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https://www.readbyqxmd.com/read/28528045/endovascular-fenestration-for-distal-aortic-sealing-after-frozen-elephant-trunk-with-thoraflex
#1
Randolph H L Wong, Peter S Y Yu, Micky W T Kwok, Simon C Y Chow, Jacky Y K Ho, Malcolm J Underwood, Simon C H Yu
We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#2
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28521856/molecular-pathogenesis-of-genetic-and-sporadic-aortic-aneurysms-and-dissections
#3
Ying H Shen, Scott A LeMaire
No abstract text is available yet for this article.
March 2017: Current Problems in Surgery
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#4
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28511923/igg4-aortopathy-an-underappreciated-cause-of-non-infectious-thoracic-aortitis
#5
Victor Aguirre, Catherine Connolly, Robert Stuklis
IgG4 related thoracic aortitis is a recent addition to the differential diagnosis for inflammatory aortic disease - a condition which is often underappreciated until complications arise such as aneurysmal formation or aortic dissection. Currently, IgG4 aortitis remains a post-surgical diagnosis reliant on positive immunohistochemistry findings. Management is guided by the extent of disease involvement, which can be gauged by serum IgG4 levels and radiological findings. Options include surgical resection, corticosteroid therapy and steroid-sparing agents to prevent relapses...
April 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506477/medical-therapy-and-intervention-do-not-improve-uncomplicated-isolated-mesenteric-artery-dissection-outcomes-over-observation-alone
#6
Jacob W Loeffler, Hideaki Obara, Naoki Fujimura, Paul Bove, Daniel H Newton, Sara L Zettervall, Andre S van Petersen, Robert H Geelkerken, Kristofer M Charlton-Ouw, Sherene Shalhub, Niten Singh, Arnaud Roussel, Natalia O Glebova, Michael P Harlander-Locke, Warren J Gasper, Misty D Humphries, Peter F Lawrence
OBJECTIVE: Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data. METHODS: All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Patients with an aortic dissection were excluded...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502544/first-experience-with-the-double-chimney-technique-in-the-treatment-of-aortic-arch-diseases
#7
Tun Wang, Chang Shu, Quan-Ming Li, Ming Li, Xin Li, Hao He, Alan Dardik, Jian Qiu
OBJECTIVE: The objective of this study was to summarize our initial experience using the double chimney technique to treat aortic arch diseases. METHODS: From December 2009 to October 2016, 23 patients with aortic arch diseases, including 20 acute aortic dissections, 2 aortic arch aneurysms, and 1 type I endoleak after thoracic endovascular aortic repair (TEVAR), were treated using a double chimney technique. An emergent operation was performed in only one patient with an acute aortic dissection for severe left lower extremity ischemia...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501661/extensive-cerebrovascular-and-visceral-artery-dissection-and-pseudoaneurysm-with-underlying-segmental-arterial-mediolysis
#8
Abhishek Sethi, Jonathan R Hyde, Christina M Thaler, Nedaa Skeik
Segmental arterial mediolysis (SAM) is a non-atherosclerotic, non-hereditary vasculopathy that most commonly involves abdominal aortic branches and predominantly affects middle-age and elderly populations. Lysis of the outer arterial media results in separation of the media from the adventitia leading to dissecting aneurysms and/or pseudoaneurysms. We report a unique case of a 47-year-old man who presented with bilateral internal carotid artery dissection followed by dissections and aneurysms involving multiple visceral arteries...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28500877/clinically-isolated-aortitis-pitfalls-progress-and-possibilities
#9
REVIEW
Ilkay Cinar, He Wang, James R Stone
Non-infectious aortitis may be caused by several distinct systemic rheumatologic diseases. In some patients, aortitis is identified either pathologically or radiologically in the absence of clinical evidence of a systemic vasculitis. By consensus nomenclature, such cases are referred to as clinically isolated aortitis (CIA). Some systemic disorders may initially present as CIA including giant cell arteritis (GCA), IgG4-related disease, infectious aortitis, and granulomatosis with polyangiitis. CIA most commonly occurs in women of European descent over the age of 50 and, thus, mirrors the gender, age, and geographic distribution of GCA...
April 23, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#10
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28493109/effectiveness-of-the-conservative-therapy-for-symptomatic-isolated-celiac-artery-dissection
#11
Shaoqin Li, Lihua Cheng, Jianfei Tu, Yabin Jiao, Xulu Wu, Zhongling Wang, Dengke Zhang, Guomin Jiang, Zhongzhi Jia
OBJECTIVE: To investigate the effectiveness of the conservative therapy for symptomatic isolated celiac artery dissection (ICAD). METHODS: Patients with symptomatic ICAD diagnosed on CT between February 2006 and June 2016 at three institutions were included. RESULTS: During the study period, a total of 24 patients (22 men, 2 women) were included in this retrospective study. Patients most commonly presented with epigastric pain (n = 21) or back pain (n = 3)...
May 10, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28493108/percutaneous-septectomy-in-chronic-dissection-with-abdominal-aortic-aneurysm-creates-uniluminal-neck-for-evar
#12
Mark Colin Gissler, Yukihisa Ogawa, Jason T Lee, Venita Chandra, Michael D Dake
PURPOSE: The intent of this report is to describe the technical details and rationale of endovascular septectomy using a wire saw maneuver in cases of chronic aortic dissection and associated infra-renal aortic aneurysm to allow standard endovascular abdominal aortic graft placement; preliminary clinical experience is also retrospectively reviewed. MATERIALS AND METHODS: Between June 2013 and June 2016, four consecutive patients (mean age 55.3 years; range 52-58 years) with chronic type B aortic dissection and isolated infra-renal abdominal aortic aneurysm (AAA) underwent endovascular aneurysm repair (EVAR) following guidewire septectomy to create a suitable proximal aortic landing zone...
May 10, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28493024/de-novo-vertebral-artery-dissecting-aneurysm-after-internal-trapping-of-the-contralateral-vertebral-artery
#13
Naoya Kidani, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Shingo Nishihiro, Yu Takahashi, Isao Date
We present the case of a de novo vertebral artery dissecting aneurysm (VADA) after endovascular trapping of a ruptured VADA on the contralateral side. The first ruptured VADA involved the posterior inferior cerebellar artery, which was successfully treated by endovascular internal trapping using a stent. A follow-up study at 3 months revealed a de novo VADA on the contralateral side. The second VADA was successfully embolized using coils while normal arterial flow in the vertebral artery was preserved using a stent...
May 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28491267/update-on-the-management-of-giant-cell-arteritis
#14
REVIEW
Janet Roberts, Alison Clifford
Giant cell arteritis (GCA) is a large vessel vasculitis that may be associated with significant complications such as blindness, stroke, or aortic aneurysm and dissection in a subset of patients. Given the serious side effects associated with prolonged courses of glucocorticoids and frequent relapses experienced when doses are tapered, increased efforts are being dedicated to the discovery of safer and more effective therapies to control this disease. The purpose of this review is to critically evaluate the role of glucocorticoid-sparing agents in the medical management of GCA with a special focus on the most recent evidence regarding the role of biologic agents, including tocilizumab (TCZ), abatacept and ustekinumab, and other novel therapies...
April 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28490606/comparison-of-10-murine-models-reveals-a-distinct-biomechanical-phenotype-in-thoracic-aortic-aneurysms
#15
C Bellini, M R Bersi, A W Caulk, J Ferruzzi, D M Milewicz, F Ramirez, D B Rifkin, G Tellides, H Yanagisawa, J D Humphrey
Thoracic aortic aneurysms are life-threatening lesions that afflict young and old individuals alike. They frequently associate with genetic mutations and are characterized by reduced elastic fibre integrity, dysfunctional smooth muscle cells, improperly remodelled collagen and pooled mucoid material. There is a pressing need to understand better the compromised structural integrity of the aorta that results from these genetic mutations and renders the wall vulnerable to dilatation, dissection or rupture. In this paper, we compare the biaxial mechanical properties of the ascending aorta from 10 murine models: wild-type controls, acute elastase-treated, and eight models with genetic mutations affecting extracellular matrix proteins, transmembrane receptors, cytoskeletal proteins, or intracellular signalling molecules...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28490232/the-candy-plug-technique-technical-aspects-and-early-results-of-a-new-endovascular-method-for-false-lumen-occlusion-in-chronic-aortic-dissection
#16
Fiona Rohlffs, Nikolaos Tsilimparis, Beatrice Fiorucci, Franziska Heidemann, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection. METHODS: A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow)...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28489237/medially-displaced-common-and-internal-carotid-arteries-presenting-as-a-pulsatile-mass-clinicoradiologic-analysis-of-62-cases
#17
Ilker Burak Arslan, Yildiz Arslan, Erhan Demirhan, Selahattin Genc, Yeliz Pekcevik, Levent Altin, Zahide Yilmaz, Ibrahim Cukurova
We conducted a prospective study to analyze the medially displaced courses of the common carotid artery (CCA) and the cervical segment of the internal carotid artery (ICA) in patients who were diagnosed with a pulsatile mass on nasopharyngolaryngoscopy and by clinicoradiologic findings. Our study group was made up of 62 patients-40 women and 22 men, aged 30 to 88 years (mean: 63.7)-who presented with a submucosal pseudomass or a bulging mass on the pharyngeal wall with obvious pulsation. For comparison purposes, we recruited a control group of 62 consecutively presenting patients who had been admitted to our Neurology Department with acute severe headache and who had undergone CT angiography based on a suspicion of an aneurysm or a vertebral or carotid artery dissection...
April 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28488025/in-stent-stenosis-after-p64-flow-diverter-treatment
#18
M Aguilar Pérez, P Bhogal, E Henkes, O Ganslandt, H Bäzner, H Henkes
PURPOSE: There is limited information available on the incidence of in-stent stenosis (ISS) secondary to the use of flow-diverting stents in the intracranial vasculature. We sought to determine the incidence, severity, and clinical course of ISS on angiographic follow-up after treatment of saccular aneurysms with p64. METHODS: We retrospectively reviewed all patients who underwent treatment of a saccular (ruptured and unruptured) intracranial aneurysm with ≥1 p64 between 2011 and 2015...
May 9, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28486683/comparison-of-endovascular-repair-with-branched-stent-graft-and-open-repair-for-aortic-arch-aneurysm%C3%A2
#19
Masahide Kawatou, Kenji Minakata, Kazuhisa Sakamoto, Taro Nakatsu, Junichi Tazaki, Hirooki Higami, Kyokun Uehara, Kazuhiro Yamazaki, Kanji Inoue, Takeshi Kimura, Ryuzo Sakata
OBJECTIVES: Although conventional open repair is our preference for patients with aortic arch aneurysms, we have often chosen thoracic endovascular aneurysm repair (TEVAR) with a handmade branched stent graft (bTEVAR) in high-risk patients. The aim of this study was to compare the midterm clinical outcomes of our bTEVAR technique to those of the open repair. METHODS: Between January 2007 and December 2014, we treated 129 patients with aortic arch aneurysm by means of either conventional open repair (OPEN, n  = 61) or bTEVAR ( n  = 68) at our institution...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28485889/mmp-family-polymorphisms-and-the-risk-of-aortic-aneurysmal-disease-a-systematic-review-and-meta-analysis
#20
REVIEW
Tan Li, Zhi Lv, Jing-Jing Jing, Jun Yang, Yuan Yuan
It has been suggested that matrix metalloproteinase (MMP) polymorphisms are associated with the pathogenesis of aortic aneurysmal diseases. In this study, we conducted a systematic review with an update meta-analysis to investigate the relationship between MMP family polymorphisms and aortic aneurysmal diseases. We systematically reviewed 24 polymorphisms in eight MMP genes related to the risk of abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA) or thoracic aortic dissection (TAD). A total of 19 case-control studies with 15 highly studied MMP polymorphisms were included in our meta-analysis...
May 9, 2017: Clinical Genetics
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