Dr. Phil O’Halloran
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Transcript of Dr. Phil O’Halloran
Dr. Phil O’Halloran
Surgical Grand Rounds
Case.
•HS 65 year old male
•electively admitted for an EVAR on the.
•Pilot Screening programme
AAA Size (cm) = 5.62
Case.•BKGD: Nil of significance.
•Meds: NKDA
•Smoker : 10/day 40 years.
•Pre-op Work up: Echo - EF 55%
•Underwent endurant bifuracted repair of AAA.
Lipitor 10mg od po
PFT’s: Normal
Post Op
•Transfer back to Ward.
•Normal bloods day 1 post-op.
•Eating and Drinking.
•Mobilizing.
•Discharged well.
AAA Screening.
•Should we be doing it?
AAA Screening
NHS Abdominal Aortic Aneurysm Screening Programme
AAA Screening -Why?
•8:1
•4% of men aged 65-74.
•Significant Morbidity & Mortality.
•Vascular Disease = 40% of UK deaths.
•Family History.
•Smoking / Hypertension.
AAA Screening
Lancet 2002; Nov 16; 360 (9345): 1531-9.
MASS Study
MASS Study
MASS Study•42% reduction of risk
in the invited group.
•Similar mortality rate in those who DNA and control group.
•Substantial benefit of AAA Screening
(P value: 0.0002)
.
Cosford PA, Leng GC. Screening for abdominal aortic aneurysm. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD002945. DOI: 10.1002/14651858.CD002945.pub2.
• Making the Case for Cardiovascular Screening in Irish Males: Detection of Abdominal Aortic Aneurysms, and Assessment of Cardiovascular Risk Factors
• M. Brosnan b, C.G. Collins a, D.S. Moneley a, C.J. Kelly a,b, A.L. Leahy a,b,*
• a Department of Surgery, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin 9, Ireland
• b Department of Vascular Diagnostic Unit, Connolly Hospital, Blanchardstown, Dublin 15, Ireland
• Eur J Vasc Endovasc Surg (2009) 37, 300e304
Irish Pilot Study.
•April 2006 - Decemeber 2007.
•Males 55-75 invited for screening.
•GP register (N = 1414)
•904 accepted: 568 (63%) aged 55-64336 (37%) aged 64-75
Irish Pilot Study.•17/904 ( 1.9%) previously
undiagnosed aneurysm detected.
•Sizes ranging from 3-5.8cm
•0.6% in 55-64 age group.
•4.2% in 65-75 age group (p<0.01)
Conclusion AAA screening in 65-75 age group in Ireland is
justified.