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Thoracic Aneurysms

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https://www.readbyqxmd.com/read/29240061/-hybrid-treatment-of-patients-with-aneurysms-and-dissections-of-the-aortic-arch-and-descending-portion-of-the-thoracic-aorta
#1
V V Shlomin, M L Gordeev, D A Zverev, E A Shloĭdo, V E Uspenskiĭ, E D Zvereva, P B Bondarenko, P D Puzdriak
The authors share herein their experience with hybrid surgical treatment of 21 patients presenting with lesions of the aortic arch and descending thoracic aorta. Aortic pathology included dissection of the thoracoabdominal aorta (n=15), a sacciform aneurysm of the aortic arch (n=5), and a spindle-shaped aneurysm of the distal portions of the aortic arch (n=1). The first stage consisted of the following operations: transposition of the left subclavian artery into the left common carotid artery (n=9; 42.8%), partial debranching (n=11; 52...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29240056/-hybrid-intervention-for-a-multilevel-aneurysmatic-lesion-of-the-aorta-in-a-patient-with-multifocal-atherosclerosis
#2
K V Kochkina, A V Sidorenko, A V Myznikov, G A Usik, A A Shtark, T A Kochkina, A V Pustovoĭtov, A V Protopopov
A multilevel aneurysmatic lesion of the aorta is a rare pathology. The authors describe herein a clinical case report regarding stage-wise treatment of a patient presenting with aneurysms of the thoracic and abdominal portions of the aorta and a haemodynamically significant lesion of coronary and carotid arteries. Strategy of surgical management was decided upon collegially. Successful endoprosthetic repair of the aneurysm of the thoracic portion of the aorta required closure of the left carotid artery with a graft, which, taking into consideration an existing occlusion of the right internal carotid artery, demanded preliminary carotid-subclavian bypass grafting...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29238621/burkholderia-aortic-aneurysm-a-case-report-and-review-of-the-literature
#3
Sreelakshmi Panginikkod, Aishwarya Ramachandran, Pratyusha Bollimunta, Roshanak Habibi, Roshan Kumar Arjal, Venu Gopalakrishnan
Melioidosis is a frequently fatal infection caused by the Gram-negative bacillus Burkholderia pseudomallei endemic to Southeast Asia and Northern Australia. It is a rare imported pathogen in the United States and is a potential bioterror agent. We report the case of an 82-year-old previously healthy man who presented with 2 weeks of fever and epigastric pain after he returned from the Philippines. A diagnosis of nondissecting mycotic aneurysm in the descending thoracic aorta was made with the help of CT angiogram and positive blood cultures...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29236196/thoracoabdominal-aortic-mural-and-floating-thrombus-extending-into-superior-mesenteric-artery
#4
Sedat Giray Kandemirli, Ozan Onur Balkanay, Muhammad Osama Awiwi, Eser Durmaz, Deniz Goksedef, Nil Comunoglu
Thrombus in the thoracic aorta not related to aneurysm or atherosclerosis is a rare clinical entity with a limited number of cases reported. Floating thrombus is defined as non-adherent part of the thrombus floating within the aortic lumen. Herein, we present a 48-year-old woman who presented with progressive midline dull, aching abdominal pain of 2-day duration. Thoracoabdominal computed tomography revealed a free floating thrombus extending from the aortic arch into the superior mesenteric artery. Transesophageal echocardiography confirmed the findings of a thrombus extending through the aortic arch...
December 13, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29235384/technique-for-fenestrated-stent-graft-implantation-as-a-proximal-extension-to-a-previous-fenestrated-endovascular-repair-for-abdominal-aortic-aneurysm
#5
Konstantinos Spanos, Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Christian-Alexander Behrendt, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe planning and a technique for fenestrated endovascular repair of a large Crawford type IV thoracoabdominal aortic aneurysm after previous 2-fenestration endovascular aneurysm repair (FEVAR). TECHNIQUE: The first FEVAR procedure performed at another center implanted a standard Zenith device with 2 fenestrations and 1 scallop for a juxtarenal abdominal aortic aneurysm. The diameter of the Crawford type IV thoracoabdominal aortic aneurysm had progressed from 68 to 75 mm within a year after the FEVAR...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29234731/endovascular-intimal-flap-septostomy-for-safe-landing-of-a-stent-graft-in-an-anastomotic-pseudoaneurysm-of-chronic-type-b-aortic-dissection
#6
Yoshiaki Saito, Kengo Tani, Satoshi Taniguchi, Ikuo Fukuda
Objective/Background: The purpose of this report is to demonstrate a novel endovascular technique for gaining and producing the maximal landing zone for a thoracic stent graft in a patient with a chronic type B aortic dissection. Methods: The patient was a 64 year old man with chronic type B aortic dissection. He had developed acute type B aortic dissection and undergone descending thoracic replacement (Zone 2-Th10) 12 years earlier. During follow-up, he developed an anastomotic false aneurysm distally...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29234609/outcomes-of-open-repair-of-mycotic-aortic-aneurysms-with-in-situ-replacement
#7
Hyo-Hyun Kim, Do Jung Kim, Hyun-Chel Joo
Background: Mycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy. Methods: From 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29233355/thoracic-pseudoaneurysm-caused-by-malignant-lymphoma
#8
Toshifumi Hiraoka, Tatsuhiko Komiya, Hiroshi Tsuneyoshi, Takeshi Shimamoto
We describe the case of a 69-year-old man with a thoracic pseudoaneurysm caused by a diffuse large B-cell lymphoma. He had a large mass inside the aortic arch. Five weeks later, an asymptomatic aneurysm protruding from the minor curvature of the distal aortic arch was observed. We suspected a mycotic pseudoaneurysm and performed total arch replacement with an omental pedicle flap graft. Intraoperative tissue cultures and histopathologic tests identified no bacteria, however. Eventually, a pathologic examination revealed that the structure initially suspected to be an intramural thrombus was a diffuse large B-cell lymphoma...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29225128/aortic-anatomy-and-complications-of-the-proximal-sealing-zone-after-endovascular-treatment-of-the-thoracic-aorta
#9
Jérémie Peidro, Mourad Boufi, Anderson Loundou, Olivier Hartung, Bianca Dona, Florent Vernet, David Bensoussan, Yves Alimi
BACKGROUND: The technical and clinical success of the thoracic aortic endovascular procedures rests mainly on the choice of the proximal sealing zone (PSZ). The latter can be the affected by multiple complications, all of them having a potential gravity and a direct link with the quality of the PSZ. The objective of this study was to analyze the risk factors of the occurrence of complications of the PSZ. METHODS: Between 2007 and 2015, all the patients treated by a thoracic stentgraft in zones 2, 3, or 4 were retrospectively reviewed, with analysis of the pre- and postoperative angio-CT...
December 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29225032/calcification-of-thoracic-and-abdominal-aneurysms-is-associated-with-mortality-and-morbidity
#10
Mohammed M Chowdhury, Lukasz P Zieliński, James J Sun, Simon Lambracos, Jonathan R Boyle, Seamus C Harrison, James H F Rudd, Patrick A Coughlin
INTRODUCTION: Cardiovascular events are common in people with aortic aneurysms. Arterial calcification is a recognised predictor of cardiovascular outcomes in coronary artery disease. Whether calcification within abdominal and thoracic aneurysm walls is correlated with poor cardiovascular outcomes is not known. PATIENTS AND METHODS: Calcium scores were derived from computed tomography (CT) scans of consecutive patients with either infrarenal (AAA) or descending thoracic aneurysms (TAA) using the modified Agatston score...
December 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29221920/treatment-of-infected-aneurysm-with-combined-endovascular-aneurysm-repair-and-abscess-drainage
#11
Ken Nakajima, Noriyuki Kato, Takashi Hashimoto, Shuji Chino, Takatoshi Higashigawa, Takafumi Ouchi, Toshiya Tokui, Yoichiro Miyake, Hajime Sakuma
PURPOSE: To evaluate the clinical utility of combination therapy with endovascular aneurysm repair (EVAR) and abscess drainage for the treatment of infected aneurysms. MATERIALS AND METHODS: Between July 2009 and May 2015, 8 patients underwent combination therapy with EVAR and abscess drainage. There were 5 men and 3 women, with a mean age of 75 years ± 7. Aneurysms were of the thoracic aorta in 5 patients, the abdominal aorta in 2, and the internal iliac artery in 1...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29214375/review-surgical-treatment-of-giant-coronary-aneurysms-in-pediatric-patients-with-kawasaki-disease
#12
Masami Ochi
In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential...
December 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29211214/hybrid-approach-of-aortic-diseases-zone-1-delivery-and-volumetric-analysis-on-the-descending-aorta
#13
José Augusto Duncan, Ricardo Ribeiro Dias, Fabrício José Dinato, Fábio Fernandes, Félix José Álvares Ramirez, Charles Mady, Fabio Biscegli Jatene
INTRODUCTION: Conventional techniques of surgical correction of arch and descending aortic diseases remains as high-risk procedures. Endovascular treatments of abdominal and descending thoracic aorta have lower surgical risk. Evolution of both techniques - open debranching of the arch and endovascular approach of the descending aorta - may extend a less invasive endovascular treatment for a more extensive disease with necessity of proximal landing zone in the arch. OBJECTIVE: To evaluate descending thoracic aortic remodeling by means of volumetric analysis after hybrid approach of aortic arch debranching and stenting the descending aorta...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210707/spinal-subdural-hematoma-after-spinal-drain-for-endovascular-thoracic-aortic-aneurysm-repair
#14
Hamdy Awad, Tsung-Pai J Huang, Esmerina Tili, Eric Bourekas
No abstract text is available yet for this article.
November 28, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29204794/thoracic-aortic-aneurysm-unlocking-the-silent-killer-secrets
#15
Ayman A Saeyeldin, Camilo A Velasquez, Syed Usman B Mahmood, Adam J Brownstein, Mohammad A Zafar, Bulat A Ziganshin, John A Elefteriades
Thoracic aortic aneurysm (TAA) is an increasingly recognized condition that is often diagnosed incidentally. This review discusses ten of the most relevant epidemiological and clinical secrets of this disease; (1) the difference in pathogenesis between ascending and descending TAAs. TAAs at these two sites act as different diseases, which is related to the different embryologic origins of the ascending and descending aorta. (2) The familial pattern and genetics of thoracic aneurysms. Syndromic TAAs only explain 5% of the pattern of inheritance...
December 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29203969/cardiovascular-disease-in-ageing-an-overview-on-thoracic-aortic-aneurysm-as-an-emerging-inflammatory-disease
#16
REVIEW
Calogera Pisano, Carmela Rita Balistreri, Alessandro Ricasoli, Giovanni Ruvolo
Medial degeneration associated with thoracic aortic aneurysm and acute aortic dissection was originally described by Erdheim as a noninflammatory lesion related to the loss of smooth muscle cells and elastic fibre fragmentation in the media. Recent evidences propose the strong role of a chronic immune/inflammatory process in aneurysm evocation and progression. The coexistence of inflammatory cells with markers of apoptotic vascular cell death in the media of ascending aorta with aneurysms and type A dissections raises the possibility that activated T cells and macrophages may contribute to the elimination of smooth muscle cells and degradation of the matrix...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/29203041/-management-of-isolated-iliac-aneurysms-a-tunisian-center-experience
#17
H Jmal, H Ben Jmaà, S Masmoudi, T Cherif, H Cheikhrouhou, A Maalej, N Elleuch, A Jemel, I Frikha
Isolated aneurysms of the iliac arteries are rare. The diagnoses of these aneurysms become easier with non-invasive radiologic investigations. The development of endovascular treatment is a recent alternative to surgical treatment. We report our experience in the management of 8 cases of isolated iliac aneurysms in the department of cardiovascular and thoracic surgery of the Habib Bourguiba Hospital of Sfax.
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29202781/acta2-mutation-and-postpartum-hemorrhage-a-case-report
#18
Kylie Cooper, Stephen Brown
BACKGROUND: ACTA2 encodes smooth muscle specific α-actin, a critical component or the contractile complex of vascular smooth muscle. Mutations in ACTA2 are the most common genetic cause of thoracic aortic aneurysm, and are also the cause of other disorders, including Moyamoya disease, coronary artery disease and stroke as well as Multisystemic Smooth Muscle Dysfunction Syndrome. We note that ACTA2 is also expressed in uterine smooth muscle, and this raises the possibility that women harboring ACTA2 mutations might exhibit uterine smooth muscle dysfunction...
December 4, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/29198629/aortic-replacement-after-tevar-diameter-correction-with-modified-use-of-the-siena-prosthesis
#19
Arminder Jassar, Maximilian Kreibich, Julia Morlock, Stoyan Kondov, Johannes Scheumann, Fabian A Kari, Bartosz Rylski, Matthias Siepe, Alexander Jonaszik, Cornelius Keyl, Frank Humburger, Friedhelm Beyersdorf, Martin Czerny
BACKGROUND: To report a new technique for diameter correction in patients after thoracic endovascular aortic repair (TEVAR) with large stent-grafts using the Vascutek Siena 4-branch collared prosthesis (Vascutek Terumo, Inchinnan, Scotland, UK) in patients undergoing thoracoabdominal (TA) aortic replacement. METHODS: Within a 24-month period, 39 patients underwent TA replacement at our center. Of these, 6 patients had undergone previous TEVAR with large stent-grafts (42 to 48 mm diameter)...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29197893/management-of-concurrent-thoracic-and-abdominal-aortic-aneurysms
#20
S T Saw, S J Feona, B D K Leong
Concurrent thoracic and abdominal aortic aneurysm is uncommon. It remains a formidable surgical challenge to vascular surgeons, as decision to treat in staged or simultaneous setting still debatable. We present, here, a case of a 62-year-old-man with asymptomatic concurrent thoracic and abdominal aortic aneurysms, which was successfully treated with two-stage hybrid endovascular repair. The aim of this case report is to discuss the treatment options available, possible associated complications and measures to prevent them...
October 2017: Medical Journal of Malaysia
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