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Type B dissection

Monica Bucchia, Samantha J Merwin, Diane B Re, Shingo Kariya
Pathogenic conditions involving degeneration of spinal motor neurons (MNs), such as amyotrophic lateral sclerosis, sarcopenia, and spinal cord injury, mostly occur in individuals whose spinal MNs are fully mature. There is currently no effective treatment to prevent death or promote axonal regeneration of the spinal MNs affected in these patients. To increase our understanding and find a cure for such conditions, easily controllable and monitorable cell culture models allow for a better dissection of certain molecular and cellular events that cannot be teased apart in whole organism models...
2018: Frontiers in Cellular Neuroscience
Harleen K Sandhu, Kristofer M Charlton-Ouw, Katherine Jeffress, Samuel Leake, Alexa Perlick, Charles C Miller, Ali Azizzadeh, Hazim J Safi, Anthony L Estrera
BACKGROUND: Patients presenting with acute aortic dissection may develop spinal cord ischemia (SCI). We sought to determine how SCI and its recovery affects outcomes. METHODS: We reviewed patients with SCI in acute type A aortic dissection (ATAAD) and acute type B aortic dissection (ATBAD) from September 1999-May 2014. SCI was defined as paraplegia or paraparesis present on admission. Monoparesis/plegia, paraesthesia, or numbness was defined as ischemic neuropathy (IN)...
March 17, 2018: Annals of Thoracic Surgery
Marco Virgilio Usai, Antje Gottschalk, Thomas Schönefeld, Johannes Frederik Schaefers, Giovanni B Torsello, Andreas Rukosujew
Aortoesophageal fistula is a rare but lethal complication after thoracic endovascular repair for thoracic aortic diseases. Extensive treatment is reserved for patients fit for surgery. Various technical approaches have been described; however, mortality rates are still high. Herein, we report a case of a 76-year-old woman with aortoesophageal fistula treated by a three-step treatment approach, with close collaboration between cardiothoracic and general surgery specialists. The patient required tracheostomy after the first procedure, but this was closed at 15 days...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Tara Talaie, Christopher Werter, Charles Drucker, Brittany O Aicher, Robert Crawford, Shahab Toursavadkohi
We report a case of a complex chronic type B aortic dissection treated by thoracic endovascular aortic repair and laser fenestration of the false septum to preserve flow to branch vessels originating from both the true and false lumen. Dissections complicated by thoracoabdominal aneurysmal degeneration with critical organs being perfused by branches arising from both true and false lumens are rare and leave limited options for repair. Despite advancements in endovascular techniques, fenestration remains one of the only means of preserving flow to both the true and false lumens and thus was necessary in the management of our patient...
April 2018: Vascular and Endovascular Surgery
Liza Laquian, Salvatore T Scali, Thomas M Beaver, Paul Kubilis, Adam W Beck, Kristina Giles, Thomas S Huber, Robert J Feezor
PURPOSE: To compare uncomplicated acute type B aortic dissection (UATBAD) patients with intractable pain/refractory hypertension treated with thoracic endovascular aortic repair (TEVAR) to UATBAD subjects without these features receiving best medical therapy (BMT). METHODS: Interrogation of the hospital database identified 101 consecutive UATBAD patients admitted between January 2011 and December 2014. Of these, 74 patients (mean age 62±13 years; 44 men) were treated with BMT; the other 27 UATBAD patients (mean age 63±13 years; 17 men) were subsequently treated with TEVAR for intractable pain (24, 89%) and/or refractory hypertension (3, 11%) at a mean 2...
April 2018: Journal of Endovascular Therapy
Prashant Rao, Jack B Keenan, Taufiek K Rajab, Samuel Kim, Richard Smith, Orazio Amabile, Zain Khalpey
INTRODUCTION: Cardiovascular complications represent the leading cause of morbidity and mortality in patients with Marfan syndrome. Here, we describe a unique case where a total artificial heart was implanted in a young Marfan syndrome woman. METHODS: A 22-year-old postpartum African American female with Marfan syndrome developed multiple severe valve dysfunction and biventricular failure that was refractory to medical management. She previously had a Bentall procedure for Type A aortic dissection and repair of a Type B dissection...
March 2018: International Journal of Artificial Organs
Yan Qu, Ying Wang, Yan Zhang, Chunyu Han, Dong Gao, Waishu Jin, Jinning Liang, Xiujuan Xia
BACKGROUND: Because of long-term exposure of skin, skin aging is an unavoidable natural law with age. Traditional Vitamin A and novel ablative fractional laser technique both have the effects of skin rejuvenation, and studies have demonstrated both of them have apparent clinical efficacy and histology-improving effects on photo-aging skin. MATERIALS AND METHODS: 45 female healthy Wistar rats were selected and the depilation areas of every rat were divided into four regions: control region(Region A), Vitamin A acid region(Region B), combination treatment region(Region C), and fractional laser region(Region D)...
March 15, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Francesca Terzi, Silvia Gianstefani, Rossella Fattori
No abstract text is available yet for this article.
February 2018: Journal of Cardiovascular Medicine
Tsung-Hsing Chen, Chieh Lee, Cheng-Tang Chiu, Yin-Yi Chu, Hao-Tsai Cheng, Jun-Te Hsu, Yung-Kuan Tsou, Ren-Chin Wu, Tse-Ching Chen, Nien-Chen Chang, Ta-Sen Yeh, Kwang-Huei Lin
MicroRNA-196a (miRNA-196a) is associated with the development of gastric cancer and metastasis. Intestinal metaplasia and low- or high-grade dysplasia are considered to be precursors of intestinal type gastric cancer. Accordingly, we investigated the expression of plasma miRNA-196a as an early detection biomarker in precancerous gastric lesions and early cancer (pT1a/b), which is otherwise treated with endoscopic submucosal dissection. Our data showed that levels of circulating (plasma) miRNA-196a were higher in patients with precancerous lesions/early gastric adenocarcinoma than in healthy controls...
February 13, 2018: Oncotarget
Kangjun Shen, Xinmin Zhou, Ling Tan, Feng Li, Jun Xiao, Hao Tang
BACKGROUND: We hypothesized that the arch-first procedure without extra devices under moderate-to-mild systemic hypothermia during acute type A aortic dissection is safe and efficient and will improve patient outcome compared with the standard total arch replacement technique. METHODS: From December 2014 to February 2017, 89 patients were enrolled in this study, 52 of whom underwent conventional deep hypothermic circulatory arrest (DHCA, 24.2 ± 0.71°C) using the antegrade cerebral perfusion surgical procedure (Group A) and 37 of whom underwent the "arch-first" technique with moderate (27...
March 12, 2018: Journal of Cardiovascular Surgery
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
Zhuming Yin, Liqiang Liu, Bingjian Xue, Jincai Fan, Wenlin Chen, Zheng Liu
INTRODUCTION: Prosthesis-assisted penile reconstruction has been performed extensively to restore a cosmetically acceptable phallus. However, a large number of patients will undergo revision surgery for various prosthesis-related complications. AIM: To develop a 1-stage prosthesis-free dynamic cavernosa reconstruction method using bilateral innervated gracilis muscles and to investigate the feasibility and reliability of the surgical design. METHODS: 10 fresh cadavers were dissected to assess the availability of bilateral gracilis muscles for functional cavernosa rebuilding...
March 7, 2018: Sexual Medicine
Kaitryn E Ronning, Gabriel Peinado Allina, Eric B Miller, Robert J Zawadzki, Edward N Pugh, Rolf Hermann, Marie E Burns
Rods and cones mediate visual perception over 9 log units of light intensities, with both photoreceptor types contributing to a middle 3-log unit range that comprises most night-time conditions. Rod function in this mesopic range has been difficult to isolate and study in vivo because of the paucity of mutants that abolish cone signaling without causing photoreceptor degeneration. Here we describe a novel Gnat2 knockout mouse line (Gnat2-/- ) ideal for dissecting rod and cone function. In this line, loss of Gnat2 expression abolished cone phototransduction, yet there was no loss of cones, disruption of the photoreceptor mosaic, nor change in general retinal morphology up to at least 9 months of age...
March 5, 2018: Experimental Eye Research
Takahiro Mizoguchi, Nobuya Zempo, Yoshikazu Kaneda
We examined the outcomes of aortic remodeling for chronic type B aortic dissection (cTBD) after thoracic endovascular aneurysm repair (TEVAR). Objective & Methods : Thirty-eight patients underwent TEVAR for cTBD at our institution. We classified cTBD patients into the early cTBD group (16 cases, 2 weeks-4 months from onset) and late cTBD group (22 cases, >4 months from onset). Results : There were no cases of paraplegia, stroke, and hospital death in both groups. There was no worsening of complicated cases...
December 25, 2017: Annals of Vascular Diseases
Frank S Cikach, Christopher D Koch, Timothy J Mead, Josephine Galatioto, Belinda B Willard, Kelly B Emerton, Matthew J Eagleton, Eugene H Blackstone, Francesco Ramirez, Eric E Roselli, Suneel S Apte
Proteoglycan accumulation is a hallmark of medial degeneration in thoracic aortic aneurysm and dissection (TAAD). Here, we defined the aortic proteoglycanome using mass spectrometry, and based on the findings, investigated the large aggregating proteoglycans aggrecan and versican in human ascending TAAD and a mouse model of severe Marfan syndrome. The aortic proteoglycanome comprises 20 proteoglycans including aggrecan and versican. Antibodies against these proteoglycans intensely stained medial degeneration lesions in TAAD, contrasting with modest intralamellar staining in controls...
March 8, 2018: JCI Insight
Toshihiro Fukui
Background: Both acute aortic dissection and ruptured aortic aneurysm are leading causes of death in cardiovascular disease. These life-threatening conditions have recently been categorized as acute aortic syndrome. This review describes the etiology, clinical presentation, and therapeutic options for acute aortic syndrome including acute aortic dissection and ruptured aortic aneurysm. Main body: Several diagnostic tools for detecting these critical conditions have been developed including computed tomography, ultrasonography, magnetic resonance imaging, and laboratory tests...
2018: Journal of Intensive Care
Grace J Wang, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Philip P Goodney, Rachel R Kelz, Christopher Wirtalla, Ronald M Fairman
OBJECTIVE: The advent of endovascular repair for both thoracic aortic aneurysm and type B dissection has transformed the management of these disease processes. This study was undertaken to better define, compare, and contrast the national trends in hospital admissions, invasive treatments, and inpatient mortality of patients with thoracic aortic aneurysm and type B dissection in the National Inpatient Sample. METHODS: The cohort was derived from International Classification of Diseases, Ninth Revision diagnosis codes for thoracic aortic dissection and thoracic aortic or thoracoabdominal aortic aneurysm...
March 2, 2018: Journal of Vascular Surgery
Cuilin Zhu, Xiaomei Zheng, Zhicheng Zhu, Dan Li, Tiance Wang, Rihao Xu, Kexiang Liu
Acute aortic dissection occurring during pregnancy poses great danger to both the mother and fetus. Cesareans are usually performed before or after the aortic repair depending on the conditions of the mother and fetus. Here we report our experience in treating a 32-week pregnant woman with a type B aortic dissection, whose baby had died before admission. A cesarean section was initially arranged after emergency aortic repair. However, the patient started to deliver the fetus vaginally after the aortic surgery and the stillborn baby was delivered vaginally...
March 5, 2018: International Heart Journal
R Scott McClure, Susan B Brogly, Katherine Lajkosz, Darrin Payne, Stephen F Hall, Ana P Johnson
OBJECTIVES: To determine hospital incidence, mortality, and management for thoracic aortic dissections and aneurysms. METHODS: A population-based retrospective cohort study of anonymously linked data for residents of Ontario, Canada, was carried out. Incident cases of thoracic aortic dissections and aneurysms were identified between 2002 and 2014. Treatment and mortality trends were assessed. RESULTS: There were 5966 aortic dissections (Type A n = 2289 [38%] and Type B n = 3632 [61%])...
February 27, 2018: Journal of Thoracic and Cardiovascular Surgery
Ludovic Canaud, Pierre Alric
Degenerative aneurysms of the thoracic aorta are increasing in prevalence. The recognition of the decreased morbidity of this approach compared with open repair was readily apparent, as it avoided left thoracotomy, aortic cross-clamping, and left heart bypass. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair...
February 23, 2018: La Presse Médicale
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