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Acute dissection

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https://www.readbyqxmd.com/read/29051203/anterior-circulation-acute-ischemic-stroke-associated-with-atherosclerotic-lesions-of-the-cervical-ica-a-nosologic-entity-apart
#1
O F Eker, P Panni, C Darganzali, G Marnat, C Arquizan, P Machi, I Mourand, G Gascou, E Le Bars, V Costalat, A Bonafé
BACKGROUND AND PURPOSE: Mechanical thrombectomy for patients with acute ischemic stroke with tandem occlusions has been shown to present varying reperfusion successes and clinical outcomes. However, the heterogeneity of tandem occlusion etiology has been strongly neglected in previous studies. We retrospectively investigated patients with acute ischemic stroke atherothrombotic tandem occlusion. MATERIALS AND METHODS: All consecutive patients with acute ischemic stroke with atherothrombotic tandem occlusions treated with mechanical thrombectomy in our center between September 2009 and April 2015 were analyzed...
October 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29050867/acute-type-a-aortic-dissection-in-a-patient-with-paraganglioma
#2
Andreia Dos Santos Borrego, Pedro Carrilho Ferreira, Fausto J Pinto
Acute aortic dissection is the most common acute aortic syndrome. It is more prevalent in males and in the elderly, and has a high mortality. Hypertension is the main risk factor. Diagnosis is based on clinical features, laboratory tests and imaging exams. Treatment is usually surgical, although in some cases an endovascular approach is an alternative. Paraganglioma is an uncommon neuroendocrine tumor. Most produce catecholamines, and so usually manifest with hypertensive crisis, palpitations, headache and sweating...
October 16, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29049981/angiotensin-receptor-blockade-improves-cardiac-mitochondrial-activity-in-response-to-an-acute-glucose-load-in-obese-insulin-resistant-rats
#3
Max Thorwald, Ruben Rodriguez, Andrew Lee, Bridget Martinez, Janos Peti-Peterdi, Daisuke Nakano, Akira Nishiyama, Rudy M Ortiz
Hyperglycemia increases the risk of oxidant overproduction in the heart through activation of a multitude of pathways. Oxidation of mitochondrial enzymes may impair their function resulting in accumulation of intermediates and reverse electron transfer, contributing to mitochondrial dysfunction. Furthermore, the renin-angiotensin system (RAS) becomes inappropriately activated during metabolic syndrome, increasing oxidant production. To combat excess oxidant production, the transcription factor, nuclear factor erythriod-2- related factor 2 (Nrf2), induces expression of many antioxidant genes...
October 7, 2017: Redox Biology
https://www.readbyqxmd.com/read/29049830/acute-debakey-type-i-aortic-dissection-without-intimal-tear-in-the-arch-is-total-arch-replacement-the-right-choice
#4
Andrea Colli, Massimiliano Carrozzini, Annalisa Francescato, Marco Galuppo, Marina Comisso, Francesca Toto, Dario Gregori, Gino Gerosa
OBJECTIVES: Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. METHODS: Between January 1998 and December 2015, 220 consecutive patients were operated for DeBakey Type I acute aortic dissection; 135 cases did not exhibit an intimal entry tear in the aortic arch and were subsequently selected to comprise the primary study cohort...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049816/triple-ultrasonography-for-iatrogenic-acute-aortic-dissection-caused-by-axillary-arterial-perfusion
#5
Masaki Yamamoto, Hideaki Nishimori, Miwa Tashiro, Kazumasa Orihashi
Iatrogenic aortic dissection caused by axillary arterial cannulation or perfusion becomes a fatal complication of cardiopulmonary bypass when surgeons do not recognize it in the surgical field of view immediately during surgery. Therefore, we routinely monitor the aorta using 'triple ultrasonography' during cardiovascular surgery. An 85-year-old woman underwent partial arch replacement for chronic type A aortic dissection. During cardiopulmonary bypass, acute aortic dissection was observed in the aortic arch from the right axillary artery on real-time transoesophageal echocardiography...
July 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049807/impact-of-initial-aortic-diameter-and-false-lumen-area-ratio-on-type-b-aortic-dissection-prognosis
#6
Akihito Matsushita, Takashi Hattori, Yu Tsunoda, Yasunori Sato, Wahei Mihara
OBJECTIVES: Medical treatment is the gold standard for uncomplicated acute Type B aortic dissection (ATBAD). Although endovascular treatment could become an alternative therapy, it is unclear which ATBAD patients should undergo endovascular intervention. We aimed to evaluate the outcomes of patients with uncomplicated ATBAD and identify the risk factors for major adverse events. METHODS: We retrospectively reviewed 134 consecutive patients who underwent initial treatment for uncomplicated ATBAD between 2004 and 2015...
October 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049664/acute-type-i-aortic-dissection-a-propensity-matched-comparison-of-elephant-trunk-and-arch-debranching-repairs
#7
Mingjia Ma, Xin Feng, Jing Wang, Yiming Dong, Taiqiang Chen, Ligang Liu, Xiang Wei
OBJECTIVES: Our goal was to compare the performance of the frozen elephant trunk (FET) and the hybrid aortic arch debranching procedures for acute Type I aortic dissection. METHODS: From January 2013 to December 2015, 168 patients with Type I aortic disease underwent ascending aorta and total aortic arch replacement with FET implantation (the FET group, n  = 132) or arch debranching with 1-stage aortic arch exclusion using an endovascular stent in a retrograde manner (the debranching group, n  = 36)...
September 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29043093/anatomical-study-of-petrous-and-cavernous-parts-of-internal-carotid-artery
#8
Manisha Vijaywargiya, Rashmi Deopujari, Sunita Arvind Athavale
The petrous and cavernous parts of internal carotid artery (ICA) are obscure and are not readily accessible to observation/imaging. These parts have broad biological and medical interest because of their peculiar shape. Given the their clinical importance and the scarce data available based mostly on imaging, the present study was aimed at studying these parts of ICA by dissection. The study was carried out on 56 ICAs obtained from embalmed adult cadavers and 10 ICAs from five fetuses. The foetal ICAs were studied in situ...
September 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/29042100/limited-root-repair-in-acute-type-a-aortic-dissection-is-safe-but-results-in-increased-risk-of-reoperation
#9
Peter Chiu, Jeffrey Trojan, Sarah Tsou, Andrew B Goldstone, Y Joseph Woo, Michael P Fischbein
OBJECTIVE: Management of the aortic root is a challenge for surgeons treating acute type A aortic dissection. METHODS: We performed a retrospective review of the acute type A aortic dissection experience at Stanford Hospital between 2005 and 2015 and identified patients who underwent either limited root repair or aortic root replacement. Differences in baseline characteristics were balanced with inverse probability weighting to estimate the average treatment effect on the controls...
September 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29040967/improvement-and-aggravation-of-spontaneous-unruptured-vertebral-artery-dissection
#10
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
October 17, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29038412/-effects-of-high-frequency-jet-ventilation-on-respiratory-failure-after-total-arch-replacement-due-to-acute-aortic-dissection-with-morbid-obesity-report-of-a-case
#11
Motoyuki Kumagai, Junichiro Nishizawa, Kazuhiro Takatoku, Takashi Ohba
A 55-year-old morbidly obese woman [body mass index (BMI) 51.2] developed acute type A aortic dissection, and she also presented with significant hypoxemia and hypercapnia. She underwent a successful emergency total arch replacement, but severe hypoxemia persisted and Pao2/Fio2 lowered to 71.9 mmHg. We therefore applied high frequency jet ventilation (HFJV), which soon improved the hypoxemia without hemodynamic compromise. HFJV was discontinued three days later, when her Pao2/Fio2 improved to 170.0 mmHg. Weaning from the respirator was initiated on postoperative day 13...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29038411/-emergent-thoracic-endovascular-aortic-repair-and-subxiphoid-pericardiotomy-for-retrograde-type-a-acute-aortic-dissection-with-cardiac-tamponade-report-of-a-case
#12
Masatoshi Sunada, Yusuke Suzuki, Takashi Takano, Hirofumi Midorikawa, Megumu Kanno
Type A acute aortic dissection has a high rate of mortality. Emergent surgical repair is the gold standard treatment, but some patients cannot tolerate the open surgery. Here, we report an 82-year-old patient with a history of cerebral infarction and cerebral bleeding who presented with a depressed level of consciousness and who was in a state of shock. A computed tomography (CT) scan showed cardiac tamponade associated with retrograde type A aortic dissection(RAAD), with a primary entry tear at a distal site of the left subclavian artery...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29035192/bacillus-cereus-bacteremia-with-central-nervous-system-involvement-a-neuropathological-study
#13
Jean Philippe Brouland, Nathalie Sala, Selin Tusgul, Caterina Rebecchini, Enikö Kovari
Bacillus cereus is a widely-distributed, gram-positive or variable, rod-shaped bacterium frequently considered a contaminant in clinical specimens. It is recognized as a potential pathogen inducing self-limiting emetic or diarrheal food poisoning or localized infection in immunocompetent patients. True B. cereus bacteremia is uncommon and mainly observed in fragile patients, notably in immunocompromised individuals. We report clinical, radiological, and pathological findings of a 64-year-old patient with a history of acute myeloid leukemia who initially presented a fever while neutropenic after the induction of a second cycle of chemotherapy...
October 16, 2017: Clinical Neuropathology
https://www.readbyqxmd.com/read/29034023/retrograde-ascending-aortic-dissection-after-stent-grafting-for-stanford-type-b-aortic-dissection-with-severe-limb-ischemia
#14
Yoshiro Higuchi, Masato Tochii, Yoshiyuki Takami, Akihiro Kobayashi, Tsutomu Yanagisawa, Kentaro Amano, Yusuke Sakurai, Michiko Ishida, Hiroshi Ishikawa, Koji Hattori, Yasushi Takagi
We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034022/mediastinal-perigraft-seroma-after-repair-of-type-a-dissection-with-a-polyester-graft
#15
Takashi Yamauchi, Suguru Kubota, Kosei Hagawa, Akira Suzuki
Perigraft seromas are uncommon after surgical repair of the thoracic aorta with woven polyester grafts. A 50-year-old woman required redo sternotomy for the treatment of a perigraft seroma 6 months after total arch replacement for acute type A dissection. After removal of a jelly-like mass, a prosthetic graft was covered with fibrin glue, and the bilateral pleurae beside the graft were opened widely for drainage of effusion into the bilateral pleural cavities. Bacterial culture and laboratory and histological examination of the content confirmed the final diagnosis of perigraft seroma...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033367/stent-implantation-and-vascular-healing-of-a-spontaneous-coronary-artery-dissection-assessed-by-optical-coherence-tomography-in-a-patient-with-acute-coronary-syndrome
#16
Kirstine Nørregaard Hansen, Lisbeth Antonsen, Lisette Okkels Jensen
A 60-year old woman with non-ST-segment elevation myocardial infarction, underwent coronary angiogram combined with optical coherence tomography (OCT) revealing a long dissection in the right coronary artery. The patient experienced peri-procedural chest pain, the electrocardiogram showed ST-segment elevations, and compromised coronary blood flow, why mechanical revascularization with percutaneous coronary intervention (PCI) was indicated. At 1-month follow-up, OCT revealed early, competent vascular healing, and a distal stenosis was treated with PCI...
September 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29033043/in%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#17
J Hunter Mehaffey, Eric J Charles, Sarah Schubert, Morgan Salmon, Ashish K Sharma, Dustin Money, Mark H Stoler, Victor E Laubach, Curtis G Tribble, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the leading cause of lung injury in adults and can lead to acute respiratory distress syndrome (ARDS). Using a novel technique of isolated in vivo lung perfusion (IVLP), we hypothesized that normothermic IVLP will improve oxygenation and compliance in a porcine model of sepsis-induced lung injury. METHODS: Mature adult swine (n = 8) were administered lipopolysaccharide (LPS; 50 μg/kg over 2 hours) via the external jugular vein, followed by sternotomy and central extracorporeal membrane oxygenation (ECMO) cannulation (right atrium to ascending aorta)...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29033036/surgery-for-acute-type-a-aortic-dissection-on-oral-anticoagulants-being-the-dispatcher-of-a-911-call
#18
EDITORIAL
Ourania Preventza, Arthur Bracey
No abstract text is available yet for this article.
September 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29032862/endovascular-treatment-of-acute-tandem-occlusion-strokes-and-stenting-first-experience
#19
Süha Akpınar, Pınar Gelener
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection...
October 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29030346/diagnostic-accuracy-of-the-aortic-dissection-detection-risk-score-plus-d-dimer-for-acute-aortic-syndromes-the-advised-prospective-multicenter-study
#20
Peiman Nazerian, Christian Mueller, Alexandre de Matos Soeiro, Bernd A Leidel, Sibilla Anna Teresa Salvadeo, Francesca Giachino, Simone Vanni, Karin Grimm, Múcio T Oliveira, Emanuele E Pivetta, Enrico Lupia, Stefano Grifoni, Fulvio Morello
Background -Acute aortic syndromes (AAS) are rare and severe cardiovascular emergencies with unspecific symptoms. For AAS, both misdiagnosis and over-testing are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS, but is inadequate as a standalone test. Integration of pre-test probability assessment (PPA) with D-dimer (DD) testing is feasible, but the safety and efficiency of such diagnostic strategy are currently unknown...
October 13, 2017: Circulation
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