" AAA WANTED " 2012 S Paulo Vascular Surgery Meeting
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Congress presentation in 2012 10 S.Paulo Vascular Surgery Meeting "AAA WANTED " Presentazione al congresso 2012 10 S.Paulo Vascular Surgery Meeting "AAA CERCASI" (Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana) (Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
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" AAA WANTED " 2012 S Paulo Vascular Surgery Meeting
- 1. AAA WANTED prevention of ruptured abdominal aortic aneurysm: a project to prevent sudden death April 13-14, 2012 DIVISION OF VASCULAR AND ENDOVASCULAR SURGERY Chief: Salvatore Ronsivalle, MD
- 3. S.Paulo area 1523 kmq 19.000.000 residents Veneto Area 18.400.000 kmq 4.900.000 residents population 250.326 residents Area 582 Kmq;density 429,87 residents / Kmq
- 4. BACKGROUND AAA: asymptomatic disease but its rupture is a surgical emergency and often leads to death Early diagnosis is very important for an optimal management and for planning surgery in a short time Literature provides evidence in favor of screening
- 5. AAA PREVALENCE FOR SEX AND AGE 1,3 0,0 12,5 5,2 0,0 1,0 2,0 3,0 4,0 5,0 6,0 7,0 8,0 9,0 10,0 45-54 years 75-84 years male female
- 6. PROJECT AIMS ★ MAIN : prevention of death due to ruptured abdominal aortic aneurysm by treating the asymptomatic pathology through identification, monitoring and early planned surgery ★ SECONDARY : observation and study of risk factors distribution in normal and affected population
- 7. MATERIALS AND METHODS ★ FREE MEDICAL EXAMINATION ★ Project that lasts 7 years ★ Each year we call all people who will turn 68 or 74 on their next birthday ★ In four years 17868 people were invited and we performed 11426 aorto–iliac district CDU with an average of 63.5% ★ shuttle bus service is organized for people who lived outside the city
- 8. ORGANIZATION ★ ELECTRONIC SUPPORT: DATA BASE to collect and store data ★ SECRETARY ORGANIZATION: sending out invitations, shuttle bus service organization, information, appointment scheduling ★ STAFF: 4 doctors, 2 nurses, 2 orderlies ★ SERVICE HOURS: 4 laboratories open from Monday to Friday (14.30-16.30)
- 9. DEPARTMENT ORGANIZATION CARDIOVASCULAR DEPARTMENTCARDIOVASCULAR DEPARTMENT CITTADELLACITTADELLA CARDIOLOGY DIVISION CARDIOLOGY DIVISION CAMPOSAMPIEROCAMPOSAMPIERO INTERVENTIONAL CARDIOLOGY UNIT INTERVENTIONAL CARDIOLOGY UNIT VASCULAR SURGERY DIVISION VASCULAR SURGERY DIVISION ANGIOLOGY UNIT ANGIOLOGY UNIT CARDIOLOGY DIVISION CARDIOLOGY DIVISION ELECTRO PHYSIOLOGY UNIT ELECTRO PHYSIOLOGY UNIT
- 10. 5 SURGEONS5 SURGEONS ANGIOLOGY UNIT ANGIOLOGY UNIT OPERATING ROOM DAY SURGERY AMBULATORY OPERATING ROOM DAY SURGERY AMBULATORY VASCULAR-ENDOVASCULAR SURGERY AND ANGIOLOGY VASCULAR AND ENDOVASCULAR SURGERY DEPARTMENT VASCULAR AND ENDOVASCULAR SURGERY DEPARTMENT WARDWARD 3 INTERNISTS3 INTERNISTS ANGIOLOGY NON INVASIVE DIAGNOSTIC DAY HOSPITAL ANGIOLOGY NON INVASIVE DIAGNOSTIC DAY HOSPITAL CARDIOVASCULAR DEPARTMENTCARDIOVASCULAR DEPARTMENT
- 11. QUESTIONNAIRE FOR PRINCIPAL VASCULAR RISK FACTORS Heart disease Obesity Hypercholesterolemia Diabetes Smoke High blood pressure Familiarity for abdominal aortic aneurysm Previous cardiovascular surgery
- 12. Aorta < 30 mm Iliac < 15 mm Aorta < 30 mm Iliac < 15 mm Aorta 30-45 mm Iliac 15-25 mm Aorta 30-45 mm Iliac 15-25 mm Aorta > 45 mm Iliac > 25 mm Aorta > 45 mm Iliac > 25 mm check upcheck up Annual follow up Annual follow up Further examination Further examination check upcheck up check upcheck up SurgerySurgery Aorto-iliac CDU Aorto-iliac CDU AORTO ILIAC DISTRICT CDU
- 13. PUBLIC HEALTH SERVICE AREA Total population at 31.12.2008: 250.326 residents Area: 582 Kmq; density 429,87 residents / Kmq 20 km 34 km 28 km 12 km 24 km 27 km
- 15. RESULTS PATHOLOGY CASES PERCENTAGES ABDOMINAL AORTIC ANEURYSM 31 0.3 % COMMON ILIAC ARTERY ANEURISM 21 0.2 % ABDOMINAL AORTIC ECTASIA 111 1 % COMMON ILIAC ARTERY ECTASIA 696 6 %
- 16. PREVALENCE OF PATHOLOGY IN TOTAL STUDIED POPULATION (11425) 31 21 111 696 0 100 200 AAA AIC EAA EAIC (6% ) (1% ) (0.2% ) (0.3% )
- 17. PREVALENCE OF PATHOLOGY IN TOTAL EXAMINED POPULATION ACCORDING TO SEX 30 1 20 1 98 13 612 84 M F AAA AAIC EAA EAIC
- 18. 1211 3392 4177 1629 7021 597 597 791 0 1000 2000 3000 4000 heartdisease obesity hiperchol diabetes H B P sm oke cv surgery fam iliarity PREVALENCE OF RISK FACTOR’S DISTRIBUTION IN TOTAL STUDY POPULATION (11426) (10.6% ) (29.7% ) (36.6%) (14.3% ) (61.4% ) (5.2% ) (1.6% ) (5.2% )
- 19. PREVALENCE OF RISK FACTOR’S DISTRIBUTION IN TOTAL AAA AND AIC AFFECTED POPULATION (52) 20 21 21 15 32 12 0 8 0 10 20 heartdisease obesity hyperchol diabetes H B P sm oke cv surgery fam iliarity (38.46% ) (40.4% ) (40.4% ) (28.8% ) (61.5% ) (23% ) (0% ) (15.4% )
- 20. PREVALENCE OF RISK FACTOR’S DISTRIBUTION IN TOTAL EAA AND EAIC AFFECTED POPULATION (696) 128 235 266 100 418 69 61 14 0 50 100 heartdisease obesity hyperchol diabetes H B P sm oke cv surgery fam iliarity (18.3% ) (33.8 % ) (38.2% ) (14.4% ) (60% ) (9.9% ) (8.8% ) (2% )
- 22. CONCLUSIONS ASYMPTOMATIC PATHOLOGY ASYMPTOMATIC PATHOLOGY AORTO-ILIAC ECTASIA AORTO-ILIAC ECTASIA AAA WANTED Screening 68-74 AAA WANTED Screening 68-74 AAA FOLLOW UPAAA FOLLOW UP AAA FAMILY Families > 60 years AAA FAMILY Families > 60 years Project development Project development FAMILIARITYFAMILIARITY SURGERYSURGERY CARDIO VASCULAR RISK CARDIO VASCULAR RISK CHECK UP CHECK UP
- 24. Responsabile del Progetto: Dr F. Faresin Telefono: 049.9424588 Segreteria organizzativa: Vania Zen - Sabrina Zanovello Telefono: 049.9424794 E-mail:vascolare_cit@ulss15.pd.it Responsabile del Progetto: Dr F. Faresin Telefono: 049.9424588 Segreteria organizzativa: Vania Zen - Sabrina Zanovello Telefono: 049.9424794 E-mail:vascolare_cit@ulss15.pd.it
- 25. Thank you