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suprarenal insufficiency

Angela M R Ferrante, Umberto Moscato, Elda C Colacchio, Francesco Snider
OBJECTIVE: This study presents a retrospective analysis of long-term outcomes and factors influencing early and late results of a 20-year experience with open repair of atherosclerotic pararenal abdominal aortic aneurysms (PAAAs). METHODS: Records of consecutive patients who underwent open repair of PAAA between 1990 and 2010 at a tertiary referral care center were analyzed for demographics, comorbidities, operative variables, complications, and 30-day mortality...
June 2016: Journal of Vascular Surgery
Rafał Z Słapa, Wiesław S Jakubowski, Katarzyna Dobruch-Sobczak, Anna A Kasperlik-Załuska
Adrenal glands are paired endocrine glands located over the upper renal poles. Adrenal pathologies have various clinical presentations. They can coexist with the hyperfunction of individual cortical zones or the medulla, insufficiency of the adrenal cortex or retained normal hormonal function. The most common adrenal masses are tumors incidentally detected in imaging examinations (ultrasound, tomography, magnetic resonance imaging), referred to as incidentalomas. They include a range of histopathological entities but cortical adenomas without hormonal hyperfunction are the most common...
December 2015: Journal of Ultrasonography
Ivika Heinola, Karoliina Halmesmäki, Ilkka Kantonen, Pirkka Vikatmaa, Pekka Aho, Mauri Lepäntalo, Maarit Venermo
BACKGROUND: Prolonged renal ischemia during vascular surgery carries high morbidity and mortality. We report an alternative technique for maintaining renal circulation during suprarenal aortic or renal artery clamping. METHODS: Between October 2007 and May 2012, 16 patients undergoing aorto-renal surgery (13 men, 3 women) were operated using temporary axillorenal bypass. Operations were performed for supra- and juxtarenal aortic aneurysms (11), occlusive aortic disease (2), renal artery stenoses (2), and abdominal myofibroblastic tumor (1)...
February 2016: Annals of Vascular Surgery
Shahin Hajibandeh, Shahab Hajibandeh, Michelle Johnpulle, Vittorio Perricone
The co-existence of abdominal aortic aneurysm (AAA) and horseshoe kidney (HSK) is rare. We report a 67-year-old man with an expanding juxtarenal AAA associated with a HSK. The aneurysm had a severely angulated neck and contained a significant amount of mural thrombus. The isthmus of HSK closely lied over the aneurysm, making its exposure extremely difficult. The aneurysm was successfully repaired using transperitoneal approach with division of the renal isthmus and without any need for the renal artery reconstruction...
2015: Journal of Surgical Case Reports
Athanasios Katsargyris, Kyriakos Oikonomou, George Kouvelos, Hermann Renner, Wolfgang Ritter, Eric L G Verhoeven
OBJECTIVE: The aim of this study was to report the incidence and associated risk factors of perioperative spinal cord ischemia (SCI) after endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) with fenestrated and branched stent grafts. METHODS: The study included consecutive patients with TAAA treated with fenestrated and branched stent grafts within the period January 2004 to December 2014. Suprarenal abdominal aortic aneurysms treated with fenestrated and branched grafts, even if including all four visceral vessels, were excluded...
December 2015: Journal of Vascular Surgery
O A Tovkay
The clinic experience for surgical treatment of patients, suffering cyst of suprarenal gland (SG), consisted of laparoscopic resection of SG together with a cyst and preserving a visually nonaffected parts of SG, due to what the risk reduction for chronic suprarenal insufficiency of various degree occurrence was achieved. The proposed method was applied in 49 (86.0%) patients of 57, who were operated on for the SG cysts. Intraoperative morbidity, complicated postoperative course and the recurrence occurrence after the SG resection were not observed...
April 2015: Klinichna Khirurhiia
Shin-Seok Yang, Young-Wook Kim, Yang Jin Park, Dong-Ik Kim, Shin-Young Woo, Seung Huh, Hyung-Kee Kim
PURPOSE: The aim of study was to review the results of open surgical repair (OSR) of chronic juxtarenal aortic occlusion (JRAO). MATERIALS AND METHODS: We retrospectively reviewed the results of OSR performed in 47 patients (male, 92%; mean age, 59.9±9.3 years [range, 44-79]) with chronic JRAO during the past 21 years. In order to reduce intraoperative renal ischemic time (RIT), we excised a portion of the occluded segment of the infrarenal aorta without proximal aortic clamping...
September 2014: Vascular Specialist International
Eun-Ki Min, Young Hoon Kim, Duck Jong Han, Youngjin Han, Hyunwook Kwon, Byung Hyun Choi, Hojong Park, Ji Yoon Choi, Tae-Won Kwon, Yong-Pil Cho
Although the standard treatment of abdominal aortic aneurysm has shifted from open surgery to endovascular repair, open surgery has remained the standard of care for complex aneurysms involving the visceral arteries and in patients unsuitable for endovascular aneurysm repair. Postoperative renal insufficiency may occur after open surgical repair of suprarenal abdominal aortic aneurysm. Methods of minimizing renal ischemic injury include aortic cross-clamping and renal reconstruction techniques. This report describes the use of renal autotransplantation for renal reconstruction during open surgical repair of a suprarenal abdominal aortic aneurysm...
July 2015: Annals of Surgical Treatment and Research
H M Soliman, M R Abd El-Haleem, S A El Tarhouny
Cholestasis, which is a component of many liver diseases, is often associated with symptoms that resemble clinical adrenal insufficiency. This work aimed to study the histomorphometrical and electron microscopic structure of adrenocorticocytes after surgical induction of bile duct resection (BDR) in adult female albino rats. Sixty rats were randomly divided into control, BDR and sham-operated groups. Six weeks after surgery, the blood serum of the rats was examined biochemically, and the suprarenal cortexes were prepared for histological, morphometrical and statistical studies...
2015: Folia Biologica (Praha)
Larry E Miller, Mahmood K Razavi, Brajesh K Lal
OBJECTIVE: The effect of stent graft fixation type on renal function after endovascular aneurysm repair (EVAR) remains controversial. This systematic review and meta-analysis was conducted to determine whether suprarenal (SR) or infrarenal (IR) fixation influences the risk of renal complications after EVAR. METHODS: We searched MEDLINE and EMBASE with no date or language restrictions for comparative studies evaluating EVAR with SR vs IR fixation on renal dysfunction, renal artery stenosis, renal artery occlusion, renal infarction, and new need for hemodialysis...
May 2015: Journal of Vascular Surgery
James H Black
Among the most important factors driving morbidity and mortality after aortic surgery is post operative renal insufficiency. The attendant metabolic derangements greatly complicate surgical care, expedite arrhythmias, and can significantly prolong hospital stay and cost. This article seeds to define factors contributory to renal complications after aortic surgery and offers a review of techniques to protect renal mass from post operative declines.
December 2013: Seminars in Vascular Surgery
Katsuyuki Hoshina, Masaru Nemoto, Kunihiro Shigematsu, Ayako Nishiyama, Akihiro Hosaka, Takuya Miyahara, Hiroyuki Okamoto, Toshiaki Watanabe
BACKGROUND: Renal insufficiency is the most frequent complication of surgeries that involve suprarenal aortic cross-clamping. Although some studies have assessed the risk of intraoperative renal ischemia by comparing juxtarenal abdominal aortic aneurysms (AAAs) and infrarenal AAAs, a critical limitation is the difference in these patients' clinical backgrounds and aneurysmal features. The present study evaluated the effect of suprarenal aortic clamping by comparing a juxtarenal AAA group with a subgroup of infrarenal AAAs (ie, short and/or large neck)...
2014: Circulation Journal: Official Journal of the Japanese Circulation Society
Katherine A Valeros, Eric Khoo
The most common presentation of metastases to the pituitary gland in systemic lymphoma is diabetes insipidus resulting from infiltration of the infundibulum/posterior lobe. We describe a 69-year-old man with diffuse large B-cell stage IV lymphoma who presented with anterior pituitary hypofunction, without features of posterior pituitary involvement. He presented with a few months of postural dizziness and hypotension, weight loss, fever, strabismus of right eye and a superficial abdominal wall mass. At this time he had no history of malignancy...
August 2014: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Katherine Phillips, May R Arroyo, Lizette Vila Duckworth
We report the postmortem findings of two siblings with gross and microscopic features consistent with IMAGe association (Intrauterine growth retardation, Metaphyseal dysplasia, Adrenal hypoplasia congenita, and Genital anomalies) with an emphasis on the histopathology of the adrenal gland in this rare syndrome. The first sibling was an 8-week old male diagnosed postnatally with primary adrenal insufficiency. There was no deletion of the DAX1 gene by FISH. Examination at autopsy revealed dysmorphic features including frontal bossing, epicanthal folds, flat philtrum, cryptorchidism, penile chordee, overriding fourth toe, and height and weight below 3rd percentile...
May 2014: Pediatric and Developmental Pathology
Taizo Kimura, Kozoh Shiraishi, Aya Furusho, Sohei Ito, Saki Hirakata, Norifumi Nishida, Koichi Yoshimura, Kyoko Imanaka-Yoshida, Toshimichi Yoshida, Yasuhiro Ikeda, Takanobu Miyamoto, Takafumi Ueno, Kimikazu Hamano, Michiaki Hiroe, Kazutaka Aonuma, Masunori Matsuzaki, Tsutomu Imaizumi, Hiroki Aoki
Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl₂ caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion...
2014: Scientific Reports
Josef Finsterer, Stefan Lässer
Mitochondrial disorder (MtD) is usually a multisystem disease due to impaired mitochondrial energy production. Severe hypokalemia resulting in muscle weakness and rhabdomyolysis has not been reported as a phenotypic feature of MtD. Here we describe a 60-year-old male patient who developed myalgias followed by generalized muscle weakness a few days before admission. Symptoms were attributed to severe hypokalemia that occurred after the patient had discontinued spironolactone, a competitive antagonist of the aldosterone receptor, four months earlier on his own judgment...
September 2013: Tohoku Journal of Experimental Medicine
Konstantinos P Donas, Giovanni Torsello, Theodosios Bisdas, Nani Osada, Eva Schönefeld, Georgios A Pitoulias
PURPOSE: To compare short-term outcomes between fenestrated and chimney endografts for pararenal aortic pathologies. METHODS: An English-language literature search up to January 2012 found 129 articles evaluating the immediate outcomes of endovascular repair of degenerative juxta-/suprarenal aortic aneurysms, type I endoleaks, and para-anastomotic aneurysms using the chimney technique or fenestrated endografts. Data concerning thoracoabdominal aortic aneurysms, ruptured aneurysms, and reports with <5 cases were excluded (n=84)...
December 2012: Journal of Endovascular Therapy
George T Pisimisis, Carlos F Bechara, Neal R Barshes, Peter H Lin, Win S Lai, Panagiotis Kougias
BACKGROUND: The incidence of renal impairment relevant to proximal fixation of aortic endograft devices remains unclear. METHODS: Retrospective cohort of 208 consecutive patients that underwent EVAR from 2006 to 2011. Estimated glomerular filtration rate (eGFR) was based on MDRD study equation. Acute kidney injury (AKI) and chronic kidney disease (CKD) were classified with ADIQ/RIFLE criteria and National Kidney Foundation criteria, respectively. Kaplan-Meier curve was applied to evaluate progression to CKD...
January 2013: Annals of Vascular Surgery
Hirofumi Kasahara, Hideyuki Shimizu, Ryohei Yozu
BACKGROUND: We report our 11-year experience of juxtarenal aortic aneurysm (JAA) repair with suprarenal aortic cross-clamping. METHODS: We retrospectively reviewed 51 consecutive JAA repairs performed between 2000 and 2010. In all 51 patients, aneurysms were replaced by prosthetic grafts with simple suprarenal aortic cross-clamping. No special renal protective measures (except inter-renal cross-clamping) were performed during interruption of perfusion to kidneys...
April 2013: Annals of Vascular Surgery
(no author information available yet)
UNLABELLED: Endovascular repair of abdominal aortic aneurysm (AAA) allows the exclusion of the dilated aneurismal segment of the aorta from the systematic circulation. The procedure requires, however, that the endograft extends to the healthy parts of the aorta above and below the aneurysm, yet the neck of a juxtarenal aortic aneurysm (JRA) is too short for a standard endovascular repair. Fenestrated endovascular aortic repair (f-EVAR) provides a solution to overcome this problem by enabling the continuation of blood flow to the renal and visceral arteries through holes or 'fenestrations' in the graft...
2009: Ontario Health Technology Assessment Series
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