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Aortic arch branches

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https://www.readbyqxmd.com/read/28228869/anomalous-right-vertebral-artery-arising-from-the-arch-of-aorta-report-of-three-cases
#1
Umar Abid Saeed, Andrei Bogdan Gorgos, Alexandre Semionov, Karl Sayegh
The right vertebral artery most commonly originates as the first branch of the right subclavian artery. Although anatomical variants of the aortic arch are commonly encountered on cross-sectional imaging, certain variants of the right vertebral artery are exceedingly rare. In this report, we present 3 cases of aberrant right vertebral artery arising as the last branch of the aortic arch, a very rare variant.
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28219557/total-endovascular-repair-of-post-dissection-aortic-arch-aneurysm-with-chimney-technique
#2
Wei-Tao Liang, Su Wang, Jian Zhou, Chen-Jun Han, Qiang Liu, Xiao-Yun Wu, Wang-Fu Zang
Open surgery remains the standard procedure for treatment of aortic arch pathologies. However, total endovascular repair can be a safe option for patients who are poor candidates for surgery because of compromised physiology. We report the case of a 63-year-old man with a post-dissection aortic arch aneurysm. We repaired the aneurysm using thoracic endovascular aortic repair (TEVAR) and used the chimney technique to reconstruct the supra-aortic branches. The patient is doing well after 12-month follow-up, demonstrating that TEVAR with the chimney technique can be used successfully for the treatment of post-dissection arch aneurysm...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#3
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28208970/isolated-hypoplasia-of-left-pulmonary-artery-with-agenesis-of-left-lobe-of-thyroid-a-case-report
#4
Mohammed Abdul Khadir, Ganesh Narayana, Ganavi Ramagopal, Pradeep G Nayar
Isolated Unilateral hypoplasia or agenesis of a branch of pulmonary artery is very rare. It is usually seen associated with congenital heart diseases such as tetralogy of Fallot, atrial septal defect, coarctation of the aorta, right aortic arch, truncus arteriosus, patent ductus arteriosus and pulmonary atresia. It occurs as a result of lack of embryological development of either the left or right sixth aortic arch and has been found to present itself with various clinical manifestations as during childhood it presents as contralateral pulmonary hypertension and in adults as haemoptysis...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28190607/patient-specific-assessment-of-hemodynamics-by-computational-fluid-dynamics-in-patients-with-bicuspid-aortopathy
#5
Naoyuki Kimura, Masanori Nakamura, Kenji Komiya, Satoshi Nishi, Atsushi Yamaguchi, Osamu Tanaka, Yoshio Misawa, Hideo Adachi, Koji Kawahito
OBJECTIVE: Hemodynamics related to eccentric blood flow may factor into the development of bicuspid aortic valve aortopathy. We investigated wall shear stress distribution by means of magnetic resonance imaging-based computational fluid dynamics in patients with a bicuspid aortic valve. METHODS: Included were 12 patients with a bicuspid aortic valve (aortic stenosis, n = 11; root enlargement, n = 1). Three patients with a normal tricuspid aortic valve (arch aneurysm, n = 1; descending aortic aneurysm, n = 2) were included for comparison...
January 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28159377/double-aortic-arch-with-previously-undescribed-head-and-neck-vessel-branching
#6
Sassan Hashemi, W James Parks, Denver Sallee, Timothy Slesnick
Vascular ring in the form of a double aortic arch is a rare anomaly that can cause airway compression. It occasionally occurs with unusual head and neck vessel branching. A 5-year-old boy with chronic respiratory symptoms was referred because of a tracheal indentation on his chest x-ray. Magnetic resonance imaging showed a double aortic arch with arch origins of a common carotid, vertebral, and subclavian on the right and internal and external carotids, vertebral, and subclavian arteries on the left. Our case represents, to our knowledge, the first report of a double aortic arch with 7 separate vessels arising from the transverse arches...
December 1, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28132091/a-case-of-unusual-configuration-of-the-right-bronchial-arteries-combined-with-cryptogenic-severe-bilateral-hypertrophy
#7
Santiago Rojas, Eduard Quintana, Marisa Ortega, Alfonso Rodríguez-Baeza
Bronchial arteries commonly originate from thoracic aorta between T5 and T6. Ectopic origins from aortic arch, supraortic trunks and their branches, coronary arteries, and even abdominal aorta have been described in the literature. In some circumstances, such as pulmonary artery malformations, chronic embolism, or inflammatory diseases of the lung, the bronchial arteries become hypertrophied and eventually could be the only supply of pulmonary circulation. Here, we describe a case of an elderly man who presented an unusual pattern of bronchial arteries of the right lung combined with severe bilateral hypertrophy of bronchial vessels...
January 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28115719/immunoinhibitory-checkpoint-deficiency-in-medium-and-large-vessel-vasculitis
#8
Hui Zhang, Ryu Watanabe, Gerald J Berry, Augusto Vaglio, Yaping Joyce Liao, Kenneth J Warrington, Jörg J Goronzy, Cornelia M Weyand
Giant cell arteritis (GCA) causes autoimmune inflammation of the aorta and its large branches, resulting in aortic arch syndrome, blindness, and stroke. CD4(+) T cells and macrophages form organized granulomatous lesions in the walls of affected arteries, destroy the tunica media, and induce ischemic organ damage through rapid intimal hyperplasia and luminal occlusion. Pathogenic mechanisms remain insufficiently understood; specifically, it is unknown whether the unopposed activation of the immune system is because of deficiency of immunoinhibitory checkpoints...
February 7, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#9
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28073667/enlargement-of-aortic-arch-vessels-after-surgical-repair-of-type-a-aortic-dissection
#10
Takashi Yamauchi, Suguru Kubota, Toshihiro Ohata, Kosei Hasegawa, Hideki Ueda
BACKGROUND: Information on the growth rate of the diameter of the residual dissected supra-aortic trunk after surgical repair of type A aortic dissection is limited. METHODS: We retrospectively reviewed 95 consecutive postsurgical patients with type A aortic dissection (acute, 91; chronic, 4) between 2005 and 2016 who were followed up with computed tomography. The diameter of the residual dissected supra-aortic trunk was measured by axial images and multiplanar reformatting, and the growth rate was calculated...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28063468/computational-fluid-dynamics-and-aortic-thrombus-formation-following-thoracic-endovascular-aortic-repair
#11
Foeke J H Nauta, Kevin D Lau, Christopher J Arthurs, Kim A Eagle, David M Williams, Santi Trimarchi, Himanshu J Patel, Carlos A Figueroa
BACKGROUND: We present the possible utility of computational fluid dynamics in the assessment of thrombus formation and virtual surgical planning illustrated in a patient with aortic thrombus in a kinked ascending aortic graft following thoracic endovascular aortic repair. METHODS: A patient-specific three-dimensional model was built from computed tomography. Additionally, we modeled 3 virtual aortic interventions to assess their effect on thrombosis potential: (1) open surgical repair, (2) conformable endografting, and (3) single-branched endografting...
January 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27935894/-outcomes-of-surgical-management-of-patients-with-nonspecific-aortoarteritis-with-isolated-lesion-of-brachiocephalic-arteries
#12
F Sh Bakhritdinov, A S Suyumov, N U Sharapov
The authors analysed herein the results of examination and surgical treatment of patients presenting with Takayasu aortoarteritis with an isolated lesion of the aortic arch branches. Discrepancy between the degree of ischaemia, dissemination, and localization of lesions, as well as ambiguity of neurological manifestations suggests large compensatory possibilities of the cerebral circulation in this disease. The revealed peculiarities of lesions of the brachiocephalic arteries characteristic the pathology concerned were as follows: high incidence of lesions of subclavian arteries (mainly in the second and third segments), utterly rare involvement of the brachiocephalic trunk, a stenosisng pattern of lesion of carotid arteries with predominant localization in the common carotid artery, not involving it into the process of bifurcation...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#13
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: The aim of this study is 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/27885195/evaluation-and-influence-of-brachiocephalic-branch-re-entry-in-patients-with-type-a-acute-aortic-dissection
#14
COMPARATIVE STUDY
Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Motohiko Goda, Shinichi Suzuki, Munetaka Masuda
BACKGROUND: Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied...
December 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27881689/acute-type-a-aortic-dissection-treated-using-a-tubular-stent-graft-in-the-ascending-aorta-and-a-multibranched-stent-graft-in-the-aortic-arch
#15
Tilo Kölbel, Christian Detter, Sebastian W Carpenter, Fiona Rohlffs, Yskert von Kodolitsch, Sabine Wipper, Herrmann Reichenspurner, E Sebastian Debus, Nikolaos Tsilimparis
PURPOSE: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. TECHNIQUE: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients...
February 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27863740/understanding-the-fluid-mechanics-behind-transverse-wall-shear-stress
#16
Yumnah Mohamied, Spencer J Sherwin, Peter D Weinberg
The patchy distribution of atherosclerosis within arteries is widely attributed to local variation in haemodynamic wall shear stress (WSS). A recently-introduced metric, the transverse wall shear stress (transWSS), which is the average over the cardiac cycle of WSS components perpendicular to the temporal mean WSS vector, correlates particularly well with the pattern of lesions around aortic branch ostia. Here we use numerical methods to investigate the nature of the arterial flows captured by transWSS and the sensitivity of transWSS to inflow waveform and aortic geometry...
January 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/27860551/congenital-variants-and-anomalies-of-the-aortic-arch
#17
Kate Hanneman, Beverley Newman, Frandics Chan
Congenital variants and anomalies of the aortic arch are important to recognize as they may be associated with vascular rings, congenital heart disease, and chromosomal abnormalities, and can have important implications for prognosis and management. The purpose of this article is to review cross-sectional imaging techniques used in the evaluation of the aortic arch, describe the embryology and anatomy of the aortic arch system, discuss aortic arch variants and anomalies, and review other malformations of the aortic arch, including interrupted aortic arch, hypoplastic aortic arch, and aortic coarctation...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27847062/preemptive-aneurysm-sac-embolization-for-thoracic-endovascular-aortic-repair-with-inadequate-proximal-landing-zone
#18
Jacky Y K Ho, Randolph H L Wong, Simon C Y Chow, Peter S Y Yu, Micky W T Kwok, Malcolm J Underwood, Simon C H Yu
Thoracic endovascular aortic repair (TEVAR) offers a less invasive treatment for aortic arch aneurysms. Clinical challenges arise when there is inadequate proximal landing for zone 1 TEVAR, such that a median sternotomy with total aortic debranching is required before stent deployment. The chimney technique was reported as an alternative approach to stent the arch branches and avoid sternotomy, but it was still associated with considerable chance of a type IA endoleak. We report a case of aortic arch aneurysm with an inadequate proximal landing for zone 1 TEVAR that was treated with debranching of head and neck vessels followed by TEVAR and preemptive and targeted coil embolization of the arch aneurysmal sac...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27843111/a-comprehensive-review-of-in-situ-fenestration-of-aortic-endografts
#19
REVIEW
M Glorion, R Coscas, R G McWilliams, I Javerliat, O Goëau-Brissonniere, M Coggia
OBJECTIVE: Despite technical advances of fenestrated and branched endografts, endovascular exclusion of aneurysms involving renal, visceral, and/or supra-aortic branches remains a challenge. In situ fenestration (ISF) of standard endografts represents another endovascular means to maintain perfusion to such branches. This study aimed to review current indications, technical descriptions, and results of ISF. METHOD: A review of the English language literature was performed in Medline databases, Cochrane Database, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27823595/status-of-branched-grafts-for-thoracic-aortic-arch-endovascular-repair
#20
REVIEW
W Anthony Lee
The aortic arch is one of the most anatomically complex segments of the thoracoabdominal aorta due the plurality of vital branch configurations, intrinsic and highly variable three-dimensional curvature, and involvement in a variety of thoracic aortic pathologies, such as aneurysmal degeneration, penetrating ulcer, and media wall dissection. Pathologies that extend the repair proximal to the left common carotid artery require more complex branch vessel management beyond a carotid-subclavian bypass. This article will review the current status of branched aortic arch endografts...
March 2016: Seminars in Vascular Surgery
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