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Type B dissection

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https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#1
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29156021/type-1a-endoleak-following-zone-1-and-zone-2-thoracic-endovascular-aortic-repair-effect-of-bird-beak-configuration
#2
Tomoaki Kudo, Toru Kuratani, Kazuo Shimamura, Tomohiko Sakamoto, Keiwa Kin, Kenta Masada, Takayuki Shijo, Kei Torikai, Koichi Maeda, Yoshiki Sawa
OBJECTIVES: Type 1a endoleak is one of the most severe complications after thoracic endovascular aortic repair (TEVAR), because it carries the risk of aortic rupture. The association between bird-beak configuration and Type 1a endoleak remains unclear. The purpose of this study was to analyse the predictors of Type 1a endoleak following Zone 1 and Zone 2 TEVAR, with a particular focus on the effect of bird-beak configuration. METHODS: From April 2008 to July 2015, 105 patients (mean age 68...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29152822/thoracic-endovascular-repair-versus-medical-management-for-acute-uncomplicated-type-b-aortic-dissection
#3
Tariq H Enezate, Jad Omran, Ashraf S Al-Dadah, Christopher White, Mitul Patel, Ehtisham Mahmud, Rossella Fattori, Jeffrey A Goldstein, Nilesh Goswami, William A Gray, Deepak L Bhatt
BACKGROUND: Current treatment options and outcomes for acute uncomplicated thoracic Type-B aortic dissection (TBAD) remain unclear between medical management (MED) and thoracic endovascular aortic repair (TEVAR). In this study we aim to compare both strategies in terms of all-cause mortality, aortic dilation, and aortic rupture. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January 1990 through March 2017. Only studies comparing TEVAR to MED for acute uncomplicated TBAD were included...
November 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148426/stabilization-and-structural-analysis-of-a-membrane-associated-hiapp-aggregation-intermediate
#4
Diana C Rodriguez Camargo, Kyle J Korshavn, Alexander Jussupow, Kolio Raltchev, David Goricanec, Markus Fleisch, Riddhiman Sarkar, Kai Xue, Michaela Aichler, Gabriele Mettenleiter, Axel Karl Walch, Carlo Camilloni, Franz Hagn, Bernd Reif, Ayyalusamy Ramamoorthy
Membrane-assisted amyloid formation is implicated in human diseases, and many of the aggregating species accelerate amyloid formation and induce cell death. While structures of membrane-associated intermediates would provide tremendous insights into the pathology and aid in the design of compounds to potentially treat the diseases, it has not been feasible to overcome the challenges posed by the cell membrane. Here we use NMR experimental constraints to solve the structure of a type-2 diabetes related human islet amyloid polypeptide intermediate stabilized in nanodiscs...
November 17, 2017: ELife
https://www.readbyqxmd.com/read/29147169/uncomplicated-acute-type-b-aortic-dissection-selection-guidelines-for-tevar
#5
Emilia Krol, Jean M Panneton
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147158/successful-hybrid-treatment-of-stent-graft-migration-caused-by-type-b-aortic-dissection-after-endovascular-aortic-aneurysm-repair-a-case-report
#6
Tsunehiro Shintani, Kouji Atsuta, Takaaki Saito
Herein, we report a rare case of type B aortic dissection that occurred after endovascular aortic aneurysm repair (EVAR). A 66-year-old man underwent successful EVAR for an abdominal aortic aneurysm (AAA). Computed tomography (CT) 2 years after EVAR showed a type B aortic dissection with stent-graft migration and AAA expansion. Juxtarenal aortic expansion precluded simple stent-graft placement. He underwent hepato-spleno-renal bypass followed by stent-graft placement just below the superior mesenteric artery...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29145712/cartilage-microrna-dysregulation-during-the-onset-and-progression-of-mouse-osteoarthritis-is-independent-of-aggrecanolysis-and-overlaps-with-candidates-from-end-stage-human-disease
#7
Louise H W Kung, Varshini Ravi, Lynn Rowley, Constanza Angelucci, Amanda J Fosang, Katrina M Bell, Christopher B Little, John F Bateman
OBJECTIVE: To identify candidate microRNAs that potentially regulate the initiation and progression of osteoarthritis. METHODS: Osteoarthritis was induced in 10-12 week old male wild-type C57BL6 mice and in mice resistant to aggrecanase cleavage (Acan p.374ALGS→374NVYS) by destabilization of the medial meniscus (DMM). Osteoarthritis pathology was scored histologically. RNA from cartilage and subchondral bone were harvested in parallel by laser micro-dissection at 1 and 6 weeks post-surgery...
November 16, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29137728/a-computational-model-for-false-lumen-thrombosis-in-type-b-aortic-dissection-following-thoracic-endovascular-repair
#8
Claudia Menichini, Zhuo Cheng, Richard G J Gibbs, Xiao Yun Xu
Thoracic endovascular repair (TEVAR) has recently been established as the preferred treatment option for complicated type B dissection. This procedure involves covering the primary entry tear to stimulate aortic remodelling and promote false lumen thrombosis thereby restoring true lumen flow. However, complications associated with incomplete false lumen thrombosis, such as aortic dilatation and stent graft induced new entry tears, can arise after TEVAR. This study presents the application and validation of a recently developed mathematical model for patient-specific prediction of thrombus formation and growth under physiologically realistic flow conditions...
November 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29137089/a-case-report-of-takayasu-arteritis-with-aortic-dissection-as-initial-presentation
#9
JiGuang Guo, GuoWu Zhang, Dan Tang, JianBin Zhang
RATIONALE: The initial symptoms and signs of Takayasu arteritis vary due to the heterogeneity of affected vessels. Moreover, the vascular lesions are difficult to detect at initial presentation, making diagnosis even more challenging. Although cases of aortic dissection with arteritis history have been reported, Takayasu arteritis in men with aortic dissection as initial presentation is very rare. PATIENT CONCERNS: A 37-year-old man presenting with persistent chest and back pain for 6 days was transferred to our hospital for further treatment...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136130/distal-re-entry-closure-with-neobranching-technique-after-thoracic-endovascular-aortic-repair-of-type-b-aortic-dissection
#10
Masaki Yamamoto, Takashi Fukutomi, Tatsuya Noguchi, Kazumasa Orihashi
Retrograde false-lumen flow after thoracic endovascular aortic repair of Type B aortic dissection occurs occasionally and may have a negative impact on aortic remodelling and even prevent the decompression of the false lumen. A 67-year-old man with a Type B aortic dissection underwent thoracic endovascular aortic repair for severe compression of the true lumen and visceral malperfusion 7 weeks after the onset. Intraoperative angiography revealed proximal entry tear closure, but the false-lumen flow increased because of retrograde flow through the re-entry tear...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29129854/update-on-the-therapeutic-strategy-of-type-b-aortic-dissection
#11
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29127469/the-right-intercostobronchial-trunk-anatomical-study-in-respect-of-posterior-intercostal-artery-origin-and-its-clinical-application
#12
Lidija Kocbek, Mateja Rakuša
PURPOSE: The right bronchial artery usually arises from the descending thoracic aorta as a common trunk with the right intercostal artery and forms the right intercostobronchial trunk. Both, the third right posterior intercostal artery and the right intercostobronchial trunk, are described as the most constant vessels. The focus of the study was to determine the characteristics of the right intercostobronchial trunk regarding the origins of the posterior intercostal arteries from the thoracic aorta...
November 10, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29123882/a-case-of-circumferential-type-a-aortic-dissection-with-intimal-intussusception-diagnosed-using-repeat-transthoracic-echocardiography-examination
#13
Toshinobu Yamagishi, Masahiro Kashiura, Kazuya Nakata, Kazuki Miyazaki, Takahiro Yukawa, Takahiro Tanabe, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe
Case: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58-year-old woman presented with sudden-onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121846/retrograde-ascending-dissection-after-thoracic-endovascular-aortic-repair-combined-with-the-chimney-technique-and-successful-open-repair-using-the-frozen-elephant-trunk-technique
#14
Koji Hirano, Toshiya Tokui, Bun Nakamura, Ryosai Inoue, Masahiro Inagaki, Yasumi Maze, Noriyuki Kato
The chimney technique can be combined with thoracic endovascular aortic repair (TEVAR) to both obtain an appropriate landing zone and maintain blood flow of the arch vessels. However, surgical repair becomes more complicated if retrograde type A aortic dissection occurs after TEVAR with the chimney technique. We herein report a case involving a 73-year-old woman who developed a retrograde ascending dissection 3 months after TEVAR for acute type B aortic dissection. To ensure an adequate proximal sealing distance, the proximal edge of the stent graft was located at the zone 2 level and an additional bare stent was placed at the left subclavian artery (the chimney technique) at the time of TEVAR...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29121340/hace1-is-essential-for-astrocyte-mitochondrial-function-and-influences-huntington-disease-phenotypes-in-vivo
#15
Dagmar E Ehrnhoefer, Amber L Southwell, Meenalochani Sivasubramanian, Xiaofan Qiu, Erika B Villanueva, Yuanyun Xie, Sabine Waltl, Lisa Anderson, Anita Fazeli, Lorenzo Casal, Boguslaw Felczak, Michelle Tsang, Michael R Hayden
Oxidative stress is a prominent feature of Huntington disease (HD), and we have shown previously that reduced levels of HACE1 (HECT domain and Ankyrin repeat containing E3 ubiquitin protein ligase 1) in patient striatum may contribute to the pathogenesis of HD. HACE1 promotes the stability of Nrf2 and thus plays an important role in antioxidant response mechanisms, which are dysfunctional in HD. Moreover, HACE1 overexpression mitigates mutant huntingtin-induced oxidative stress in vitro through promotion of the Nrf2 antioxidant response...
November 7, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/29113657/huang-s-three-step-maneuver-shortens-the-learning-curve-of-laparoscopic-spleen-preserving-splenic-hilar-lymphadenectomy
#16
REVIEW
Chang-Ming Huang, Ze-Ning Huang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Lu Jun, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu
BACKGROUND: The goal of this study was to investigate the difference between the learning curves of different maneuvers in laparoscopic spleen-preserving splenic hilar lymphadenectomy for advanced upper gastric cancer. METHODS: From January 2010 to April 2014, 53 consecutive patients who underwent laparoscopic spleen-preserving splenic hilar lymphadenectomy via the traditional-step maneuver (group A) and 53 consecutive patients via Huang's three-step maneuver (group B) were retrospectively analyzed...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29108310/significance-of-the-thrombo-inflammatory-status-based-novel-prognostic-score-as-a-useful-predictor-for-in-hospital-mortality-of-patients-with-type-b-acute-aortic-dissection
#17
Dongze Li, Lei Ye, Jing Yu, Lixia Deng, Lianjing Liang, Yan Ma, Lei Yi, Zhi Zeng, Yu Cao, Zhi Wan
Background: Inflammation and thrombosis are associated with development and progression of acute aortic dissection (AAD). The aim of this study was to assess the prognostic significance of Simplified Thrombo-Inflammatory Prognostic Score (sTIPS), in patients with early phase type B AAD. Methods: We retrospectively reviewed 491 patients with type B AAD between November 2012 and September 2015. sTIPS was calculated from the white blood cell count (WBC) and mean platelet volume to platelet count (MPV/PC) ratio, at the time of admission...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29106452/acute-aortic-syndromes-diagnosis-and-management-an-update
#18
Eduardo Bossone, Troy M LaBounty, Kim A Eagle
Acute aortic syndromes (AAS) encompass a constellation of life-threatening medical conditions including classic acute aortic dissection (AAD), intramural haematoma, and penetrating atherosclerotic aortic ulcer. Given the non-specific symptoms and physical signs, a high clinical index of suspicion is necessary to detect the disease before irreversible lethal complications occur. In order to reduce the diagnostic time delay, a comprehensive flowchart for decision-making based on pre-test sensitivity of AAS has been designed by the European Society of Cardiology guidelines on aortic diseases and should be thus applied in the emergency scenario...
June 30, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29104203/-acute-type-b-aortic-dissection-complicated-with-malperfusion-of-celiac-artery-alone-report-of-a-case
#19
Motohiro Koyama, Kae Ito, Keishi Ueyama
Malperfusion of the superior mesenteric artery(SMA) in acute type B aortic dissection is potentially fatal. Revascularization should therefore be aggressively considered in a proactive way. However, this is not the case with the celiac artery malperfusion. We present a case of malperfusion of isolated malperfusion of the celiac artery due to acute type B aortic dissection. Although the collateral blood flow from the SMA via the pancreatic arcade was identified, ischemic gastric ulcer and pancreatitis developed later on...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29101840/ex%C3%A2-vivo-culture-of-human-atherosclerotic-plaques-a-model-to-study-immune-cells-in-atherogenesis
#20
Anna Lebedeva, Daria Vorobyeva, Murad Vagida, Oxana Ivanova, Eugeny Felker, Wendy Fitzgerald, Natalya Danilova, Vladimir Gontarenko, Alexander Shpektor, Elena Vasilieva, Leonid Margolis
BACKGROUND AND AIMS: The mechanisms that drive atherosclerotic plaque progression and destabilization in humans remain largely unknown. Laboratory models are needed to study these mechanisms under controlled conditions. The aim of this study was to establish a new ex vivo model of human atherosclerotic plaques that preserves the main cell types in plaques and the extracellular components in the context of native cytoarchitecture. METHODS: Atherosclerotic plaques from carotid arteries of 28 patients undergoing carotid endarterectomy were dissected and cultured...
October 7, 2017: Atherosclerosis
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