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Rupture aortic aneurysm

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https://www.readbyqxmd.com/read/27922338/pathophysiology-of-aortic-aneurysm-insights-from-human-genetics-and-mouse-models
#1
Nicole K Wilson, Russell A Gould, Elena Gallo MacFarlane, Mibava Leducq Consortium
Aneurysms are local dilations of an artery that predispose the vessel to sudden rupture. They are often asymptomatic and undiagnosed, resulting in a high mortality rate. The predisposition to develop thoracic aortic aneurysms is often genetically inherited and associated with syndromes affecting connective tissue homeostasis. This review discusses how elucidation of the genetic causes of syndromic forms of thoracic aortic aneurysm has helped identify pathways that contribute to disease progression, including those activated by TGF-β, angiotensin II and Notch ligands...
December 6, 2016: Pharmacogenomics
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
#2
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/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#3
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/27909281/-transaortic-thoracic-endovascular-aortic-repair-via-right-anterior-mini-thoracotomy-report-of-a-case
#4
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/27908817/clinical-outcome-after-endovascular-sealing-of-abdominal-aortic-aneurysms-evas-a-retrospective-cohort-study
#5
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/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
#6
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
https://www.readbyqxmd.com/read/27904852/analysis-of-in-hospital-mortality-and-long-term-survival-excluding-in-hospital-mortality-after-open-surgical-repair-of-ruptured-abdominal-aortic-aneurysm
#7
Jun Gyo Gwon, Tae-Won Kwon, Yong-Pil Cho, Young Jin Han, Min Su Noh
PURPOSE: The aim of this study was to confirm the factors that affect the mortality associated with the open surgical repair of ruptured abdominal aortic aneurysm (rAAA) and to analyze the long-term survival rates. METHODS: A retrospective review was performed on a prospectively collected database that included 455 consecutive patients who underwent open surgical repair for AAA between January 2001 and December 2012. We divided our analysis into in-hospital and postdischarge periods and analyzed the risk factors that affected the long-term survival of rAAA patients...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27904124/mycotic-aneurysm-caused-by-bacteroides-fragilis-in-an-elderly-immunosuppressed-patient
#8
Takahiko Fukuchi, Sadao Kawasaki, Hiroki Hayashi, Daisuke Koreeda, Takahiro Ashikawa
An 82-year-old Japanese man, who presented with a fever and abdominal pain, was admitted to our hospital. According to enhanced computed tomography images, the probable diagnosis was abdominal aortic mycotic aneurysm. Eight sets of blood cultures obtained from the patient were negative. Despite administering treatment with vancomycin and ceftriaxone, the aneurysm progressively enlarged. He underwent open debridement surgery and in situ replacement because of an aneurysmal rupture. Bacteroides fragilis was isolated from the tissue culture of the aortic wall...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#9
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27903534/high-structural-stress-and-presence-of-intraluminal-thrombus-predict-abdominal-aortic-aneurysm-18f-fdg-uptake-insights-from-biomechanics
#10
Yuan Huang, Zhongzhao Teng, Maysoon Elkhawad, Jason M Tarkin, Nikhil Joshi, Jonathan R Boyle, John R Buscombe, Timothy D Fryer, Yongxue Zhang, Ah Yeon Park, Ian B Wilkinson, David E Newby, Jonathan H Gillard, James H F Rudd
BACKGROUND: Abdominal aortic aneurysm (AAA) wall inflammation and mechanical structural stress may influence AAA expansion and lead to rupture. We hypothesized a positive correlation between structural stress and fluorine-18-labeled 2-deoxy-2-fluoro-d-glucose ((18)F-FDG) positron emission tomography-defined inflammation. We also explored the influence of computed tomography-derived aneurysm morphology and composition, including intraluminal thrombus, on both variables. METHODS AND RESULTS: Twenty-one patients (19 males) with AAAs below surgical threshold (AAA size was 4...
November 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#11
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infra-renal aorta using custom-made bovine pericardium grafts...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903470/preoperative-white-blood-cell-count-in-patients-with-abdominal-aortic-aneurysms-and-its-relation-to-survival-following-surgery
#12
Camilla Berge, Anne I Hagen, Hans O Myhre, Torbjørn Dahl
OBJECTIVES: The aim of the present study was to explore whether preoperative white blood cell count (WBC) may predict 30-day mortality and long-term survival following surgery for abdominal aortic aneurysm (AAA). Secondarily we wanted to assess the potential sex differences in WBC in these patients. MATERIAL AND METHODS: The study was carried out as a retrospective cohort study. Patients undergoing surgery for intact and ruptured AAA at our institution consecutively in the time-period 1994-2007 were included...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27894897/the-long-term-durability-of-intra-operatively-placed-palmaz-stents-for-the-treatment-of-type-ia-endoleaks-after-evar-of-abdominal-aortic-aneurysm
#13
M Abdulrasak, T Resch, B Sonesson, J Holst, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. METHODS: This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months' follow-up...
November 25, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#14
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893065/histology-and-biaxial-mechanical-behavior-of-abdominal-aortic-aneurysm-tissue-samples
#15
Francesco Q Pancheri, Robert A Peattie, Nithin D Reddy, Touhid Ahamed, Wenjian Lin, Timothy D Ouellette, Mark D Iafrati, A Luis Dorfmann
Abdominal aortic aneurysms (AAA) represent permanent, localized dilations of the abdominal aorta that can be life-threatening if progressing to rupture. Evaluation of risk of rupture depends on understanding the mechanical behavior of patient AAA walls. In this project, a series of patient AAA wall tissue samples have been evaluated through a combined anamnestic, mechanical and histopathologic approach. Mechanical properties of the samples have been characterized using a novel, strain-controlled, planar biaxial testing protocol emulating the in vivo deformation of the aorta...
November 18, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27890842/treatment-of-a-patient-with-abdominal-aortic-aneurysm-and-hepatocelular-carcinoma
#16
Slobodan Cvetkovic, Igor Koncar, Daniel Galun, Jelena Ribac, Miroslav Markovic, Nikola Ilic, Marko Dragas, Lazar Davidovic
INTRODUCTION: The surgical tactics in cases of AAA and intra-abdominal malignancy are not uniform in the literature and are still a matter of debate. CASE REPORT: In this case report, we present a patient with coexisting AAA and primary liver cancer managed by simultaneous open AAA repair and liver resection After laparotomy and intraoperative liver ultrasonography that confirmed resectability of the tumor, aneurysm repair was performed with aorto-aortic tube grafting after interrenal cross-clamping Radiofrequency-assisted liver transection was performed to complete an anterior anatomic resection of liver segments VI and VII...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890835/acute-kidney-injury-after-open-repair-of-intact-abdominal-aortic-aneurysms
#17
REVIEW
Charles Dariane, Raphaël Coscas, Celia Boulitrop, Isabelle Javerliat, Eve Vilaine, Olivier Goeau-Brissonniere, Marc Coggia, Ziad A Massy
BACKGROUND: These last years, considerable attention has been given to renal issues following endovascular aortic repair (EVAR) but acute kidney injury (AKI) also remains one of the most frequent complications following open repair (OR). OBJECTIVES: Since AKI definition has evolved, our aim was to review the aetiology, incidence, classifications and consequences of AKI after OR for intact abdominal aortic aneurysm (AAA). METHODS: A review of the English language literature published between 2004 and 2016 was conducted according to the PRISMA criteria...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27889204/tauroursodeoxycholic-acid-attenuates-angiotensin-ii-induced-abdominal-aortic-aneurysm-formation-in-apolipoprotein-e-deficient-mice-by-inhibiting-endoplasmic-reticulum-stress
#18
Y Qin, Y Wang, O Liu, L Jia, W Fang, J Du, Y Wei
OBJECTIVE/BACKGROUND: Abdominal aortic aneurysm (AAA) is characterised by the infiltration of smooth muscle cell (SMC) apoptosis, inflammatory cells, neovascularisation, and degradation of the extracellular matrix. Previous work has shown that endoplasmic reticulum (ER) stress and SMC apoptosis were increased both in a mouse model and human thoracic aortic aneurysm. However, whether the ER stress is activated in AAA formation and whether suppressing ER stress attenuates AAA is unknown...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27887855/regional-anesthesia-as-the-anesthetic-of-choice-for-high-risk-surgical-patients-undergoing-repair-of-juxtarenal-aortic-aneurysms-with-fenestrated-stent-grafts
#19
Jesse Manunga, Jessica Titus
Juxtarenal aortic aneurysms (JAAs) have been conventionally treated using open repair with excellent results. Recent approval of fenestrated stent grafts by the United States Food and Drug Administration has given patients with JAAs an alternative for repair. However, most of these procedures are still performed under general anesthesia, making some surgeons reluctant to offer repair to a subset of patients deemed too high risk for general anesthesia. We present three patients with JAAs at high surgical risk, including one patient with a ruptured aneurysm, who were successfully treated using a fenestrated stent graft under regional anesthesia...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#20
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
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