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Type B dissection

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https://www.readbyqxmd.com/read/28438361/influence-of-distal-entry-tears-in-acute-type-b-aortic-dissection-after-thoracic-endovascular-aortic-repair
#1
Chenmou Zhu, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Fei Xiong, Tiehao Wang
OBJECTIVE: This study evaluated the clinical influence of distal entry tears in acute type B aortic dissection (ATBAD) after thoracic endovascular aortic repair (TEVAR). METHODS: From August 2009 to December 2014, the clinical outcomes of 130 patients who underwent TEVAR for ATBAD were retrospectively analyzed. According to whether distal entry tears existed after TEVAR, patients were divided into group A (n = 25, absence of distal entry tears) and group B (n = 105, presence of distal entry tears)...
April 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28436152/multispecialty-involvement-in-the-management-of-type-b-aortic-dissections-in-the-endovascular-era-implications-for-training-cardiothoracic-residents
#2
Corbin Muetterties, Rohan Menon, William Moser, Nels Carroll, Kathleen Marulanda, Myunghan Choi, Grayson H Wheatley
PURPOSE: Involvement of qualified specialists with proficiency in endovascular therapies has created flux regarding the role of cardiothoracic surgeons, vascular surgeons, and other catheter-skilled specialists in the management of type B aortic dissections. We used manuscript authorship trends and recent match data in order to study how multi-specialty involvement in treating aortic dissections has changed in the endovascular era. METHODS: A PubMed review of published literature between 1998 and 2015 was performed with "aortic dissection" in the title...
April 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28434549/systematic-review-of-reintervention-after-thoracic-endovascular-repair-for-chronic-type-b-dissection
#3
REVIEW
Mourad Boufi, Benjamin O Patterson, Matthew Joe Grima, Alan Karthikesalingam, Mohammed T Hudda, Peter J Holt, Ian M Loftus, Matthew M Thompson
This review analyzed the incidence, mechanisms, and risk factors of aortic-related reintervention after endovascular repair of chronic dissections. The systematic review identified 28 studies describing 1,249 patients at median 27 months follow-up (range, 10.3 to 64.4). There were six reinterventions, 0.7 ruptures, and 1.2 surgical conversions per 100 patient-years of follow-up. Stent-related reinterventions were more frequent than nonstent related (80.2% vs 19.8%). Distal false lumen perfusion was the most common complication (40...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#4
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#5
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/28428527/-treatment-strategy-for-complicated-acute-type-b-aortic-dissection-in-the-thoracic-endovascular-aortic-repair-era
#6
Norihisa Karube, Keiji Uchida, Shinichi Suzuki, Munetaka Masuda
Our treatment strategy for acute type B aortic dissection (ABAD) included complicated type is as follows. Indications of thoracic endovascular aortic repair (TEVAR) for ABAD are rupture and organ ischemia, and TEVAR has been the 1st line central repair therapy since January 2009 in our institution. At the time of TEVAR for ruptured communicating type ABAD, we usually seal the proximal entry tear and cover the existing range of hematoma at descending aorta. Procedures for ABAD with malperfusion should be changed according to the patient's condition such as branch vessel obstructions either dynamic type or static type...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428526/-strategy-of-thoracic-endovascular-aortic-repair-for-uncomplicated-type-b-aortic-dissection-in-subacute-and-chronic-phase-interval-from-onset-and-maximum-diameter
#7
Masatoshi Sunada, Kyohei Ueno, Rie Kageyama, Satoru Maeba, Hirofumi Midorikawa, Megumu Kanno
We classified 59 patients who underwent thoracic endovascular aortic repair for uncomplicated type B aortic dissection from April 2008 to April 2016 into 3 groups based on time from onset and maximum aortic diameter:SA (2weeks to 1 year since onset;n=29), C (>1 year since onset;n=17), and D(maximum aneurysm size≥60 mm;n=13). We used the Kaplan-Meier method tso analyze survival, major adverse cardiovascular event and the need for additional treatment. There was no significant difference in outcomes between the SA and C groups (p=0...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428114/epigenetics-the-third-pillar-of-nitric-oxide-signaling
#8
REVIEW
Samantha Socco, Rhea C Bovee, Marianne B Palczewski, Jason R Hickok, Douglas D Thomas
Nitric oxide (NO), the endogenously produced free radical signaling molecule, is generally thought to function via its interactions with heme-containing proteins, such as soluble guanylyl cyclase (sGC), or by the formation of protein adducts containing nitrogen oxide functional groups (such as S-nitrosothiols, 3-nitrotyrosine, and dinitrosyliron complexes). These two types of interactions result in a multitude of down-stream effects that regulate numerous functions in physiology and disease. Of the numerous purported NO signaling mechanisms, epigenetic regulation has gained considerable interest in recent years...
April 17, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28420537/bilateral-versus-unilateral-antegrade-cerebral-perfusion-in-total-arch-replacement-for-type-a-aortic-dissection
#9
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
#10
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/28413699/white-matter-connections-of-the-inferior-parietal-lobule-a-study-of-surgical-anatomy
#11
Joshua D Burks, Lillian B Boettcher, Andrew K Conner, Chad A Glenn, Phillip A Bonney, Cordell M Baker, Robert G Briggs, Nathan A Pittman, Daniel L O'Donoghue, Dee H Wu, Michael E Sughrue
INTRODUCTION: Interest in the function of the inferior parietal lobule (IPL) has resulted in increased understanding of its involvement in visuospatial and cognitive functioning, and its role in semantic networks. A basic understanding of the nuanced white-matter anatomy in this region may be useful in improving outcomes when operating in this region of the brain. We sought to derive the surgical relationship between the IPL and underlying major white-matter bundles by characterizing macroscopic connectivity...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#12
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...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28407142/obinutuzumab-induces-superior-b-cell-cytotoxicity-to-rituximab-in-rheumatoid-arthritis-and-systemic-lupus-erythematosus-patient-samples
#13
Venkat Reddy, Christian Klein, David A Isenberg, Martin J Glennie, Geraldine Cambridge, Mark S Cragg, Maria J Leandro
Objective.: A proportion of RA and SLE patients treated with standard doses of rituximab (RTX) display inefficient B cell deletion and poor clinical responses that can be augmented by delivering higher doses, indicating that standard-dose RTX is a sub-optimal therapy in these patients. This study aimed to investigate whether better responses could be achieved with mechanistically different anti-CD20 mAbs. Methods.: We compared RTX with obinutuzumab (OBZ), a new-generation, glycoengineered type II anti-CD20 mAb, in a series of in vitro assays measuring B cell cytotoxicity in RA and SLE patient samples...
April 11, 2017: Rheumatology
https://www.readbyqxmd.com/read/28398536/remnant-aortic-remodelling-in-younger-patients-after-acute-type-i-aortic-dissection-surgery
#14
Jihoon Kim, Sun Kyun Ro, Joon Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee, Suk Jung Choo
OBJECTIVES: To study the influence of age on remnant aortic remodelling after acute DeBakey type I aortic dissection (AD) surgery. METHODS: Between January 1999 and December 2013, 118 acute type I AD patients (26 aged <50 years, Group A; 92 aged  ≥ 50 years, Group B) with either ascending or ascending hemiarch replacement in whom preoperative and >1-month postoperative chest computed tomography (CT) were available were included. RESULTS: At median CT follow-up of 35...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28396948/a-novel-classification-scheme-for-advanced-laryngeal-cancer-midline-involvement-implications-for-the-contralateral-neck
#15
Arne Böttcher, Heidi Olze, Nadine Thieme, Carmen Stromberger, Steffen Sander, Adrian Münscher, Johannes Bier, Steffen Knopke
PURPOSE: There are insufficient data concerning risk factors for contralateral regional metastases in laryngeal cancer. The aim of this study was to investigate the frequency and risk factors for contralateral lymph node metastases and their dependence on midline involvement of the primary tumor in patients with advanced laryngeal squamous cell carcinoma. METHODS: 58 consecutive patients (8 females, 50 males; mean age 64.2 ± 9.8 years; AJCC stage III disease in 43...
April 10, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28395436/-surgical-treatment-of-aortic-dissection-with-lower-extremity-ischemia
#16
J R Xue, B Li, Y M Liu, T Bai, X D Pan, N N Liu, Z Qu, L Z Sun
Objective: To explore the clinical outcome of the surgical treatment for aortic dissection with lower extremity ischemia. Methods: Between March 2009 and April 2013, 14 patients with type A aortic dissection and lower extremity ischemia underwent Sun's procedure in Beijing Anzhen Hospital. Ascending aorta-iliac artery bypass, ascending aorta-femoral artery bypass, femoral-femoral artery bypass and axillary -femoral artery bypass were performed on some severe patients at the same time. Results: Two death occurred, and the others were improved or recovered from symptoms...
April 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28392975/the-effect-of-retinal-melanin-on-optical-coherence-tomography-images
#17
Melissa A Wilk, Alison L Huckenpahler, Ross F Collery, Brian A Link, Joseph Carroll
PURPOSE: We assessed the effect of melanin on the appearance of hyperreflective outer retinal bands in optical coherence tomography (OCT) images. METHODS: A total of 23 normal subjects and 51 patients with albinism were imaged using the Bioptigen high-resolution spectral-domain OCT. In addition, three wild type, three albino (slc45a2(b4/b4) ), and eight tyrosinase mosaic zebrafish were imaged with the hand-held Bioptigen Envisu R2200 OCT. To identify pigmented versus nonpigmented regions in the tyrosinase mosaic zebrafish, en face summed volume projections of the retinal pigment epithelium (RPE) were created from volume scans...
April 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28390915/predictors-of-stable-aortic-dimensions-in-medically-managed-acute-aortic-syndromes
#18
Arnoud V Kamman, Frederik Hw Jonker, Udo Sechtem, Kevin M Harris, Arturo Evangelista, Daniel G Montgomery, Himanshu J Patel, Kim A Eagle, Santi Trimarchi
PURPOSE: We aimed to identify predictors of stable aortic dimensions in medically managed type B aortic dissections (TBAD). METHODS: Medically managed TBAD patients from the International Registry of Acute Aortic Dissection (IRAD) with available aortic measurements at up to 24 months were included. Growth rate was calculated by dividing the largest descending diameter at the latest endpoint not influenced by intervention minus initial descending diameter, by the recorded time interval...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390772/outcomes-of-thoracic-endovascular-repair-for-type-b-aortic-dissection-with-multichanneled-morphology
#19
Baolei Guo, Kai Hou, Daqiao Guo, Xin Xu, Zhenyu Shi, Yan Shan, Peng Lv, Weiguo Fu
OBJECTIVE: Clinical outcomes after thoracic endovascular aortic repair (TEVAR) for patients with multichanneled aortic dissection (MCAD) are poorly understood but seem substantially different from those for patients with double-channeled aortic dissection (AD). This study compared the anatomic and clinical factors for patients with MCAD who underwent TEVAR with or without full true lumen (TL) collapse. METHODS: From January 2012 to March 2016, 54 of 644 consecutive type B AD patients (8...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390767/management-and-outcomes-of-carotid-artery-extension-of-aortic-dissections
#20
Adriana Laser, Charles B Drucker, Donald G Harris, Tanya Flohr, Shahab Toursavadkohi, Rajabrata Sarkar, Bradley Taylor, Robert S Crawford
BACKGROUND: Aortic dissection (AD) is the most common aortic catastrophe. Carotid artery dissection due to extension of AD (CAEAD) is one severe complication of this condition. Despite years of refinement in the techniques for repair of AD, the optimal management strategy for CAEAD remains yet to be described. We hypothesized that CAEAD eventually resolves on antiplatelet therapy with a low but not insignificant risk of cerebrovascular accident (CVA). METHODS: This was a single-institution retrospective review of patients admitted with nontraumatic coincident aortic and carotid dissection between 2001 and 2013...
April 5, 2017: Journal of Vascular Surgery
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