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Suprarenal aneurysm

Qiulun Lu, Xiuxin Jiang, Cheng Zhang, Wei Zhang, Wencheng Zhang
BACKGROUND: Abdominal aortic aneurysm (AAA) affects more than 5% of the population in developed countries. To study the formation and progression of AAA, we developed a non-invasive method to analyse regional aortic stiffness to monitor the formation and progression of AAA. METHODS: Saline or Angiotensin II (AngII) was subcutaneously infused in apolipoprotein E knockout (ApoE(-/-)) mice for 28 days; a high-resolution imaging system was used to identify changes in arterial stiffness measured by pulse-wave velocity (PWV) and aortic lumen diameter in the suprarenal aorta...
August 17, 2016: Heart, Lung & Circulation
Hongyou Yu, Corey S Moran, Alexandra F Trollope, Lynn Woodward, Robert Kinobe, Catherine M Rush, Jonathan Golledge
Angiogenesis and inflammation are implicated in aortic aneurysm and atherosclerosis and regulated by angiopoietin-2 (Angpt2). The effect of Angpt2 administration on experimental aortic aneurysm and atherosclerosis was examined. Six-month-old male apolipoprotein E deficient (ApoE(-/-)) mice were infused with angiotensin II (AngII) and administered subcutaneous human Fc-protein (control) or recombinant Angpt2 (rAngpt2) over 14 days. Administration of rAngpt2 significantly inhibited AngII-induced aortic dilatation and rupture of the suprarenal aorta (SRA), and development of atherosclerosis within the aortic arch...
October 21, 2016: Scientific Reports
Xavier Chaufour, Julien Gaudric, Yann Goueffic, Réda Hassen Khodja, Patrick Feugier, Sergei Malikov, Guillaume Beraud, Jean-Baptiste Ricco
OBJECTIVE: Endovascular aneurysm repair (EVAR) is widely used with excellent results, but its infectious complications can be devastating. In this paper, we report a multicenter experience with infected EVAR, symptoms, and options for explantation and their outcome. METHODS: We have reviewed all consecutive endograft explants for infection at 11 French university centers following EVAR, defined as index EVAR, from 1998 to 2015. Diagnosis of infected aortic endograft was made on the basis of clinical findings, cultures, imaging studies, and intraoperative findings...
October 5, 2016: Journal of Vascular Surgery
Hou-Zao Chen, Fang Wang, Peng Gao, Jian-Fei Pei, Yue Liu, Ting-Ting Xu, Xiaoqiang Tang, Wen-Yan Fu, Jie Lu, Yun-Fei Yan, Xiao-Man Wang, Lei Han, Zhu-Qin Zhang, Ran Zhang, Ming-Hui Zou, De-Pei Liu
RATIONALE: Uncontrolled growth of abdominal aortic aneurysms (AAAs) is a life-threatening vascular disease without an effective pharmaceutical treatment. AAA incidence dramatically increases with advancing age in men. However, the molecular mechanisms by which aging predisposes individuals to AAAs remain unknown. OBJECTIVE: In this study, we investigated the role of Sirtuin 1 (SIRT1), a class Ⅲ histone deacetylase, in AAA formation and the underlying mechanisms linking vascular senescence and inflammation...
September 20, 2016: Circulation Research
Amit Bardia, Akshay Sood, Feroze Mahmood, Vwaire Orhurhu, Ariel Mueller, Mario Montealegre-Gallegos, Marc R Shnider, Klaas H J Ultee, Marc L Schermerhorn, Robina Matyal
Importance: Epidural analgesia (EA) is used as an adjunct procedure for postoperative pain control during elective abdominal aortic aneurysm (AAA) surgery. In addition to analgesia, modulatory effects of EA on spinal sympathetic outflow result in improved organ perfusion with reduced complications. Reductions in postoperative complications lead to shorter convalescence and possibly improved 30-day survival. However, the effect of EA on long-term survival when used as an adjunct to general anesthesia (GA) during elective AAA surgery is unknown...
September 7, 2016: JAMA Surgery
Daphne Elisabeth Gray, Markus Eisenack, Michael Gawenda, Giovanni Torsello, Payman Majd, Jan Brunkwall, Nani Osada, Konstantinos P Donas
OBJECTIVE: The influence of endovascular aneurysm repair (EVAR) on renal function is of high concern. The question whether stent graft fixation type plays a significant role in renal outcome after EVAR is still debated. However, other factors, such as repeated contrast medium exposure, should also be considered. METHODS: We performed a two-center, stratified-cohort case control study to evaluate the influence of last-generation abdominal endografts with suprarenal (SR) vs infrarenal (IR) fixation on renal function...
August 26, 2016: Journal of Vascular Surgery
Drosos Kotelis, Karina Schleimer, Houman Jalaie, Jochen Grommes, Michael J Jacobs, Johannes Kalder
PURPOSE: To report operative and midterm outcomes of fenestrated endovascular aneurysm repair (FEVAR) with the Anaconda device. METHODS: A retrospective analysis was conducted of 39 consecutive patients (median age 74 years; 36 men) treated with the fenestrated Anaconda stent-graft between July 2011 and December 2015 at a single center. Indications for FEVAR were abdominal aortic aneurysms (AAAs) with neck anatomy unsuitable for a standard stent-graft. Median infrarenal neck length was 4 mm (range 0-9)...
August 29, 2016: Journal of Endovascular Therapy
Michael Ertl, Wilma Schierling, Piotr M Kasprzak, Reinhard Kopp, Corinna Brückl, Felix Schlachetzki, Karin Pfister
BACKGROUND AND PURPOSE: Quantification of changes in optic nerve sheath diameter (ONSD) using ocular sonography (OS) constitutes an elegant technique for estimating intracranial and intraspinal pressure. Aortic aneurysm repair (AAR) is associated with a reasonable risk of increased spinal fluid pressure, which is largely dependent on the extent of aneurysm repair (supra- vs. infrarenal). The aim of this study was to compare ONSD measurements in patients with suprarenal AAR (sAAR) or infrarenal AAR (iAAR)...
August 22, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
J L De Bruin, J R Brownrigg, B O Patterson, A Karthikesalingam, P J Holt, R J Hinchliffe, I M Loftus, M M Thompson
BACKGROUND: The chimney technique using parallel grafts offers an alternative to fenestrated or branched endovascular solutions for juxtarenal and suprarenal aneurysms. Endograft deployment proximal to the renal or visceral ostia is combined with parallel stents to the aortic side branches. Application of the chimney technique using the Nellix device (Ch-EVAS) may offer some potential advantages with respect to the seal between the endograft and the parallel grafts. This study aimed to investigate the feasibility and efficacy of the Nellix endovascular aneurysm sealing (EVAS) system in conjunction with parallel grafts for the treatment of juxtarenal and suprarenal aneurysms...
October 2016: European Journal of Vascular and Endovascular Surgery
Jonathan L Eliason, Dawn M Coleman, Enrique Criado, James C Stanley
OBJECTIVE: Pediatric abdominal aortic aneurysms (AAAs) are rare. The intent of this report was to review the presentation and surgical management of AAAs in infancy and early childhood. METHODS: The clinical courses of young children undergoing AAA surgery were subjected to a retrospective review and analysis. RESULTS: Eleven children, nine boys and two girls, ranging in age from 2 weeks to 6 years, underwent surgical treatment of AAA at the University of Michigan from 2002 to 2014...
July 18, 2016: Journal of Vascular Surgery
Chenyang Shen, Weihao Li, Yongbao Zhang, Qingle Li, Yang Jiao, Tao Zhang, Xiaoming Zhang
OBJECTIVES: Behcet's disease is a form of systematic vasculitis that affects vessels of various sizes. Aortic pseudoaneurysm is one of the most important causes of death among patients with Behcet's disease due to its high risk of rupture and associated mortality. Our study aimed to investigate the outcomes of Behcet's disease patients with aortic pseudoaneurysms undergoing open surgery and endovascular aortic repair. METHODS: From January 2003 to September 2014, ten consecutive patients undergoing surgery for aortic pseudoaneurysm met the diagnostic criteria for Behcet's disease...
July 2016: Clinics
Sara Martorell, Luisa Hueso, Herminia Gonzalez-Navarro, Aida Collado, Maria-Jesus Sanz, Laura Piqueras
OBJECTIVE: Abdominal aortic aneurysm (AAA) is a vascular disorder characterized by chronic inflammation of the aortic wall. Low concentrations of vitamin D3 are associated with AAA development; however, the potential direct effect of vitamin D3 on AAA remains unknown. This study evaluates the effect of oral treatment with the vitamin D3 receptor (VDR) ligand, calcitriol, on dissecting AAA induced by angiotensin-II (Ang-II) infusion in apoE(-/-) mice. APPROACH AND RESULTS: Oral treatment with calcitriol reduced Ang-II-induced dissecting AAA formation in apoE(-/-) mice, which was unrelated to systolic blood pressure or plasma cholesterol concentrations...
August 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Mafalda Massara, David Barillà, Gaetana Franco, Alberto Volpe, Raffaele Serra, Giovanni De Caridi, Antonino Alberti, Pietro Volpe
Endovascular aortic repair (EVAR) has been shown to be a valid and minimally invasive alternative to open abdominal aortic aneurysm repair. A major shortcoming for EVAR is the need to submit patients to regular follow-up to detect potential complications such as endoleak, limb occlusion, aneurysm expansion, aneurysm rupture, infection, structural failure, and migration. In this case report, we describe an uncommon case of late type III endoleak due to complete detachment of the stent-graft main body segment from its suprarenal uncovered fixation stent...
August 2016: Annals of Vascular Surgery
Matthew R Bersi, Chiara Bellini, Paolo Di Achille, Jay D Humphrey, Katia Genovese, Stéphane Avril
Many vascular disorders, including aortic aneurysms and dissections, are characterized by localized changes in wall composition and structure. Notwithstanding the importance of histopathologic changes that occur at the microstructural level, macroscopic manifestations ultimately dictate the mechanical functionality and structural integrity of the aortic wall. Understanding structure-function relationships locally is thus critical for gaining increased insight into conditions that render a vessel susceptible to disease or failure...
July 1, 2016: Journal of Biomechanical Engineering
Enrico Gallitto, Mauro Gargiulo, Antonio Freyrie, Claudio Bianchini Massoni, Rodolfo Pini, Chiara Mascoli, Gianluca Faggioli, Andrea Stella
OBJECTIVE: The aim of this study was to evaluate long-term outcomes of endovascular aneurysm repair (EVAR) using a standard suprarenal fixation endograft in abdominal aortic aneurysms (AAAs) with infrarenal neck length ≤10 mm (short-neck AAA [SN-AAA]). METHODS: From 2005 to 2010, data of high-risk patients with SN-AAA, unfit for open repair (OR) and fenestrated EVAR, were prospectively collected. Follow-up was performed by duplex ultrasound and contrast-enhanced ultrasound or computed tomography angiography at 1 month, 6 months, and 12 months and yearly thereafter...
September 2016: Journal of Vascular Surgery
Frank B Pearce, Shu Yang, Runhua Shi, Tze-Woei Tan, Wayne W Zhang
BACKGROUND: Traditional open surgery for juxtarenal aortoiliac occlusive disease (AIOD) requires suprarenal aortic cross-clamping (SRCC), which is associated with high incidence of acute kidney injury (AKI). This study was to compare the outcomes of circumferential aortic endarterectomy followed by immediate infrarenal cross-clamping (IRCC) with the traditional approach of SRCC during surgery for juxtarenal AIOD. METHODS: A 10-year retrospective review of 87 patients who underwent open surgery for AIOD at our University Medical Center was performed...
July 2016: Annals of Vascular Surgery
Damian M Bailey, Tom G Evans, Kate Gower Thomas, Richard D White, Chistopher P Twine, Michael H Lewis, Ian M Williams
What is the central question of this study? To what extent focal abdominal aortic aneurysmal (AAA) disease is associated with systemic remodelling of the vascular tree remains unknown. The present study examined whether anatomical differences exist between distances of the intervisceral artery origins and AAA location/size in patients with disease compared with healthy patients. What is the main finding and its importance? Intervisceral artery distances were shown to be consistently greater in AAA patients, highlighting the systemic nature of AAA disease that extends proximally to the abdominal aorta and its branches...
August 1, 2016: Experimental Physiology
Maude Gagné-Loranger, Éric Dumont, Pierre Voisine, Siamak Mohammadi, François Dagenais
OBJECTIVE: The natural history of root/ascending aortic aneurysms is based on studies from the 1980s to 1990s. Imaging and follow-up guidelines are based on these studies. Dedicated thoracic aortic clinics (TAC) ensure strict patient/imaging follow-up and tight blood pressure (BP) control. The aim of this study was to evaluate the natural history of medically treated root/ascending aortic aneurysms in the current era of dedicated TAC. METHOD: Two hundred and fifty-one patients with 40-50 mm root/ascending aneurysms (all other aortic segments of <40 mm) were identified through a prospective collected databank...
September 2016: European Journal of Cardio-thoracic Surgery
Sarah E Deery, Robert T Lancaster, Donald T Baril, Jeffrey E Indes, Daniel J Bertges, Mark F Conrad, Richard P Cambria, Virendra I Patel
OBJECTIVE: The recent commercial availability of fenestrated stent grafts is likely to result in increasing endovascular repair of complex (juxtarenal and suprarenal) abdominal aortic aneurysms (cAAAs). Whereas most studies providing benchmarking for outcomes after open repair have been from high-volume centers, we sought to evaluate outcomes after elective open cAAA repair vs infrarenal AAA repair at a regional level. METHODS: We used the Vascular Study Group of New England registry, which recorded 1875 open AAA repairs in New England from 2003 to 2011...
May 2016: Journal of Vascular Surgery
Xiaofeng Chen, Debra L Rateri, Deborah A Howatt, Anju Balakrishnan, Jessica J Moorleghen, Lisa A Cassis, Alan Daugherty
AngII and TGF-β interact in development of thoracic and abdominal aortic diseases, although there are many facets of this interaction that have not been clearly defined. The aim of the present study was to determine the effects of TGF-β neutralization on AngII induced-aortic pathologies. Male C57BL/6J mice were administered with either a rabbit or mouse TGF-β neutralizing antibody and then infused with AngII. The rabbit TGF-β antibody modestly reduced serum TGF-β concentrations, with no significant enhancements to AngII-induced aneurysm or rupture...
2016: PloS One
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