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https://www.readbyqxmd.com/read/27903477/simultaneous-endovascular-repair-for-thoracic-and-abdominal-aortic-pathologies-early-and-mid-term-results
#1
Yuanyuan Guo, Hongbo Cai, Bin Yang, Hui Jin
OBJECTIVES: To analyse information from a single clinical centre, evaluating early and mid-term results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for co-existing thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years, range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903476/rapid-aneurysmal-sac-expansion-following-endovascular-repair-of-a-dissecting-thoracoabdominal-aneurysm
#2
Pau Bargay-Juan, Teresa Martin-Gonzalez, Rachel Clough, Rafaëlle Spear, Jonathan Sobocinski, Stephan Haulon
Endovascular repair of dissecting thoracoabdominal aneurysms (TAAA) is challenging and often requires multiple procedures. A 61-year-old man with a dissecting type-II TAAA treated first by placement of a thoracic endograft, and subsequently implantation of a fenestrated endograft. Six months postoperatively, a 10mm increase of the aorta was observed. A re-entry tear in left external iliac artery(EIA) was perfusing the false lumen in a retrograde fashion connecting with the endoleak caused by the inferior mesenteric artery and lumbar arteries...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903475/technical-aspects-of-open-repair-for-degenerative-aneurysmal-evolution-despite-early-thoracic-endovascular-repair-of-type-b-aortic-dissection
#3
Sonia Aguir, Salma El Batti, Paul Achouh, Pierre Julia, Alain Bel, Jean-Noël Fabiani, Jean-Marc Alsac
: Closure of the proximal tear by Thoracic Endovascular Aortic Repair (TEVAR) at the acute phase appears to be an safe effective treatment to prevent aneurysmal degeneration type B dissection. However, it appears to be inefficient in up to a third of the patient. We report the technical aspects of our experience with patients undergoing secondary open repair after TEVAR for dissecting thoraco-abdominal aneurysm despite early closure proximal tear by TEVAR. METHODS: During a period of 5 years, 96 patients presenting acute Type B Aortic Dissections (TBAD) were treated by TEVAR and followed-up in our institution...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27894713/abdominal-aortic-aneurysm-in-marfan-syndrome
#4
Tracy Hagerty, Patrick Geraghty, Alan C Braverman
OBJECTIVE: Marfan syndrome (MFS) leads to aortic root aneurysm, while descending thoracic aortic aneurysm (TAA) occurs less commonly. Abdominal aortic aneurysm (AAA) is rarely reported in MFS. Risk factors for AAA are poorly understood and there are no guidelines for AAA screening in MFS. We sought to characterize AAA among Marfan patients in our center. METHODS: The records of 12 adults with MFS and AAA disease were reviewed. Clinical features, imaging, operative reports, and outcomes were analyzed...
November 25, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27893734/an-ipsc-derived-vascular-model-of-marfan-syndrome-identifies-key-mediators-of-smooth-muscle-cell-death
#5
Alessandra Granata, Felipe Serrano, William George Bernard, Madeline McNamara, Lucinda Low, Priya Sastry, Sanjay Sinha
Marfan syndrome (MFS) is a heritable connective tissue disorder caused by mutations in FBN1, which encodes the extracellular matrix protein fibrillin-1. To investigate the pathogenesis of aortic aneurysms in MFS, we generated a vascular model derived from human induced pluripotent stem cells (MFS-hiPSCs). Our MFS-hiPSC-derived smooth muscle cells (SMCs) recapitulated the pathology seen in Marfan aortas, including defects in fibrillin-1 accumulation, extracellular matrix degradation, transforming growth factor-β (TGF-β) signaling, contraction and apoptosis; abnormalities were corrected by CRISPR-based editing of the FBN1 mutation...
November 28, 2016: Nature Genetics
https://www.readbyqxmd.com/read/27890847/fenestrated-and-branched-stent-grafting-in-complex-aneurysmatic-aortic-disease-a-single-center-early-experience
#6
Georgios D Vourliotakis, Vasileios D Tzilalis, Panagiotis G Theodoridis, Charalampos S Stoumpos, Dimitrios G Kamvysis, Giannis G Kantounakis
PURPOSE: To present our early experience and highlight the technical difficulties associated with the use of fenestrated and branched stent-grafts to treat patients with juxta-, para-renal abdominal aortic aneurysms (AAA) and thoracoabdominal aortic aneurysms (TAAA). METHODS: A prospectively held database maintained at our department, was queried for patients who have undergone branched and fenestrated stent-grafting for AAA or TAAA treatment. Indication for repair, co-morbidity precluding open repair, technical challenges associated with the repair, as well as operative mortality, morbidity and re-intervention rate were evaluated...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#7
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890754/endovascular-treatment-of-spontaneous-intracranial-fusiform-and-dissecting-aneurysms-outcomes-related-to-imaging-classification-of-309-cases
#8
Yisen Zhang, Zhongbin Tian, Binbin Sui, Yang Wang, Jian Liu, Miao Li, Youxiang Li, Chuhan Jiang, Xinjian Yang
OBJECTIVE: This study aimed to propose a modified classification of spontaneous intracranial dissecting aneurysms (IDAs) and to guide the treatment for IDAs. METHODS: Between January 2010 and December 2015, 3183 consecutive patients were referred to our department for endovascular treatment of a cerebral aneurysm and 309 patients harboring 323 spontaneous IDAs were identified from them. Based on a modified imaging classification, spontaneous IDAs were classified into four subtypes: classic dissecting aneurysm, segmental ectasia, dolichoectatic dissecting aneurysm, and large mural bleeding ectasia...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890183/imaging-evaluation-and-treatment-of-vascular-lesions-at-the-skull-base
#9
REVIEW
Gaurav Jindal, Timothy Miller, Prashant Raghavan, Dheeraj Gandhi
A wide range of congenital and acquired vascular entities may occur in the skull base. Although some are diagnosed incidentally and merit no treatment, others may require surgical or image-guided endovascular or percutaneous approaches for management. The complex anatomy of the skull base can make diagnosis challenging. A combination of computed tomography scans and MR imaging, and catheter angiography may be required for diagnosis and mapping. Endovascular treatment plays an important part in many of the acquired vascular lesions, such as vascular neoplasms and traumatic dissections/aneurysms...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27881343/-surgical-management-of-proximal-anterior-cerebral-artery-a1-aneurysms
#10
Hua-Wei Wang, Zhe Xue, Yu-Dong Ma, Wen-Xin Wang, Chen Wu, Zheng-Hui Sun
OBJECTIVE: To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients. METHODS: Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27879313/international-registry-of-patients-carrying-tgfbr1-or-tgfbr2-mutations-results-of-the-montalcino-aortic-consortium
#11
Guillaume Jondeau, Jacques Ropers, Ellen Regalado, Alan Braverman, Arturo Evangelista, Guisela Teixido, Julie De Backer, Laura Muiño-Mosquera, Sophie Naudion, Cecile Zordan, Takayuki Morisaki, Hiroto Morisaki, Yskert Von Kodolitsch, Sophie Dupuis-Girod, Shaine A Morris, Richmond Jeremy, Sylvie Odent, Lesley C Adès, Madhura Bakshi, Katherine Holman, Scott LeMaire, Olivier Milleron, Maud Langeois, Myrtille Spentchian, Melodie Aubart, Catherine Boileau, Reed Pyeritz, Dianna M Milewicz
BACKGROUND: -The natural history of aortic diseases in patients with TGFBR1 or TGFBR2 mutations reported by different investigators has varied greatly. In particular, the current recommendations for the timing of surgical repair of the aortic root aneurysms may be overly aggressive. METHODS AND RESULTS: -The Montalcino Aortic Consortium, which includes 15 centers worldwide that specialize in heritable thoracic aortic diseases, was used to gather data on 441 patients from 228 families, with 176 cases harboring a mutation in TGBR1 and 265 in TGFBR2 Patients harboring a TGFBR1 mutation have similar survival rates (80% survival at 60 years), aortic risk (23% aortic dissection, 18% preventive aortic surgery), and prevalence of extra-aortic features (29% hypertelorism, 53% cervical arterial tortuosity, 27% wide scars) when compared to patients harboring a TGFBR2 mutation...
November 21, 2016: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/27879251/altered-smooth-muscle-cell-force-generation-as-a-driver-of-thoracic-aortic-aneurysms-and-dissections
#12
REVIEW
Dianna M Milewicz, Kathleen M Trybus, Dongchuan Guo, H Lee Sweeney, Ellen Regalado, Kristine Kamm, James T Stull
The importance of maintaining contractile function in aortic smooth muscle cells (SMCs) is evident by the fact that heterozygous mutations in the major structural proteins or kinases controlling contraction lead to the formation of aneurysms of the ascending thoracic aorta that predispose to life-threatening aortic dissections. Force generation by SMC requires ATP-dependent cyclic interactions between filaments composed of SMC-specific isoforms of α-actin (encoded by ACTA2) and myosin heavy chain (MYH11). ACTA2 and MYH11 mutations shown to disrupt this cyclic interaction predispose to thoracic aortic disease...
November 22, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27874962/analysis-of-risk-factors-of-type-a-aortic-dissection-taad-operation-of-frozen-elephant-trunk-and-total-arch-replacement
#13
W Shang, M Ma, Y-P Ge, N Liu, J-M Zhu, L-Z Sun
OBJECTIVE:  To investigate the incidence and risk factors of acute renal failure (ARF) after operation of frozen elephant trunk and total arch replacement for acute thoracic aortic aneurysm and dissection (TAAD) with mild hypothermic circulatory arrest (MHCA), and to analyze the long-term survival rate of the patients with ARF. PATIENTS AND METHODS: From February 2009 to March 2015, patients with acute TAAD accepted operation of frozen elephant trunk and total arch replacement were enrolled...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27873570/dissecting-aneurysm-of-the-interventricular-septum-due-to-rupture-of-the-sinus-of-valsalva
#14
Mehnaz Atiq, Fatima Ali, Sulaiman B Hasan
Aneurysm of the sinus of Valsalva is a rare congenital cardiac anomaly. It occurs as an outpouching that progresses like a windsock, and it may rupture producing aortic regurgitation, cardiac tamponade, congestive heart failure, conduction abnormalities, and stroke. We describe a case of rupture of the sinus of Valsalva into the interventricular septum producing a large dissecting aneurysm. Despite the location, it did not produce a conduction abnormality.
November 22, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27873519/use-of-three-dimensional-curved-multiplanar-reconstruction-images-for-sylvian-dissection-in-microsurgery-of-middle-cerebral-artery-aneurysms
#15
Taek Kyun Nam, Yong Sook Park, Jun Soo Byun, Seung Won Park, Jeong Taik Kwon
PURPOSE: The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27873227/the-relationship-between-aortic-root-size-and-hypertension-an-unsolved-conundrum
#16
Giuseppe Mulè, Emilio Nardi, Massimiliano Morreale, Antonella Castiglia, Giulio Geraci, Dario Altieri, Valentina Cacciatore, Margherita Schillaci, Francesco Vaccaro, Santina Cottone
Thoracic aortic aneurysms rupture and dissection are among the most devastating vascular diseases, being characterized by elevated mortality, despite improvements in diagnostic imaging and surgical techniques.An increased aortic root diameter (ARD) represents the main risk factor for thoracic aortic dissection and rupture and for aortic valve regurgitation.Even though arterial hypertension is commonly regarded as a predisposing condition for the development of thoracic aorta aneurysms, the role of blood pressure (BP) as determinant of aortic root enlargement is still controversial...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27871488/thoracic-endovascular-aneurysm-repair-for-uncomplicated-type-b-dissection
#17
EDITORIAL
Richard P Cambria, Mark F Conrad
No abstract text is available yet for this article.
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27864249/positive-predictive-value-of-cardiovascular-diagnoses-in-the-danish-national-patient-registry-a-validation-study
#18
Jens Sundbøll, Kasper Adelborg, Troels Munch, Trine Frøslev, Henrik Toft Sørensen, Hans Erik Bøtker, Morten Schmidt
OBJECTIVE: The majority of cardiovascular diagnoses in the Danish National Patient Registry (DNPR) remain to be validated despite extensive use in epidemiological research. We therefore examined the positive predictive value (PPV) of cardiovascular diagnoses in the DNPR. DESIGN: Population-based validation study. SETTING: 1 university hospital and 2 regional hospitals in the Central Denmark Region, 2010-2012. PARTICIPANTS: For each cardiovascular diagnosis, up to 100 patients from participating hospitals were randomly sampled during the study period using the DNPR...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27858381/fatal-rupture-of-dissecting-anterior-inferior-cerebellar-artery-aneurysm-as-an-unexpected-complication-after-anterior-skull-base-surgery-a-case-report
#19
Eyyub S Al-Beyati, Ihsan Dogan, Agahan Ünlü, Melih Bozkurt
Aneurysm of the anterior inferior cerebellar artery (AICA) is a very rare entity and the manifestation and manipulation of such aneurysms remain contentious. In this paper, we report a case where a successful surgery for an olfactory groove meningioma was performed and the patient discharged but readmitted to hospital with loss of consciousness and subsequently passed away three hours after re-admission. The patient was diagnosed with subarachnoid hemorrhage. The cause of the fatal subarachnoid hemorrhage was rupture of a new onsetting AICA dissecting aneurysm which had provided neither clinical nor radiological signs before the operation...
October 13, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27853085/bilateral-vertebral-artery-aneurysms-at-the-atlantoaxial-joint-level-causing-recurrent-stroke
#20
Kenichi Komatsu, Akihiko Ozaki, Koichi Iwasaki, Sadayuki Matsumoto
Vertebral arteries (VAs) are vulnerable to mechanical stress between the atlas and axis, and subsequent VA dissection can cause posterior circulation infarction. We herein present a rare but informative case of bilateral VA aneurysms that caused recurrent stroke. The localization of the aneurysms and dynamic angiography with neck movement suggested a pathogenesis related to chronic mechanical injury of the VAs, though no skeletal abnormality was detected. The recurrences stopped and both aneurysms shrank after neck collar fixation and after the combination use of antithrombotics...
2016: Internal Medicine
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