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Chronic dissection

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https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#1
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432004/impact-of-right-ventricular-side-branch-occlusion-during-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-right-ventricular-function
#2
Pepijn A van Diemen, Wynand J Stuijfzand, Stefan P Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Alexander Nap, Albert C van Rossum, Niels van Royen, Robin Nijveldt, Paul Knaapen
OBJECTIVE: To determine the impact of right ventricular side branch (RVB) occlusion, during percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) of the right coronary artery (RCA), on right ventricular (RV) function. BACKGROUND: Developments in PCI techniques have expanded PCI CTO feasibility. However, the utilization of dissection and reentry techniques and extensive stent implantation increases the risk of coronary side branch occlusion...
April 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28431651/modified-inside-out-technique-for-continued-use-of-chronically-occluded-upper-central-veins
#3
Adnan Hadziomerovic, Zameer Hirji, Niamh Coffey
This report describes a 2-step, inside-out procedure for upper body central venous access in patients with chronic central venous occlusions. Blunt cephalad dissection through the mediastinum was achieved with a curved metal cannula and guide wire followed by percutaneous puncture of an open snare from a right supraclavicular approach and dilation of the tract for a tunneled central venous catheter insertion. Of 9 patients, all had a successful placement of a tunneled central venous catheter using this method...
May 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28428528/-challenge-of-treating-thoracoabdominal-aortic-aneurysms-with-hybrid-thoracic-endovascular-aortic-repair
#4
Takashi Shuto, Shinji Miyamoto
The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428526/-strategy-of-thoracic-endovascular-aortic-repair-for-uncomplicated-type-b-aortic-dissection-in-subacute-and-chronic-phase-interval-from-onset-and-maximum-diameter
#5
Masatoshi Sunada, Kyohei Ueno, Rie Kageyama, Satoru Maeba, Hirofumi Midorikawa, Megumu Kanno
We classified 59 patients who underwent thoracic endovascular aortic repair for uncomplicated type B aortic dissection from April 2008 to April 2016 into 3 groups based on time from onset and maximum aortic diameter:SA (2weeks to 1 year since onset;n=29), C (>1 year since onset;n=17), and D(maximum aneurysm size≥60 mm;n=13). We used the Kaplan-Meier method tso analyze survival, major adverse cardiovascular event and the need for additional treatment. There was no significant difference in outcomes between the SA and C groups (p=0...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428525/-total-arch-replacement-using-manufactured-frozen-elephant-trunk-after-acute-type-a-dissection-repair
#6
Makoto Hibino, Masato Mutsuga, Hideki Oshima, Yuji Narita, Tomonobu Abe, Kazuro Fujimoto, Yoshiyuki Tokuda, Akihiko Usui
The purpose of this study is to assess the result of total arch replacement(TAR) using manufactured frozen elephant trunk(FET) for chronic aortic dissection after initial repair including the effect of aortic remodeling by the FET. Between 2003 and 2015, we performed 11 TAR using manufactured FET. Initial repairs before were 9 ascending aortic replacements and 2 Bentall operations. The entry of residual dissection was located at arch in 7 and at distal anastomosis site in 4. There was no hospital death. The operative complication included 2 surgical site infection, 1 interstitial pneumonia and 1 paraplegia with almost full recovery...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28421165/the-diverse-cellular-and-animal-models-to-decipher-the-physiopathological-traits-of-mycobacterium-abscessus-infection
#7
REVIEW
Audrey Bernut, Jean-Louis Herrmann, Diane Ordway, Laurent Kremer
Mycobacterium abscessus represents an important respiratory pathogen among the rapidly-growing non-tuberculous mycobacteria. Infections caused by M. abscessus are increasingly found in cystic fibrosis (CF) patients and are often refractory to antibiotic therapy. The underlying immunopathological mechanisms of pathogenesis remain largely unknown. A major reason for the poor advances in M. abscessus research has been a lack of adequate models to study the acute and chronic stages of the disease leading to delayed progress of evaluation of therapeutic efficacy of potentially active antibiotics...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28420841/tranexamic-acid-controlled-chronic-disseminated-intravascular-coagulation-associated-with-aortic-dissection-and-patent-false-lumen-for-three-years
#8
Yodo Gatate, Nobuyuki Masaki, Atsushi Sato, Risako Yasuda, Takayuki Namba, Hirotaka Yada, Akio Kawamura, Takeshi Adachi
The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28419506/neuronal-loss-demyelination-and-volume-change-in-the-multiple-sclerosis-neocortex
#9
D Carassiti, D R Altmann, N Petrova, B Pakkenberg, F Scaravilli, K Schmierer
AIMS: Indices of brain volume (grey matter, white matter, lesions) are being used as outcomes in clinical trials of patients with multiple sclerosis (MS). We investigated the relationship between cortical volume, the number of neocortical neurons estimated using stereology, and demyelination. METHODS: Nine MS and seven control hemispheres were dissected into coronal slices. On sections stained for Giemsa, the cortex was outlined and optical disectors applied using systematic uniform random sampling...
April 18, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28417604/rotational-atherectomy-in-the-subadventitial-space-to-allow-safe-and-successful-chronic-total-occlusion-recanalization-pushing-the-limit-further
#10
Giuliana Capretti, Mauro Carlino, Antonio Colombo, Lorenzo Azzalini
Dissection and re-entry (DR) techniques have played a key role in the increase of success rates of chronic total occlusion (CTO) recanalization. DR usually allows wiring complex occlusions, even in case of important calcification. In extreme cases, such as in balloon failure-to-cross, rotational atherectomy (RA) might be decisive. However, according to experts' recommendations, RA should not be performed in dissection planes because of the high risk of perforation and further extending the dissection, so that its use after DR might be limited...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28414896/nk-cells-in-self-limited-hcv-infection-exhibit-a-more-extensively-differentiated-but-not-memory-like-repertoire
#11
Rik A de Groen, Zwier M A Groothuismink, Gertine van Oord, Neeltje A Kootstra, Harry L A Janssen, Maria Prins, Janke Schinkel, André Boonstra
Natural killer (NK) cells have long been thought of as a purely innate immune cell population, but increasing reports have described developmental and functional qualities of NK cells that are commonly associated with cells of the adaptive immune system. Of these features, the ability of NK cells to acquire functional qualities associated with immunological memory and continuous differentiation resulting in the formation of specific NK cell repertoires has recently been highlighted in viral infection settings...
April 17, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#12
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
March 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28402522/gene-expression-profiling-of-acute-type-a-aortic-dissection-combined-with-in-vitroassessment%C3%A2
#13
Naoyuki Kimura, Kyoko Futamura, Mamoru Arakawa, Naoko Okada, Fabian Emrich, Homare Okamura, Tetsuya Sato, Yasuhiro Shudo, Tiffany K Koyano, Atsushi Yamaguchi, Hideo Adachi, Akio Matsuda, Koji Kawahito, Kenji Matsumoto, Michael P Fischbein
OBJECTIVES: The mechanisms underlying aortic dissection remain to be fully elucidated. We aimed to identify key molecules driving dissection through gene expression profiling achieved by microarray analysis and subsequent in vitro experiments using human aortic endothelial cells (HAECs) and aortic vascular smooth muscle cells (AoSMCs). METHODS: Total RNA, including microRNA (miRNA), was isolated from the intima-media layer of dissected ascending aorta obtained intraoperatively from acute type A aortic dissection (ATAAD) patients without familial thoracic aortic disease ( n  = 8) and that of non-dissected ascending aorta obtained from transplant donors ( n  = 9)...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28399038/intraoperative-optical-coherence-tomography-assisted-descemet-stripping-automated-endothelial-keratoplasty-for-anterior-chamber-fibrous-ingrowth
#14
Tarek A Shazly, Lillian K To, Ian P Conner, Ladan Espandar
PURPOSE: Here, we present the first reported case of intraoperative optical coherence tomography (OCT)-assisted Descemet membrane stripping automated endothelial keratoplasty (DSAEK) in a patient with anterior segment fibrous ingrowth. METHODS: A 61-year-old woman with corneal edema and chronic angle-closure glaucoma secondary to fibrous ingrowth after 2 glaucoma shunt device implantations underwent dissection and removal of anterior chamber fibrous ingrowth and DSAEK...
April 10, 2017: Cornea
https://www.readbyqxmd.com/read/28395872/outcomes-of-antegrade-stent-graft-deployment-during-hybrid-aortic-arch-repair
#15
Seyed Hossein Aalaei-Andabili, Salvatore Scali, Charles Klodell, Teng Lee, Philip Hess, Tomas Martin, Adam Beck, Robert Feezor, Mahmoud Alhussaini, George Arnaoutakis, Thomas Beaver
BACKGROUND: Complex aortic arch disease can be a formidable challenge and is often treated with a two-stage elephant trunk technique. We examined our experience with hybrid arch repair with combined zone 0 stent graft deployment. METHODS: A retrospective review was conducted of all patients who underwent type 2 hybrid arch replacement and zone 0 antegrade endovascular stent graft deployments at a single university center from June 2010 to August 2015. RESULTS: The review included 48 patients, 25 (52%) elective and 23 (48%) nonelective, with a mean ± SD age of 64 ± 11 years...
April 7, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28395786/vascular-imaging-of-the-mesenteric-vasculature
#16
REVIEW
Louisa J D van Dijk, André S van Petersen, Adriaan Moelker
Imaging of the mesenteric vasculature is crucial in diagnosing vascular disease of the gastro-intestinal tract such as acute or chronic mesenteric ischemia caused by arterial stenosis, embolism or thrombosis, mesenteric vein thrombosis and mesenteric aneurysm or dissection. The reference standard for imaging of the mesenteric vasculature is digital subtraction angiography. However, modalities as duplex ultrasonography, computed tomography angiography and magnetic resonance angiography are developing rapidly and may provide accurate imaging non-invasively...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28393673/lower-extremity-revascularization-using-optical-coherence-tomography-guided-directional-atherectomy-final-results-of-the-evaluation-of-the-pantheris-optical-coherence-tomography-imaging-atherectomy-system-for-use-in-the-peripheral-vasculature-vision-study
#17
Arne G Schwindt, J Gray Bennett, William H Crowder, Suhail Dohad, Sean F Janzer, Jon C George, Barry Tedder, Thomas P Davis, Ian M Cawich, Roger S Gammon, Patrick E Muck, John P Pigott, Dwight A Dishmon, Lou A Lopez, Jaafer A Golzar, Jack R Chamberlin, Michael J Moulton, Ramzan M Zakir, Amir K Kaki, Gary J Fishbein, Huey B McDaniel, Ayala Hezi-Yamit, John B Simpson, Arjun Desai
PURPOSE: To evaluate the safety and efficacy of a novel optical coherence tomography (OCT)-guided atherectomy catheter in treating patients with symptomatic femoropopliteal disease. METHODS: The VISION trial ( ClinicalTrials.gov identifier NCT01937351) was a single-arm, multicenter, global investigational device exemption study enrolling 158 subjects (mean age 67.2±10.5 years; 87 men) across 20 participating sites. In this cohort, 198 lesions were treated with an average length of 53±40 mm using the Pantheris catheter alone or Pantheris + adjunctive therapy...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28390917/thoracic-endovascular-aortic-repair-into-the-false-lumen-in-chronic-aortic-dissection
#18
Arnoud V Kamman, David M Williams, Himanshu J Patel
PURPOSE: We present two different cases of chronic aortic dissection, where we opted to land the stent graft into the false lumen to treat the associated aneurysm. CASE DESCRIPTIONS: For the first case, the goal of thoracic endovascular aortic repair (TEVAR) was to exclude the aneurysm from within the false lumen, because of a slit-like true lumen. In the second case, the visceral arteries came off the false lumen, with the renal vessels from the true lumen. False lumen TEVAR was performed and the infra-renal aorta fenestrated, as to ensure adequate perfusion...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390478/clinical-phenotypes-and-endophenotypes-of-atopic-dermatitis-where-are-we-and-where-should-we-go
#19
REVIEW
Thomas Bieber, Angelo M D'Erme, Cezmi A Akdis, Claudia Traidl-Hoffmann, Roger Lauener, Georg Schäppi, Peter Schmid-Grendelmeier
Atopic dermatitis (AD) is a paradigmatic chronic inflammatory skin disease characterized by a complex pathophysiology and a wide spectrum of the clinical phenotype. Despite this high degree of heterogeneity, AD is still considered a single disease and usually treated according to the "one-size-fits-all" approach. Thus more tailored prevention and therapeutic strategies are still lacking. As for other disciplines, such as oncology or rheumatology, we have to approach AD in a more differentiated way (ie, to dissect and stratify the complex clinical phenotype into more homogeneous subgroups based on the endophenotype [panel of biomarkers]) with the aim to refine the management of this condition...
April 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28386925/vagus-nerve-stimulation-surgical-technique-of-implantation-and-revision-and-related-morbidity
#20
Flavio Giordano, Anna Zicca, Carmen Barba, Renzo Guerrini, Lorenzo Genitori
Indications for vagus nerve stimulation (VNS) therapy include focal, multifocal epilepsy, drop attacks (tonic/atonic seizures), Lennox-Gastaut syndrome, tuberous sclerosis complex (TSC)-related multifocal epilepsy, and unsuccessful resective surgery. Surgical outcome is about 50-60% for seizures control, and may also improve mood, cognition, and memory. On this basis, VNS has also been proposed for the treatment of major depression and Alzheimer's' disease. The vagus nerve stimulator must be implanted with blunt technique on the left side to avoid cardiac side effects through the classic approach for anterior cervical discectomy...
April 2017: Epilepsia
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