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Thoracic Aneurysms

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https://www.readbyqxmd.com/read/28102232/aetiology-and-management-of-hereditary-aortopathy
#1
REVIEW
Aline Verstraeten, Ilse Luyckx, Bart Loeys
Aortic aneurysms are a major health problem because they account for 1-2% of all deaths in the Western population. Although abdominal aortic aneurysms (AAAs) are more prevalent than thoracic aortic aneurysms (TAAs), TAAs have been more exhaustively studied over the past 2 decades because they have a higher heritability and affect younger individuals. Gene identification in both syndromic and nonsyndromic TAA is proceeding at a rapid pace and has already pinpointed >20 genes associated with familial TAA risk...
January 19, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28102102/impact-of-thoracic-endovascular-aortic-repair-on-pulsatile-circumferential-and-longitudinal-strain-in-patients-with-aneurysm
#2
Foeke J H Nauta, Guido H W van Bogerijen, Chiara Trentin, Michele Conti, Ferdinando Auricchio, Frans L Moll, Joost A van Herwaarden, Santi Trimarchi
PURPOSE: To quantify both pulsatile longitudinal and circumferential aortic strains before and after thoracic endovascular aortic repair (TEVAR), potentially clarifying TEVAR-related complications. METHODS: This retrospective study assessed the impact of TEVAR on pulsatile aortic strains through custom developed software and cardiac-gated computed tomography imaging of 8 thoracic aneurysm patients (mean age 71.0±8.2 years; 6 men) performed before TEVAR and during follow-up (median 0...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28099082/therapeutics-targeting-drivers-of-thoracic-aortic-aneurysms-and-acute-aortic-dissections-insights-from-predisposing-genes-and-mouse-models
#3
Dianna M Milewicz, Siddharth K Prakash, Francesco Ramirez
Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28097194/the-mystery-of-the-z-score
#4
REVIEW
Alexander E Curtis, Tanya A Smith, Bulat A Ziganshin, John A Elefteriades
Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28097184/kif6-719arg-genetic-variant-and-risk-for-thoracic-aortic-dissection
#5
Olga A Iakoubova, Carmen H Tong, Joseph Catanese, Charles M Rowland, May M Luke, Maryann Tranquilli, John A Elefteriades
BACKGROUND: Carriers of the 719Arg variant in KIF6, compared with noncarriers, have been reported to be at greater risk for coronary heart disease (CHD) in six prospective studies. Because CHD, thoracic aortic dissection, and nondissection thoracic aortic aneurysm share some risk factors and aspects of pathophysiology, we investigated whether carriers of the 719Arg variant also have greater odds of thoracic aortic dissection or nondissected thoracic aortic aneurysm than noncarriers. METHODS: We genotyped 140 thoracic aortic dissection cases, 497 nondissection thoracic aortic aneurysm cases, and 275 disease-free controls collected in the United States, Hungary, and Greece and investigated the association between KIF6 719Arg carrier status and thoracic aortic dissection, and between KIF6 719Arg carrier status and nondissection thoracic aortic aneurysm, using logistic regression models adjusted for age, sex, hypertension, smoking, and country...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28095402/a-general-shear-dependent-model-for-thrombus-formation
#6
Alireza Yazdani, He Li, Jay D Humphrey, George Em Karniadakis
Modeling the transport, activation, and adhesion of platelets is crucial in predicting thrombus formation and growth following a thrombotic event in normal or pathological conditions. We propose a shear-dependent platelet adhesive model based on the Morse potential that is calibrated by existing in vivo and in vitro experimental data and can be used over a wide range of flow shear rates ([Formula: see text]). We introduce an Eulerian-Lagrangian model where hemodynamics is solved on a fixed Eulerian grid, while platelets are tracked using a Lagrangian framework...
January 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28094152/use-of-3d-printer-technology-to-facilitate-surgical-correction-of-a-complex-vascular-anomaly-with-esophageal-entrapment-in-a-dog
#7
A Dundie, G Hayes, P Scrivani, L Campoy, D Fletcher, K Ash, E Oxford, N S Moïse
A 10 week old female intact Staffordshire terrier was presented with a total of five congenital cardio-thoracic vascular anomalies consisting of a patent ductus arteriosus (PDA) with an aneurysmic dilation, pulmonic stenosis, persistent right aortic arch, aberrant left subclavian artery and persistent left cranial vena cava. These abnormalities were identified with a combination of echocardiogram and computed tomography angiography (CTA). The abnormalities were associated with esophageal entrapment, regurgitation, and volume overload of the left heart with left atrial and ventricular enlargement...
January 13, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28089662/electroacupuncture-pretreatment-attenuates-spinal-cord-ischemia-reperfusion-injury-via-inhibition-of-high-mobility-group-box-1-production-in-a-lxa4-receptor-dependent-manner
#8
Xiao-Ling Zhu, Xin Chen, Wei Wang, Xu Li, Jia Huo, Yu Wang, Yu-Yuan Min, Bin-Xiao Su, Jian-Ming Pei
Paraplegia caused by spinal cord ischemia is a severe complication following surgeries in the thoracic aneurysm. HMGB1 has been recognized as a key mediator in spinal inflammatory response after spinal cord injury. Electroacupuncture (EA) pretreatment could provide neuroprotection against cerebral ischemic injury through inhibition of HMGB1 release. Therefore, the present study aims to test the hypothesis that EA pretreatment protects against spinal cord ischemia-reperfusion (I/R) injury via inhibition of HMGB1 release...
January 12, 2017: Brain Research
https://www.readbyqxmd.com/read/28068871/predilation-technique-with-balloon-angioplasty-to-facilitate-percutaneous-groin-access-of-large-size-sheath-through-scar-tissue
#9
Felice Pecoraro, Mayur Krishnaswamy, Johnny Steuer, Gilbert Puippe, Nicola Mangialardi, Thomas Pfammatter, Zoran Rancic, Frank J Veith, Neal S Cayne, Mario Lachat
Purpose Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28067899/nitric-oxide-mediates-aortic-disease-in-mice-deficient-in-the-metalloprotease-adamts1-and-in-a-mouse-model-of-marfan-syndrome
#10
Jorge Oller, Nerea Méndez-Barbero, E Josue Ruiz, Silvia Villahoz, Marjolijn Renard, Lizet I Canelas, Ana M Briones, Rut Alberca, Noelia Lozano-Vidal, María A Hurlé, Dianna Milewicz, Arturo Evangelista, Mercedes Salaices, J Francisco Nistal, Luis Jesús Jiménez-Borreguero, Julie De Backer, Miguel R Campanero, Juan Miguel Redondo
Heritable thoracic aortic aneurysms and dissections (TAAD), including Marfan syndrome (MFS), currently lack a cure, and causative mutations have been identified for only a fraction of affected families. Here we identify the metalloproteinase ADAMTS1 and inducible nitric oxide synthase (NOS2) as therapeutic targets in individuals with TAAD. We show that Adamts1 is a major mediator of vascular homeostasis, given that genetic haploinsufficiency of Adamts1 in mice causes TAAD similar to MFS. Aortic nitric oxide and Nos2 levels were higher in Adamts1-deficient mice and in a mouse model of MFS (hereafter referred to as MFS mice), and Nos2 inactivation protected both types of mice from aortic pathology...
January 9, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28065489/chronobiology-of-acute-aortic-dissection-in-the-marfan-syndrome-from-the-national-registry-of-genetically-triggered-thoracic-aortic-aneurysms-and-cardiovascular-conditions-and-the-international-registry-of-acute-aortic-dissection
#11
Hasan K Siddiqi, Steven N Luminais, Dan Montgomery, Eduardo Bossone, Harry Dietz, Arturo Evangelista, Eric Isselbacher, Scott LeMaire, Roberto Manfredini, Dianna Milewicz, Christoph A Nienaber, Mary Roman, Udo Sechtem, Michael Silberbach, Kim A Eagle, Reed E Pyeritz
Marfan syndrome (MFS) is an autosomal dominant connective tissue disease associated with acute aortic dissection (AAD). We used 2 large registries that include patients with MFS to investigate possible trends in the chronobiology of AAD in MFS. We queried the International Registry of Acute Aortic Dissection (IRAD) and the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) registry to extract data on all patients with MFS who had suffered an AAD. The group included 257 patients with MFS who suffered an AAD from 1980 to 2012...
December 2, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28065433/ascending-thoracic-aortic-aneurysm-usefulness-of-the-speckle-tracking-transesophageal-echocardiogram
#12
EDITORIAL
Cipriano Abad
No abstract text is available yet for this article.
December 13, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#13
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28056759/should-we-be-concerned-about-the-inflammatory-response-to-endovascular-procedures
#14
Djordje Radak, Nenad Djukic, Slobodan Tanaskovic, Milan Obradovic, Desanka Cenic-Milosevic, Esma R Isenovic
Endovascular surgery represents a minimally invasive procedure for the treatment of occlusive and aneurysmal arterial disease. However, it is followed by inflammatory response, with a rise in specific inflammatory biomarkers, such as C-reactive protein, serum amyloid A and fibrinogen. Shear stress during balloon inflation and vascular injury represents triggering events for the inflammatory process, stimulating the production of proinflammatory molecules and activation of circulating monocytes. The current literature indicates that stent implantation induces more prominent inflammatory reaction...
January 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28051196/perioperative-occupational-exposure-to-coxiella-burnetii-infected-thoracic-endovascular-aneurysm-stent-graft
#15
Adebisi Idowu Obafemi, Jade Le
We conducted this study to determine the risk of transmission of Q fever to health care workers (HCWs) during perioperative exposure to Coxiella burnetii-infected thoracic endovascular aneurysm stent graft. Pre-operative and 6-week post-operative phase I and II IgG Q fever antibody titers were determined in 14 staff members of an operation room. The room had a negative pressure and all the members of the surgical team wore either a fitted N-95 mask or a powered purified air respirator. Phase I and II IgG antibody titers were <1:16 for 11 of the 14 studied HCWs; 2 HCWs did not follow up at 6 weeks and 1 had a pre-exposure phase II IgG titer of 1:128 with no change 6 weeks later...
January 2017: International Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28045418/primary-coarctation-related-isthmus-aneurysm-in-an-adult
#16
Jose María González-Santos, María Elena Arnáiz-García, María José Dalmau-Sorlí, Javier Rodríguez-Collado, Javier López Rodríguez
A 56-year-old female patient was transferred due to the presence of a left supraclavicular pulsatile mass. Further work-up was performed to confirm diagnosis. Angiography and computed tomography were also performed. The anatomy of the thoracic aorta suggested an unknown and untreated aortic coarctation. A second aortic narrowing was identified at the aortic arch, a result of elongation of the aorta. Endovascular approach was not possible, due to complexity of the aortic anatomy, and tortuosity. Open surgical repair was successfully performed...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28043989/impact-of-thoracic-endovascular-aortic-repair-on-radial-strain-in-an-ex-vivo-porcine-model
#17
Foeke J H Nauta, Hector W L de Beaufort, Michele Conti, Stefania Marconi, Arnoud V Kamman, Anna Ferrara, Joost A van Herwaarden, Frans L Moll, Ferdinando Auricchio, Santi Trimarchi
OBJECTIVES: To quantify the impact of thoracic endovascular aortic repair (TEVAR) on radial aortic strain with the aim of elucidating stent-graft-induced stiffening and complications. METHODS: Twenty fresh thoracic porcine aortas were connected to a mock circulatory loop driven by a centrifugal flow pump. A high-definition camera captured diameters at five different pressure levels (100, 120, 140, 160, and 180 mmHg), before and after TEVAR. Three oversizing groups were created: 0-9% (n = 7), 10-19% (n = 6), and 20-29% (n = 6)...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28040750/a-minimally-invasive-approach-for-open-surgical-thoracoabdominal-aortic-replacement-experimental-concept-for-a-novel-surgical-procedure
#18
Terézia B Andrási, Violetta Kékesi, Béla Merkely, Marius Grossmann, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#19
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28031661/percutaneous-in-situ-left-subclavian-artery-fenestration-using-reentry-catheter-during-endovascular-thoracic-aortic-aneurysm-repair
#20
Tze-Woei Tan, Amy H Coulter, Wayne W Zhang
Left subclavian artery (LSA) revascularization is recommended during elective thoracic endovascular aortic aneurysm repair (TEVAR) when coverage is required for adequate proximal seal. Reported method for LSA revascularization includes open bypass, covered stent placement using chimney technique, and in situ laser fenestration. We reported a novel technique using percutaneous Outback reentry device for LSA revascularization in a 68-year-old male patient who underwent TEVAR for a 9-cm thoracic aortic aneurysm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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