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abdominal aortic aneurysm, imaging

Xin Li, Daniel Staub, Vasileios Rafailidis, Mohammed Al-Natour, Sanjeeva Kalva, Sasan Partovi
Ultrasound has been established as an important diagnostic tool in assessing vascular abnormalities. Standard B-mode and Doppler techniques have inherent limitations with regards to detection of slow flow and small vasculature. Contrast-enhanced ultrasound (CEUS) is a complementary tool and is useful in assessing both the macro- and microvascular anatomy of the aorta. CEUS can also provide valuable physiological information in real-time scanning sessions due to the physical and safety profiles of the administered microbubbles...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Ahmed Elmallah, Mohamed Elnagar, Niamh Bambury, Zeeshan Ahmed, Joseph Dowdall, Denis Mehigan, Stephen Sheehan, Mary Barry
Background The current advancement and increasing use of diagnostic imaging has led to increased detection of abdominal aortic aneurysms (AAA). Many of these patients are unfit for elective AAA surgery. Aim To investigate the outcome of conservative management of unfit patients with large AAA (>5.5 cm) who are turned down for elective surgical intervention. Patients and methods Between January 2006 and April 2017, 457 patients presented with AAA >5.5 cm. Seventy-six patients (M: F 54:22) were deemed unfit for elective repair...
October 14, 2018: Vascular
Robert Ohle, Omar Anjum, Helena Bleeker, Sarah McIsaac
INTRODUCTION: Acute aortic syndrome (AAS) is a time sensitive and difficult to diagnose aortic emergency. The American Heart Association (AHA) proposed the acute aortic dissection detection risk score (ADD-RS) as a means to reduce miss rate and improve time to diagnosis. Previous validation studies were performed in a high prevalence population of patients. We do not know how the rule will perform in a lower prevalence population. This is important because application of a rule with low specificity would increase imaging rates and complications...
October 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mohamed S Kuziez, Daniel Picus, Luis A Sanchez, Mohamed A Zayed
Ruptured abdominal aortic aneurysm (rAAA) with an associated Type II endoleak is rare. Emergent surgical repair is often necessary and may be associated with high morbidity and mortality. We report an alternative unique trans-luminal repair strategy in an 84-year-old male who presented with a rAAA with prior EVAR, and Type Ia and Type II endoleaks. The operative strategy consisted of proximal endograft extension into the para-renal aorta, followed by staged sac embolization using glue. Postoperatively, the patient recovered well from the repair, and follow-up imaging demonstrated a stable repair...
October 2018: Journal of Surgical Case Reports
Nicholas J Swerdlow, Douglas W Jones, Alexander B Pothof, Thomas F X O'Donnell, Patric Liang, Chun Li, Mark C Wyers, Marc L Schermerhorn
OBJECTIVE: Three-dimensional (3D) image fusion is associated with lower radiation exposure, contrast agent dose, and operative time during endovascular abdominal aortic aneurysm repair. Therefore, we evaluated the impact of this technology on carotid artery stenting (CAS). METHODS: We identified consecutive CAS procedures from 2009 to 2017 and compared those performed with and without 3D image fusion. For image fusion, we created a 3D reconstruction of the aortic arch anatomy based on preoperative computed tomography or magnetic resonance angiography that we merged with two-dimensional fluoroscopy, allowing 3D image overlay...
October 6, 2018: Journal of Vascular Surgery
Seyed M Qaderi, Nam T Tran, Billi Tatum, Jan D Blankensteijn, Niten Singh, Benjamin W Starnes
OBJECTIVE: Long-term outcomes after endovascular aneurysm repair (EVAR) are threatened by aortic neck dilation (AND), graft migration, and subsequent endoleak development. The aim of this study was to determine the rate of AND and the occurrence of endoleaks after fenestrated EVAR of juxtarenal aneurysms with physician-modified endovascular grafts (PMEGs). METHODS: The study included 77 patients presenting with asymptomatic and ruptured juxtarenal abdominal aortic aneurysms treated with PMEGs who received radiologic follow-up...
October 6, 2018: Journal of Vascular Surgery
Doran S Mix, Michael C Stoner, Steven W Day, Michael S Richards
Ultrasound (US) elastography, or elasticity imaging, is an adjunct imaging technique that utilizes sequential US images of soft tissues to measure the tissue motion and infer or quantify the underlying biomechanical characteristics. For abdominal aortic aneurysms (AAA), biomechanical properties such as changes in the tissue's elastic modulus and estimates of the tissue stress may be essential for assessing the need for the surgical intervention. Abdominal aortic aneurysms US elastography could be a useful tool to monitor AAA progression and identify changes in biomechanical properties characteristic of high-risk patients...
September 19, 2018: Journal of Visualized Experiments: JoVE
Nelson F G Oliveira, Frederico Bastos Gonçalves, Klaas Ultee, José Pedro Pinto, Marie Josee van Rijn, Sander Ten Raa, Patrice Mwipatayi, Dittmar Böckler, Sanne E Hoeks, Hence J M Verhagen
OBJECTIVE: Standard endovascular aneurysm repair (EVAR) is the most common treatment of abdominal aortic aneurysms (AAAs). EVAR has been increasingly used in patients with hostile neck features. This study investigated the outcomes of EVAR in patients with neck diameters ≥30 mm in the prospectively maintained Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). METHODS: This is a retrospective study comparing patients with neck diameters ≥30 mm with patients with neck diameters <30 mm...
October 3, 2018: Journal of Vascular Surgery
Matthew J TerBush, Khurram Rasheed, Zane Z Young, Jennifer L Ellis, Roan J Glocker, Adam J Doyle, Kathleen G Raman, Michael C Stoner
BACKGROUND: An anatomic severity grade (ASG) score to categorize and to define anatomic factors for abdominal aortic aneurysm (AAA) repair was proposed. Other studies have previously reported that aortic anatomic complexity is a marker of survival and resource utilization after repair, although it remains unclear whether individual components of the ASG score independently contribute to survival. This study analyzed and validated an aortic and iliac artery calcium scoring system that can potentially predict survival after AAA repair...
October 3, 2018: Journal of Vascular Surgery
Hanneke P F X Moonen, Olivier H J Koning, Ronald F van den Haak, Bart A N Verhoeven, Jan Willem Hinnen
The objective is to evaluate our center's experience with the safety and efficacy of the percutaneous approach to endovascular abdominal aortic aneurysm repair (PEVAR) with use of the Perclose Proglide device, in the first period after introduction in our center in 2014. We retrospectively identified all patients that underwent PEVAR or endograft extension with percutaneous approach in our center in the urgent and elective setting. Included were all procedures performed between the introduction of the technique in January 2014 and February 2016 when PEVAR had become the predominant technique in our center...
September 26, 2018: Cardiovascular Intervention and Therapeutics
Amirhossein Arzani
Patient-specific computational fluid dynamics (CFD) is a promising tool that provides highly resolved haemodynamics information. The choice of blood rheology is an assumption in CFD models that has been subject to extensive debate. Blood is known to exhibit shear-thinning behaviour, and non-Newtonian modelling has been recommended for aneurysmal flows. Current non-Newtonian models ignore rouleaux formation, which is the key player in blood's shear-thinning behaviour. Experimental data suggest that red blood cell aggregation and rouleaux formation require notable red blood cell residence-time (RT) in a low shear rate regime...
September 26, 2018: Journal of the Royal Society, Interface
Michael C Soult, Brian T Cheng, Neel A Mansukhani, Heron E Rodriguez, Mark K Eskandari, Andrew W Hoel
INTRODUCTION: Endovascular aortic aneurysm repair (EVAR) is the preferred first line treatment for abdominal aortic aneurysms. Current post-procedure surveillance recommendations by manufacturers are a one-month computed tomography angiography (CTA) followed by a twelve-month CTA in most circumstances. The objective of this study is to determine the utility of the one month CTA following elective EVAR and determine if initial surveillance at six-months CTA is appropriate. METHODS: Single-center retrospective chart review of all elective EVARs at a tertiary medical center over a twelve-year period...
September 22, 2018: Annals of Vascular Surgery
Matthew R Bersi, Chiara Bellini, Jay D Humphrey, Stéphane Avril
We recently developed an approach to characterize local nonlinear, anisotropic mechanical properties of murine arteries by combining biaxial extension-distension testing, panoramic digital image correlation, and an inverse method based on the principle of virtual power. This experimental-computational approach was illustrated for the normal murine abdominal aorta assuming uniform wall thickness. Here, however, we extend our prior approach by adding an optical coherence tomography (OCT) imaging system that permits local reconstructions of wall thickness...
September 24, 2018: Biomechanics and Modeling in Mechanobiology
Emily Lagergren, Deena Chihade, Henry Zhan, Sebastian Perez, Luke Brewster, Shipra Arya, William D Jordan, Yazan Duwayri
BACKGROUND: Endovascular aneurysm repair (EVAR) accounts for the majority of all abdominal aortic aneurysm (AAA) repairs in the United States. EVAR utilization in the aging population is increasing due to the minimally invasive nature of the procedure, the low associated perioperative morbidity, and early survival benefit over open repair. The objective of this study is to compare the outcomes of octogenarians after elective EVAR to their younger counterparts, a question that can be answered by a long-term, institutional data set...
September 19, 2018: Annals of Vascular Surgery
Muriel Sprynger, Fausto Rigo, Marie Moonen, Victor Aboyans, Thor Edvardsen, Monica L de Alcantara, Marianne Brodmann, Katerina K Naka, Serge Kownator, Iana Simova, Charalambos Vlachopoulos, Jean-Claude Wautrecht, Patrizio Lancellotti
The main goal of the present document is to provide a set of practical recommendations for ultrasound imagers who are interested in artery diseases or for physicians who intend to undertake vascular procedures. This is the first part of the work. It is dedicated to general principles of ultrasonography, cervicoencephalic, subclavian, aortoiliac and lower extremity arteries, abdominal aorta, and popliteal aneurysms. It also discusses miscellaneous items such as medial arterial calcinosis, arterial embolism, arteritis, arterial stents and bypasses, false aneurysms, aortic dissection, popliteal entrapment syndrome, and iliac endofibrosis...
September 18, 2018: European Heart Journal Cardiovascular Imaging
Mateusz K Hołda, Paweł Iwaszczuk, Karolina Wszołek, Jakub Chmiel, Andrzej Brzychczy, Mariusz Trystuła, Marcin Misztal
BACKGROUND: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented. METHODS: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD. RESULTS: Significant coronary stenosis (> 70%) were found in 65...
September 20, 2018: Cardiology Journal
Michio Taya, Cody McHargue, Zina J Ricci, Milana Flusberg, Stefanie Weinstein, Judy Yee
PURPOSE: To compare the distribution of extracolonic findings and clinical outcomes between screening and diagnostic CT colonography (CTC) populations. METHODS: 388 consecutive patients (369 men, 19 women; mean ± SD age 67.8 ± 10 years) who underwent first-time CTC (4/2011-4/2017) at a Veteran's Affairs Medical Center were divided into screening (asymptomatic) or diagnostic (symptomatic) cohorts based on CTC indication. CTC reporting and data system E-scores for extracolonic findings were retrospectively assigned based on prospective CTC radiologic reports...
September 12, 2018: Abdominal Radiology
Josiah D Sault, Andrew A Post, Amanda Y Butler, Michael A O'Hearn
BACKGROUND: Abdominal aortic aneurysms (AAAs) are found in 1-12% of older males. Low back pain (LBP) is prevalent with incidence increasing with age and can respond to manual therapy (MT). To date, the safety of the application of MT for LBP in the presence of a known AAA has not been reported. This case reports on the short-term effects of MT in a patient with LBP and AAA and pre- and post-therapy imaging. CASE DESCRIPTION: A 76-year-old male presented with mechanical LBP, groin pain, and a known 4...
September 10, 2018: Physiotherapy Theory and Practice
Nathan K Itoga, Kara A Rothenberg, Paola Suarez, Thuy-Vy Ho, Matthew W Mell, Baohui Xu, Catherine M Curtin, Ronald L Dalman
BACKGROUND: Identification of a safe and effective medical therapy for abdominal aortic aneurysm (AAA) disease remains a significant unmet medical need. Recent small cohort studies indicate that metformin, the world's most commonly prescribed oral hypoglycemic agent, may limit AAA enlargement. We sought to validate these preliminary observations in a larger cohort. METHODS: All patients with asymptomatic AAA disease managed in the Veterans Affairs Health Care System between 2003 and 2013 were identified by International Classification of Diseases, Ninth Revision codes...
September 6, 2018: Journal of Vascular Surgery
Thomas Le Houérou, Dominique Fabre, Carlos G Alonso, Philippe Brenot, Ryiad Bourkaib, Claude Angel, Myriam Amsallem, Stephan Haulon
INTRODUCTION: The technique and preliminary outcomes are reported for laser fenestrated endografting (LfEVAR), developed as an alternative procedure for endovascular repair of thoraco-abdominal aortic aneurysms (TAAAs), type IA endoleaks (T1AELs), and pararenal aortic aneurysms (PAAAs). METHODS: Patients with TAAA, T1AEL, and PAAA considered unfit for open repair by a multidisciplinary team and who could not benefit from a custom made device were selected. LfEVAR is a physician modified technique requiring sequential steps...
September 2018: European Journal of Vascular and Endovascular Surgery
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