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stanford B aortic dissection

Kenichiro Sato, Ryo Itagaki, Kenshiro Arao, Kouzou Makita
A 44-year-old man was transported to our hospital with chief complaints of back pain and paralysis of the leg. Contrast-enhanced computed tomography (CT) imaging revealed an acute Stanford B aortic dissection (AD), which was complicated by acute arterial occlusion of the left external iliac artery. The patient was treated by femorofemoral crossover bypass. Thereafter, abdominal pain was noted, and the patient was diagnosed with intestinal ischemia due to occlusion of the celiac artery and superior mesenteric artery (SMA)...
2016: Annals of Vascular Diseases
H W Wu, L Sun, D M Li, H Jing, B Xu, C T Wang, L Zhang
Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Xintian Liu, Xi Su, Hesong Zeng
OBJECTIVE: To find out the association between serum total cholesterol (TC) on admission and in-hospital mortality in patients with acute aortic dissection (AAD). METHODS: From January 2007 to January 2014, we enrolled 1492 consecutive AAD patients with serum TC measured immediately on admission. Baseline characteristics and in-hospital mortality were compared between the patients with serum TC above and below the median (4.00 mmol/L). Propensity score matching (PSM) was used to account for known confounders in the study...
July 2016: Pakistan Journal of Medical Sciences Quarterly
B N Kozlov, D S Panfilov, V V Saushkin, K V Zavadovskiĭ, M S Kuznetsov, G G Nasrashvili, V M Shipulin
BACKGROUND: The variety of pathology of the thoracic aorta supposes different approaches of surgical management, including the use of hybrid technologies. OBJECTIVE: To broaden a possible spectrum of indications for implantation of the "E-vita open plus" hybrid stent graft. RESULTS: Surgical treatment of thoracic aorta with the help of the "E-vita open plus" hybrid stent graft according to the "frozen elephant trunk" technique demonstrated satisfactory results in patients with various pathology: type A and B acute and chronic dissection according to the Stanford classification, as well as rare diseases (post-traumatic false aneurysm, complicated atherosclerosis of the thoracic aorta)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Takayuki Nishimoto, Yukihiro Bonkohara, Takashi Azuma, Masaki Iijima, Masafumi Higashidate
A 60-year-old woman was transfer-red to the emergency department of our medical center with worsening chest and back pain. Computed tomography revealed Stanford type B aortic dissection. There was a false lumen from the distal arch to the abdominal aorta just above the celiac artery. Although she was at 1st treated conservatively, she abruptly developed acute renal failure and lower limb ischemia because of an enlarged false lumen, and emergency axillo-femoral bypass surgery was performed with an 8 mm tube graft...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Chaoyi Qin, Jun Gu, Hong Qian, Ruiqi Liu, Fei Xu, Yajiao Li, Zhenghua Xiao, Qian He, Jia Hu, Wei Meng
BACKGROUND: Acute aortic dissection (AD) is a lethal cardiovascular disease with severe inflammatory complications. Considering the proinflammatory properties of plasma mitochondrial DNA (mtDNA), we postulate that plasma mtDNA from activated platelets may be responsible for post-acute AD inflammatory responses. METHODS: We consecutively enrolled 68 patients with acute AD as well as matched hypertensive and healthy participants. Blood samples were collected on admission for blood routine tests, mtDNA assay, and inflammatory cytokine analysis...
August 17, 2016: Cardiology
Wouter W Jansen Klomp, Linda M Peelen, George J Brandon Bravo Bruinsma, Arnoud W J Van't Hof, Jan G Grandjean, Arno P Nierich
BACKGROUND: Transesophageal echocardiography (TEE) is a key diagnostic modality in patients with acute aortic dissection, yet its sensitivity is limited by a "blind-spot" caused by air in the trachea. After placement of a fluid-filled balloon in the trachea visualization of the thoracic aorta becomes possible. This method, modified TEE, has been shown to be an accurate test for the diagnosis of upper aortic atherosclerosis. In this study we discuss how we use modified TEE for the diagnosis and management of patients with (suspected) acute aortic dissection...
2016: Cardiovascular Ultrasound
Kristofer M Charlton-Ouw, Harleen K Sandhu, Samuel S Leake, Katherine Jeffress, Charles C Miller, Christopher A Durham, Tom C Nguyen, Anthony L Estrera, Hazim J Safi, Ali Azizzadeh
INTRODUCTION: /Objectives: Acute aortic dissection (AAD) can cause limb ischemia due to branch vessel occlusion. A minority of patients have persistent ischemia after central aortic repair and require peripheral arterial revascularization. We investigated whether the need for limb revascularization is associated with adverse outcomes. METHODS: We reviewed our cases of AAD from 2000 to 2014 and identified patients with malperfusion syndromes (coronary, cerebral, spinal, visceral, renal, or peripheral ischemia)...
July 13, 2016: Annals of Vascular Surgery
Junwei Wang, Yonghui Li, Yongxin Li, Zefang Ren, Peng Chen, Xueke Qian, Shenming Wang, Jinsong Wang
BACKGROUND: Improvements in stent-graft devices and increasing clinical experience with the technique have improved outcomes and expanded clinical indications in patients with Stanford type B aortic dissection (AD) in China. However, the evolution of and modifications to stent grafts have not been reviewed. The aim of this study was to summarize all available published data on technical success, potential benefits, complications, stent evolution, and survival rates associated with endovascular stent-graft placements in patients with Stanford type B AD in China...
July 13, 2016: Annals of Vascular Surgery
Abe DeAnda, Eugene A Grossi, Leora B Balsam, Marc R Moon, Clifford W Barlow, Daniel O Navia, Patricia Ursomanno, Bulat A Ziganshin, Annette E Rabinovich, John A Elefteriades, Julian A Smith
BACKGROUND: Seasonal variations of Stanford Type A dissections (STADs) have been previously described in the Northern Hemisphere (NH). This study sought to determine if these variation are mirrored in the Southern Hemisphere (SH). METHODS: Data from patients treated surgically for STADs were retrospectively obtained from existing administrative and clinical databases from NH and SH sites. Data points of interest included age, sex, date of dissection, and 30-day mortality...
December 2015: Aorta (Stamford, Conn.)
Yashwant Agrawal, Vishal Gupta
We report the case of a 19-year-old man with a history of Loeys-Dietz syndrome (LDS), which was diagnosed when he had a Stanford type A aortic dissection. He also had multiple aneurysms including ones in the innominate, right common carotid, and right internal mammary arteries. He had had multiple procedures including Bentall's procedure, repeat sternotomy with complete arch and valve replacement, and coil embolization of internal mammary artery aneurysm in the past. His LDS was characterized by gene mutation for transforming growth factor-β receptor 1...
July 2016: Journal of the Saudi Heart Association
Yeni Li, Chao Ji, Jian Zhang, Yanshuo Han
BACKGROUND: The aim of this work was to study the associations between weather conditions and the occurrence of type B acute aortic dissections (ABAD). PATIENTS AND METHODS: This study was a retrospective review of all ABAD cases between January 1st, 2006 and December 31st, 2015. Using a time-series design and distributed lag non-linear models (DLNM), we estimated the relative risk (RR) of ABAD presentation associated with mean daily temperatures, including cumulative RR for a 28-day period, and RR for individual daily lags through 28 days...
September 2016: VASA. Zeitschrift Für Gefässkrankheiten
Vikalp Jain, Mark A Farber, Raghuveer Vallabhaneni
INTRODUCTION: For the last several decades, initial management of Stanford type B aortic dissections (DeBakey IIIa or IIIb) has involved medical therapy aimed at reducing blood pressure and impulse stress (Dp/dT). This concept has been indoctrinated into the medical field but is now being challenged with advancements in endovascular therapies and devices. Although there have been advances in the medical management and intensive care unit care, medical modalities alone may still pose a 25 -50% complication rate to the patients, resulting in some physicians seeking alternative approaches to reduce this risk in certain subsets of these patients...
September 2016: Expert Review of Cardiovascular Therapy
J Bachet, B Goudot, G Dreyfus, D Brodaty, C Dubois, P Delentdecker, F Teimouri, D Guilmet
Every acute dissection involving the ascending aorta (Stanford type A) must undergo emergency sugical repair. However, the surgical techniques must vary according to the clinical presentation of the patients or the anatomical patterns observed. Furthermore, surgery is generally difficult because of the poor condition of the aortic tissues. To reduce those difficulties many technical artifacts have been described. In 1977, we proposed the use of gelatin-resorcin-formalin (GRF) biological glue to reinforce the suture areas...
October 2000: Zeitschrift Für Kardiologie
Hiroshi Kondo, Itsuo Nakagawa, Shozo Hidaka, Yoshinori Okada, Yoshikazu Erabi, Yoshie Kuwahara, Atsushi Morio
BACKGROUND: Some biomarkers are helpful for AD diagnosis. Although many studies on efficacy of D-dimer have been reported, there are few reports about SFMC. Therefore we conducted a retrospective comparative study of efficacy of SFMC and D-dimer for diagnosis of AD. METHODS: Nineteen patients diagnosed as AD in the emergency visit were examined. Patients with cardiopulmonary arrest on arrival were excluded. These patients were classified into three patterns as follows, Stanford A or B, terms of arriving at hospital, and closing type or patent type...
May 2016: Masui. the Japanese Journal of Anesthesiology
Toshihiko Ichihara, Michio Sasaki, Yoshio Watanabe, Tomonobu Abe
Therapeutic strategies for treating Stanford type B dissection with endo-organ malperfusion remain controversial, and whether surgery or conservative treatment should be performed is a matter of ongoing debate. In this study, we examined the treatment strategies used in cases of malperfusion in which treatment was initiated conservatively at the onset of symptoms without superior mesenteric artery (SMA) or limb artery obstruction. A total of 16 patients had organ ischemia in this series. The obstructed branches were the SMA in 5 patients, the artery of Adamkiewicz in 2, the bilateral renal arteries in 3, the celiac artery in 3 and limb arteries in 3...
June 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Reiko Kemmochi, Mitsuaki Matsumoto, Yoji Kubo, Takefumi Oka, Masaki Yoshikawa
A 66-year-old man was admitted to our hospital because of uncomplicated Stanford B acute aortic dissection. Antihypertensive therapy was initially started; however, he suddenly experienced vomiting, diarrhea, anuria, and paraparesis on the fourteenth hospital day. Contrast-enhanced computed tomography (CECT) revealed expansion of the false lumen and severe stenosis of the true lumen at the distal aortic arch, which caused malperfusion syndrome of the lower body. Percutaneous cardiopulmonary support (PCPS) was immediately initiated to restore lower body organ perfusion, and an extra-anatomic ascending-to-abdominal aorta bypass was performed with a 16-mm Dacron graft...
May 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kay F Weipert, Astrid Most, Oliver Dörr, Inga Helmig, Meshal Elzien, Gabriele Krombach, Christian W Hamm, Damir Erkapic, Joern Schmitt
Clinical trials have demonstrated significant and durable reduction in arterial pressure from baroreflex activation therapy (BAT) in patients with resistant arterial hypertension. There is a lack of data, however, concerning the use of BAT in a rescue approach during therapy-refractory hypertensive crisis resulting in life-threatening end-organ damage. Here, we describe the first case in which BAT was applied as a rescue procedure in an intensive care setting after ineffective maximum medical treatment. A 34-year-old male patient presented with Stanford B aortic dissection and hypertensive crisis...
June 2016: Journal of the American Society of Hypertension: JASH
Liang Zhang, Xiao-Gang Sun, Cun-Tao Yu, Qian Chang, Xiang-Yang Qian
BACKGROUND: To retrospectively analyze the role of intercostal artery reconstruction in the spinal cord protection for patients undergoing extensive thoracoabdominal aortic aneurysm repair. METHODS: From August 2007 to 2014, thoracoabdominal aortas (Crawford II) of 81 consecutive patients with mean age 39.4 ± 10.32 years were repaired. Seventy-three of these patients (90.12%) were diagnosed with aortic dissection in our group, 25 (30.86%) with Stanford type A dissection and 48 (59...
July 2016: Annals of Vascular Surgery
Anton Sabashnikov, Stephanie Heinen, Antje-Christin Deppe, Mohamed Zeriouh, Alexander Weymann, Ingo Slottosch, Kaveh Eghbalzadeh, Aron-Frederik Popov, Oliver-Johannes Liakopoulos, Parwis B Rahmanian, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, André R Simon, Thorsten Wahlers, Jens Wippermann
BACKGROUND: The choice of an optimal cannulation site for aortic repair in patients with Stanford A acute aortic dissection remains controversial. The aim of this study was to compare the early results and long-term outcomes of axillar and direct aortic cannulation. METHODS: A total of 235 consecutive patients who underwent surgical aortic repair with the use of axillar or direct aortic cannulation from January 2006 to April 2015 were analyzed. The primary end points were long-term overall cumulative survival and freedom from major cerebrovascular events with up to 10 years of follow-up...
September 2016: Annals of Thoracic Surgery
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