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https://www.readbyqxmd.com/read/27921203/treatment-of-uncomplicated-type-b-aortic-dissection
#1
REVIEW
Hitoshi Matsuda
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset...
December 5, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919458/impact-of-preoperative-pulmonary-function-on-outcomes-after-open-repair-of-descending-and-thoracoabdominal-aortic-aneurysms
#2
Leonard N Girardi, Christopher Lau, Monica Munjal, Mohamed Elsayed, Ivancarmine Gambardella, Lucas B Ohmes, Mario Gaudino
OBJECTIVE: To evaluate the impact of preoperative pulmonary function on outcomes after open repair of descending thoracic (DTA) and thoracoabdominal aortic (TAAA) aneurysms. METHODS: The outcomes of patients undergoing open repair of DTA or TAAA were analyzed in relation to the results of preoperative pulmonary function tests. Receiver operating characteristic was adopted to assess the effect of forced expiratory volume in one second (FEV1) on the incidence of mortality...
November 10, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919457/management-of-a-duplicated-inferior-vena-cava-in-thoracoabdominal-aortic-aneurysm-repair
#3
Melissa M Levack, Suresh Keshavamurthy, Paul Schoenhagen, Douglas R Johnston
No abstract text is available yet for this article.
November 3, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27918318/alternative-treatment-for-residual-aortobronchial-fistula-after-thoracic-endovascular-aortic-repair
#4
Kosuke Ujihira, Yoshihiko Kurimoto, Ryushi Maruyama, Yutaka Iba, Naritomo Nishioka, Akira Yamada, Katsuhiko Nakanishi, Hiroaki Kato, Masaru Abe, Yoshiaki Narita, Masayuki Osawa
A patient with an aortobronchial fistula secondary to a thoracic endovascular aortic repair was successfully treated with a re-thoracic endovascular aortic repair with debranching technique. Five months postoperatively, the aneurysm had shrunk; however, computed tomography revealed air in the thrombo-excluded aortic aneurysmal sac without signs of infection. Because of worsening air finding at the eighth month, we performed a resection of the residual fistula and wrapped the stent graft in a pedicled muscle flap...
December 1, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27916478/development-and-external-validation-of-a-model-predicting-death-after-surgery-in-patients-with-a-ruptured-abdominal-aortic-aneurysm-the-dutch-aneurysm-score
#5
G C I von Meijenfeldt, S C van Beek, F Bastos Gonçalves, H J M Verhagen, C J Zeebregts, A C Vahl, W Wisselink, M J van der Laan, R Balm
OBJECTIVE: The decision whether or not to proceed with surgical intervention of a patient with a ruptured abdominal aortic aneurysm (rAAA) is very difficult in daily practice. The primary objective of the present study was to develop and to externally validate a new prediction model: the Dutch Aneurysm Score (DAS). METHODS: With a prospective cohort of 10 hospitals (n = 508) the DAS was developed using a multivariate logistic regression model. Two retrospective cohorts with rAAA patients from two hospitals (n = 373) were used for external validation...
December 1, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27916243/safe-reentry-for-false-aneurysm-operations-in-high-risk-patients
#6
Gian Luca Martinelli, Attilio Cotroneo, Philippe Primo Caimmi, Gabriele Musica, David Barillà, Edmond Stelian, Angelo Romano, Eugenio Novelli, Luca Renzi, Marco Diena
BACKGROUND: In the absence of a standardized safe surgical reentry strategy for high-risk patients with large or anterior postoperative aortic false aneurysm (PAFA), we aimed to describe an effective and safe approach for such patients. METHODS: We prospectively analyzed patients treated for PAFA between 2006 and 2015. According to the preoperative computed tomography scan examination, patients were divided into two groups according to the anatomy and extension of PAFA: in group A, high-risk PAFA (diameter ≥3 cm) developed in the anterior mediastinum; in group B, low-risk PAFA (diameter <3 cm) was situated posteriorly...
December 1, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27914637/redo-thoracoabdominal-aortic-aneurysm-repair-a-single-center-experience-over-25%C3%A2-years
#7
Rana O Afifi, Harleen K Sandhu, Amy E Trott, Tom C Nguyen, Charles C Miller, Anthony L Estrera, Hazim J Safi
BACKGROUND: Aortic disease is a lifelong, progressive illness that may require repeated intervention over time. We reviewed our 25-year experience with open redo thoracoabdominal aortic aneurysm (TAAA) and descending thoracic aortic aneurysm (DTAA) repair. Our objectives were to determine patient outcomes after redo repair of DTAA/TAAA and compare them with nonredo repair. We also attempted to identify the risk factors for poor outcome. METHODS: We reviewed all open redo TAAA and DTAA repairs between 1991 and 2014...
November 30, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27914533/prophylactic-abdominal-aortic-aneurysm-repair-open-repair-brings-early-pain-but-later-gain
#8
EDITORIAL
J T Powell
No abstract text is available yet for this article.
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#9
Sofia Barbosa, Márcia Sequeira, Sara Castro, Rita Manso, Catarina Klut Câmara, Bruno Trancas, Nuno Borja-Santos, Teresa Maia
INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27912196/nox-isoforms-in-the-development-of-abdominal-aortic-aneurysm
#10
Kin Lung Siu, Qiang Li, Yixuan Zhang, Jun Guo, Ji Youn Youn, Jie Du, Hua Cai
Oxidative stress plays an important role in the formation of abdominal aortic aneurysm (AAA), and we have recently established a causal role of uncoupled eNOS in this severe human disease. We have also shown that activation of NADPH oxidase (NOX) lies upstream of uncoupled eNOS. Therefore, identification of the specific NOX isoforms that are required for eNOS uncoupling and AAA formation would ultimately lead to novel therapies for AAA. In the present study, we used the Ang II infused hph-1 mice to examine the roles of NOX isoforms in the development of AAA...
November 19, 2016: Redox Biology
https://www.readbyqxmd.com/read/27910812/inflammatory-markers-associated-with-abdominal-aortic-aneurysm
#11
Sarah Lindberg, Moncef Zarrouk, Jan Holst, Anders Gottsäter
PURPOSE: Inflammation with leukocytic infiltration, degradation of extracellular matrix (ECM), and depletion of vascular smooth muscle cells (VSMC) are pathological hallmarks of abdominal aortic aneurysm (AAA). The aim of this study was to further evaluate relationships between AAA and inflammatory biomarkers, interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), endothelin-1 (ET-1) and soluble urokinase-type plasminogen activator receptor (suPAR), by comparing levels in 65-year-old men with and without AAA at ultrasound screening...
September 1, 2016: European Cytokine Network
https://www.readbyqxmd.com/read/27909281/-transaortic-thoracic-endovascular-aortic-repair-via-right-anterior-mini-thoracotomy-report-of-a-case
#12
Keitaro Okamoto, Tomoyuki Wada, Hirofumi Anai, Satoshi Takebayashi, Takashi Shuto, Takayuki Kawashima, Kazuki Mori, Norio Hongo, Noritaka Kamei, Hiromu Mori, Shinji Miyamoto
An 81-year-old man presented with ruptured thoracic aortic aneurysm under stable condition. He had been suffering from chronic obstructive pulmonary disease, chronic renal failure and rheumatoid arthritis. We performed hybrid thoracic endovascular aortic repair via right anterior mini-thoracotomy inserting a device through a conduit on the ascending aorta. The patient was discharged without aorta-related complications.
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27908893/tracking-monocyte-recruitment-and-macrophage-accumulation-in-atherosclerotic-plaque-progression-using-a-novel-hcd68gfp-apoe-reporter-mouse
#13
Eileen McNeill, Asif J Iqbal, Daniel Jones, Jyoti Patel, Patricia Coutinho, Lewis Taylor, David R Greaves, Keith M Channon
OBJECTIVE: To create a model of atherosclerosis using green fluorescent protein (GFP)-targeted monocytes/macrophages, allowing analysis of both endogenous GFP(+) and adoptively transferred GFP(+) myeloid cells in arterial inflammation. APPROACH AND RESULTS: hCD68GFP reporter mice were crossed with ApoE(-/-) mice. Expression of GFP was localized to macrophages in atherosclerotic plaques and in angiotensin II-induced aortic aneurysms and correlated with galectin 3 and mCD68 expression. Flow cytometry confirmed GFP(+) expression in CD11b(+)/CD64(+), CD11c(+)/MHC-II(HI), and CD11b(+)/F4/80(+) myeloid cells...
December 1, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27908891/the-paraoxonase-gene-cluster-protects-against-abdominal-aortic-aneurysm-formation
#14
Yun-Fei Yan, Jian-Fei Pei, Ran Zhang, Fang Wang, Peng Gao, Zhu-Qin Zhang, Ting-Ting Wang, Yang Zhang, Zhi-Gang She, Hou-Zao Chen, De-Pei Liu
OBJECTIVE: Abdominal aortic aneurysm (AAA) is a life-threatening vascular pathology, the pathogenesis of which is closely related to oxidative stress. However, an effective pharmaceutical treatment is lacking because the exact cause of AAA remains unknown. Here, we aimed at delineating the role of the paraoxonases (PONs) gene cluster (PC), which prevents atherosclerosis through the detoxification of oxidized substrates, in AAA formation. APPROACH AND RESULTS: PC transgenic (Tg) mice were crossed to an Apoe(-/-) background, and an angiotensin II-induced AAA mouse model was used to analyze the effect of the PC on AAA formation...
December 1, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27908818/ascending-aorta-to-hepatic-and-mesenteric-artery-bypassing-in-patients-with-chronic-mesenteric-ischaemia-and-extensive-aortic-disease-a-case-report-and-review-of-the-literature
#15
James Barr, John Kokotsakis, Pantelis Tsipas, Prodromos Papapavlou, Konstantinos Velissarios, Theodoros Kratimenos, Thanos Athanasiou
Chronic mesenteric ischaemia (CMI) is a rare disorder caused by severe stenosis of the mesenteric arterial supply that results in post prandial pain and weight loss. Treatment options are surgical or endovascular. Surgical bypass can be performed in an antegrade fashion from the supracoeliac abdominal aorta or the distal descending thoracic aorta or in a retrograde fashion from the infra-renal aorta or the common iliac artery. However in some patients with disease of the descending thoracic aorta (DTA) or the abdominal aorta (AA) another site for the proximal anastomosis needs to be found...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908817/clinical-outcome-after-endovascular-sealing-of-abdominal-aortic-aneurysms-evas-a-retrospective-cohort-study
#16
Maria Karouki, Charles Swaelens, Luigi Iazzolino, Richard G McWilliams, Robert K Fisher, Andrew England, Francesco Torella
PURPOSE: To present the clinical outcome of endovascular sealing of abdominal aortic aneurysms (EVAS) with the Nellix endoprosthesis in patients with abdominal aortic aneurysms treated in our institution. METHODS: This was a retrospective, single centre, observational cohort study. A departmental database was interrogated in order to extract demographics, clinical information and outcome of all patients treated with EVAS between December 2013 and December 2015. Outcome measures included technical success (successful device deployment and absence of any endoleak at completion angiography), mortality, major complications, incidence of endoleaks, aneurysm rupture and reintervention...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#17
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908813/coil-embolization-assisted-thoracic-endovascular-aortic-repair-for-multiple-saccular-descending-aortic-aneurysms-with-insufficient-landing-zone
#18
Akito Imai, Tomomi Nakajima, Masataka Sato, Yasunori Watanabe, Shunichi Kondo, Motoo Osaka, Yuji Hiramatsu
We report a coil embolization -assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Due to the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10mm, a coil embolization of the distal saccular aneurysm was performed prior to stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908811/decreased-serum-levels-of-high-mobility-group-box-1-hmgb-1-after-graft-replacement-or-stenting-of-abdominal-aortic-aneurysm
#19
Daiki Ousaka, Yasuhiro Fujii, Susumu Oozawa, Masahiro Nishibori, Yosuke Kuroko, Zenichi Masuda, Shunji Sano
OBJECTIVES: High-mobility group box 1 (HMGB-1) is a key substance mediating inflammation and development of atherosclerotic lesions (AL), including abdominal aortic aneurysms (AAA). Serum levels of HMGB-1 are increased in patients with AAA than in normal controls because the ALs in AAAs secrete HMGB-1. We therefore postulate that the serum HMGB-1 level should decrease after endovascular aortic repair (EVAR) or open aortic repair (OAR). However, there is no evidence of this in the literature...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908810/emergent-treatment-of-a-ruptured-thoraco-abdominal-aortic-aneurysm-by-off-label-rescue-implantation-of-the-ovation-%C3%A2-stent-graft-in-nonagenarians-patient
#20
Chiara Pranteda, Pasqualino Sirignano, Federica Fornelli, Wassim Mansour, Nunzio Montelione, Laura Capoccia, Francesco Speziale
We report a case of a compassionate treatment of a ruptured thoraco-abdominal aortic aneurysm in a 92-year-old patient. Patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomographic angiography showed the presence of a thoraco-abdominal aortic aneurysm with a contained rupture at infrarenal level. Given of the presence of a relative healthy visceral aorta, we decided to treat the patient by Ovation(®) (Endologix, Irvine, CA - USA) implantation in an off-label fashion...
November 28, 2016: Annals of Vascular Surgery
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