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Abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#1
Seungjun Song, Suk-Won Song, Tae Hoon Kim, Kwang-Hun Lee, Kyung-Jong Yoo
BACKGROUND: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies. Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial. METHODS: From 2012 to 2014, 162 patients underwent TEVAR at a single institution...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931420/presence-of-periaortic-gas-in-clostridium-septicum-infected-aortic-aneurysm-aids-in-early-diagnosis-a-case-report-and-systematic-review-of-the-literature
#2
Fumihito Ito, Ryota Inokuchi, Akinori Matsumoto, Yoshibumi Kumada, Hideyuki Yokoyama, Tokiya Ishida, Katsuhiko Hashimoto, Masashi Narita, Kazuaki Shinohara
BACKGROUND: Clostridium septicum-infected aortic aneurysm is a fatal and rare disease. We present a fatal case of C. septicum-infected aortic aneurysm and a pertinent literature review with treatment suggestions for reducing mortality rates. CASE PRESENTATION: A 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. Upon recognition of signs of an abdominal aortic aneurysm and paraplegia, we suspected an occluded Adamkiewicz artery and performed a contrast-enhanced computed tomography scan, which revealed an aortic aneurysm with periaortic gas extending from his chest to his abdomen and both kidneys...
September 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28929042/the-physical-examination-does-matter-a-case-of-spontaneous-aortocaval-fistula
#3
Rupak Desai, Mikhail Akbashev, Leon Rubinsztain, Andro G Kacharava
A spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysms. In 50 percent of the patients, it presents with the classic signs of a pulsatile abdominal mass, continuous bruit, and low back pain. A high degree of clinical suspicion and a well-performed physical examination are important for its timely diagnosis.
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28928956/a-primer-on-infrarenal-abdominal-aortic-aneurysms
#4
REVIEW
Norman R Hertzer
Ruptured abdominal aortic aneurysms have an alarmingly high mortality rate that often exceeds 50%, even when patients survive long enough to be transported to hospitals. Historical data have shown that ruptures are especially likely to occur with aneurysms measuring ≥6 cm in diameter, but there are so many exceptions to this that several randomized clinical trials have been done in an attempt to determine whether smaller aneurysms should be repaired electively as soon as they are discovered. More recently, further trials have been conducted in order to compare the relative benefits and disadvantages of modern endovascular aneurysm repair to those of traditional open surgery...
2017: F1000Research
https://www.readbyqxmd.com/read/28927932/chitosan-doxycycline-hydrogel-an-mmp-inhibitor-sclerosing-embolizing-agent-as-a-new-approach-to-endoleak-prevention-and-treatment-after-endovascular-aneurysm-repair
#5
Fatemeh Zehtabi, Pompilia Ispas-Szabo, Djahida Djerir, Lojan Sivakumaran, Borhane Annabi, Gilles Soulez, Mircea Alexandru Mateescu, Sophie Lerouge
The success of endovascular repair of abdominal aortic aneurysms remains limited due to the development of endoleaks. Sac embolization has been proposed to manage endoleaks, but current embolizing materials are associated with frequent recurrence. An injectable agent that combines vascular occlusion and sclerosing properties has demonstrated promise for the treatment of endoleaks. Moreover, the inhibition of aneurysmal wall degradation via matrix metalloproteinases (MMPs) may further prevent aneurysm progression...
September 16, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28925872/abdominal-aorta-aneurysm-aaa-is-there-a-role-for-prevention-and-therapy-using-antioxidants
#6
Joël Pincemail, Jean-Olivier Defraigne, Audrey Courtois, Adelin Albert, Jean-Paul Cheramy-Bien, Natzi Sakalihasan
Abdominal aortic aneurysm (AAA) is a degenerative disease that cause mortality in people aged > 65 years. Increased reactive oxygen species (ROS) and oxidative stress seems to play a pivotal role in AAA pathogenesis. Several sources of ROS have been identified in aortic tissues using experimental models: inflammation, increased activity of NAD(P)H or NOX, over-expression of inducible nitric oxide synthase (iNOS), uncoupled endothelial nitric oxide synthase (eNOS), platelets activation and iron release from hemoglobin...
September 18, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28922970/use-of-synchrotron-radiation-to-accurately-assess-cross-sectional-area-reduction-of-the-aortic-branch-ostia-caused-by-suprarenal-stent-wires
#7
Zhonghua Sun, Curtise K C Ng
PURPOSE: To compare in vivo the use of synchrotron radiation to computed tomography angiography (CTA) for the measurement of cross-sectional area (CSA) reduction of the aortic branch ostia caused by suprarenal stent-graft wires. METHODS: This study was performed with a Zenith stent-graft placed in a phantom of the human aorta to simulate treatment of abdominal aortic aneurysm. Synchrotron radiation scans were performed using beam energies between 40 and 100 keV and spatial resolution of 19...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28922688/medium-term-outcomes-of-fenestrated-endovascular-repair-of-juxtarenal-abdominal-aortic-aneurysms
#8
Timothy P Shiraev, Trevor M Y Kwok, Steven R Dubenec
BACKGROUND: Abdominal aortic aneurysms pose a substantial clinical burden, and a significant proportion are not anatomically suitable for open repair or standard endovascular aneurysm repair (EVAR), instead requiring fenestrated EVAR (fEVAR). We sought to compare clinical outcomes and trends over time in patients undergoing fEVAR in Australia. METHODS: We conducted a retrospective analysis of all patients undergoing fEVAR at a tertiary referral centre between 2010 and 2015, including outcomes and complications, both as inpatients and after discharge...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28919522/the-incidence-of-ischemic-colitis-after-repair-of-ruptured-abdominal-aortic-aneurysms-is-decreasing-in-the-endovascular-era
#9
S K Desikan, N Singh, S R Steele, N Tran, E Quiroga, P Danaher, B T Garland, B W Starnes
OBJECTIVE: Ischemic colitis (IC) is a well-described complication of ruptured abdominal aortic aneurysms (rAAA). The purpose of this study was to compare the incidence of IC in patients with rAAA undergoing open (OR) vs. endovascular aneurysm repair (EVAR) at a single institution. In addition, we analyzed the incidence of ischemic colitis pre- and post- implementation of a formal rupture AAA protocol (rEVAR protocol). METHODS: A retrospective analysis of prospectively collected data on all patients presenting with rAAA to our institution between Jan 2002 and Oct 2013 was performed...
September 14, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28916304/rationale-and-design-of-the-arrest-trial-investigating-mesenchymal-stem-cells-in-the-treatment-of-small-aaa
#10
S Keisin Wang, Linden A Green, Ashley R Gutwein, Natalie A Drucker, Raghu L Motaganahalli, Andres Fajardo, Clifford C Babbey, Michael P Murphy
BACKGROUND: Abdominal aortic aneurysms (AAA) are a major source of morbidity and mortality despite continuing advances in surgical technique and care. Although the inciting factors for AAA development continue to be elusive, accumulating evidence suggests a significant peri-aortic inflammatory response leading to degradation and dilation of the aortic wall. Previous human trials have demonstrated safety and efficacy of mesenchymal stem cells (MSCs) in the treatment of inflammation-related pathologies such as rheumatoid arthritis, graft vs host disease, and transplant rejection...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#11
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28913716/a-case-of-a-mucin-producing-bile-duct-tumor-diagnosed-over-the-course-of-6%C3%A2-years
#12
Sho Yamada, Yosuke Kato, Masahiro Hada, Masanori Kotake, Kaeko Oyama, Takuo Hara
We report a case of a mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB) diagnosed over a period of 6 years. A 64-year-old man underwent follow-up evaluations for an abdominal aortic aneurysm at our hospital. In 2009, a computed tomography (CT) scan revealed a simple hepatic cyst in segment 3 of the liver. Annual CT scans initially showed almost no change in the size or shape of the cyst. The cystic lesion, which measured 5 cm in 2014, had increased to 11 cm by 2015, and a solid component was detected within the cyst...
September 14, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28912363/tgf%C3%AE-transforming-growth-factor-%C3%AE-blockade-induces-a-human-like-disease-in-a-nondissecting-mouse-model-of-abdominal-aortic-aneurysm
#13
Fabien Lareyre, Marc Clément, Juliette Raffort, Stefanie Pohlod, Meghana Patel, Bruno Esposito, Leanne Master, Alison Finigan, Marie Vandestienne, Nikolaos Stergiopulos, Soraya Taleb, Bram Trachet, Ziad Mallat
OBJECTIVE: Current experimental models of abdominal aortic aneurysm (AAA) do not accurately reproduce the major features of human AAA. We hypothesized that blockade of TGFβ (transforming growth factor-β) activity-a guardian of vascular integrity and immune homeostasis-would impair vascular healing in models of nondissecting AAA and would lead to sustained aneurysmal growth until rupture. APPROACH AND RESULTS: Here, we test this hypothesis in the elastase-induced AAA model in mice...
September 14, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28912007/adventitial-adipogenic-degeneration-is-an-unidentified-contributor-to-aortic-wall-weakening-in-the-abdominal-aortic-aneurysm
#14
Stefan A Doderer, Gabor Gäbel, Vivianne B C Kokje, Bernd H Northoff, Lesca M Holdt, Jaap F Hamming, Jan H N Lindeman
OBJECTIVE: The processes driving human abdominal aortic aneurysm (AAA) progression are not fully understood. Although antiinflammatory and proteolytic strategies effectively quench aneurysm progression in preclinical models, so far all clinical interventions failed. These observations hint at an incomplete understanding of the processes involved in AAA progression and rupture. Interestingly, strong clinical and molecular associations exist between popliteal artery aneurysms (PAAs) and AAAs; however, PAAs have an extremely low propensity to rupture...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28903623/endovascular-stenting-of-mid-aortic-syndrome-due-to-takayasu-arteritis
#15
Ali Dogan, Kenan Sever, Emrah Ozdemir, Denyan Mansuroglu, Nuri Kurtoglu
Introduction-patients: Takayasu arteritis may involve various parts of the aorta and its major branches. It leads to occlusive or aneurysmal disease of the vessel. It can be treated either with surgery or percutaneous intervention. We report a successful endovascular treatment of stenosis of the descending thoracic and abdominal aorta in a 19-year-old female. Methods-results-conclusions: Self-expandable nitinol stent was deployed and adequate opening of the aorta was obtained in this patient. Long-term durability of endovascular approach is a matter of debate...
September 13, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28899569/on-the-influence-of-wall-calcification-and-intraluminal-thrombus-on-prediction-of-abdominal-aortic-aneurysm-rupture
#16
Hilary E Barrett, Eoghan M Cunnane, Hena Hidayat, Julie M O'Brien, Michael A Moloney, Eamon G Kavanagh, Michael T Walsh
OBJECTIVE: Parameters other than maximum diameter that predict rupture of abdominal aortic aneurysms (AAAs) may be helpful for risk-benefit analysis in individual patients. The aim of this study was to characterize the biomechanical-structural characteristics associated with AAA walls to better identify the related mechanistic variables required for an accurate prediction of rupture risk. METHODS: Anterior AAA wall (n = 40) and intraluminal thrombus (ILT; n = 114) samples were acquired from 18 patients undergoing open surgical repair...
September 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28899568/long-term-survival-after-acute-kidney-injury-following-ruptured-abdominal-aortic-aneurysm-repair
#17
Hamid Jalalzadeh, Reza Indrakusuma, Liffert Vogt, Sytse C van Beek, Anco C Vahl, Willem Wisselink, Mark J W Koelemay, Ron Balm
OBJECTIVE: Acute kidney injury (AKI) is a major complication of ruptured abdominal aortic aneurysm (RAAA). Severe AKI is associated with high morbidity and mortality in the short term. The objective of this study was to determine the association between AKI after RAAA repair and long-term survival. METHODS: We conducted a retrospective cohort study of all patients undergoing RAAA repair in three hospitals between 2004 and 2011. Outcomes were long-term survival after RAAA repair, incidence of postoperative AKI, and chronic dialysis rates...
September 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28898997/angiotensin-ii-infusion-into-apoe-mice-a-model-for-aortic-dissection-rather-than-abdominal-aortic-aneurysm
#18
Bram Trachet, Lydia Aslanidou, Alessandra Piersigilli, Rodrigo A Fraga-Silva, Jessica Sordet-Dessimoz, Pablo Villanueva-Perez, Marco F M Stampanoni, Nikolaos Stergiopulos, Patrick Segers
Aims: Angiotensin II-infused ApoE-/- mice are a popular mouse model for preclinical aneurysm research. Here, we provide insight in the often-reported but seldom-explained variability in shape of dissecting aneurysms in these mice. Methods and results: N = 45 excised aortas were scanned ex vivo with phase-contrast X-ray tomographic microscopy. Micro-ruptures were detected near the ostium of celiac and mesenteric arteries in 8/11 mice that were sacrificed after 3 days of angiotensin II-infusion...
August 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28895447/early-experience-with-endovascular-aneurysm-sealing-in-combination-with-parallel-grafts-for-the-treatment-of-complex-abdominal-aneurysms-the-ascend-registry
#19
Matt Thompson, Marwan Youssef, Rudolf Jacob, Sebastian Zerwes, Michel Reijnen, Piotr Szopinski, Patrick Berg, Grzegorz Oszkinis, Andrew Holden
PURPOSE: To report the results of the ASCEND Registry of cases involving endovascular aneurysm sealing (EVAS) in combination with chimney grafts (chEVAS) for the treatment of para- and juxtarenal aortic aneurysms (AAA). METHODS: A retrospective, multicenter registry established in 8 vascular centers between 2013 and 2016 recorded the treatment results and follow-up of chEVAS procedures for nonruptured AAAs; data were analyzed using standardized outcome measures...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28895367/is-management-of-complex-abdominal-aortic-aneurysms-consistent-across-the-uk-a-questionnaire-based-survey
#20
Eleanor Atkins, Ranjeet Narlawar, Francesco Torella, George A Antoniou
BACKGROUND: Our objective was to quantify variability across the UK in the management of a complex abdominal aortic aneurysm (AAA). METHODS: An online survey was emailed to all members of the Vascular Society for Great Britain and Ireland. The survey presented a vignette of a 63-year-old woman with significant respiratory co-morbidity whose computed tomographic (CT) angiogram demonstrated a 54 mm AAA with a short (7 mm) proximal neck but no other adverse morphological features for a standard or complex endovascular aneurysm repair (EVAR)...
September 11, 2017: International Angiology: a Journal of the International Union of Angiology
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