prevention
- Venous Thromboembolism Diagnosis and Management
- Acute Ischemic Stroke Management
- Diagnosis and Treatment of Venous Diseases
- Intracranial Aneurysms: Treatment and Complications
- Connective tissue disorders research
- Lipoproteins and Cardiovascular Health
- Cardiac and Coronary Surgery Techniques
- Coronary Interventions and Diagnostics
- Cardiovascular Disease and Adiposity
- Reconstructive Surgery and Microvascular Techniques
- Aortic Thrombus and Embolism
- Diversity and Career in Medicine
- Oropharyngeal Anatomy and Pathologies
- Abdominal vascular conditions and treatments
- Antiplatelet Therapy and Cardiovascular Diseases
- Central Venous Catheters and Hemodialysis
Queen Mary University of London
2023
University Hospitals Sussex NHS Foundation Trust
2023
Imperial College London
2010-2020
Charing Cross Hospital
2004-2018
National Institute for Health Research
2010
National Health Service
2008-2010
National and Kapodistrian University of Athens
2008
MRC Clinical Trials Unit at UCL
2000-2004
MRC Biostatistics Unit
2004
Ealing Hospital
2001
Short-term survival benefits of endovascular aneurysm repair (EVAR) versus open intact abdominal aortic aneurysms have been shown in randomised trials, but this early benefit is lost after a few years. We investigated whether EVAR had long-term compared with repair.We used data from the controlled trial (EVAR 1), which enrolled 1252 patients 37 centres UK between Sept 1, 1999, and Aug 31, 2004. Patients to be aged 60 years or older, at least 5·5 cm diameter, deemed suitable fit for either...
Abstract The risk of rupture an abdominal aortic aneurysm increases with diameter. To obtain insight into the pathological processes associated vascular remodeling that accompanies dilatation, we compared histological features and activity matrix metalloproteinases (MMPs) in biopsies from 21 small (4.0 to 5.5 cm diameter) 45 larger aneurysms. feature most clearly enlarging diameter was a higher density inflammatory cells adventitia, P =.018. This inflammation nonspecific, principally...
Intervention to reduce abdominal aortic aneurysm (AAA) expansion and optimization of screening intervals would improve current surveillance programs. The aim this study was characterize AAA growth in a national cohort patients with both overall by cardiovascular risk factors.In study, 1743 were monitored for changes diameter ultrasonography over mean follow-up 1.9 years. Mean initial rate 43 mm (range 28 85 mm) 2.6 mm/year (95% range, -1.0 6.1 mm/year), respectively. Baseline strongly...
Endovascular repair of abdominal aortic aneurysm was originally developed for patients who were considered to be physically ineligible open surgical repair. Data are lacking on the question whether endovascular reduces rate death among these patients.
Abstract Background In regional and population studies, the mortality rate within 30 days of elective surgical repair abdominal aortic aneurysm is approximately 8 per cent. Identification preoperative factors associated with this risk important for informing policy may suggest suitable interventions. Methods UK Small Aneurysm Trial, 820 patients aged 60–80 years underwent open an aneurysm. The relationship between 30-day 13 prespecified potential prognostic was investigated. value a...
To assess the rate and factors associated with rupture after endovascular aneurysm repair (EVAR) or open (OR) of abdominal aortic aneurysm.Graft EVAR has been reported, often preceded by graft-related complications. Graft also reported OR.By July 2009, a total 848 elective EVARs 594 ORs were performed in United Kingdom trials 1 2. Patients followed up for complications, reinterventions, rupture. The incidence was explored relation to baseline anatomy subsequent complications Cox regression...
Abstract Background A steady rise in mortality from abdominal aortic aneurysm (AAA) was reported the 1980s and 1990s, although this is now declining rapidly. Reasons for recent decline AAA rupture are investigated here. Methods Routine statistics mortality, hospital admissions procedures England Wales were investigated. All data age-standardized. Trends smoking, hypertension treatment hypercholesterolaemia (statins), together with regression coefficients available public sources those aged...
The aim of the study was to compare long-term total and aneurysm-related mortality in physically frail patients with abdominal aortic aneurysm (AAA) randomized either early endovascular repair (EVAR) or no-intervention.EVAR-2 remains sole trial identify whether EVAR reduces ineligible for open repair.Between September 1999 August 2004, 404 from 33 centers United Kingdom aged ≥60 years AAA >5.5 cm diameter were 1:1 using computer-generated sequences randomly permuted blocks stratified by...
Background Short-term survival benefits of endovascular aneurysm repair (EVAR) compared with open (OR) intact abdominal aortic aneurysms have been shown in randomised trials, but this early benefit is soon lost. Survival EVAR was unclear at follow-up to 10 years. Objective To assess the long-term efficacy against OR patients deemed fit and suitable for both procedures (EVAR trial 1; EVAR-1); no intervention unfit 2; EVAR-2). appraise significance type II endoleak define criteria...
Background —There is no treatment proven to limit the growth of abdominal aortic aneurysms, in which histological hallmarks include inflammation and medial atrophy, with apoptosis smooth muscle cells destruction elastin. Methods Results —Aneurysm biopsies were used for explant cultures, preparation cell isolation macrophages. Tissue macrophages stained strongly cyclooxygenase 2. Prostaglandin E 2 (PGE ) concentrations aneurysm tissue homogenates, conditioned medium from explants, isolated...
Abstract Smoking impairs the endothelium-dependent relaxation of arteries and veins, with maximum in response to calcium ionophore A23187 saphenous vein rings being reduced from 53±4% nonsmokers 27±5% smokers. We have investigated whether this endothelial dysfunction was attributable altered activity or concentration nitric oxide synthase (NOS). The NOS endothelium, determined by Western blotting immunohistochemistry, not different Nitrite production strips stimulated higher (median 23.6...
Abstract The repeatability, observer bias and instrument of aortic diameter measurement by ultrasonography, were investigated in ten patients with small (3–6 cm computed tomography) infrarenal abdominal aneurysm. repeatability maximum ultrasonography was much better for anterior—posterior than transverse diameter, coefficients 3·0–7·5 mm 10–15 respectively. suprarenal poor. Surprisingly, using larger that tomography, the difference being least measurements. At best a single, experienced...
To determine the effects of smoking, plasma lipids, lipoproteins, apolipoproteins, and fibrinogen on patency saphenous vein femoropopliteal bypass grafts at one year.Prospective study patients with entered into a multicentre trial.Surgical wards, outpatient clinics, home visits coordinated by two tertiary referral centres in London Birmingham.157 Patients (mean age 66.6 (SD 8.2) years), 113 patent 44 occluded year after bypass.Cumulative percentage year.Markers for smoking (blood...