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Surgery aorta damage

Anja Püschel, Rasmus Ebel, Patricia Fuchs, Janet Hofmann, Jochen K Schubert, Jan P Roesner, Stefan Bergt, Andreas Wree, Brigitte Vollmar, Ernst Klar, Carsten M Bünger, Sabine Kischkel
BACKROUND: Paraplegia due to spinal cord ischemia (SCI) is a serious complication after repair of thoraco-abdominal aortic aneurysms. For prevention and early treatment of spinal ischemia intraoperative monitoring of spinal cord integrity is essential. This study was intended to improve recognition of SCI through a combination of transcranial motor-evoked potentials (tc-MEPs), serum markers and innovative breath analysis. METHODS: In nine female German landrace pigs, tc-MEPs were captured, markers of neuronal damage were determined in blood and volatile organic compounds (VOCs) were analysed in exhaled air...
March 5, 2018: Annals of Vascular Surgery
Mesut Özgökçe, Veysel Atilla Ayyıldız, Hayri Oğul, Harun Arslan, Abdussamet Batur, Alpaslan Yavuz, Suat İnce, Deniz Yüce
BACKGROUND: There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Celiacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). MATERIALS AND METHODS: A total of 1000 CT angiography images were analyzed retrospectively, and the patients with mesenteric and celiac arteries arising from the abdominal aorta with a single root were identified...
March 3, 2018: Folia Morphologica (Warsz)
Shinya Takahashi, Kei Nakagawa, Mayumi Tomiyasu, Ayumu Nakashima, Keijiro Katayama, Takeshi Imura, Bagus Herlambang, Fumie Okubo, Koji Arihiro, Yumi Kawahara, Louis Yuge, Taijiro Sueda
BACKGROUND: Spinal cord ischemia is a devastating complication following thoracic and thoracoabdominal aortic surgery. In this study, we aimed to investigate the effects of mesenchymal stem cells (MSCs), which have regenerative capability and exert paracrine actions on damaged tissues, injected into rat models of spinal cord ischemia-reperfusion injury. METHODS: Forty-five Sprague-Dawley rats were divided into sham, phosphate-buffered saline (PBS), and MSC groups...
January 11, 2018: Annals of Thoracic Surgery
Bianca Pane, Valerio Gazzola, Giovanni Spinella, Paola Bagnato, Federica Grillo, Valerio Gaetano Vellone, Domenico Palombo
BACKGROUND: Ischemia/reperfusion (I/R) injury represents one of the most severe complications in vascular surgery where cross-clamping of the aorta and subsequent visceral ischemia are a recurrent issue. The literature describes a family of nuclear receptors, that is, peroxisome proliferator-activated receptors (PPARs), in particular PPARγ isoform, which are important modulators of vascular inflammation resulting from I/R injury. The aim of our study is to evaluate how PPARγ agonist administration could reduce local and systemic inflammatory response after I/R injury during aortic supraceliac clamping in animal model...
November 29, 2017: Annals of Vascular Surgery
A J Vicéns-Morton, C Callaghan, J Olsburgh
Introduction: Live donors, extended donor criteria, and the maximum usage of organs with anatomical variants are some of the mechanisms used to increase the number of organs available. Case: We present the case of a kidney transplant, in which the organ had an iatrogenic injury to a lower pole arterial branch during retrieval. The donor was a 35-year-old male (DCD, Maastricht III). The right kidney was accepted; it had three veins in a single cava patch and three renal arteries, the main artery with aorta patch that is 8 cm long...
2017: Case Reports in Transplantation
Junya Tsurukiri, Shoichi Ohta, Akira Hoshiai, Hidefumi Sano, Eitaro Okumura, Nobuhiko Tsubouchi, Hiroyuki Konishi, Tetsuo Yukioka
Trauma patients with uncontrolled hemorrhage encountering coagulopathy are often associated with poor outcome. Recently, the concept of damage control interventional radiology, which focuses on "speedy stoppage of bleeding" by interventional radiology among trauma patients with hemodynamic instability and acute traumatic coagulopathy, was proposed as an alternative to damage control surgery. N-butyl cyanoacrylate (NBCA) has been used as a liquid embolic agent in various non-traumatic situations, where it has been shown to have a high technical success rate and low recurrent bleeding rate, especially in patients with coagulopathy...
April 2017: Acute Medicine & Surgery
Patrícia O Benedet, Angela C O Menegatti, Muryel C Gonçalves, Hernán Terenzi, Jamil Assreuy
Cardiovascular dysfunction and organ damage are hallmarks of sepsis and septic shock. Protein S-nitrosylation by nitric oxide has been described as an important modifier of protein function. We studied whether protein nitrosylation/denitrosylation would impact positively in hemodynamic parameters of septic rats. Polymicrobial sepsis was induced by cecal ligation and puncture. Female Wistar rats were treated with increasing doses of DTNB [5,5'-dithio-bis-(2-nitrobenzoic acid)] 30min before or 4 or 12h after sepsis induction...
January 2018: Biochimica et Biophysica Acta
Shane A Smith, R Hilsden, A Beckett, V C McAlister
Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care...
August 9, 2017: Journal of the Royal Army Medical Corps
Carolina Nilsson, Linda Bilos, Tal Hörer, Artai Pirouzram
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
Annemarie Schönfeld, Zacharia Mbäıdjol Kabra, Mihai Constantinescu, Dieter Bosshardt, Michael H Stoffel, Kirsten Peters, Martin Frenz
BACKGROUND AND OBJECTIVE: The clinical application of laser-assisted vascular anastomosis is afflicted by unreliable and low bonding strengths as well as tedious handling during microvascular surgery. The challenge to be met arises from the flow-off of the chromophore during soldering that changes the absorption and stains the surrounding tissue, leading to an uncontrollable thermal damage zone. In this study, we investigated the feasibility to produce an indocyanine green (ICG)-loaded patch by electrospinning and tested its applicability to both in vitro and in vivo microvascular laser soldering...
July 12, 2017: Lasers in Surgery and Medicine
Sergey Leontyev, Maja-Theresa Dieterlen, Michelle Halling, Franziska Schlegel, Alexandro Hoyer, Susann Ossmann, Kerstin Klaeske, Christian D Etz, Friedrich W Mohr
OBJECTIVES: The treatment of patients with extensive thoracic aortic disease involving the arch and descending aorta is often performed using the frozen elephant trunk technique (FET). Spinal cord blood flow (SCBF) in cervical, thoracic and lumbar sections prior, during and after aortic arch surgery were compared in conventional elephant trunk (cET) and FET technique in a pig model. METHODS: German Landrace pigs (75-85 kg) underwent aortic arch surgery using the FET (n = 8) or cET (n = 8) techniques...
September 1, 2017: European Journal of Cardio-thoracic Surgery
Kazumasa Orihashi, Kazuki Kihara, Masaki Yamamoto, Hideaki Nishimori
A case of an unusual iatrogenic aortic dissection is reported. A 77-year-old male patient in shock status due to acute type A aortic dissection underwent emergency surgery. Systemic perfusion was started via the femoral artery, but another dissection appeared in the descending aorta detected by transoesophageal echocardiography. However, the flap was unusually thin, and there was no change in the pre-existing thrombosed false lumen. These findings suggested subintimal development of dissection. After systemic perfusion was promptly switched to antegrade perfusion, the new dissection could no longer be detected...
October 1, 2017: European Journal of Cardio-thoracic Surgery
Prakashchandra Shetty, Satheesha B Nayak
INTRODUCTION: Knowledge of vascular variations near the kidney is of importance to many clinical disciplines such as nephrologists, radiologists, gastroenterologists, and general surgeons. Variant branches of the abdominal aorta and renal arteries are the victims of iatrogenic bleeding during surgery. We found multiple vascular variations in the upper part of the abdomen during our dissection classes. METHODS: During the dissection classes of the abdomen for undergraduate medical students, we observed multiple vascular variations in the abdomen of an adult male cadaver...
January 2017: Journal of Cardiovascular Echography
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Audrey Courtois, Wouter Coppieters, Vincent Bours, Jean-Olivier Defraigne, Alain Colige, Natzi Sakalihasan
Heterozygous mutations in the SMAD3 gene were recently described as the cause of a form of non-syndromic familial aortic thoracic aneurysm and dissection (FTAAD) transmitted as an autosomal dominant disorder and often associated with early-onset osteoarthritis. This new clinical entity, called aneurysms-osteoarthritis syndrome (AOS) or Loeys-Dietz syndrome 3 (LDS3), is characterized by aggressive arterial damages such as aneurysms, dissections and tortuosity throughout the arterial tree. We report, here, the case of a 45 year-old man presenting multiple visceral arteries and abdominal aortic aneurysms but without dissection of the thoracic aorta and without any sign of osteoarthritis...
April 2017: European Journal of Medical Genetics
Timothy K Williams, Lucas P Neff, Michael Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, John Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
April 2017: Journal of Trauma and Acute Care Surgery
Jian-An Li, Chun-Fang Zan, Peng Xia, Chang-Jun Zheng, Zhi-Ping Qi, Chun-Xu Li, Zhi-Gang Liu, Ting-Ting Hou, Xiao-Yu Yang
The temporal expression of microRNA after spinal cord ischemia/reperfusion injury is not yet fully understood. In the present study, we established a model of spinal cord ischemia in Sprague-Dawley rats by clamping the abdominal aorta for 90 minutes, before allowing reperfusion for 24 or 48 hours. A sham-operated group underwent surgery but the aorta was not clamped. The damaged spinal cord was removed for hematoxylin-eosin staining and RNA extraction. Neuronal degeneration and tissue edema were the most severe in the 24-hour reperfusion group, and milder in the 48-hour reperfusion group...
November 2016: Neural Regeneration Research
Shih-Yuan Fang, Jung-Shun Lee, Jun-Neng Roan, Yu-Chuan Tsai, Chen-Fuh Lam
BACKGROUND: Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia-reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord's functional recovery in a rat model of cord ischemia...
January 2017: Anesthesia and Analgesia
Gulcin Sahin Ersoy, Meryem Kurek Eken, Ozge Cevik, Ozlem T Cilingir, Reshef Tal
This study evaluated the effect of mycophenolate mofetil (MMF) on uterine tissue preservation following ischaemia/reperfusion (I/R) injury. Uterine I/R injury was induced in rats by clamping the lower abdominal aorta and ovarian arteries for 30 min. Group I/R + V (n = 7) received vehicle alone while Group I/R + M (n = 7) received 20 mg/kg/day MMF. Control groups underwent sham surgery and received vehicle (Group C) or 20 mg/kg/day MMF (Group M) (n = 7 for both). Four hours after detorsion, uterine tissue 8-hydroxy-2'-deoxyguanosine (8-OHdG), glutathione, malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and serum ischaemia modified albumin (IMA) concentrations were measured...
February 2017: Reproductive Biomedicine Online
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