Impact of patient sex on selection for abdominal aortic aneurysm repair: a discrete choice experiment.

Objectives: Women with an abdominal aortic aneurysm (AAA) are less likely to receive elective repair than men. This study explored the effect of patient sex and other attributes on vascular surgeons' decision-making for infrarenal AAA repair.

Design: Discrete choice experiment.

Trial emulation to assess the effect of surgery on survival when there are competing risks, with application to patients with thoracic aortic aneurysms.

Objectives: This study extends methods to estimate average causal effect of aneurysm repair surgery on (i) overall survival and (ii) aneurysm-related mortality, accounting for competing risks using data from the Effective Treatment for Thoracic Aortic Aneurysm (ETTAA) cohort.

Study Design And Setting: ETTAA, a prospective cohort study, recruited 886 patients between 2014 and 2018. Patients were linked to UK national hospital and mortality databases by National Health Service digital and followed-up for later surgeries and deaths.

Sex-specific differences in alive hospital discharge following infrarenal abdominal aortic aneurysm repair.

Background And Aims: A longer time to alive hospital discharge following infrarenal abdominal aortic aneurysm (AAA) repair is associated with reduced patient-satisfaction and increased length of stay, hospital-acquired deconditioning, infection and costs. This study investigated sex-specific differences in, and drivers of, the rate of alive hospital discharge.

Methods: Examination of UK National Vascular Registry (UK NVR), 2014-2019 and Swedish National Patient Registry (SE NPR) elective AAA patients, 2010-2018, for endovascular (EVAR) or open (OAR) aneurysm repair.

Heart rate variability as a dynamic marker of surgeons' stress during vascular surgery.

Background: A surgeon experiences elevated stress levels when operating. Acute stress is linked to cognitive overload, worsening surgical performance. Chronic stress poses a significant risk to a surgeon's health.

Longitudinal health-related quality of life in people with thoracic aortic aneurysms.

Background: Surgical intervention for thoracic aortic aneurysms is high risk. Understanding changes in health-related quality of life before and after endovascular stent grafting and open surgical repair can aid treatment decision-making.

Methods: The Effective Treatments for Thoracic Aortic Aneurysms ('ETTAA') study (ISRCTN04044627) was a longitudinal, observational study.

Inequalities for women diagnosed with distal arch and descending thoracic aortic aneurysms: results from the Effective Treatments for Thoracic Aortic Aneurysms (ETTAA) cohort study.

Background: Women with thoracic aortic aneurysms within the arch or descending thoracic aorta have poorer survival than men. Sex differences in relative thoracic aortic aneurysm size may account for some of the discrepancy. The aim of this study was to explore whether basing clinical management on aneurysm size index (maximum aneurysm diameter/body surface area) rather than aneurysm size can restore equality of survival by sex.

Use of Artificial Intelligence With Deep Learning Approaches for the Follow-up of Infrarenal Endovascular Aortic Repair.

Introduction: Endoleaks represent one of the main complications after endovascular aortic repair (EVAR) and can lead to increased re-intervention rates and secondary rupture. Serial lifelong surveillance is required and traditionally involves cross-sectional imaging with manual axial measurements. Artificial intelligence (AI)-based imaging analysis has been developed and may provide a more precise and faster assessment.

Genome sequence and annotation of phage Ruchi (AS1) isolated from soil in Lumpkin County, Georgia.

Ruchi a temperate, AS1 subcluster bacteriophage isolated in Lumpkin County, Georgia using host , possesses a genome of 38,571 bp and 67.7% GC. Annotation of this virus revealed 64 predicted reading frames, no predicted tRNA genes, and a close evolutionary relationship to AS1 phage Basilisk.

Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm: A Systematic Review and Narrative Synthesis.

Background: Thoracoabdominal aortic aneurysms (TAAA) pose significant risks of morbidity and mortality. Considering the evolving techniques for TAAA intervention and the growing interest in quality of life (QoL) outcomes for decision-making, we aimed to evaluate the impact of patient and perioperative characteristics on short-term, medium-term, and long-term postoperative QoL in TAAA repair patients.

Methods: A systematic search was conducted in CINAHL, APA PsycINFO, EMBASE, Medline and Cochrane to identify primary research studies evaluating QoL post TAAA surgery, published in English or Swedish between January 01, 2012 and September 26, 2022.

Costs of endovascular and open repair of thoracic aortic aneurysms.

Background: Repair of thoracic aortic aneurysms with either endovascular repair (TEVAR) or open surgical repair (OSR) represents major surgery, is costly and associated with significant complications. The aim of this study was to establish accurate costs of delivering TEVAR and OSR in a cohort of UK NHS patients suitable for open and endovascular treatment for the whole treatment pathway from admission and to discharge and 12-month follow-up.

Methods: A prospective study of UK NHS patients from 30 NHS vascular/cardiothoracic units in England aged ≥18, with distal arch/descending thoracic aortic aneurysms (CTAA) was undertaken.

Consensus statement on the interhospital transfer of patients with acute aortic syndrome: TRAVERSING Delphi study.

Background: Standardisation of referral pathways and the transfer of patients with acute aortic syndromes (AAS) to regional centres are recommended by NHS England in the Acute Aortic Dissection Toolkit. The aim of the Transfer of Thoracic Aortic Vascular Emergencies to Regional Specialist INstitutes Group study was to establish an interdisciplinary consensus on the interhospital transfer of patients with AAS to specialist high-volume aortic centres.

Methods: Consensus on the key aspects of interhospital transfer of patients with AAS was established using the Delphi method, in line with Conducting and Reporting of Delphi Studies guidelines.

Outcomes After Endovascular Aortic Intervention in Patients With Connective Tissue Disease.

Importance: Endovascular treatment is not recommended for aortic pathologies in patients with connective tissue diseases (CTDs) other than in redo operations and as bridging procedures in emergencies. However, recent developments in endovascular technology may challenge this dogma.

Objective: To assess the midterm outcomes of endovascular aortic repair in patients with CTD.

Carbon dioxide flushing versus saline flushing of thoracic aortic stents (INTERCEPTevar): protocol for a multicentre pilot randomised controlled trial.

Introduction: Thoracic endovascular aortic repair (TEVAR) carries a 3%-6.1% stroke risk, including risk of 'silent' cerebral infarction (SCI). Stent-grafts are manufactured in room air and retain air.

Systematic review of the development and effectiveness of digital health information interventions, compared with usual care, in supporting patient preparation for paediatric hospital care, and the impact on their health outcomes.

Background And Aim: Elective surgery can be overwhelming for children, leading to pre-operative anxiety, which is associated with adverse clinical and behavioural outcomes. Evidence shows that paediatric preparation digital health interventions (DHIs) can contribute to reduced pre-operative anxiety and negative behavioural changes. However, this evidence does not consider their design and development in the context of behavioural science.

Systems leadership: how chief executives manage tension between organisation and system pressures.

Aim: System leadership is the requirement for a leader of a single organisation to operate on behalf of a wider system, rather than their individual organisation. The current policy landscape does not incentivise system leadership, as many national structures emphasise a focus on individual organisations. This study aims to understand how chief executives in the National Health Service (NHS) in England implement system leadership in practice when faced with decisions that benefit the system to the detriment of their own trust.

Quantifying the burden of survivorship associated with infrarenal abdominal aortic aneurysms.

Objectives: Survivorship encompasses the physical, psychological, social, functional, and economic experience of a living with a chronic condition for both the patient and their caregiver. It is made up of nine distinct domains and remains understudied in nononcological pathologies, including infrarenal abdominal aortic aneurysmal disease (AAA). This review aims to quantify the extent to which existing AAA literature addresses the burden of survivorship.

Sex-specific differences in the standard of care for infrarenal abdominal aortic aneurysm repair, and risk of major adverse cardiovascular events and death.

Background: This study investigated whether sex-specific differences in preoperative/perioperative standard of care (SOC) account for disparity in outcomes after elective infrarenal abdominal aortic aneurysm repair.

Methods: This was a retrospective cohort study of elective infrarenal abdominal aortic aneurysm repairs (2013-2020) using depersonalized patient-level National Vascular Registry data. SOC was defined for waiting times, preoperative assessment (multidisciplinary/anaesthetic review), cardiovascular risk prevention, and perioperative medication.