BACKGROUND AND OBJECTIVE: Although the endovascular method of treating abdominal aortic aneurysms (AAA) shows good early results and benefits, the late outcome of this treatment remains uncertain. This study evaluated the late outcome following an endovascular AAA repair. SUBJECTS AND METHODS: Thirty-three patients that had undergone an endovascular AAA repair at our institute were evaluated. The results of the treatment were evaluated by an angiography, taken just after the completion of the procedure, and by contrast-enhanced CT scans at 1, 3, 6 and 12 months, and annually thereafter. RESULTS: The patient's characteristics were as follows: 29 (88%) were male, 19 (58%) had coronary artery disease and 7 (21%) had renal insufficiency. A technical success was achieved in 31 patients (94%), with primary endoleaks in two. Two patients (6.1%) died within 1 month of the procedure, both at an elderly age, with high risk. There was 1 (3%) incidence of early complications that required treatment. During the 28 month follow-up period, 6 patients (20%) needed a secondary procedure. Endoleaks remained in 4 patients, and the size of aneurysm increased in 3 patients. Four patients died during follow-up, and two had an endoleak. The cause of death was not related to cardiovascular diseases in the other two patients. The event free survival at 24 months was 72%. CONCLUSION: The late outcome after an endovascular AAA repair was favorable. However, a secondary procedure was needed, and endoleaks observed, in half of the patients that died during follow-up. Therefore, regular evaluation of aneurysms and the management of endoleaks are very important for a favorable late outcome in endovascular AAA repair patients.
Aged ; Aneurysm ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiovascular Diseases ; Cause of Death ; Coronary Artery Disease ; Disease-Free Survival ; Endoleak ; Follow-Up Studies ; Humans ; Incidence ; Male ; Renal Insufficiency ; Tomography, X-Ray Computed

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.