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Suprarenal aneurysm

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https://www.readbyqxmd.com/read/28782415/no-difference-in-neck-enlargement-for-patients-treated-with-double-proximal-self-expandable-suprarenal-fixation-endografting
#1
Andrés Reyes Valdivia, Georgios Pitoulias, África Duque Santos, Martín Fabregate Fuente, Apostolos G Pitoulias, Julia Ocaña Guaita, Claudio Gandarias
INTRODUCTION: Neck enlargement is well described in patients treated with self-expandable endografts for abdominal aortic aneurysms. Double endografting (ie, overlapping of stent grafts) occurs in patients with proximal cuffs or bifurcated to monoiliacal configuration conversions. When the aortic neck of patients receives 2 suprarenal fixation endografts, it may behave differently in terms of radial force and interaction of additional suprarenal stents extending to the visceral aorta...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28779856/renal-complications-after-evar-with-suprarenal-versus-infrarenal-fixation-among-all-users-and-routine-users
#2
S L Zettervall, S E Deery, P A Soden, K Shean, J J Siracuse, M Alef, V I Patel, M L Schermerhorn
BACKGROUND: Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE). METHODS: All patients undergoing EVAR in the VSGNE from 2003 to 2014 were identified...
August 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28739454/parallel-grafts-used-in-combination-with-physician-modified-fenestrated-stent-grafts-for-complex-aortic-aneurysms-in-high-risk-patients-with-hostile-anatomies
#3
Joseph Touma, Dorian Verscheure, Marek Majewski, Pascal Desgranges, Frederic Cochennec
OBJECTIVE: To evaluate the feasibility and early outcomes of complex aortic aneurysm repair in high risk patients with hostile anatomies using both parallel stents and physician-modified stent-graft (PMSG) techniques to address the renovisceral arteries METHODS: Consecutive patients with complex suprarenal (SRA) and thoracoabdominal aortic aneurysms (TAAA) undergoing endovascular repair using combined parallel stents technique and PMSG between September 2013 and November 2015 were evaluated...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689483/the-influence-of-positioning-of-the-nellix-endovascular-aneurysm-sealing-system-on-suprarenal-and-renal-flow-an-in-vitro-study
#4
Johannes T Boersen, Erik Groot Jebbink, Lennart Van de Velde, Michel Versluis, Guillaume Lajoinie, Cornelius H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To examine the influence of device positioning and infrarenal neck diameter on flow patterns in the Nellix endovascular aneurysm sealing (EVAS) system. METHODS: The transition of the aortic flow lumen into two 10-mm-diameter stents after EVAS creates a mismatched area. Flow recirculation may affect local wall shear stress (WSS) profiles and residence time associated with atherosclerosis and thrombosis. To examine these issues, 7 abdominal aortic aneurysm flow phantoms were created, including 3 unstented controls and 3 stented models with infrarenal neck diameters of 24, 28, and 32 mm...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#5
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28640121/effects-of-anatomical-characteristics-as-factors-in-abdominal-aortic-aneurysm-rupture-ct-aortography-analysis
#6
Kyoung Min Lee, Sun Young Choi, Min Uk Kim, Do Yun Lee, Kyung Ah Kim, Sanghui Park
The aim of this study was to analyze the anatomical characteristics of patients with ruptured abdominal aortic aneurysms (AAAs) using computed tomography (CT) aortography in order to determine the risk factors for rupture.We retrospectively reviewed the CT aortography findings and medical records of patients with ruptured AAAs who underwent CT aortography between February 2002 and December 2014. Age, sex, blood pressure at the time of rupture, treatment methods used for the ruptured AAAs, and treatment outcomes were analyzed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28632534/administration-of-tetrahydrobiopterin-bh4-protects-the-renal-microcirculation-from-ischemia-and-reperfusion-injury
#7
Lokmane Rahmania, Diego Orbegozo, Fuhong Su, Fabio Silvio Taccone, Jean-Louis Vincent, Daniel De Backer
BACKGROUND: Abdominal aortic aneurysm surgery with suprarenal cross-clamping is often associated with renal injury. Although the mechanism underlying such injury is unclear, tissue ischemia and reperfusion, which induces endothelial dysfunction and decreases the availability of tetrahydrobiopterin (BH4), may play a role. We evaluated whether BH4 administration prevents renal ischemia/reperfusion injury in an animal model of aortic cross-clamping. METHODS: Nineteen anesthetized, mechanically ventilated, and invasively monitored adult sheep were randomized into 3 groups: sham animals (n = 5) that underwent surgical preparation but no aortic clamping; an ischemia/reperfusion group (n = 7), where the aorta was clamped above the renal arteries for 1 hour, and a BH4 group (n = 7), in which animals received 20 mg/kg of BH4 followed by aortic cross-clamp for 1 hour...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28583733/treatment-strategy-based-on-the-natural-course-of-the-disease-for-patients-with-spontaneous-isolated-abdominal-aortic-dissection
#8
Ji-Hee Kang, Young-Wook Kim, Seon-Hee Heo, Shin-Young Woo, Yang-Jin Park, Dong-Ik Kim, Duk-Kyung Kim
OBJECTIVE: This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD. METHODS: We searched the database of thoracoabdominal computed tomography (CT) performed at a single institution from January 2003 to July 2016 using the keywords "aortic dissection" and "dissection AND aorta." Once a diagnosis of SIAAD was made, we investigated the initial clinical and morphologic features and aorta-related events for all patients and morphologic changes of the aortic dissection (AD) during the follow-up period for the patients who underwent follow-up CT scans...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28574051/-stagewise-hybrid-method-of-treating-a-patient-with-connective-tissue-dysplasia-aortic-aneurysm-and-distal-dissection
#9
É R Charchian, A A Skvortsov, D A Chakal, Z R Khachatrian
Presented herein is a clinical case report concerning the use of a hybrid technique in stagewise surgical management of a patient with distal dissection and an aneurysm of the thoracoabdominal portion of the aorta. The patient at high risk with the connective tissue dysplasia syndrome had a past medical history of prosthetic repair of the descending thoracic aorta with type-1 haemodynamic correction. Three years later, the findings of computed tomography demonstrated fenestration in the area of the distal anastomosis, a patent false channel, and an increase in the diameter of the unoperated thoracoabdominal portion of the aorta...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28554696/-hypertension-during-takayasu-s-disease-an-algerian-single-center-experience-of-279-patients
#10
A Mammeri, R Guermaz, A Hatri, F Kessal, S Taharboucht, F Hamrour, M Ammi, S Zekri, M Brouri
INTRODUCTION: Takayasu arteritis (TA) is an uncommon large vessel arteritis. Lesions produced by the inflammatory process can be stenotic, occlusive, or aneurysmal. Vascular changes lead to the main complications, including hypertension, most often due to renal artery stenosis or, more rarely, stenosis of the suprarenal aorta. AIM OF STUDY: Our study will assess the prevalence of hypertension during TA and describe its clinical profile. MATERIAL AND METHODS: Among 279 patients with TA resulting from single center study over a period of 35 years, we collected 128 hypertensive patients...
June 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28410923/infrarenal-endograft-clamping-in-late-open-conversions-after-endovascular-abdominal-aneurysm-repair
#11
Paolo Perini, Alessandro de Troia, Tiziano Tecchio, Matteo Azzarone, Claudio Bianchini Massoni, Pierfranco Salcuni, Antonio Freyrie
OBJECTIVE: The aim of this study was to report the technical aspects and outcomes of late open conversion (LOC) after endovascular aneurysm repair (EVAR) in a single center by using exclusively infrarenal clamping of the endograft as an alternative to suprarenal or supraceliac aortic clamping. METHODS: A retrospective analysis of EVAR requiring late explantation (>30 days) from January 1996 to October 2016 was performed. Patients' demographics, type of endograft, duration of implantation, reason for removal, extent of stent graft removal, type of reconstruction, 30-day mortality, postoperative complications, and long-term survival were obtained for analysis...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389291/a-word-of-caution-for-extra-large-self-expandable-nitinol-stents
#12
Andrés Reyes Valdivia, Africa Duque Santos, Francisco Alvarez Marcos, Asunción Romero Lozano, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
BACKGROUND: To report an unsuccessful use of large nitinol stent to prevent proximal endoleak in endograft treatment for juxtarenal aortic aneurysm. CASE REPORT: An 82-year-old male presented coronary disease and severe chronic obstructive pulmonary disease requiring oxygen support. A large 80-mm juxtarenal aneurysm was found on routine urological examination. Neck features were as follows: 7 mm and high anterior-posterior angulation. ASA risk score IV was given...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28366303/comparison-of-midterm-results-for-the-talent-and-endurant-stent-graft
#13
Yannick W 't Mannetje, Philippe W M Cuypers, Ben R Saleem, Aron S Bode, Joep A W Teijink, Marc R H M van Sambeek
OBJECTIVE: Stent graft evolution is often addressed as a cause for improved outcomes of endovascular aneurysm repair for patients with an abdominal aortic aneurysm. In this study, we directly compared the midterm result of Endurant stent graft with its predecessor, the Talent stent graft (both Medtronic, Santa Rosa, Calif). METHODS: Patient treated from January 2005 to December 2010 in a single tertiary center in The Netherlands with a Talent or Endurant stent graft were eligible for inclusion...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28364044/high-serum-thrombospondin-1-concentration-is-associated-with-slower-abdominal-aortic-aneurysm-growth-and-deficiency-promotes-angiotensin-ii-induced-aneurysm-in-mice
#14
Smriti M Krishna, Saiwang Seto, Roby Jose, Jiaze Li, Joseph V Moxon, Paula Clancy, David J Crossman, Paul E Norman, Theophilus I Emeto, Jonathan Golledge
Abdominal aortic aneurysm (AAA) is a common age-related vascular disease characterized by progressive weakening and dilatation of the aortic wall. Thrombospondin-1 (TSP-1; gene Thbs1) is a member of the matricellular protein family important in the control of extracellular matrix remodeling. In this study, the association of serum TSP-1 concentration with AAA progression was assessed in 276 men that underwent repeat ultrasound for a median 5.5 years. AAA growth was negatively correlated with serum TSP-1 concentration ( Spearman's rho (-)0...
March 31, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28349777/aortic-curvature-is-a-predictor-of-late-type-ia-endoleak-and-migration-after-endovascular-aneurysm-repair
#15
Richte C L Schuurmann, Kim van Noort, Simon P Overeem, Kenneth Ouriel, William D Jordan, Bart E Muhs, Yannick 't Mannetje, Michel Reijnen, Bram Fioole, Çağdaş Ünlü, Peter Brummel, Jean-Paul P M de Vries
PURPOSE: To evaluate the association between aortic curvature and other preoperative anatomical characteristics and late (>1 year) type Ia endoleak and endograft migration in endovascular aneurysm repair (EVAR) patients. METHODS: Eight high-volume EVAR centers contributed 116 EVAR patients (mean age 81±7 years; 103 men) to the study: 36 patients (mean age 82±7 years; 31 men) with endograft migration and/or type Ia endoleak diagnosed >1 year after the initial EVAR and 80 controls without early or late complications...
June 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28285931/flow-and-wall-shear-stress-characterization-after-endovascular-aneurysm-repair-and-endovascular-aneurysm-sealing-in-an-infrarenal-aneurysm-model
#16
Johannes T Boersen, Erik Groot Jebbink, Michel Versluis, Cornelis H Slump, David N Ku, Jean-Paul P M de Vries, Michel M P J Reijnen
BACKGROUND: Endovascular aneurysm repair (EVAR) with a modular endograft has become the preferred treatment for abdominal aortic aneurysms. A novel concept is endovascular aneurysm sealing (EVAS), consisting of dual endoframes surrounded by polymer-filled endobags. This dual-lumen configuration is different from a bifurcation with a tapered trajectory of the flow lumen into the two limbs and may induce unfavorable flow conditions. These include low and oscillatory wall shear stress (WSS), linked to atherosclerosis, and high shear rates that may result in thrombosis...
March 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28279653/comparison-of-renal-complications-between-endografts-with-suprarenal-and-infrarenal-fixation
#17
S L Zettervall, P A Soden, S E Deery, K Ultee, K E Shean, F Shuja, R L Amdur, M L Schermerhorn
OBJECTIVES: Surgeons have multiple grafts options available for the endovascular treatment of abdominal aortic aneurysm (EVAR), and some hypothesize that suprarenal fixation endografts may result in higher rates of renal complications than infrarenal endografts. This study aimed to compare the outcomes of contemporary suprarenal and infrarenal endografts. METHODS: The Targeted Vascular Module of the National Surgical Quality Improvement Project was utilised to identify patients undergoing EVAR for infrarenal aneurysm from 2011 to 2013...
July 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28274751/predictors-of-early-aortic-neck-dilatation-after-endovascular-aneurysm-repair-with-endoanchors
#18
MULTICENTER STUDY
Apostolos K Tassiopoulos, Spyridon Monastiriotis, William D Jordan, Bart E Muhs, Kenneth Ouriel, Jean Paul De Vries
OBJECTIVE: Dilatation of the aorta within the proximal neck after endovascular aneurysm repair (EVAR) can be associated with late endoleaks and migration. This study was designed to identify predictors of early neck dilation in patients undergoing EVAR with Heli-FX EndoAnchors (Medtronic, Santa Rosa, Calif) measured perioperatively to 1 year at different longitudinal levels of neck length. METHODS: The study group of Aneurysm Treatment Using the Heli-FX Aortic Securement System (ANCHOR) comprises 257 consecutive patients prospectively enrolled between April 2012 and September 2014 undergoing EVAR with Heli-FX EndoAnchor implantation at 38 investigational sites...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28270294/effect-of-bortezomib-on-angiotensin-%C3%A2-induced-abdominal-aortic-aneurysm-in-apoe-mice
#19
Fangda Li, Huihua Li, Cui Tian, Hao Nie, Yuehong Zheng
Objective To investigate the role of proteasome inhibitor bortezomib (BTZ) in inflammatory response in abdominal aortic aneurysm (AAA) formation induced by angiotensin Ⅱ (Ang Ⅱ). Methods Ang Ⅱ-induced ApoE(-/-) mice AAA models were established. Forty male ApoE(-/-) mice (8-10-week-old) were randomly and equally divided into four groups:Sham group,BTZ group,Ang Ⅱ group,and Ang Ⅱ+BTZ group.HE staining,immunohistochemical staining,and flow cytometry were used to analyze the inflammatory response. Real-time quantitative polymerase chain reaction (qPCR) was used to analyze the mRNA expression of intercellular cell adhesion molecule-1 (ICAM-1)...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28237648/risk-factors-for-abdominal-aortic-aneurysm-in-the-korean-population
#20
Sang-Ah Han, Jin Hyun Joh, Ho-Chul Park
BACKGROUND: Ultrasound screening shows a clinical benefit in reducing abdominal aortic aneurysm (AAA)-related mortality. However, its cost-effectiveness remains unclear. Understanding the relationship between risk factors and AAA is important to maximize the benefit of AAA screening. However, risk factors for AAA have not been reported in Korea. The purpose of this study is to determine the prevalence of, and risk factors for, AAA among the Korean population. METHODS: The study population consisted of patients >50 years of age who consented for AAA screening...
May 2017: Annals of Vascular Surgery
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