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https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#1
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28431733/neonatal-repair-of-persistent-fifth-aortic-arch-coarctation-and-interrupted-fourth-aortic-arch
#2
Enrico Cetrano, Angelo Polito, Matteo Trezzi, Adriano Carotti
Persistent left fifth aortic arch is a rare anomaly often associated with aortic coarctation. We report the case of a newborn presenting with signs of duct-dependent aortic coarctation. Echocardiography showed an interrupted fourth aortic arch, persistent left fifth aortic arch associated with aortic coarctation, and a restrictive arterial duct. Arch repair was accomplished using the fifth aortic arch as an in situ flap to enlarge the hypoplastic fourth aortic arch associated with coarctectomy and extended end-to-end anastomosis...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431720/hybrid-endovascular-repair%C3%A2-of%C3%A2-a-right-sided-thoracoabdominal-aortic%C3%A2-aneurysm
#3
Mamoru Hamuro, Tomoyuki Yamada, Kenji Yamamoto, Sakae Enomoto, Masahide Kawatou
A right-sided thoracoabdominal aortic aneurysm involving a right-sided aortic arch is extremely rare. Surgical treatment for a right-sided thoracoabdominal aortic aneurysm is challenging due to the anatomical complexity. We report a case of a right-sided thoracoabdominal aortic aneurysm with a right-sided aortic arch successfully treated by hybrid visceral debranching and endovascular repair.
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28428525/-total-arch-replacement-using-manufactured-frozen-elephant-trunk-after-acute-type-a-dissection-repair
#4
Makoto Hibino, Masato Mutsuga, Hideki Oshima, Yuji Narita, Tomonobu Abe, Kazuro Fujimoto, Yoshiyuki Tokuda, Akihiko Usui
The purpose of this study is to assess the result of total arch replacement(TAR) using manufactured frozen elephant trunk(FET) for chronic aortic dissection after initial repair including the effect of aortic remodeling by the FET. Between 2003 and 2015, we performed 11 TAR using manufactured FET. Initial repairs before were 9 ascending aortic replacements and 2 Bentall operations. The entry of residual dissection was located at arch in 7 and at distal anastomosis site in 4. There was no hospital death. The operative complication included 2 surgical site infection, 1 interstitial pneumonia and 1 paraplegia with almost full recovery...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428524/-hybrid-thoracic-endovascular-aortic-repair-with-total-debranching-of-supra-aortic-trunks
#5
Yoshimasa Seike, Hiroshi Tanaka, Hitoshi Matsuda
The method of hybrid arch thoracic endovascular aortic repair (TEVAR) to treat aneurysm with zone 0 landing has changed according to its invasiveness and complications. The real chimney technique allows supra-aortic bypass from ascending aorta without side clamp is the current choice of treatment. The comprehensive strategy to prevent stroke during hybrid arch TEVAR consisting of magnetization-prepared rapid acquisition with gradient-echo for evaluation of the atheromatous change and balloon protection of the left subclavian artery has contributed for the marked reduction of stroke...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428523/-efficacy-of-total-debranching-thoracic-endovascular-aortic-repair-for-the-re-operation-of-aortic-arch-aneurysm
#6
Kyohei Ueno, Megumu Kanno, Hirofumi Midorikawa, Gaku Takinami, Rie Kageyama
Thoracic endovascular aortic repair (TEVAR) combined with all-neck-branch reconstruction (total debranching TEVAR)[td TEVAR] is applied to aortic arch aneurysms as a minimally invasive procedure to improve treatment results. We report the initial and long-term results of td TEVAR for the reoperation of aortic arch aneurysm. By September 2016, td TEVAR for reoperation had been applied in 5 cases. The reasons for the reoperation were dilation of the arch aneurysm after ascending aorta replacement in 4 cases and localized dissection of the proximal landing zone after zone 2 TEVAR in 1 case...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428521/-simple-evaluation-of-left-hand-function-after-thoracic-endovascular-aortic-repair-with-obstruction-of-left-subclavian-artery
#7
Ryo Onishi, Nobuhiro Kataoka, Tomomi Nakajima, Masami Kuramochi, Mayumi Shinonaga, Setsuo Kuraoka
We evaluated left hand function with or without obstruction of left subclavian artery for 29 cases of thoracic endovascular aortic repair (TEVAR). 18 cases of distal true aortic aneurysm were undergone surgery with simple direct closure of left subclavian artery (LSCA). The other 11 cases of true arch aneurysm were revascularized by axilla-carotid-axilla bypass grafting with TEVAR. Later 26 cases were evaluated by blood pressure, maximal grasping power, persisting duration of 60% maximal grasping power, circumferential length of upper and forearms, and simple test for evaluating hand function (STEF)...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28424013/anterior-spinal-artery-aneurysm-in-aortic-stenosis-of-different-etiology-report-of-three-cases
#8
Vivek Singh, Suprava Naik, Sanjeev K Bhoi, R V Phadke
Isolated aneurysms of spinal arteries are rare. Spinal artery aneurysms are commonly found in association with spinal cord arteriovenous malformation and coarctation of aorta and rarely with aortic arch interruption and Klippel-Trenaunay syndrome. Spinal angiograms are the gold standard for diagnosing these spinal artery aneurysms but with the advances in computed tomography technology these aneurysms can also be very well demonstrated in computed tomography angiograms. We describe three cases of anterior spinal artery aneurysm, those are flow related aneurysms, associated with coarctation of aorta and with Takayasu arteritis...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28420891/diagnostic-value-of-dual-time-point-f-18-fdg-pet-ct-and-chest-ct-for-the-prediction-of-thymic-epithelial-neoplasms
#9
Takayoshi Shinya, Takashi Tanaka, Junichi Soh, Toshi Matsushita, Shuhei Sato, Shinichi Toyooka, Tadashi Yoshino, Shinichiro Miyoshi, Susumu Kanazawa
We retrospectively assessed the dual-time-point (DTP) F-18 FDG PET/CT findings of thymic epithelial neoplasms (TENs) and investigated the diagnostic capacity of PET/CT compared to that of CT for predicting carcinoma. We calculated the ratio of the standardized uptake value of the tumor and that of the aortic arch (T/M ratio) for both the 90-min early scan and the 2-h delayed scan in 56 TEN patients. We used a multivariate logistic regression (MLR) analysis to estimate the CT features of carcinoma. We compared the diagnostic capacities of PET/CT and chest CT using receiver operating characteristic (ROC) analyses...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28420537/bilateral-versus-unilateral-antegrade-cerebral-perfusion-in-total-arch-replacement-for-type-a-aortic-dissection
#10
Guang Tong, Ben Zhang, Xuan Zhou, Ye Tao, Tao Yan, Xianyue Wang, Hua Lu, Zhongchan Sun, Weida Zhang
BACKGROUND: Antegrade cerebral perfusion (ACP) is the most widely used cerebral protection strategy for complex aortic repair and includes unilateral (u-ACP) and bilateral (b-ACP) techniques. The superiority of b-ACP over u-ACP has been the subject of much debate. Focusing on type A aortic dissection requiring total arch replacement, we investigated the clinical effects of b-ACP versus u-ACP. METHODS: Between September 2006 and August 2014, 203 patients presenting with type A aortic dissection (median age, 51...
March 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28420337/right-aortic-arch-analysis-anatomical-variant-or-serious-vascular-defect
#11
Agata Arazińska, Michał Polguj, Konrad Szymczyk, Magdalena Kaczmarska, Łukasz Trębiński, Ludomir Stefańczyk
BACKGROUND: The right-sided aortic arch (RAA) is a rare congenital defect of the aorta. The aim of the study was to assess the occurrence of RAA in diagnoses performed by the University Radiology Department and analyze the frequency of concomitant vascular abnormalities. METHODS: The database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 with the keyword "right aortic arch". Twenty patients with this diagnosis were identified from a total of 11,690 CT examinations of the chest area, 19,623 CT examinations of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries...
April 19, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28419519/deletion-of-a-distal-rankl-gene-enhancer-delays-progression-of-atherosclerotic-plaque-calcification-in-hypercholesterolemic-mice
#12
Sohel Shamsuzzaman, Melda Onal, Hillary C St John, J Wesley Pike
Receptor activator of NF-κB ligand (RANKL) is a TNFα-like cytokine which mediates diverse physiological functions including bone remodeling and immune regulation. RANKL has been identified in atherosclerotic lesions; however, its role in atherosclerotic plaque development remains elusive. An enhancer located 75kb upstream of the murine RANKL gene's transcription start site designated D5 is important for its calciotropic hormone- and cytokine-mediated expression. Here, we determined the impact of RANKL levels in atherosclerotic plaque development in the D5 enhancer-null (D5(-/-) ) mice in an atherogenic Apoe(-/-) background fed a high-fat diet (HFD)...
April 17, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#13
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412259/right-aortic-arch-with-left-sided-arteria-lusoria-a-challenge-for-radial-interventionalists
#14
Nagaraja Moorthy, Rajiv Ananthakrishna, Dattatreya P V Rao, Madhav Hegde, Manjunath C Nanjappa
No abstract text is available yet for this article.
April 6, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#15
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#16
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
March 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28411261/feasibility-and-diagnostic-value-of-cardiovascular-magnetic-resonance-imaging-after-acute-ischemic-stroke-of-undetermined-origin
#17
Karl Georg Haeusler, Christian Wollboldt, Laura Zu Bentheim, Juliane Herm, Sebastian Jäger, Claudia Kunze, Holger-Carsten Eberle, Claudia Christina Deluigi, Oliver Bruder, Carolin Malsch, Peter U Heuschmann, Matthias Endres, Heinrich J Audebert, Andreas J Morguet, Christoph Jensen, Jochen B Fiebach
BACKGROUND AND PURPOSE: Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. METHODS: One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE)...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28408933/endovascular-stent-grafting-for-aortic-arch-aneurysm-in-aortoiliac-occlusive-disease-following-aortic-arch-debranching-and-aortobifemoral-reconstruction
#18
Didem Melis Oztas, Cagla Canbay, Yilmaz Onal, Metin Onur Beyaz, Omer Ali Sayin, Mehmet Barburoglu, Mehmet Buget, Mesut Yornuk, Aziz Ari, Murat Ugurlucan, Bulent Acunas, Ufuk Alpagut, Enver Dayioglu
Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28406244/cortistatin-reduces-atherosclerosis-in-hyperlipidemic-apoe-deficient-mice-and-the-formation-of-foam-cells
#19
Virginia Delgado-Maroto, Raquel Benitez, Irene Forte-Lago, Maria Morell, Elena Maganto-Garcia, Luciana Souza-Moreira, Francisco O'Valle, Mario Duran-Prado, Andrew H Lichtman, Elena Gonzalez-Rey, Mario Delgado
Atherosclerosis is a chronic inflammatory cardiovascular disease that is responsible of high mortality worldwide. Evidence indicates that maladaptive autoimmune responses in the arterial wall play critical roles in the process of atherosclerosis. Cortistatin is a neuropeptide expressed in the vascular system and atherosclerotic plaques that regulates vascular calcification and neointimal formation, and inhibits inflammation in different experimental models of autoimmune diseases. Its role in inflammatory cardiovascular disorders is largely unexplored...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28405010/toll-like-receptor-7-deficiency-protects-apolipoprotein-e-deficient-mice-from-diet-induced-atherosclerosis
#20
Cong-Lin Liu, Marcela M Santos, Cleverson Fernandes, Mengyang Liao, Karine Iamarene, Jin-Ying Zhang, Galina K Sukhova, Guo-Ping Shi
Toll-like receptor 7 (TLR7) mediates autoantigen and viral RNA-induced cytokine production. Increased TLR7 expression in human atherosclerotic lesions suggests its involvement in atherogenesis. Here we demonstrated TLR7 expression in macrophages, smooth muscle cells (SMCs), and endothelial cells from mouse atherosclerotic lesions. To test a direct participation of TLR7 in atherosclerosis, we crossbred TLR7-deficient (Tlr7 (-/-)) mice with apolipoprotein E-deficient (Apoe (-/-)) mice and produced Apoe (-/-) Tlr7 (-/-) and Apoe (-/-) Tlr7 (+/+) littermates, followed by feeding them an atherogenic diet to produce atherosclerosis...
April 12, 2017: Scientific Reports
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