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Rupture aortic aneurysm

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https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#1
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#2
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
#3
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/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/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#5
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular 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
#6
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/28916405/love-death-a-retrospective-and-prospective-follow-up-mortality-study-over-45-years
#7
Lena Lange, Barbra Zedler, Marcel A Verhoff, Markus Parzeller
BACKGROUND: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events. METHODS: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany...
September 12, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#8
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/28912363/tgf%C3%AE-transforming-growth-factor-%C3%AE-blockade-induces-a-human-like-disease-in-a-nondissecting-mouse-model-of-abdominal-aortic-aneurysm
#9
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
#10
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/28906534/management-of-a-complicated-redo-giant-dissecting-aortic-aneurysm
#11
Ibrahim Kara, Alper Erkin, MHalil Ibrahim Erkengel, Kiyasettin Asil
Giant aortic aneurysm is defined as an aneurysm of the aorta of greater than 10 cm in diameter. This rare condition is associated with a high risk of morbidity and mortality and it may lead to fatal complications such as rupture and/or dissection if not managed with proper surgical planning and expertise. Other than atherosclerosis, the main causes of giant ascending aortic aneurysms include Marfan and Ehlers-Danhlos syndromes. Herein we report on a young male patient who had had an aortic valve replacement five years earlier due to a bicuspid aortic valve leading to aortic failure, accompanied by aortic coarctation...
July 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28905268/fluid-and-biomechanical-analysis-of-ascending-thoracic-aorta-aneurysm-with-concomitant-aortic-insufficiency
#12
F Condemi, S Campisi, M Viallon, T Troalen, G Xuexin, A J Barker, M Markl, P Croisille, O Trabelsi, C Cavinato, A Duprey, S Avril
We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair...
September 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28902661/giant-thoracoabdominal-aortic-aneurysm
#13
Luca Di Marco, Domenico Attinà, Davide Pacini
: Aneurysms of the descending thoracic and thoracoabdominal aorta are life-threatening conditions. All aneurysms which have not yet had an indication for the treatment need regular follow-up to prevent rupture or dissection. We present a case of a patient with a giant aneurysm of the thoracoabdominal aorta who was denied both surgery and endovascular treatment.
September 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28899569/on-the-influence-of-wall-calcification-and-intraluminal-thrombus-on-prediction-of-abdominal-aortic-aneurysm-rupture
#14
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
#15
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
#16
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/28894058/-ruptured-aneurysm-of-the-sinus-of-valsalva-accompanied-with-a-bicuspid-aortic-valve-in-an-elderly-man-report-of-a-case
#17
Toshifumi Murase, Susumu Tamura, Yasuhiro Ohzeki, Kunio Ebine
The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28890785/staged-approach-for-surgical-management-of-a-true-femoral-artery-aneurysm-combined-with-bilateral-iliac-artery-aneurysms
#18
Ahmet Dolapoglu, Serkan Ertugay, Hakan Posacioglu
True femoral artery aneurysm is a rare vascular entity and is often associated with aortic or peripheral aneurysms. Life-threatening complications associated with peripheral arterial aneurysms include rupture, thrombosis, and embolization. In patients with multiple aneurysms, any symptomatic aneurysms should be treated first; in asymptomatic patients, the aneurysms can be repaired either simultaneously in a single operation or serially in a staged procedure. We report a case of concomitant true femoral aneurysm and bilateral iliac artery aneurysms, which were treated with a combination of open surgical and endovascular techniques...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#19
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890065/comparison-of-endovascular-stent-grafts-for-abdominal-aortic-aneurysm-repair-in-medicare-beneficiaries
#20
Dominique B Buck, Peter A Soden, Sarah E Deery, Sara L Zettervall, Klaas H J Ultee, Bruce E Landon, A James O'Malley, Marc L Schermerhorn
BACKGROUND: Increased renal complications have been suggested with suprarenal stent grafts, but long-term analyses have been limited. Therefore, the purpose of this study was to evaluate the effect of endograft choice on perioperative and long-term outcomes. METHODS: We compared Medicare beneficiaries undergoing endovascular AAA repair from 2005-2008 with endografts with infrarenal fixation and a single docking limb (AneuRx, Excluder) to those with suprarenal fixation and two docking limbs (Zenith), or a unibody configuration (Powerlink)...
September 7, 2017: Annals of Vascular Surgery
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