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stanford B aortic dissection

Wenwen Zhang, Qian Han, Zhao Liu, Wei Zhou, Qing Cao, Weimin Zhou
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder characterized by progressive cyst formation and expansion in the kidneys, which culminates in end-stage renal disease. Aortic dissection is a rare vascular complication of ADPKD and related literature is currently limited. CASE PRESENTATION: In this report, we described a patient with asymptomatic Stanford B aortic dissection. Further investigation revealed a positive family history of ADPKD and normal renal function...
January 30, 2018: BMC Medical Genetics
Jordan R Stern, Danielle E Cafasso, Darren B Schneider, Andrew J Meltzer
Here, we describe a totally percutaneous technique for longitudinal fenestration of a chronic dissection flap in the setting of endovascular aneurysm repair (EVAR), where the septum would otherwise preclude proper endograft sealing. This technique is demonstrated in a 65-year-old man with a history of open surgical repair of a Stanford type A aortic dissection, with a type B component that was managed nonoperatively. The patient developed aneurysmal degeneration of the infrarenal aorta during follow-up, and his anatomy was well suited for EVAR with the exception of a chronic dissection flap dividing the proximal seal zone...
January 1, 2018: Vascular and Endovascular Surgery
Wan Naimah Wan Ab Naim, Poo Balan Ganesan, Zhonghua Sun, Jing Lei, Shirley Jansen, Shahrul Amry Hashim, Teik Kok Ho, Einly Lim
Endovascular stent graft repair has become a common treatment for complicated Stanford Type B aortic dissection in order to restore true lumen flow and induce false lumen thrombosis. Using computational fluid dynamics, this study reports the differences in flow patterns and wall shear stress distribution in complicated Stanford Type B aortic dissection patients after endovascular stent graft repair. Five patients were included in this study: two having more than 80% false lumen thrombosis (Group 1), while three others had less than 80% false lumen thrombosis (Group 2) within one year following endovascular repair...
January 13, 2018: International Journal for Numerical Methods in Biomedical Engineering
J T Qiu, L Zhang, X J Luo, J Yang, S Liu, W X Jiang, C T Yu
Objective: To explore the relationship between the incidence of aortic dissection and climate change. Methods: The characteristics of 345 acute aortic dissection patients came from Beijing in Department of Vascular Surgery, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College from January 2005 to December 2015 were analyzed, retrospectively. There were 266 male and 79 female patients with a mean age of (49±12) years. There were 209 cases of Stanford type A aortic dissection, and 136 cases of type B...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Akihiko Sasaki, Shuhei Nishijima, Hitoki Hashiguchi
Massive hemoptysis caused by bronchiectasis threatens life, so early bronchial arterial embolization (BAE) is needed. In case 1, a 80-year-old female complained of hemoptysis and back pain caused by bronchiectasis and Stanford type B aortic dissection. In case 2, a 78-year-old male had history of the surgery of descending thoracic aortic aneurysm and bronchiectasis combined with aortopulmonary fistula. Both cases in bronchiectasis with massive hemoptysis were difficult to perform BAE due to complicated with acute aortic dissection and aortopulmonary fistula...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
John Nathan Gifford, Angeline Choo Choo Poh
A 77-year-old man presented with acute-onset severe chest pain radiating to the back and elevated blood pressure. Multiphasic computed tomography of the aorta revealed an intimal tear in the descending thoracic aorta which extended both retrograde to the aortic root and antegrade to the infra-renal abdominal aorta. The initial impression, that the images showed a Stanford type B aortic dissection, was because the portion of the false lumen that extended beyond the aortic arch remained unopacified even on delayed phases, making it challenging to assess the extent of the dissection flap...
December 2017: Singapore Medical Journal
Daniella Rakotoniaina Masinarivo, Jenny Larissa Rakotomanana
We here report the case of a 52-year old hypertensive, obese woman (BMI 32,46 kg/m(2)) with a past history of smoking and without evidence-based risk factors of venous thromboembolism, hospitalized for left chest pain radiating to the dorsolumbar region associated with dyspnoea. Clinical examination on hopitalization showed left blood pressure 100/60 mmHg, tachycardia 100/min, oxygen desaturation index at 88% with the patient breathing ambient air, normal cardiopulmonary auscultation, peripheral pulses palpable and no symptoms of phlebitis of the lower limbs...
2017: Pan African Medical Journal
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
Toshinobu Yamagishi, Masahiro Kashiura, Kazuya Nakata, Kazuki Miyazaki, Takahiro Yukawa, Takahiro Tanabe, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe
Case: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58-year-old woman presented with sudden-onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed...
July 2017: Acute Medicine & Surgery
Tao Ma, Zhi Hui Dong, Wei Guo Fu, Da Qiao Guo, Xin Xu, Bin Chen, Jun Hao Jiang, Jue Yang, Zhen Yu Shi, Ting Zhu, Yun Shi, Bao Hong Jiang, Xiao Yun Xu
OBJECTIVE: Stent graft (SG)-induced new entry (SINE) and retrograde type A dissection (RTAD) are serious device-related complications occurring after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) and may lead to endograft-related complications including retrograde dissection and death. The purpose of this study was to investigate the incidence and risk factors for the development of RTAD and SINE after TEVAR for TBAD and to identify the complications associated with this...
October 30, 2017: Journal of Vascular Surgery
Ahmed El-Medany, W Wallace, E Mcrorie, Sy Tan, K Lim
This report provides a rare histological example and the appropriate management of spontaneous aortic dissection secondary to giant cell arteritis.
October 2017: JRSM Open
Peter Chiu, Jeffrey Trojan, Sarah Tsou, Andrew B Goldstone, Y Joseph Woo, Michael P Fischbein
OBJECTIVE: Management of the aortic root is a challenge for surgeons treating acute type A aortic dissection. METHODS: We performed a retrospective review of the acute type A aortic dissection experience at Stanford Hospital between 2005 and 2015 and identified patients who underwent either limited root repair or aortic root replacement. Differences in baseline characteristics were balanced with inverse probability weighting to estimate the average treatment effect on the controls...
January 2018: Journal of Thoracic and Cardiovascular Surgery
Yoshiro Higuchi, Masato Tochii, Yoshiyuki Takami, Akihiro Kobayashi, Tsutomu Yanagisawa, Kentaro Amano, Yusuke Sakurai, Michiko Ishida, Hiroshi Ishikawa, Koji Hattori, Yasushi Takagi
We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure...
March 24, 2017: Annals of Vascular Diseases
Robert Shahverdyan, Spyridon Mylonas, Michael Gawenda, Jan Brunkwall
Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate...
January 1, 2017: Vascular
Choon-Bing Chua, Chih-Wei Hsu, Hsuan-Yin Wu, Chao-Sheng Chang, Kuo-Hsin Lee
No abstract text is available yet for this article.
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Tamer Ghazy, Sandra Mikulasch, Christian Reeps, Ralf-Thorsten Hoffmann, Kasia Wijatkowska, Abdel-Hannan Diab, Utz Kappert, Klaus Matschke, Norbert Weiss, Adrian Mahlmann
OBJECTIVES: The aim of this study was to evaluate the early and mid-term clinical results, the device performance, and the mid-term re-intervention rates of patients suffering blunt thoracic aortic injury (BTAI) managed by a multidisciplinary team in a low-volume BTAI centre. METHODS: This was a retrospective observational study in a tertiary hospital setting. From December 2005 to March 2016, all patients over 18 years old admitted with BTAI were included in the study...
November 2017: European Journal of Vascular and Endovascular Surgery
Rui-Xia He, Lei Zhang, Tie-Nan Zhou, Wen-Jie Yuan, Yan-Jie Liu, Wen-Xia Fu, Quan-Min Jing, Hai-Wei Liu, Xiao-Zeng Wang
BACKGROUND: Acute aortic dissection is known as the most dangerous aortic disease, with management and prognosis determined as the disruption of the medial layer provoked by intramural bleeding. The objective of this study was to evaluate the safety and necessity of antiplatelet therapy on patients with Stanford Type B aortic dissection (TBAD) who underwent endovascular aortic repair (EVAR). METHODS: The present study retrospectively analyzed 388 patients with TBAD who underwent EVAR and coronary angiography...
October 5, 2017: Chinese Medical Journal
Amaury Dujardin, Awena Le Fur, Diego Cantarovich
We report the case of a patient with long-term history of hypertension, presenting with transient neurological disorders and severe graft failure several years after kidney transplantation. Cause of end-stage renal disease was hypertensive nephrosclerosis. Chronic hemodialysis lasted for 1 year. After transplantation and throughout follow-up, serum creatinine ranged from 200 to 230 μmol/L and maintenance immunosuppression included sirolimus and low-dose steroids. Six years after transplantation, the patient presented with right hip pain radiating to the lower back, transient aphasia, confusion, and hemiparesis...
September 2017: Transplantation Direct
Emma van der Weijde, Olaf J Bakker, Arnoud V Kamman, Joost A van Herwaarden, Santi Trimarchi, Jan Albert Vos, Robin H Heijmen
PURPOSE: To evaluate the applicability of an off-the-shelf scalloped stent-graft to preserve left subclavian artery (LSA) flow in thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection. METHODS: The computed tomography angiograms (CTA) of 70 consecutive patients (median age 64 years; 44 men) with acute Stanford type B aortic dissection were retrospectively analyzed to identify patients in whom a short proximal landing zone (<15 mm from the retrogradely dissected wall layers) would require LSA overstenting during TEVAR...
August 1, 2017: Journal of Endovascular Therapy
Jie Jin, Jun Bai, Yongfa Wu, Kangkang Zhi, Xiaomin Wang, Xingzhu Wen, Jianjin Wu, Lefeng Qu
PURPOSE: To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion...
August 1, 2017: Journal of Endovascular Therapy
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