Etiology of saccular aortic aneurysms

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...

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.

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...

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...

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...

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...

24-year-old black female presenting with progressive paralysis of the left lower limb. The clinical examination and investigations describe an extensive retroperitoneal mass. An exploratory laparotomy reveals a ruptured saccular infrarenal aortic aneurysm, a narrowing of the distal aorta and a complete obstruction of the left common iliac artery. The aneurysm was resected, an aortoiliac bypass and femorofemoral crossover bypass were performed, with success. The clinical presentation of this ruptured abdominal aneurysm is unusual...

In an unselected series of 3,375 autopsies performed during five years there were 114 cases of aortic aneurysm (3.4%). Males were affected 9.4 times as often as females. Average age at death of those with aneurysm was 72.8 years, of those with rupture 69 years. Of the aneurysms 73.8% were located in the lumbar aorta, 22.8% in the thoracic aorta and 3.5% involved the entire aorta. Saccular or fusiform aneurysms accounted for 73.4%, dissecting ones for 18.4% and pseudoaneurysms for 1.8%. Arteriosclerosis was the underlying cause of the aneurysm in 95...

Two patients with bronchial artery aneurysm were surgically treated. One patient had a saccular aneurysm in the root of the left bronchial artery, and the other had a mediastinal as well as an intrapulmonary aneurysm, rupture of the latter of which had resulted in massive hemoptysis. Twelve reports of bronchial artery aneurysm have appeared in the literature to date. Those of mediastinal location frequently have symptoms mimicking dissecting aortic aneurysm, whereas their intrapulmonary counterparts usually are manifested by hemoptysis...

A five-year-old boy with a large saccular aneurysm of the thoracic descending aorta extending rightward in the mediastinum underwent operation. Through a left thoracotomy descending aorta was clamped during partial femoro-femoral bypass and a examination of somatosensory evoked potential of the spinal cord. Placing a vertical incision on the aorta, a orifice of the aneurysm was closed with a xenograft pericardial patch. The aneurysm was left untouched. Nine months after operation the aneurysm was not recognized on chest X-ray and computed tomography...

A forty-eight-year-old man presented with cavitary pulmonary tuberculosis and widening of the mediastinum. Mediastinal widening was due to multiple saccular aneurysms of the ascending aorta and the arch of the aorta. The various presentations of tubercular aortitis and the reasons for considering alternative etiology for the thoracic aneurysms in this case are discussed. The authors report this interesting association of pulmonary tuberculosis with luetic aortic aneurysm.

In the evaluation of thoracic masses adjacent to vascular structures, aneurysms must be considered as a possible etiology. Particular consideration must be given to this possibility before percutaneous biopsy is performed. While contrast-enhanced computed tomography or magnetic resonance imaging is usually sufficient for making the diagnosis, angiography remains the gold standard for characterization and preoperative planning.