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abdominal aortic aneurysm, imaging

Miriam Brazzelli, Rodolfo Hernández, Pawana Sharma, Clare Robertson, Michal Shimonovich, Graeme MacLennan, Cynthia Fraser, Russell Jamieson, Srinivasa Rao Vallabhaneni
BACKGROUND: Endovascular abdominal aortic aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) is less invasive than open surgery, but may be associated with important complications. Patients receiving EVAR require long-term surveillance to detect abnormalities and direct treatments. Computed tomography angiography (CTA) has been the most common imaging modality adopted for EVAR surveillance, but it is associated with repeated radiation exposure and the risk of contrast-related nephropathy...
December 2018: Health Technology Assessment: HTA
Monica Torres-Fonseca, María Galan, Diego Martinez-Lopez, Laia Cañes, Raquel Roldan-Montero, Judit Alonso, Teresa Reyero-Postigo, Mar Orriols, Nerea Mendez-Barbero, Marc Sirvent, Luis Miguel Blanco-Colio, José Martínez, Jose Luis Martin-Ventura, Cristina Rodríguez
Abdominal aortic aneurysm (AAA) is a vascular pathology with a high rate of morbidity and mortality and a prevalence that, in men over 65 years, can reach around 8%. In this disease, usually asymptomatic, there is a progressive dilatation of the vascular wall that can lead to its rupture, a fatal phenomenon in more than 80% of cases. The treatment of patients with asymptomatic aneurysms is limited to periodic monitoring with imaging tests, control of cardiovascular risk factors and treatment with statins and antiplatelet therapy...
December 6, 2018: Clínica e Investigación en Arteriosclerosis
Hsu-Ting Yen, Chun-Che Shih, I-Ming Chen
OBJECTIVE: To treat thoracoabdominal aortic aneurysm (TAAA), we introduced an alternative "Hexapus" technique by double-barreled and branched endografting. TECHNIQUE AND RESULT: We established 2 transfemoral and 2 transaxillary access routes first and then deployed two abdominal bifurcated stentgrafts landing at the descending thoracic aorta through transfemoral routes, respectively. Two pairs of parallel stentgrafts were deployed via bilateral transaxillary route from each of contralateral limbs of main body stentgrafts to visceral arteries...
December 6, 2018: Cardiovascular and Interventional Radiology
Carola M Wieker, Philipp von Stein, Claudio Bianchini Massoni, Fabian Rengier, Dittmar Böckler, Philipp Geisbüsch
OBJECTIVE: The objective of this study was to investigate the long-term outcome after open repair of inflammatory infrarenal aortic aneurysms. METHODS: A total of 62 patients (mean age, 68.9 ± 8.8 years; 91.9% male) undergoing open surgery for inflammatory aortic aneurysm from 1995 until 2014 in a high-volume vascular center were retrospectively evaluated. The patients' demographics, preoperative and postoperative clinical characteristics, imaging measurements, and procedural data were collected...
June 28, 2018: Journal of Vascular Surgery
Authors Felice Pecoraro, Umberto M Bracale, Arduino Farina, Giovanni Badalamenti, Francesca Ferlito, Mario Lachat, Ettore Dinoto, Vincenzo Asti, Guido Bajardi
AIM: . Intravascular ultrasound (IVUS) has been introduced as diagnostic adjunct to provide new insights in the diagnosis and therapy of vascular disease. Herein we compared the outcomes of conventional endovascular aneurysm repair (EVAR) and EVAR with IVUS in patients presenting infrarenal abdominal aortic aneurysm using a propensity-matched cohort. METHODS: From May 2013 to August 2017, 221 patients were retrospectively analysed. 122 patients were eligible for inclusion and underwent to propensity score matching...
November 27, 2018: Annals of Vascular Surgery
Yolanda Bryce, Cuong Ken Lam, Suvranu Ganguli, Brian J Schiro, Kyle Cooper, Michael Cline, Rahmi Oklu, Geogy Vatakencherry, Constantino S Peña, Ripal T Gandhi
Seventy-five percent of abdominal aortic aneurysms are now treated by endovascular aneurysm repair (EVAR) rather than open repair, given the decreased periprocedural mortality, complications, and length of hospital stay for EVAR compared to the surgical counterpart. An endoleak is a potential complication after EVAR, characterized by continued perfusion of the aneurysm sac after stent graft placement. Type II endoleak is the most common endoleak, and often has a benign course with spontaneous resolution, occurring in the first 6 months after repair...
September 2018: Techniques in Vascular and Interventional Radiology
Halim Yammine, Charles S Briggs, Gregory A Stanley, Jocelyn K Ballast, Frank R Arko Iii
The complex aortic anatomy of patients who present with juxtarenal and pararenal abdominal aortic aneurysms requires advanced techniques to ensure adequate coverage and complete exclusion of the aneurysm. Parallel stent grafting is one option for endovascular repair of complex aneurysms. Using chimneys, periscopes, or snorkels, it is possible to extend the length of the proximal seal zone and maintain perfusion to branch vessels. Because readily available stent grafts and covered stents are used, this technique is highly adaptable to each patient's unique anatomical challenges...
September 2018: Techniques in Vascular and Interventional Radiology
Iisa Lindström, Niina Khan, Teemu Vänttinen, Mikko Peltokangas, Niko Sillanpää, Niku Oksala
BACKGROUND: Sarcopenia is associated with mortality after abdominal aortic aneurysm (AAA) repair. The reliability of computed tomography (CT) core muscle areas and quality i.e. densities and their association with postoperative survival in patients undergoing AAA treatment were retrospectively studied. METHODS: Psoas and multifidus areas (PMA, MFA) and densities (PMD, MFD) were measured from CT images and analysed to lean values. Results were standardized by z-scoring...
November 23, 2018: Annals of Vascular Surgery
Manuel Patino, Anushri Parakh, Grace C Lo, Mukta Agrawal, Avinash R Kambadakone, George R Oliveira, Dushyant V Sahani
OBJECTIVE: The purpose of this study was to assess the feasibility of performing abdominopelvic aortoiliac CT angiography (CTA) with 16.0 g of iodine contrast medium acquired with low-energy (40 and 50 keV) virtual monochromatic (VMC) images with rapid-kilovoltage-switching dual-energy CT. SUBJECTS AND METHODS: A total of 52 adults with abdominal aortoiliac aneurysm and prior 120-kVp single-energy CTA (SECTA) with 33 g iodine (standard dose) underwent follow-up dual-energy CTA (DECTA) with a 52% reduced iodine dose...
November 26, 2018: AJR. American Journal of Roentgenology
Dustin M Nguyen, Markus U Wagenhäuser, Dennis Mehrkens, Matti Adam, Philip S Tsao, Anand K Ramasubramanian
Arterial diseases including abdominal aortic aneurysm and atherosclerosis are biomechanical diseases characterized by significant changes in the structure and strength of the vessel wall. It is now established that local variations in fibrillar collagen and elastin matrix turnover is critical to arterial stiffening and progression of the disease. The collagen content in the aortic wall has nominally been quantified by biochemical assays and immunohistochemical analysis as the total amount because of the difficulty in separating the media and adventitia...
November 19, 2018: Journal of Histochemistry and Cytochemistry: Official Journal of the Histochemistry Society
Hiromitsu Domen, Yasuhiro Hida, Masaaki Sato, Haruka Takahashi, Tatsuru Ishikawa, Yosuke Shionoya, Midori Hashimoto, Kaoru Nishiyama, Yuma Aoki, Kazuho Inoko, Syotaro Furukawa, Kazuomi Ichinokawa, Hidehisa Yamada
BACKGROUND: Thymic large cell neuroendocrine carcinoma (LCNEC) is extremely rare. The detailed clinical features of thymic LNCECs remain unknown. CASE PRESENTATION: A 90-year-old man with a history of diabetes mellitus, chronic renal failure, and an abdominal aortic aneurysm underwent computed tomography for follow-up, which showed an anterior mediastinal tumor, measuring 31 mm × 28 mm in diameter. Magnetic resonance imaging showed an iso-intensity mass on T1-weighted images and high intensity on T2-weighted images...
November 16, 2018: Surgical Case Reports
Jonathan Golledge
Abdominal aortic aneurysm (AAA) rupture is an important cause of death in adults. Currently, the only treatment for AAA is open or endovascular surgical repair. In most parts of the developed world, AAAs can be identified at an early stage as a result of incidental imaging and screening programmes. Randomized clinical trials have demonstrated that early elective surgical repair of these small AAAs is not beneficial, and an unmet clinical need exists to develop medical therapies for small AAAs that limit or prevent the progressive expansion and rupture of the aneurysm...
November 15, 2018: Nature Reviews. Cardiology
Konstantinos P Donas, Marco V Usai, Gergana T Taneva, Frank J Criado, Giovanni B Torsello, Paul Kunilis, Salvatore Scali, Frank J Veith
OBJECTIVE: Chimney endovascular aortic aneurysm repair is gaining ever greater acceptance. However, persistent gutters leading to type IA endoleaks represent an unsolved issue. The aim of the current study was to analyze the impact of abdominal endograft oversizing to the occurrence of this phenomenon. METHODS: The PERformance of the snorkel/chImney endovascular teChnique in the treatment of compLex aortic PathologiesES registry includes the largest experience with chimney endovascular aortic aneurysm repair from 13 vascular centers in Europe and the U...
November 12, 2018: Vascular
Giasemi Koutouzi, Behrooz Nasihatkton, Monika Danielak-Nowak, Henrik Leonhardt, Mårten Falkenberg, Fredrik Kahl
BACKGROUND: A crucial step in image fusion for intraoperative guidance during endovascular procedures is the registration of preoperative computed tomography angiography (CTA) with intraoperative Cone Beam CT (CBCT). Automatic tools for image registration facilitate the 3D image guidance workflow. However their performance is not always satisfactory. The aim of this study is to assess the accuracy of a new fully automatic, feature-based algorithm for 3D3D registration of CTA to CBCT. METHODS: The feature-based algorithm was tested on clinical image datasets from 14 patients undergoing complex endovascular aortic repair...
November 8, 2018: BMC Medical Imaging
Stephen Hofmeister, Matthew B Thomas, Joseph Paulisin, Nicolas J Mouawad
The management of vascular emergencies is dependent on rapid identification and confirmation of the diagnosis with concurrent patient stabilization prior to immediate transfer to the operating suite. A variety of technological advances in diagnostic imaging as well as the advent of minimally invasive endovascular interventions have shifted the contemporary treatment algorithms of such pathologies. This review provides a comprehensive discussion on the current state and future trends in the management of ruptured abdominal aortic aneurysms as well as acute aortic dissections...
November 8, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Tsunehisa Yamamoto, Katsuhiko Oka, Keiichi Kanda, Osamu Sakai, Taiji Watanabe, Hitoshi Yaku
Listeria monocytogenes infection and rupture of the aneurysm sac, after endovascular aneurysm repair (EVAR), are both rare. We report the case of an 82-year-old man who presented with a ruptured aneurysm by infection with L. monocytogenes after EVAR. We successfully treated him by in situ reconstruction with a bifurcated expanded polytetrafluoroethylene (ePTFE) graft, with partial removal of the infected stent graft. At 30 months from the reoperation, the patient was in good health at home, with no symptoms of infection, and the gallium-67-citrate single-photon emission computed tomography/computed tomography (SPECT/CT) fusion images confirmed no fluid accumulation...
September 25, 2018: Annals of Vascular Diseases
Abdul Aziz Qazi, Arash Jaberi, Oleg Mironov, Jamil Addas, Emmad Qazi, Emidio Tarulli, Martin Simons, Kong Teng Tan
PURPOSE: Proximal type 1A endoleaks on completion intra-operative angiography are not infrequently seen following endovascular abdominal aneurysm repair (EVAR). The natural course of these leaks is not well established. We sought to determine the rate of spontaneous resolution and a conservative treatment approach to these endoleaks. METHODS: All cases involving endovascular repairs of infra-renal abdominal aortic aneurysms resulting in proximal type 1A endoleak on final intra-operative completion angiography were retrospectively reviewed from 1 April 2010 and 30 March 2015...
November 5, 2018: Vascular
Bader Aldeen Alhafez, Van Thi Thanh Truong, Daniel Ocazionez, Sahand Sohrabi, Harleen Sandhu, Anthony Estrera, Hazim J Safi, Artur Evangelista, Lydia Dux-Santoy Hurtado, Andrea Guala, Siddharth K Prakash
INTRODUCTION: Arterial tortuosity has emerged as a predictor of adverse outcomes in congenital aortopathies using 3D reconstructed images. We validated a new method to estimate aortic arch tortuosity on 2D CT. We hypothesize that arch tortuosity may identify bicuspid aortic valve (BAV) patients at high risk to develop thoracic aortic aneurysms or aortic dissections (TAD). METHODS: BAV subjects with chest CT scans were retrospectively identified in our clinical records and matched to tricuspid aortic valve (TAV) controls by age, gender, and presentation with TAD...
October 17, 2018: International Journal of Cardiology
Hamzeh B Sumrein, Sally D Parry, Ravi V Ayer, Andrew P Leonard
We present the case of a 68-year-old male, who underwent open abdominal aortic graft in August 2016 owing to a ruptured large infrarenal abdominal aneurysm. He subsequently presented 6 months later with back pain, general weakness, reduced mobility and cachexia. He underwent CT, MRI and fluorodeoxyglucose (PDG)-PET spinal imaging, all modalities showing signs of aortic graft infection complicated by L4/5 discitis. The patient was treated conservatively with intravenous antibiotics and spinal brace support, as his general condition did not allow for surgery...
2018: BJR Case Reports
Dimitrios M Kapetanios, Christos D Karkos, Konstantinos O Papazoglou
The presence of an abdominal aortic aneurysm (AAA) is associated with increased thrombin formation, fibrin turnover and fibrinolysis. The aim of this study was to review the relevant literature and summarize the evidence regarding the impact of endovascular repair on the circulating markers of coagulation and fibrinolysis post procedure. The main findings are that the increased thrombin activation, and formation, as well as fibrinolysis, in patients with AAA is exacerbated after endovascular repair in the short-term and the mid-term, implying that this may be a period associated with an increased likelihood for adverse cardiovascular events...
October 23, 2018: International Angiology: a Journal of the International Union of Angiology
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