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Aortic arch dissection

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https://www.readbyqxmd.com/read/28734943/deficits-in-col5a2-expression-result-in-novel-skin-and-adipose-abnormalities-and-predisposition-to-aortic-aneurysms-and-dissections
#1
Arick C Park, Noel Phan, Dawiyat Massoudi, Zhenjie Liu, John F Kernien, Sheila M Adams, Jeffrey M Davidson, David E Birk, Bo Liu, Daniel S Greenspan
Classic Ehlers-Danlos syndrome (cEDS) is characterized by fragile, hyperextensible skin and hypermobile joints. cEDS can be caused by heterozygosity for missense mutations in genes COL5A2 and COL5A1, which encode the α2(V) and α1(V) chains, respectively, of collagen V, and is most often caused by COL5A1 null alleles. However, COL5A2 null alleles have yet to be associated with cEDS or other human pathologies. We previously showed that mice homozygous null for the α2(V) gene Col5a2 are early embryonic lethal, whereas haploinsufficiency caused aberrancies of adult skin, but not a frank cEDS-like phenotype, as skin hyperextensibility at low strain and dermal "cauliflower"-contoured collagen fibril aggregates, two cEDS hallmarks, were absent...
July 19, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28734449/double-aortic-arch-complicated-by-acute-type-a-dissection-in-an-aged-patient
#2
Kenji Toyokawa, Yukinori Moriyama, Takayuki Ueno, Kazuya Terazono, Yoshihiro Fukumoto
No abstract text is available yet for this article.
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28716989/high-prevalence-of-multiple-arterial-bed-lesions-in-patients-with-fibromuscular-dysplasia-the-arcadia-registry-assessment-of-renal-and-cervical-artery-dysplasia
#3
Pierre-François Plouin, Jean-Philippe Baguet, Frédéric Thony, Olivier Ormezzano, Arshid Azarine, François Silhol, Catherine Oppenheim, Béatrice Bouhanick, Louis Boyer, Alexandre Persu, Frank Hammer, Philippe Gosse, Claire Mounier-Vehier, Claire Le Hello, Xavier Jeunemaitre, Michel Azizi, Laurence Amar, Gilles Chatellier, Elie Mousseaux, Emmanuel Touzé
Fibromuscular dysplasia (FMD) commonly affects the renal and cervical arteries but has been described to affect other vascular beds as well. The prevalence of and clinical characteristics associated with multisite FMD (string-of-beds or focal stenoses affecting at least 2 vascular beds) are not known. In the prospective ARCADIA registry (Assessment of Renal and Cervical Artery Dysplasia), symptomatic patients with renal artery (RA) FMD underwent tomographic- or magnetic resonance-angiography from the aortic arch to the intracranial arteries and those with cervical FMD from the diaphragm to the pelvis...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28716447/elevated-wall-shear-stress-in-aortic-type-b-dissection-may-relate-to-retrograde-aortic-type-a-dissection-a-computational-fluid-dynamics-pilot-study
#4
A Osswald, C Karmonik, J R Anderson, F Rengier, M Karck, J Engelke, K Kallenbach, D Kotelis, S Partovi, D Böckler, A Ruhparwar
OBJECTIVE: Retrograde aortic type A dissection (RTAD) is a known complication in patients with aortic type B dissection. The purpose of this computational fluid dynamics (CFD) study was to identify haemodynamic risk factors for the occurrence of RTAD. METHODS: Computed tomographic angiography (CTA) images of 10 patients with type B dissections, who subsequently developed a RTAD, were retrospectively analysed together with patients constituting a control group (n = 10) where no further vascular events after the initial type B dissection occurred...
July 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#5
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28698420/-intravascular-hemolysis-caused-by-stenosis-of-an-elephant-trunk-report-of-a-case
#6
Rikako Takamaru, Koji Kawahito, Kei Aizawa, Yoshio Misawa
Symptomatic intravascular hemolysis after prosthetic aortic graft replacement is rare. It is primarily attributed to mechanical injury of red blood cells caused by stenosis of the vascular graft. A 50-year-old man presented with hemolytic anemia, 5 years after total arch replacement with an elephant trunk for type A aortic dissection. The hemolysis was caused by graft stenosis of the elephant trunk. Endovascular treatment for the stenotic elephant trunk was successfully performed. The postoperative course was uneventful, and the hemolysis was resolved immediately after operation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28697941/early-outcomes-of-the-conformable-stent-graft-for-acute-complicated-and-uncomplicated-type-b-aortic-dissection
#7
Ting Zhu, Yi Si, Yuan Fang, Bin Chen, Jue Yang, Junhao Jiang, Jianing Yue, Weiguo Fu
OBJECTIVE: The objective of this study was to evaluate the safety, efficacy, and outcomes of the conformable thoracic endograft (Conformable TAG Thoracic Endoprosthesis [CTAG]; W. L. Gore & Associates, Flagstaff, Ariz) for acute complicated and uncomplicated type B aortic dissection (TBAD). METHODS: Between February and October 2016, 52 consecutive patients with acute complicated or uncomplicated TBAD were treated with a CTAG device. We assessed safety, complications, and device conformability using intraoperative angiography and computed tomography angiography...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28693049/hybrid-repair-techniques-for-complex-aneurysms-and-dissections-involving-the-aortic-arch-and-thoracic-aorta
#8
Rami Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, James F McKinsey, Michael L Marin, Allan S Stewart, Sharif Ellozy
Aortic aneurysms involving the ascending aorta, aortic arch, and descending thoracic aorta have been a challenging entity to surgically treat for over 60 years. Despite the mortality of the disease, early open surgical procedures also had significant morbidity and mortality. The inherent risk in treating multiple anatomic segments simultaneously led to the innovation of the staged elephant trunk (ET) approach by Borst in 1983. To avoid the thoracotomy and associated complications related to the second stage of the procedure, an endovascular completion paradigm was begun by Volodos in 1991...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28689951/spot-stenting-of-supra-aortic-branch-vessels-for-residual-type-a-dissection
#9
Ciro Ferrer, Raffaele Grande, Luigi Venturini, Valerio Scarano Catanzaro, Gabriele Maritati, Luca di Marzo
of this report is to describe the exclusion of the false lumen in a residual type A aortic dissection (TAAD) by the deployment of two covered stents: one in the right common carotid artery (RCCA) and one in the left subclavian artery (LSA). A 77-year-old female, already treated with ascending aorta replacement for acute TAAD, was referred to our center for a 97-mm post-dissection arch aneurysm. A computed tomography angiography (CTA) showed false lumen patency by reperfusion from secondary tears located at level of RCCA and LSA...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689484/transcatheter-aortic-valve-implantation-as-a-bailout-procedure-for-acute-aortic-valve-regurgitation-during-endovascular-arch-repair
#10
Adrien Hertault, Rachel E Clough, Thomas Modine, Jean-Luc Auffray, Mohamad Koussa, Stéphan Haulon
PURPOSE: To report emergent transcatheter aortic valve implantation (TAVI) to treat acute severe aortic regurgitation caused by valve cusp dysfunction following proximal migration of an endograft implanted in the ascending aorta during endovascular arch repair. CASE REPORT: A 65-year-old man had been previously treated with thoracic and fenestrated endografts in a 2-stage procedure for a chronic type B dissection. At 2-year follow-up, aneurysmal evolution of the distal arch led to development of a proximal type Ia endoleak...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28687501/endovascular-repair-with-periscope-technique-for-aortic-dissection-with-an-aberrant-right-subclavian-artery
#11
Xiangjiu Ding, Sanyuan Hu, Jianjun Jiang
A type B aortic dissection with an aberrant right subclavian artery is an uncommon entity. Most cases have been treated by open or hybrid surgery. We present a case that was managed by endovascular aortic repair with the periscope technique. A thoracic stent-graft was implanted into the aortic arch beyond the origin of the right subclavian artery. Two overlapping periscope grafts were placed to maintain perfusion to the right subclavian artery. The presented technique is a feasible and minimally invasive approach for this rare entity...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28683905/acute-type-a-aortic-dissection
#12
REVIEW
Ramsey S Elsayed, Robbin G Cohen, Fernando Fleischman, Michael E Bowdish
Type A aortic dissection is a surgical emergency occurring when an intimal tear in the aorta creates a false lumen in the ascending aorta. Prompt diagnosis and surgical treatment are imperative to optimize outcomes. Surgical repair requires replacement of the ascending aorta with or without aortic root or aortic arch replacement. Surgical outcomes for this highly lethal diagnosis have improved, with contemporary survival to discharge at Centers of Excellence of 85% to 90%. Survival is related to prompt treatment, preexisting medical comorbidities, presence or absence of end organ malperfusion, extent of aortic repair required, and the development of postoperative complications...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28678519/intermittent-hypoxia-and-hypercapnia-accelerate-atherosclerosis-partially-via-trimethylamine-oxide
#13
Jin Xue, Dan Zhou, Orit Poulsen, Toshihiro Imamura, Yu-Hsin Hsiao, Travis H Smith, Atul Malhotra, Pieter Dorrestein, Rob Knight, Gabriel G Haddad
RATIONALE: Obstructive sleep apnea (OSA) is a common disorder characterized by intermittent hypoxia and hypercapnia (IHC) during sleep. OSA has been shown as a risk factor for atherosclerosis but the relation of IHC to induction or progression of atherosclerosis is not well understood. To dissect the mechanisms involved, we compared atherosclerotic formation between two mouse models, i.e., the apolipoprotein E (ApoE) and the low density lipoprotein receptor (Ldlr) deficient mice, with or without IHC exposure...
July 5, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28671865/quality-of-life-after-surgery-for-stanford-type-a-aortic-dissection-influences-of-different-operative-strategies
#14
Tamer Ghazy, Mohamed Eraqi, Adrian Mahlmann, Helena Hegelmann, Klaus Matschke, Utz Kappert, Norbert Weiss
BACKGROUND: Outcome of surgery for acute Stanford type A aortic dissection extends beyond mortality and morbidity. More than one operative strategy is available but little is known regarding their influence on quality of life. This study analyzes the influence of defensive and aggressive operative strategies on the patients' midterm quality of life (QoL). METHODS: From July 2007 to July 2010, 95 patients underwent surgery for acute Stanford type A aortic dissection in our institution...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28668875/neck-dissection-and-thoracoscopic-esophagectomy-in-esophageal-cancer-with-aberrant-subclavian-artery
#15
Hiroyuki Kitagawa, Tsutomu Namikawa, Kazuhiro Hanazaki
We report a case of esophageal cancer with a non-recurrent inferior laryngeal nerve associated with aberrant right subclavian artery treated with neck dissection followed by thoracoscopic esophagectomy. A 60-year-old man experienced esophageal cancer, hoarseness, and left supraclavicular lymph node swelling was noted on endoscopy. Computed tomography revealed an aberrant right subclavian artery between the esophagus and vertebrae. We administered neo-adjuvant chemotherapy and performed thoracoscopic esophagectomy...
July 2017: Anticancer Research
https://www.readbyqxmd.com/read/28663040/aortic-elongation-and-stanford-b-dissection-the-t%C3%A3-bingen-aortic-pathoanatomy-taipan-project
#16
M Lescan, K Veseli, A Oikonomou, T Walker, H Lausberg, G Blumenstock, F Bamberg, C Schlensak, T Krüger
OBJECTIVE/BACKGROUND: Aortic elongation has not yet been considered as a potential risk factor for Stanford type B dissection (TBD). The role of both aortic elongation and dilatation in patients with TBD was evaluated. METHODS: The aortic morphology of a healthy control group (n = 236) and patients with TBD (n = 96) was retrospectively examined using three dimensional computed tomography imaging. Curved multiplanar reformats were used to examine aortic diameters at defined landmarks and aortic segment lengths...
June 26, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28660114/a-rare-complication-of-tevar-performed-for-complex-acute-stanford-b-aortic-dissection
#17
George Awad, Patrick Zardo, Hassina Baraki, Ingo Kutschka
Management of aortic dissection with a novel endovascular technique known as thoracic endovascular aortic repair (TEVAR) paired with surgical debranching as a less invasive alternative to conventional repair has gained widespread acceptance. However, experience for complicated, Stanford type B dissection involving the aortic arch is still limited.
January 2017: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28659818/managing-thoracic-aortic-aneurysm-in-patients-with-bicuspid-aortic-valve-based-on-aortic-root-involvement
#18
REVIEW
Elizabeth Norton, Bo Yang
Bicuspid aortic valve (BAV) can be both sporadic and hereditary, is phenotypically variable, and genetically heterogeneous. The clinical presentation of BAV is diverse and commonly associated with a high prevalence of valvular dysfunction producing altered hemodynamics and aortic abnormalities (e.g., aneurysm and dissection). The thoracic aortic aneurysm (TAA) in BAV frequently involves the proximal aorta, including the aortic root, ascending aorta, and aortic arch, but spares the aorta distal to the aortic arch...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28648532/the-stent-is-not-to-blame-lessons-learned-with-a-simplified-us-version-of-the-frozen-elephant-trunk
#19
Ourania Preventza, Joseph S Coselli, Jessica Mayor, Katherine Simpson, Julius Carillo, Matt D Price, Lorraine D Cornwell, Shuab Omer, Kim I de la Cruz, Faisal G Bakaeen, Arin Jobe
BACKGROUND: We analyzed trends, assessed outcomes and lessons learned, and investigated whether using a simplified US version of the frozen elephant trunk (FET) technique to treat complex arch pathology poses additional risk. METHODS: From 2010 to 2015, we performed 129 consecutive ET procedures (traditional ET [t-ET], n = 92 [71.3%]; FET, n = 37 [28.7%]) for chronic dissecting (n = 62 [48.1%]) and atherosclerotic aneurysms (n = 67 [51.9%]). A stepwise logistic regression model using preoperative and intraoperative variables was created to analyze the outcomes...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#20
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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