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https://www.readbyqxmd.com/read/28418891/risk-of-aortic-aneurysm-and-dissection-in-patients-with-autosomal-dominant-polycystic-kidney-disease-a-nationwide-population-based-cohort-study
#1
Pei-Hsun Sung, Yao-Hsu Yang, Hsin-Ju Chiang, John Y Chiang, Chi-Jen Chen, Chien-Ting Liu, Cheuk-Man Yu, Hon-Kan Yip
Although cardiovascular complications are the most common cause of death in patients with autosomal-dominant polycystic kidney disease (ADPKD), the incidence and risk of aortic aneurysm and dissection (AAD) in ADPKD remains unclear due to limited data and insufficient cases. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to do a population-based cohort study (1997-2008). After excluding those patients with age <18 years old and initially concomitant diagnoses of end-stage renal disease and AAD, a total of 2076 ADPKD patients were selected from 1,000,000 of general population...
March 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#2
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413555/dissecting-intracranial-aneurysm-in-pregnancy-a-rare-association
#3
Manasi Mehrotra, Anant Mehrotra, Anup Nair, Arun Srivastava, Rabi Narayan Sahu, Mandakini Pradhan, Raj Kumar
We report a case of dissecting aneurysm of the right posterior cerebral artery presenting with sudden onset headache and altered behavior during labor. A 26-year-old P1001 with uncomplicated antenatal period, except history of headache off and on since 32 weeks of pregnancy, developed sudden onset headache and altered behavior during 3(rd) stage of labor. She had vaginal delivery and a live born male baby was delivered with good Apgar score. The CT was suggestive of subarachnoid hemorrhage and DSA was suggestive of dissecting aneurysm of the right P2 segment with hypoplasia of right P1 segment and A1 segment of posterior and anterior cerebral artery, respectively...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#4
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
March 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28402517/posterior-inferior-cerebellar-artery-vertebral-artery-subarachnoid-hemorrhage-a-comparison-of-saccular-vs-dissecting-aneurysms
#5
Mitchell T Foster, Amit Herwadkar, Hiren C Patel
BACKGROUND: Two distinct categories of aneurysms are described in relation to the posterior inferior cerebellar artery (PICA) and vertebral artery (VA): saccular (SA) and dissecting (DA) types. This distinction is often unrecognized because abnormalities here are uncommon and most studies are small. OBJECTIVE: To determine if there are any differences in the clinical presentation, in-hospital course, or outcomes in patients with DA vs SA of the PICA or VA. METHODS: Thirty-eight patients with a VA or PICA aneurysm were identified from a departmental subarachnoid hemorrhage database and categorized into DA or SA types...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28400556/precise-treatment-of-aortic-aneurysm-by-three-dimensional-printing-and-simulation-before-endovascular-intervention
#6
Ding Yuan, Han Luo, Hongliu Yang, Bin Huang, Jingqiang Zhu, Jichun Zhao
In this study, three-dimensional printing (3Dp) models and simulation surgeries (SSs) were applied in two challenging aortic cases. The first was an abdominal aortic aneurysm with a complex neck, and the second was a thoracic aortic dissection aneurysm (TADA) with an angled arch. In order to avoid unpredictable obstacles and difficulties, we made optimal surgical plans by using 3D models and virtual simulations. Based on preoperative evaluation system, the surgical plans seemed more reasonable and time-saving...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#7
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28398537/intima-migration-from-the-iliac-artery-to-a-debranched-graft-after-thoracic-endovascular-aortic-repair
#8
Kazuki Kihara, Miwa Tashiro, Hideaki Nishimori, Kazumasa Orihashi
An 84-year-old woman underwent single-debranched thoracic endovascular aortic repair for aortic aneurysm. A few hours later, malperfusion of the left upper extremity occurred. Surgical exploration revealed a tubular-shaped intima packed in the debranched graft. As computed tomography showed localized dissection in the right external iliac artery probably due to access route injury, the intima roll was thought to have migrated from the iliac artery. This extremely rare case is described in detail with a discussion of the potential mechanism...
April 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28395786/vascular-imaging-of-the-mesenteric-vasculature
#9
REVIEW
Louisa J D van Dijk, André S van Petersen, Adriaan Moelker
Imaging of the mesenteric vasculature is crucial in diagnosing vascular disease of the gastro-intestinal tract such as acute or chronic mesenteric ischemia caused by arterial stenosis, embolism or thrombosis, mesenteric vein thrombosis and mesenteric aneurysm or dissection. The reference standard for imaging of the mesenteric vasculature is digital subtraction angiography. However, modalities as duplex ultrasonography, computed tomography angiography and magnetic resonance angiography are developing rapidly and may provide accurate imaging non-invasively...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28391405/postmortem-genetic-testing-should-be-recommended-in-sudden-cardiac-death-cases-due-to-thoracic-aortic-dissection
#10
Marina Gago-Díaz, Eva Ramos-Luis, Silvia Zoppis, Esther Zorio, Pilar Molina, Aitana Braza-Boïls, Juan Giner, Beatriz Sobrino, Jorge Amigo, Alejandro Blanco-Verea, Ángel Carracedo, María Brion
BACKGROUND: Acute thoracic aortic dissections and ruptures, the main life-threatening complications of the corresponding aneurysms, are an important cause of sudden cardiac death. Despite the usefulness of the molecular diagnosis of these conditions in the clinical setting, the corresponding forensic field remains largely unexplored. The main goal of this study was to explore and validate a new massive parallel sequencing candidate gene​ assay as a diagnostic tool for acute thoracic aortic dissection autopsy cases...
April 8, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28390917/thoracic-endovascular-aortic-repair-into-the-false-lumen-in-chronic-aortic-dissection
#11
Arnoud V Kamman, David M Williams, Himanshu J Patel
PURPOSE: We present two different cases of chronic aortic dissection, where we opted to land the stent graft into the false lumen to treat the associated aneurysm. CASE DESCRIPTIONS: For the first case, the goal of thoracic endovascular aortic repair (TEVAR) was to exclude the aneurysm from within the false lumen, because of a slit-like true lumen. In the second case, the visceral arteries came off the false lumen, with the renal vessels from the true lumen. False lumen TEVAR was performed and the infra-renal aorta fenestrated, as to ensure adequate perfusion...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28387791/contemporary-results-of-hemiarch-replacement
#12
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Antonino Di Franco, Lucas B Ohmes, Fawad Hameedi, Cristiano Spadaccio, Leonard N Girardi
OBJECTIVES: Our goal was to report on early and midterm outcomes of hemiarch replacement performed in a high-volume centre. METHODS: We extrapolated hemiarch replacements from our institutional aortic database. We also analysed the impact of aortic disease (dissection vs aneurysm) on the outcomes of de novo hemiarch replacement. RESULTS: A total of 756 patients underwent hemiarch replacement between 1997 and 2016. After elimination of cases involving the aortic root/valve and redo cases, we identified 426 cases of de novo -isolated hemiarch replacement (369 aneurysms and 57 dissections)...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28387631/aneurysm-wall-enhancement-on-magnetic-resonance-imaging-as-a-risk-factor-for-progression-of-unruptured-vertebrobasilar-dissecting-aneurysms-after-reconstructive-endovascular-treatment
#13
Yisen Zhang, Binbin Sui, Jian Liu, Yang Wang, Zhongbin Tian, Junfan Chen, Zhongxue Wu, Xinjian Yang
OBJECTIVE The recurrence rate of vertebrobasilar dissecting aneurysms (VBDAs) after reconstructive endovascular treatment (EVT) is relatively high. The aneurysm wall enhancement on high-resolution MRI (HRMRI) reportedly predicts an unsteady state of an intracranial aneurysm. The authors used HRMRI to investigate the relationship between wall enhancement on HRMRI and progression of VBDAs after reconstructive EVT. METHODS From January 2012 to December 2015, patients with an unruptured VBDA who underwent reconstructive EVT were enrolled in this study...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387623/flow-diverter-devices-in-ruptured-intracranial-aneurysms-a-single-center-experience
#14
Emilio Lozupone, Mariangela Piano, Luca Valvassori, Luca Quilici, Guglielmo Pero, Emiliano Visconti, Edoardo Boccardi
OBJECTIVE In this single-center series, the authors retrospectively evaluated the effectiveness, safety, and midterm follow-up results of ruptured aneurysms treated by implantation of a flow diverter device (FDD). METHODS The records of 17 patients (12 females, 5 males, average World Federation of Neurosurgical Societies score = 2.9) who presented with subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm treated with an FDD were retrospectively reviewed. Of 17 ruptured aneurysms, 8 were blood blister-like aneurysms and the remaining 9 were dissecting aneurysms...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387611/thoracic-endovascular-aortic-repair-with-single-double-chimney-technique-for-aortic-arch-pathologies
#15
Tun Wang, Chang Shu, Ming Li, Quan-Ming Li, Xin Li, Jian Qiu, Kun Fang, Alan Dardik, Chen-Zi Yang
PURPOSE: To summarize a single-center experience using the single/double chimney technique in association with thoracic endovascular aortic repairs (TEVAR) for aortic arch pathologies. METHODS: From November 2007 to March 2016, 122 patients (mean age 50.4±12.7 years, range 29-80; 92 men) with aortic arch pathologies underwent TEVAR combined with single (n=101) or double (n=21) chimney grafts to reconstruct the supra-aortic branches: 21 innominate arteries, 114 left common carotid arteries, and 8 left subclavian arteries (LSA)...
March 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28386838/minimally-invasive-medial-supraorbital-combined-subfrontal-interhemispheric-approach-to-the-anterior-communicating-artery-complex-a-cadaveric-study
#16
Alexander Spiessberger, F Baumann, E Nevzati, K F Kothbauer, J Fandino, C Muroi
INTRODUCTION: In selected cases, microsurgical clipping remains a valuable treatment alternative to endovascular occlusion of anterior communicating artery (AComA) aneurysms. Their clipping is challenging and carries a risk of postsurgical cognitive impairment. We evaluate the microsurgical anatomy of a new, minimally invasive combined interhemispheric-subfrontal approach to the AComA complex via a medial supraorbital craniotomy. METHODS: In this descriptive anatomic study, four alcohol-embedded, silicon-injected human cadaver heads were used...
April 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28383849/-myocardial-infarction-on-spontaneous-coronary-dissection-caused-by-fibromuscular-dysplasia
#17
L Jackers, L Davin, B Falque, M Magnée, L Piérard
Spontaneous Coronary Artery Dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Although uncommon, it should be suspected in any young patient with acute myocardial infarction especially without risk factor of cardiovascular disease. Early coronary angiography is essential in the diagnosis of SCAD. Fibromuscular dysplasia is a rare cause of SCAD, particularly encountered in young women. This is a nonatherosclerotic and noninflammatory vascular disease. Fibromuscular dysplasia may cause stenosis, aneurysm, dissection and / or occlusion of arteries...
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28377913/acute-type-b-aortic-dissection-in-a-patient-with-previous-endovascular-abdominal-aortic-aneurysm-repair
#18
Sung Hun Park, Seung-Woon Rha
Endovascular aortic repair (EVAR) was relatively safe, and became a widely performed procedure. If aortic dissection (AD) occurred in patient with previous EVAR, it could cause fatal complications like endograft collapse. Surgical treatment was limited in this situation for comorbidities and complex anatomies. Here we report a rare case of acute type B AD developed following trans-radial coronary intervention in a patient with previous EVAR of abdominal aortic aneurysm, which was treated with thoracic EVAR.
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28369453/fate-of-the-dissected-aortic-arch-after-ascending-replacement-in-type-a-aortic-dissection%C3%A2
#19
Bartosz Rylski, Natalie Hahn, Friedhelm Beyersdorf, Stoyan Kondov, Martin Wolkewitz, Philipp Blanke, Tomasz Plonek, Martin Czerny, Matthias Siepe
OBJECTIVES: To evaluate the fate of a dissected aortic arch after limited surgical repair of type A aortic dissection. METHODS: Of the 271 patients operated for acute type A dissection between 2001 and 2015, 86 (age 57 ± 13 years, 74% men) with predischarge computed tomographic (CT) scans had a residual dissection in the arch. Aortic diameters, lengths, ellipticity and communications between lumina were assessed using predischarge and follow-up CT scans. The median CT scan follow-up was 31 months (first quartile 15, third quartile 52)...
March 28, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28367219/alpha-1-antitrypsin-deficiency-presenting-with-mpo-anca-associated-vasculitis-and-aortic-dissection
#20
Bram M Voorzaat, Jan van Schaik, Stijn L P Crobach, Catharina S P van Rijswijk, Joris I Rotmans
The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy...
2017: Case Reports in Medicine
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