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Aortic aneurysms

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https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#1
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932555/does-bioglue-contribute-to-anastomotic-pseudoaneurysm-after-thoracic-aortic-surgery
#2
Wei-Guo Ma, Bulat A Ziganshin, Chang-Fa Guo, Mohammad A Zafar, Richard S Sieller, Maryann Tranquilli, John A Elefteriades
BACKGROUND: Although bovine serum albumin-glutaraldehyde glue (BioGlue®) has been successfully used as a hemostatic adjunct in aortic surgical procedures, there are reports that it may lead to anastomotic pseudoaneurysm formation. We seek to examine if the use of BioGlue is associated with a high incidence of anastomotic pseudoaneurysm formation following surgical repair of thoracic aortic disease. METHODS: We reviewed the medical records and follow-up computed tomography (CT) scans of patients from 2001 to 2015 in whom BioGlue was used during surgical repair of thoracic aortic disease to detect postoperative anastomotic pseudoaneurysm formation...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#3
Seungjun Song, Suk-Won Song, Tae Hoon Kim, Kwang-Hun Lee, Kyung-Jong Yoo
BACKGROUND: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies. Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial. METHODS: From 2012 to 2014, 162 patients underwent TEVAR at a single institution...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931420/presence-of-periaortic-gas-in-clostridium-septicum-infected-aortic-aneurysm-aids-in-early-diagnosis-a-case-report-and-systematic-review-of-the-literature
#4
Fumihito Ito, Ryota Inokuchi, Akinori Matsumoto, Yoshibumi Kumada, Hideyuki Yokoyama, Tokiya Ishida, Katsuhiko Hashimoto, Masashi Narita, Kazuaki Shinohara
BACKGROUND: Clostridium septicum-infected aortic aneurysm is a fatal and rare disease. We present a fatal case of C. septicum-infected aortic aneurysm and a pertinent literature review with treatment suggestions for reducing mortality rates. CASE PRESENTATION: A 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. Upon recognition of signs of an abdominal aortic aneurysm and paraplegia, we suspected an occluded Adamkiewicz artery and performed a contrast-enhanced computed tomography scan, which revealed an aortic aneurysm with periaortic gas extending from his chest to his abdomen and both kidneys...
September 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28929526/the-influence-of-marfans-and-bicuspid-valves-on-outcomes-following-aortic-valve-reimplantation
#5
Carlos E Martín, Carlos García Montero, Santiago-Fiz Serrano, Ana González, Susana Mingo, Vanessa Moñivas, Jorge Centeno, Alberto Forteza
BACKGROUND: We analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. METHODS: Between March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 50 ± 3 mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome...
September 20, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28929042/the-physical-examination-does-matter-a-case-of-spontaneous-aortocaval-fistula
#6
Rupak Desai, Mikhail Akbashev, Leon Rubinsztain, Andro G Kacharava
A spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysms. In 50 percent of the patients, it presents with the classic signs of a pulsatile abdominal mass, continuous bruit, and low back pain. A high degree of clinical suspicion and a well-performed physical examination are important for its timely diagnosis.
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28928956/a-primer-on-infrarenal-abdominal-aortic-aneurysms
#7
REVIEW
Norman R Hertzer
Ruptured abdominal aortic aneurysms have an alarmingly high mortality rate that often exceeds 50%, even when patients survive long enough to be transported to hospitals. Historical data have shown that ruptures are especially likely to occur with aneurysms measuring ≥6 cm in diameter, but there are so many exceptions to this that several randomized clinical trials have been done in an attempt to determine whether smaller aneurysms should be repaired electively as soon as they are discovered. More recently, further trials have been conducted in order to compare the relative benefits and disadvantages of modern endovascular aneurysm repair to those of traditional open surgery...
2017: F1000Research
https://www.readbyqxmd.com/read/28928251/whipple-s-endocarditis-presenting-as-ulnar-artery-aneurysm-if-you-don-t-look-you-won-t-find
#8
Owen Seddon, Irasha Hettiarachchi
A 54-year-old female patient presented to her local district general hospital with a painful, swollen left arm. Imaging revealed an ulnar artery aneurysm. The aetiology was embolic, with an echocardiogram revealing vegetations on the aortic valve. The patient was treated empirically for 6 weeks with amoxicillin and gentamicin for endocarditis. Eight months later, she had an elective aortic valve replacement for symptomatic aortic regurgitation. The valve was culture negative but analysis by 16S rDNA PCR was positive for Tropheryma whipplei In retrospect, the ulnar artery aneurysm and a history of arthralgia were attributed to an underlying diagnosis of Whipple's endocarditis...
September 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28927932/chitosan-doxycycline-hydrogel-an-mmp-inhibitor-sclerosing-embolizing-agent-as-a-new-approach-to-endoleak-prevention-and-treatment-after-endovascular-aneurysm-repair
#9
Fatemeh Zehtabi, Pompilia Ispas-Szabo, Djahida Djerir, Lojan Sivakumaran, Borhane Annabi, Gilles Soulez, Mircea Alexandru Mateescu, Sophie Lerouge
The success of endovascular repair of abdominal aortic aneurysms remains limited due to the development of endoleaks. Sac embolization has been proposed to manage endoleaks, but current embolizing materials are associated with frequent recurrence. An injectable agent that combines vascular occlusion and sclerosing properties has demonstrated promise for the treatment of endoleaks. Moreover, the inhibition of aneurysmal wall degradation via matrix metalloproteinases (MMPs) may further prevent aneurysm progression...
September 16, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28925872/abdominal-aorta-aneurysm-aaa-is-there-a-role-for-prevention-and-therapy-using-antioxidants
#10
Joël Pincemail, Jean-Olivier Defraigne, Audrey Courtois, Adelin Albert, Jean-Paul Cheramy-Bien, Natzi Sakalihasan
Abdominal aortic aneurysm (AAA) is a degenerative disease that cause mortality in people aged > 65 years. Increased reactive oxygen species (ROS) and oxidative stress seems to play a pivotal role in AAA pathogenesis. Several sources of ROS have been identified in aortic tissues using experimental models: inflammation, increased activity of NAD(P)H or NOX, over-expression of inducible nitric oxide synthase (iNOS), uncoupled endothelial nitric oxide synthase (eNOS), platelets activation and iron release from hemoglobin...
September 18, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28925817/using-multiple-classifiers-for-predicting-the-risk-of-endovascular-aortic-aneurysm-repair-re-intervention-through-hybrid-feature-selection
#11
Omneya Attallah, Alan Karthikesalingam, Peter Je Holt, Matthew M Thompson, Rob Sayers, Matthew J Bown, Eddie C Choke, Xianghong Ma
Feature selection is essential in medical area; however, its process becomes complicated with the presence of censoring which is the unique character of survival analysis. Most survival feature selection methods are based on Cox's proportional hazard model, though machine learning classifiers are preferred. They are less employed in survival analysis due to censoring which prevents them from directly being used to survival data. Among the few work that employed machine learning classifiers, partial logistic artificial neural network with auto-relevance determination is a well-known method that deals with censoring and perform feature selection for survival data...
September 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28925368/a-marfan-syndrome-human-induced-pluripotent-stem-cell-line-with-a-heterozygous-fbn1-c-4082g-a-mutation-ismmsi002-b-for-disease-modeling
#12
Sandra Klein, Jill L Dvornik, Akshitha R Yarrabothula, Christoph Schaniel
Fibroblasts of a 28-year-old female with Marfan syndrome (MFS) due to a heterozygous FBN1 c.4082G>A mutation were reprogrammed using the Sendai virus delivery method. The established human induced pluripotent stem cell (hiPSC) line named ISMMSi002-B expresses pluripotency markers, has a normal karyotype, carries the specific FBN1 mutation and is able to differentiate into three germ layers in vitro. ISMMSi002-B has utility in studying MFS pathogenesis, including skeletal abnormalities, cardiomyopathy, and vascular smooth muscle cell dysfunction associated with aortic aneurysm...
August 2017: Stem Cell Research
https://www.readbyqxmd.com/read/28925047/voxel-by-voxel-4d-flow-mri-based-assessment-of-regional-reverse-flow-in-the-aorta
#13
Xin Shen, Susanne Schnell, Alex J Barker, Kenichiro Suwa, Lingzi Tashakkor, Kelly Jarvis, James C Carr, Jeremy D Collins, Shyam Prabhakaran, Michael Markl
BACKGROUND: Complex and reverse flow in the aorta has been implicated in aneurysm development and stroke via retrograde embolization. PURPOSE: To evaluate global and regional differences between standard 2D plane-based and volumetric voxel-based quantification of regional forward/reverse flow, and reverse flow fraction (RFF) in the aorta. STUDY TYPE: Retrospective. SUBJECTS: In all, 35 subjects: 10 healthy controls (age: 57 ± 7 years, nine male), nine patients without aortic valve regurgitation (AR) (age: 63 ± 10 years, seven male), six patients with mild AR (age: 66 ± 6 years, five male), and 10 with moderate or severe AR (age: 60 ± 16 years, eight male)...
September 18, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28922970/use-of-synchrotron-radiation-to-accurately-assess-cross-sectional-area-reduction-of-the-aortic-branch-ostia-caused-by-suprarenal-stent-wires
#14
Zhonghua Sun, Curtise K C Ng
PURPOSE: To compare in vivo the use of synchrotron radiation to computed tomography angiography (CTA) for the measurement of cross-sectional area (CSA) reduction of the aortic branch ostia caused by suprarenal stent-graft wires. METHODS: This study was performed with a Zenith stent-graft placed in a phantom of the human aorta to simulate treatment of abdominal aortic aneurysm. Synchrotron radiation scans were performed using beam energies between 40 and 100 keV and spatial resolution of 19...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28922688/medium-term-outcomes-of-fenestrated-endovascular-repair-of-juxtarenal-abdominal-aortic-aneurysms
#15
Timothy P Shiraev, Trevor M Y Kwok, Steven R Dubenec
BACKGROUND: Abdominal aortic aneurysms pose a substantial clinical burden, and a significant proportion are not anatomically suitable for open repair or standard endovascular aneurysm repair (EVAR), instead requiring fenestrated EVAR (fEVAR). We sought to compare clinical outcomes and trends over time in patients undergoing fEVAR in Australia. METHODS: We conducted a retrospective analysis of all patients undergoing fEVAR at a tertiary referral centre between 2010 and 2015, including outcomes and complications, both as inpatients and after discharge...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28921013/spinal-cord-injury-as-a-complication-of-thoracic-endovascular-aneurysm-repair
#16
REVIEW
Taijiro Sueda, Shinya Takahashi
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented. METHODS AND RESULTS: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid...
September 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#17
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28919708/alginate-oligosaccharide-indirectly-affects-toll-like-receptor-signaling-via-the-inhibition-of-microrna-29b-in-aneurysm-patients-after-endovascular-aortic-repair
#18
Yong Yang, Zhenhuan Ma, Guokai Yang, Jia Wan, Guojian Li, Lingjuan Du, Ping Lu
Endovascular aortic repair (EVAR) is often followed by aneurysm recurrence. Alginate oligosaccharide (AOS) has potential antitumor properties as a natural product while the related mechanisms remain unclear. Toll-like receptor (TLR) signaling is associated with inflammatory activity of aneurysm and may be affected by miR-29b. Thus, inhibitory function of AOS on aneurysms was explored by measuring the important molecules in TLR4 signaling. After EVAR, a total of 248 aortic aneurysm patients were recruited and randomly assigned into two groups: AOS group (AG, oral administration 10-mg AOS daily) and control group (CG, placebo daily)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28919522/the-incidence-of-ischemic-colitis-after-repair-of-ruptured-abdominal-aortic-aneurysms-is-decreasing-in-the-endovascular-era
#19
S K Desikan, N Singh, S R Steele, N Tran, E Quiroga, P Danaher, B T Garland, B W Starnes
OBJECTIVE: Ischemic colitis (IC) is a well-described complication of ruptured abdominal aortic aneurysms (rAAA). The purpose of this study was to compare the incidence of IC in patients with rAAA undergoing open (OR) vs. endovascular aneurysm repair (EVAR) at a single institution. In addition, we analyzed the incidence of ischemic colitis pre- and post- implementation of a formal rupture AAA protocol (rEVAR protocol). METHODS: A retrospective analysis of prospectively collected data on all patients presenting with rAAA to our institution between Jan 2002 and Oct 2013 was performed...
September 14, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28916405/love-death-a-retrospective-and-prospective-follow-up-mortality-study-over-45-years
#20
Lena Lange, Barbra Zedler, Marcel A Verhoff, Markus Parzeller
BACKGROUND: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events. METHODS: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany...
September 12, 2017: Journal of Sexual Medicine
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