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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Related Experiment Video

Updated: Sep 8, 2025

Manufacturing Abdominal Aorta Hydrogel Tissue-Mimicking Phantoms for Ultrasound Elastography Validation
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Delay in Surgery for Ruptured Aortic Aneurysm in Hemodynamically Stable Patients: A Multicenter Retrospective

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Summary

Patients with stable blood pressure and ruptured thoracic or abdominal aortic aneurysms (TAA/AAA) experienced longer door-to-surgery times. This highlights potential treatment delays for hemodynamically stable TAA/AAA patients.

Keywords:
abdominal aortic aneurysmsemergency medicine physiciangeneral and vascular surgeryphysical diagnosisthoracic aortic rupture

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Area of Science:

  • Vascular Surgery
  • Emergency Medicine
  • Aortic Aneurysm Research

Background:

  • Ruptured thoracic or abdominal aortic aneurysms (TAA/AAA) are life-threatening surgical emergencies.
  • Timely surgical intervention is critical for improving patient survival rates in TAA/AAA cases.
  • The impact of initial hemodynamic status on treatment timelines for ruptured TAA/AAA is not fully understood.

Purpose of the Study:

  • To investigate the association between initial systolic blood pressure and door-to-surgery time in ruptured TAA/AAA patients.
  • To test the hypothesis that hemodynamically stable patients (non-hypotensive) experience longer delays to surgery compared to hypotensive patients.

Main Methods:

  • Retrospective study including patients with ruptured TAA/AAA admitted between 2010 and 2021 at two Japanese hospitals.
  • Comparison of door-to-surgery times between patients with stable blood pressure (>90 mmHg) and those with hypotension (≤90 mmHg).
  • Multivariable linear regression analysis was employed to assess the relationship between blood pressure and time to surgery.

Main Results:

  • Out of 94 patients, 29.8% presented with hypotension.
  • Hemodynamically stable patients had significantly longer door-to-surgery times (152 min) compared to hypotensive patients (95.5 min, p=0.003).
  • Multivariable analysis confirmed shorter door-to-surgery times for hypotensive patients (percent difference: -26.3%).

Conclusions:

  • Hemodynamically stable patients with ruptured TAA/AAA may face longer delays in surgical treatment.
  • These delays in treatment for stable ruptured TAA/AAA patients can potentially lead to worse outcomes.
  • Increased clinical vigilance is necessary to ensure timely intervention for all ruptured TAA/AAA patients, regardless of initial hemodynamic status.