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Etiology of saccular aortic aneurysms

Joel Sousa, João Neves, Vicente Riambau, José Teixeira
INTRODUCTION: Thoracic endovascular aortic aneurysm repair (TEVAR) is an established treatment for thoracic aortic disease in both the acute and elective setting, with such a widespread use that almost 50% of all thoracic aortic surgery in Europe is performed by these means. Nonetheless, the feasibility of TEVAR is determined by several anatomic factors, and the suitability of the proximal and distal landing zones remain one of the main limitations to its use. The advent of custom-made thoracic stent grafts widened the endovascular options in some challenging anatomies...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Mark F Conrad, James Tuchek, Robert Freezor, Joseph Bavaria, Rodney White, Ronald Fairman
BACKGROUND: The 1-year results of endovascular exclusion of degenerative descending thoracic aortic aneurysms (DTA) with the Valiant Thoracic Stent Graft (Medtronic Vascular, Santa Rosa, Calif) have been previously reported. With long-term follow-up now complete, the 5-year results are reported. METHODS: The VALOR II trial (Evaluation of the Clinical Performance of the Valiant Thoracic Stent Graft System in the Treatment of Descending Thoracic Aneurysms of Degenerative Etiology in Subjects Who Are Candidates for Endovascular Repair) was a prospective, nonrandomized trial of the Valiant Thoracic Stent Graft system in patients with degenerative DTA...
August 2017: Journal of Vascular Surgery
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
Ourania Preventza, Joseph S Coselli
Saccular aneurysms of the aortic arch, whether single or multiple, are uncommon. The choice of repair technique is influenced by patients' comorbidities and age. Repairing saccular aneurysms with traditional open techniques can be technically demanding; therefore, endovascular technology and a variety of hybrid approaches have been developed to facilitate such repairs and, potentially, to improve clinical outcomes, especially in high-risk patients. There have been no large, randomized studies to compare the outcomes of these different treatment options in patients with single or multiple saccular aneurysms of the arch...
April 2015: Aorta (Stamford, Conn.)
A Yannoutsos, O Mercier, E Messas, M E Safar, J Blacher
Tropical aortitis is a rare and poorly described aortic disease, sometimes confounded with Takayasu's disease, mainly in people from Africa. In this case report, the panaortic aneurysmal disease in a young woman from Haiti, first diagnosed after a work-up on renovascular hypertension, would appear to approach this particular arterial disease with no clinical, radiological or biological argument for an infectious etiology. The initially suspected diagnosis of Takayasu's disease had to be rethought because of the presence of several saccular aneurysms extending from the aortic arch to the infrarenal aorta, rarely described in Takayasu's aortitis...
May 2014: Journal des Maladies Vasculaires
Hajime Mizukami, Shuichi Hara, Masamune Kobayashi, Shirushi Takahashi, Shinjiro Mori, Fumi Kuriiwa, Tatsushige Fukunaga
We report an autopsy case of bronchial asthma patient with a specific abdominal aortic aneurysm. The aneurysm did not show arteriosclerosis, and a specific saccular morphology was noted above the bifurcation. Histologically, necrosis of the media resembling acute aortic dissociation was observed. However, angiitis was ruled out. In addition, the aneurysm showed a cicatrized, old intimal crack in addition to the rupture site, suggesting repeated failures. The long-term steroid therapy-related fragility of the arterial wall may have been involved in the etiology of the aneurysm...
January 2014: Legal Medicine
Vojko Flis, Joze Matela, Silva Breznik, Nina Kobilica
PURPOSE: To report the use of multilayer uncovered stent to treat primary infected juxtarenal aortic aneurysm. CASE REPORT: A 50-year-old man was admitted to hospital for rapid onset of intractable abdominal pain and high fever. Computed tomographic scan showed 2 juxtarenal saccular aneurysms of abdominal aorta with morphologic and clinical changes compatible with infectious etiology. Patient was treated with multilayer flow-modulating stent. Follow-up imaging showed persistent aneurysm exclusion and continuous aneurysm shrinkage of the sac until complete regression to a normal aortic configuration was seen at 1 year...
October 2013: Vascular and Endovascular Surgery
María Teresa González López, Ali Sadek Dorgham, Fernando Calleja Rosas, Julio Gutiérrez de Loma
True aneurysm formation in arterialized autologous veins is an unusual complication. A saccular aneurysmal degeneration of 53 mm (maximal diameter) of a saphenous vein graft inserted for repair of a popliteal aneurysm, four years after implantation, is reported. The patient (with prior history of abdominal aortic aneurysm) had been initially treated through a posterior approach. A new saphenous vein bypass grafting (medial approach) was performed. Histological examination revealed myointimal fibrosis, medial degeneration and inflammation...
October 2012: Vascular
Balaji Rao, Rajesh Botchu, Aman Khan, Mansoor Aslam
Pseudocoarctaion is a rare congenital anomaly due to elongation of aortic arch. The exact etiology is still uncertain. It may be associated with other congenital cardiac and vascular anomalies. We report an unusual case of pseudocarctation associated with aberrant right subclavian artery, left SVC and multiple saccular aneurysms in the kinked arch and we feel that this is the first documented case in literature.
2010: Journal of Radiology Case Reports
Maresa A Brake, Joseph Shalhoub, Jeremy S Crane, Richard G J Gibbs, Ian J Franklin
Inflammatory abdominal aortic aneurysms (IAAAs) account for 5% to 10% of all abdominal aortic aneurysms, occurring primarily in males. Their true etiology is unknown. Symptoms and signs of IAAA are so variable that they present to a wide range of specialties. There is debate in the literature whether IAAA is a manifestation of systemic autoimmune disease. We describe the case of a young female patient with complicated inflammatory aortoiliac aneurysmal disease, illustrating diagnostic and treatment challenges that remain...
February 2012: Vascular and Endovascular Surgery
Sérgio Silva, Vitor Bettencourt, Tiago Neves, Alexandre Aranha, Daniela Gonçalves, Orlanda Castelobranco, Duarte Medeiros
The aneurismatic aortic disease is one of the most frequent conditions challenging the vascular surgeon. It can be caused by atherosclerosis, vasculitis, trauma, infection or others. The treatment, even when elective, can be associated to high rates of morbid-mortality, related to the etiology, anatomic location and type of treatment. The authors describe the case of a patient with concomitant syphilitic aneurysms of the descending thoracic aorta, pararenal and aortic bifurcation. The diagnostic presumption was supported by clinical and epidemiology data (the patient was treated for a syphilitic saccular infrarenal aortic aneurysm 5 years before)...
January 2010: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Satomi Kasashima, Yoh Zen, Atsuhiro Kawashima, Masamitsu Endo, Yasushi Matsumoto, Fuminori Kasashima, Hiroshi Ohtake, Yasuni Nakanuma
OBJECTIVE: Immunoglobulin G4-related sclerosing disease (IgG4-SD) has recently been reported to occur in the cardiovascular system and manifest as inflammatory abdominal aortic aneurysm. Thoracic aortic lesions are often associated with aortitis in several divergent etiologies. Thus, this study was performed to review thoracic aortic lesions from the aspect of IgG4-SD and to elucidate the clinicopathologic characteristics of this subgroup in the thoracic aorta. METHODS: The study comprised 125 patients, including 71 with thoracic aortic aneurysm (TAA), 44 with aortic dissection, 7 with Takayasu aortitis, and 3 with infectious aortitis...
December 2010: Journal of Vascular Surgery
Yasuhiro Aoki, Masataka Takamiya, Hisae Niitsu, Sachiko Fujita, Kiyoshi Saigusa
An autopsy case of spontaneous rupture of a clinically undiagnosed inflammatory aneurysm of the aortic sinus is presented. A 34-year-old man consulted a physician complaining of anterior chest pain and heartburn persisting for 2 days. Diagnoses of common cold and gastritis were made, but 3h later his condition deteriorated, leading to death. Autopsy revealed hemopericardium due to rupture of a saccular aneurysm of the aortic sinus. Histological examination of the aortic sinus disclosed aortitis characterized by fragmentation and loss of elastic tissues with fibrous thickening of the intima...
January 2009: Legal Medicine
K Kasirajan, R K Greenberg, D Clair, K Ouriel
PURPOSE: To retrospectively review our experience with visceral artery aneurysms (VAAs) treated with percutaneous coil embolization techniques. METHODS: Patient records were retrospectively reviewed between 1988 and 1998 for VAA cases treated with catheter-based techniques. Nine patients (5 women; mean age 64 +/- 11 years) with 12 (8 false and 4 true) VAAs were identified. The majority (67%) of these patients presented with symptoms of aneurysm rupture. The etiology of the aneurysm was iatrogenic in 4, pancreatitis in 4, and idiopathic in 4...
April 2001: Journal of Endovascular Therapy
R A White, C E Donayre, I Walot, M Lippmann, J Woody, J Lee, N Kim, G E Kopchok, T J Fogarty
OBJECTIVE: The objective of this study was to analyze a single-center experience in which descending thoracic aortic aneurysms (TAAs) were treated with a new self-expanding endovascular prosthesis (Medtronic AVE). METHODS: Twenty-six patients (13 men, 13 women) with American Society of Anesthesiology grades II to IV and ages ranging from 53 to 92 years (average, 74 years) consented as part of a Phase I Food and Drug Administration-approved trial. Treated lesions included TAAs that were 5 to 10 cm in diameter, 12 diffuse dilations or fusiform aneurysms, and four saccular aneurysms...
May 2001: Journal of Vascular Surgery
J Salas Millán, J L Martínez Calzón, N González de Vega, J L Castillo Castro
Nowdays, cardiovascular manifestations of syphilis are uncommon. We report the case of a 69-year-old man who underwent surgery for saccular aneurysm of the ascending aorta associated with aortic regurgitation of this etiology, due to sexual transmission of the disease 25 years previously. The patient was born in Morocco and 2 years after surgery he remains asymptomatic.
December 2000: Revista Española de Cardiología
S Amin, J Luketich, A Wald
Aortoesophageal fistula is a rare but fatal cause of upper gastrointestinal bleeding. The classic clinical triad consists of midthoracic pain or dysphagia, a sentinel episode of hematemesis, followed by fatal exsanguination. In a patient with hemodynamically significant upper gastrointestinal bleeding of unknown etiology, who has evidence of a tortuous aorta or aneurysm by chest x-ray or who exhibits Chiari's triad, the presence of AEF should be entertained. A prompt and definitive diagnosis at the time of the initial hemorrhage is necessary for a successful surgical outcome...
August 1998: Digestive Diseases and Sciences
S J Lin, Y C Lai, P J Wang, L C Wang, S S Wang
A 15-year-old girl with voice hoarseness and neck soreness for 4 months had a pulsating mass, sized 3 x 5 cm, adjacent to the right mastoid process. Physical examination revealed normal blood pressure recordings in 4 limbs and no stigmata of Marfan syndrome. Examination of the oral cavity showed bulging of the right pharyngeal wall medially, and the tongue deviated to the right at protrusion. Laboratory workups including complete blood counts, biochemistry, electrolytes, serological and immunological surveys revealed nothing particular...
March 1994: Zhonghua Minguo Xiao Er Ke Yi Xue Hui za Zhi [Journal]
P S Gronemeyer, D E deMello
Takayasu's arteritis or nonspecific arteritis is a term used to designate a primary arteries of unknown etiology involving the aorta and its major branches at any level. Generally, the lesions are obliterative; however, aneurysms and saccular dilations have also been described. The arteritis was originally believed to be limited to the aortic arch; however, involvement of the descending thoracic and abdominal aorta has been reported. In fact, the majority of cases of Takayasu's disease in children involve the descending thoracic and abdominal aorta...
May 1982: Pediatrics
S J Lang, H S Gewirtz, J D Baker
Suprarenal abdominal aortic aneurysms are rare and pose special problems in diagnosis and management. These aneurysms often involve one or more visceral branches and frequently require a thoracoabdominal approach for surgical repair. The operative management of an unusual saccular suprarenal aortic aneurysm suspected to be of mycotic etiology is discussed. The diagnosis was made preoperatively with the aid of CT scanning and arteriography. Surgical repair was accomplished through an abdominal approach by excision and primary closure using a lateral suture technique...
November 1985: Journal of Cardiovascular Surgery
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