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Saccular aortic aneurysm

Akito Imai, Tomomi Nakajima, Masataka Sato, Yasunori Watanabe, Shunichi Kondo, Motoo Osaka, Yuji Hiramatsu
We report a coil embolization -assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Due to the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10mm, a coil embolization of the distal saccular aneurysm was performed prior to stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak...
November 28, 2016: Annals of Vascular Surgery
Efstratios Georgakarakos, Christos Argyriou, Nikolaos Schoretsanitis, George S Georgiadis
PURPOSE: to describe the use of the combination of a conical custom-made TREO® (TREO CM) stent-graft in the treatment of a saccular abdominal aortic endograft (AAA) with long but tight and calcified distal neck. TECHNIQUE: A 65-year female patient was treated for a saccular 5.2 cm AAA with a 3cm-long but calcified and tight (16mm) distal neck, precluding the safe use of a bifurcated endograft. Since the patient refused an open surgery, a conical TREO CM endograft was manufactured with 20% proximal oversizing, whereas the 3cm caudal sealing segment demonstrated a conical configuration comprised of a 2cm and 1cm nitinol-supported zones of 20% and 10% oversizing, respectively, in order to avoid excessive strain and incomplete expand at the most distal calcified area, leading ultimately to an insidious infolding and consequent type Ib endoleak...
November 28, 2016: Annals of Vascular Surgery
Sebastian Nagel, Athanasios Katsargyris, Kyriakos Oikonomou, Eric L G Verhoeven
PURPOSE: To report a hybrid technique for the treatment of a suprarenal aortic aneurysm (SAA) in a patient with iliac occlusive disease. Initially an infrarenal aorto-bifemoral surgical graft was implanted, followed by deployment of a fenestrated bifurcated stent-graft at the suprarenal part of the aorta. CASE REPORT: A 69-year old man presented with a 51-mm saccular SAA and iliac occlusive disease with intermittent claudication. Both common iliac arteries had been previously treated with kissing stents...
November 24, 2016: Annals of Vascular Surgery
Emma van der Weijde, Olaf J Bakker, Ignace F J Tielliu, Clark J Zeebregts, Robin H Heijmen
PURPOSE: To report the perioperative results and short-term follow-up of patients treated with scalloped thoracic stent-grafts. METHODS: A multicenter registry in the Netherlands captured data on 30 patients (mean age 68 years; 17 men) with thoracic aortic pathology and a short (<20 mm) proximal or distal landing zone who received a custom-made scalloped stent-graft between January 2013 and February 2016. Patients were treated for saccular (n=13) aneurysms, fusiform (n=9) aneurysms, pseudoaneurysms (n=4), or chronic type B dissections (n=4)...
November 3, 2016: Journal of Endovascular Therapy
Giacomo Murana, Mariano Cefarelli, Geoffrey Kloppenburg, Wim J Morshuis, Robin H Heijmen
In adult the patent ductus arteriosus is a rare condition associated sometimes with lethal complications. We describe the case of a 44-year-old woman with a history of systemic lupus erythematosus admitted to our hospital with hoarseness and severe dyspnea. Clinical imaging examinations indicated a saccular aneurysm within a persistent ductus arteriosus with signs of impending rupture. Patient was not considered suitable for transcatheter closure and therefore she underwent open aortic repair. The procedure was uneventful and any significant complications occurred during postoperative course...
October 19, 2016: Future Cardiology
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara
We herein report a case of a rare complication of spinal cord ischemia (SCI) following endovascular aneurysm repair (EVAR). Computed tomography showed stenosis and calcification of bilateral iliac arteries and a saccular aneurysm of the terminal aorta. Paraplegia occurred soon after balloon angioplasty of iliac arteries and EVAR. Cerebrospinal fluid drainage was not performed because the patient was on dual antiplatelet drugs. The patient was treated with intravenous methylpredonisolone and naloxone; however, this did not improve his paraplegia...
2016: Annals of Vascular Diseases
Jahir Richard DE Oliveira, Maurício DE Amorim Aquino, Svetlana Barros, Guilherme Benjamin Brandão Pitta, Adamastor Humberto Pereira
OBJECTIVE: to determine the blood flow pattern changes after endovascular treatment of saccular abdominal aortic aneurysm with triple stent. METHODS: we conducted a hemodynamic study of seven Landrace and Large White pigs with saccular aneurysms of the infrarenal abdominal aorta artificially produced according to the technique described. The animals were subjected to triple stenting for endovascular aneurysm. We evaluated the pattern of blood flow by duplex scan before and after stent implantation...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
Han Li, Kexin Lin, Danial Shahmirzadi
This study aims to quantify the effects of geometry and stiffness of aneurysms on the pulse wave velocity (PWV) and propagation in fluid-solid interaction (FSI) simulations of arterial pulsatile flow. Spatiotemporal maps of both the wall displacement and fluid velocity were generated in order to obtain the pulse wave propagation through fluid and solid media, and to examine the interactions between the two waves. The results indicate that the presence of abdominal aortic aneurysm (AAA) sac and variations in the sac modulus affect the propagation of the pulse waves both qualitatively (eg, patterns of change of forward and reflective waves) and quantitatively (eg, decreasing of PWV within the sac and its increase beyond the sac as the sac stiffness increases)...
2016: Biomedical Engineering and Computational Biology
Ioakeim T Giagtzidis, Konstantinos Konstantinidis, Thomas E Kalogirou, Christos D Karkos, Konstantinos O Papazoglou
AIM: To describe our experience with the endovascular treatment of focal abdominal aortic pathology with an adequate distal neck length using Endurant (Medtronic) aortic extension cuffs. METHODS: From July 2010 to May 2015, 16 patients (14 male), with a mean age of 73.6 years (range 59-88), were treated for focal abdominal aortic pathology using only Endurant (Medtronic) aortic cuff extensions. The indication for intervention was a saccular abdominal aortic aneurysm (AAA) in 5 patients, a fusiform aortic aneurysm in 6, abdominal aortic dissection in 2, an aortic juxtarenal rupture in one, a large anastomotic pseudoaneurysm of previous bifurcated open repair in one, and a juxtarenal aneurysm above a previous open AAA repair...
July 12, 2016: Annals of Vascular Surgery
Hirokazu Minamimura, Takumi Ishikawa, Tadahiro Murakami, Shinsuke Kotani
Although there are several mitral valve aneurysm reports, studies on aortic valve aneurysm are extremely rare. This paper describes an uncommon case of a large saccular aortic valve aneurysm associated with infective endocarditis. A 37-year-old man was hospitalized in our hospital with fever and dyspnea. Echocardiography found severe aortic regurgitation and aortic valve aneurysm of the non-coronary cusp going in and out of the left ventricular chamber. Blood cultures grew Streptococcus viridance. Therefore, the patient underwent aortic valve replacement...
July 2, 2016: General Thoracic and Cardiovascular Surgery
K Spanos, A D Giannoukas
No abstract text is available yet for this article.
August 2016: European Journal of Vascular and Endovascular Surgery
W J Zhang, Y L Yang, M X Xie, X F Wang, Q Lyu, L He, J Wang, L Li, J Zhang, Y Wang, J F Liu
OBJECTIVE: To observe image features of sinus of Valsalva aneurysm (SVA) extending into left ventricle by echocardiography. METHODS: Echocardiographic features of 5 cases of SVA extending into left ventricle and underwent surgery at Union Hospital from July 1995 to September 2015 were reviewed retrospectively and image and surgical findings were compared. A total of 4 patients were diagnosed by conventional and 3D echocardiography before surgery, and 1 patient was diagnosed by conventional echocardiography...
June 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Steven M Jones, Francesco Torella
PURPOSE: To describe a life-threatening complication during endovascular aneurysm repair that was caused by a series of errors. CASE REPORT: A 64-year-old man received a Zenith aortouni-iliac stent-graft for a 61-mm saccular aortic aneurysm. During retrieval of the delivery system, the sheath became dislodged from the common femoral artery. Reintroduction caused the top cap to disengage from the pusher rod because the pin vice had not been tightened as per the instructions for use...
October 2016: Journal of Endovascular Therapy
Sacha D Nandlall, Elisa E Konofagou
Purpose To assess whether the stability of murine aortic aneurysms is associated with the homogeneity of pulse wave propagation within the saccular wall. Materials and Methods All animal procedures were approved by the institutional Animal Care and Use Committee. Apolipoprotein E and tissue inhibitor of metalloproteinases-1 knockout mice (n = 26) were infused with angiotensin II by using subcutaneously implanted osmotic pumps, with an additional control mouse used for histologic examination (n = 1). Pulse wave imaging (PWI) was performed just before infusion and 15 days after infusion by using 40-MHz ultrasonography at 8000 frames per second (with electrocardiographic gating)...
December 2016: Radiology
Himanshu J Patel, Michael D Dake, Joseph E Bavaria, Michael J Singh, Mark Filinger, Michael P Fischbein, David M Williams, Jon S Matsumura, Gustavo Oderich
BACKGROUND: Endovascular treatment for aortic arch aneurysms often requires adjunctive use of hybrid debranching procedures to maintain branch vessel perfusion. This study describes early results with a novel branched arch endograft for total endovascular repair of distal arch aneurysms. METHODS: This US feasibility multicenter clinical trial evaluated 22 patients (mean age, 74.1 ± 10.5 years; 54.5% male) undergoing branched thoracic endovascular aortic repair in Ishimaru zone 2...
October 2016: Annals of Thoracic Surgery
Simon De Freitas, Caoilfhionn Connolly, Colm Neary, Sherif Sultan
An aneurysm of the ductus arteriosus is a rare finding, particularly in the adult population. These saccular aneurysms arise at the site of an incompletely obliterated ductus arteriosus along the lesser curvature of the aortic arch. Left untreated, it is associated with a high risk of potentially life-threatening complications including rupture, infection and thromboembolism. As a result, surgical correction is recommended. Previously, options were limited to open repair but as endovascular experience grows, novel techniques afford safer and less invasive alternatives...
2016: Journal of Surgical Case Reports
William P Robinson, Manuela Schuksz
Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine...
May 2016: Vascular and Endovascular Surgery
Maurício de Amorim Aquino, Svetlana Maria Wanderley de Barros, Aldemar Araújo Castro, Guilherme Benjamin Brandão Pitta, Adamastor Humberto Pereira
OBJECTIVE: To consider modifications in an experimental model of saccular aortic aneurysm, aiming at better reproducibility, to be used in the development of vascular prostheses. METHODS: Experimental study in two phases, developed in the Center of Experimental Surgery and Bioterium (CCEB) of the University of Health Sciences of Alagoas (UNCISAL), with 11 hybrid swine, female, mean weight of 20 ± 5 kg, according to modifications in the Perini technique was performed...
February 2016: Brazilian Journal of Cardiovascular Surgery
Ram Das Nayak, Mathews Paul, George Jose Valooran, Rosh Varghese
Aneurysms of aortic arch are rare but amenable to endovascular therapy. Arch aneurysm presenting with aorto-esophageal fistula and hematemesis is a feared, but relatively rare complication. The extrapolation of the safety and rapidity of emergent endovascular repair for bleeding arch aneurysms has been infrequently reported. A bovine arch anatomy confers distinct advantages for endovascular therapy often avoiding a preceding debranching surgery. However, its endovascular treatment might be complicated by the nonhealing of fistula and potential risk for mediastinitis...
December 2015: Indian Heart Journal
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