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ruptured abdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29439891/resuscitative-endovascular-balloon-occlusion-of-the-aorta-using-a-low-profile-device-is-easy-and-safe-for-emergency-physicians-in-cases-of-life-threatening-hemorrhage
#1
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
February 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29437802/acute-haemorrhage-from-a-retroperitoneal-liposarcoma-a-rare-presentation
#2
Mohammed Al Sheikh, Nick Simson, Obinna Obi-Njoku, Ahmed Qteishat
A previously healthy 61-year-old Caucasian woman presented to the emergency department after collapsing at home with associated abdominal pain radiating to her back. An urgent CT angiogram was requested to rule out a ruptured aortic aneurysm. This showed a large 21 cm fat-containing lesion arising from the mid-pole of the left kidney, with an adjacent 4 cm perirenal haematoma. An initial diagnosis of a ruptured angiomyolipoma was made. Her haemoglobin was 105 g/L, with a creatinine of 104 mmol/L and an eGFR of 47 mL/min...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29437576/deletion-of-bmal1-brain-and-muscle-arnt-like-protein-1-in-smooth-muscle-cells-protects-mice-from-abdominal-aortic-aneurysms
#3
Jenny Lutshumba, Shu Liu, Yu Zhong, Tianfei Hou, Alan Daugherty, Hong Lu, Zhenheng Guo, Ming C Gong
OBJECTIVE: Abdominal aortic aneurysm (AAA) has high mortality rate when ruptured, but currently, there is no proven pharmacological therapy for AAA because of our poor understanding of its pathogenesis. The current study explored a novel role of smooth muscle cell (SMC) BMAL1 (brain and muscle Arnt-like protein-1)-a transcription factor known to regulate circadian rhythm-in AAA development. APPROACH AND RESULTS: SMC-selective deletion of BMAL1 potently protected mice from AAA induced by (1) MR (mineralocorticoid receptor) agonist deoxycorticosterone acetate or aldosterone when provided with high salt and (2) angiotensin II infusion in hypercholesterolemia mice...
February 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29437572/cilostazol-attenuates-angiotensin-ii-induced-abdominal-aortic-aneurysms-but-not-atherosclerosis-in-apolipoprotein-e-deficient-mice
#4
Ryoko Umebayashi, Haruhito A Uchida, Yuki Kakio, Venkateswaran Subramanian, Alan Daugherty, Jun Wada
OBJECTIVE: Abdominal aortic aneurysm (AAA) is a permanent dilation of the abdominal aorta associated with rupture, which frequently results in fatal consequences. AAA tissue is commonly characterized by localized structural deterioration accompanied with inflammation and profound accumulation of leukocytes, although the specific function of these cells is unknown. Cilostazol, a phosphodiesterase III inhibitor, is commonly used for patients with peripheral vascular disease or stroke because of its anti-inflammatory effect, which is vasoprotective effects through its anti-inflammatory effect...
February 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29432192/cysteinyl-leukotriene-receptor-1-antagonism-prevents-experimental-abdominal-aortic-aneurysm
#5
Antonio Di Gennaro, Ana Carolina Araújo, Albert Busch, Hong Jin, Dick Wågsäter, Emina Vorkapic, Kenneth Caidahl, Per Eriksson, Bengt Samuelsson, Lars Maegdefessel, Jesper Z Haeggström
Cysteinyl-leukotrienes (cys-LTs) are 5-lipoxygenase-derived lipid mediators involved in the pathogenesis and progression of inflammatory disorders, in particular asthma. We have previously found evidence linking these mediators to increased levels of proteolytic enzymes in tissue specimens of human abdominal aortic aneurysm (AAA). Here we show that antagonism of the CysLT1 receptor by montelukast, an established antiasthma drug, protects against a strong aorta dilatation (>50% increase = aneurysm) in a mouse model of CaCl 2 -induced AAA at a dose comparable to human medical practice...
February 5, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29428533/greater-compliance-within-instruction-for-use-ifu-for-concomitant-iliac-aneurysms-and-adverse-aneurysm-characteristics-initial-experience-with-the-nellix-endovascular-aneurysm-sealing-system-evas-at-a-single-institution
#6
J X Hing, J K Ch'ng, K H Tay, T T Chong
AIM: The Nellix was introduced to Asia in 2014. Data in Asians have been sparse. Two balloon expandable stents, each surrounded by a polymer-filled endobag are deployed in parallel to obliterate and seal the aneurysm. This paradigm shift to treating abdominal aortic aneurysms confers advantages for certain adverse aneurysm morphology that is outside the IFU for standard EVAR devices. We examine outcomes of fifteen Asian patients with concomitant infrarenal aortic and iliac artery aneurysms treated with the Nellix at our institution...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29421423/rupture-of-an-abdominal-aortic-aneurysm-in-a-young-man-with-marfan-syndrome
#7
Maria Weinkouff Pedersen, Khiem Dinh Huynh, Ulrik Thorngren Baandrup, Dorte Guldbrand Nielsen, Niels Holmark Andersen
Abdominal aortic aneurysms are very rare in Marfan syndrome. We present a case with a young non-smoking and normotensive male with Marfan syndrome, who developed an infrarenal abdominal aortic aneurysm that presented with rupture to the retroperitoneal cavity causing life-threatening bleeding shock. The patient had acute aortic surgery and survived. Five months before this incident, the patient had uneventful elective aortic root replacement (a.m David) due to an enlarged aortic root. At that time, his abdominal aorta was assessed with a routine ultrasound scan that showed a normal sized abdominal aorta...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29421415/clinical-outcomes-of-total-endovascular-aneurysm-repair-for-aortic-aneurysms-involving-the-proximal-anastomotic-aneurysm-following-initial-open-repair-for-infrarenal-abdominal-aortic-aneurysm
#8
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Naoki Toya, Hiroki Ohta, Soichiro Fukushima, Masayuki Hara
PURPOSE: To evaluate initial and midterm clinical outcomes of aortic aneurysms involving the proximal anastomotic aneurysm (AAPAA) following initial open repair for infrarenal abdominal aortic aneurysm. METHODS: Between July 2006 and August 2015, 24 patients underwent elective endovascular repair for the treatment of AAPAAs at our institution. AAPAA classification has been categorized as three types. Type I AAPAA is the most extensive, extending from the descending aorta to the prior proximal anastomosis as similar to Crawford type II or III thoracoabdominal aortic aneurysm (TAAA)...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29417985/nationwide-analysis-of-risk-factors-for-in-hospital-mortality-in-patients-undergoing-abdominal-aortic-aneurysm-repair
#9
M Trenner, A Kuehnl, B Reutersberg, M Salvermoser, H-H Eckstein
BACKGROUND: There is increasing awareness that women may have worse outcomes following repair of abdominal aortic aneurysm (AAA). The aim of this study was to analyse the association between sex, age and in-hospital mortality after AAA using hospital episode data collected routinely at the nationwide level. METHODS: Data were extracted from the nationwide statutory Diagnosis Related Group statistics provided by the German Federal Statistical Office. Patients with a diagnosis of intact (non-ruptured) AAA (ICD-10 GM I71...
February 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29415911/inflammatory-mechanisms-of-cardiovascular-remodeling
#10
Toshihisa Anzai
Inflammation and fibrosis play an important role in the development and progression of cardiovascular diseases. Acute coronary syndrome (ACS) is caused by rupture of inflamed atherosclerotic plaque and subsequent atherothrombosis. Recent studies have shown that inflammatory markers such as C-reactive protein (CRP) can predict ACS development and have demonstrated the effectiveness of new therapeutic approaches targeting inflammation. Studies have also shown that an enhanced inflammatory response after myocardial infarction (MI) is associated with cardiac rupture, ventricular aneurysm formation, and exacerbation of left ventricular (LV) remodeling...
February 7, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29415193/ten-year-experience-of-the-thoraco-abdominal-aortic-aneurysm-treatment-using-a-hybrid-thoracic-endovascular-aortic-repair
#11
Takashi Shuto, Tomoyuki Wada, Shinji Miyamoto, Noritaka Kamei, Norio Hongo, Hiromu Mori
OBJECTIVES: The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair. METHODS: Sixty patients underwent a hybrid repair for the treatment of the thoraco-abdominal aortic aneurysm between 2007 and 2016...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29406857/-18-f-sodium-fluoride-uptake-in-abdominal-aortic-aneurysms-the-sofia-3-study
#12
Rachael O Forsythe, Marc R Dweck, Olivia M B McBride, Alex T Vesey, Scott I Semple, Anoop S V Shah, Philip D Adamson, William A Wallace, Jakub Kaczynski, Weiyang Ho, Edwin J R van Beek, Calum D Gray, Alison Fletcher, Christophe Lucatelli, Aleksander Marin, Paul Burns, Andrew Tambyraja, Roderick T A Chalmers, Graeme Weir, Neil Mitchard, Adriana Tavares, Jennifer M J Robson, David E Newby
BACKGROUND: Fluorine-18-sodium fluoride ( 18 F-NaF) uptake is a marker of active vascular calcification associated with high-risk atherosclerotic plaque. OBJECTIVES: In patients with abdominal aortic aneurysm (AAA), the authors assessed whether 18 F-NaF positron emission tomography (PET) and computed tomography (CT) predicts AAA growth and clinical outcomes. METHODS: In prospective case-control (n = 20 per group) and longitudinal cohort (n = 72) studies, patients with AAA (aortic diameter >40 mm) and control subjects (aortic diameter <30 mm) underwent abdominal ultrasound, 18 F-NaF PET-CT, CT angiography, and calcium scoring...
February 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29402733/impact-of-isotropic-constitutive-descriptions-on-the-predicted-peak-wall-stress-in-abdominal-aortic-aneurysms
#13
V Man, S Polzer, T C Gasser, T Novotny, J Bursa
Biomechanics-based assessment of Abdominal Aortic Aneurysm (AAA) rupture risk has gained considerable scientific and clinical momentum. However, computation of peak wall stress (PWS) using state-of-the-art finite element models is time demanding. This study investigates which features of the constitutive description of AAA wall are decisive for achieving acceptable stress predictions in it. Influence of five different isotropic constitutive descriptions of AAA wall is tested; models reflect realistic non-linear, artificially stiff non-linear, or artificially stiff pseudo-linear constitutive descriptions of AAA wall...
February 2, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29401512/mechanical-and-geometrical-determinants-of-wall-stress-in-abdominal-aortic-aneurysms-a-computational-study
#14
Dara Azar, Donya Ohadi, Alexander Rachev, John F Eberth, Mark J Uline, Tarek Shazly
An aortic aneurysm (AA) is a focal dilatation of the aortic wall. Occurrence of AA rupture is an all too common event that is associated with high levels of patient morbidity and mortality. The decision to surgically intervene prior to AA rupture is made with recognition of significant procedural risks, and is primarily based on the maximal diameter and/or growth rate of the AA. Despite established thresholds for intervention, rupture occurs in a notable subset of patients exhibiting sub-critical maximal diameters and/or growth rates...
2018: PloS One
https://www.readbyqxmd.com/read/29399616/a-case-of-a-rectal-stricture-related-to-ischemic-proctitis-following-rupture-of-an-aortic-aneurysm
#15
Tomoya Iida, Yosuke Ohkubo, Toshiyuki Kubo, Kentaro Yamashita, Kei Onodera, Eiichiro Yamamoto, Katsuhiko Nosho, Toshiro Ito, Hiroo Yamano, Hiroshi Nakase
Background and study aims  Ischemic proctitis is a rare disease and comprises 2 % to 5 % of cases of ischemic colitis, because the rectum has abundant blood supply and rich collaterals. Herein, we report a case of a 73-year-old male patient with a pronounced rectal stricture caused by ischemic proctitis resulting from an abdominal aortic rupture and treated by endoscopic balloon dilation therapy. To date, only 3 cases of rectal stricture related to ischemic proctitis including our case have been reported, and this is the first case of rectal stricture related to ischemic proctitis, which was successfully treated by endoscopic balloon dilation...
February 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29398907/patients-perceptions-of-conservative-treatment-for-a-small-abdominal-aortic-aneurysm
#16
Stephanie M Tomee, Winifred A Gebhardt, Jean-Paul Pm de Vries, Victoria C Hamelinck, Jaap F Hamming, Jan Hn Lindeman
Background: An abdominal aortic aneurysm (AAA) is a progressive, generally symptomless disease that could ultimately result in a fatal rupture. Current guidelines advise conservative follow-up, and preventive surgical repair once the risk of rupture outweighs the cost of repair (55 mm in men). In developed countries, the majority of patients are diagnosed with AAAs less than 55 mm, and so enter a period of conservative surveillance. An important question is how patients perceive and cope with risk of rupture, AAA diagnosis and treatment, and presented AAA information...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29398314/infrarenal-aortic-repair-with-or-without-false-lumen-intentional-placement-of-endografts-for-hybrid-management-of-complex-aortic-dissection
#17
William J Quinones-Baldrich, Taimur Saleem, Adam Oskowitz
OBJECTIVE: Aortic dissection (AD) often involves the infrarenal aorta. We review our experience with open infrarenal aortic repair with or without false lumen intentional placement (FLIP) of endografts in the proximal dissected aorta as part of a hybrid strategy to treat complex AD. METHODS: A prospectively maintained database of patients undergoing intervention for AD was reviewed. Data regarding diagnosis, imaging features, nature of the infrarenal repair (one- vs two-stage procedure), endoleaks, need for additional interventions, morbidity, and mortality were collected...
February 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29394977/bladder-distension-as-a-cause-of-abdominal-compartment-syndrome
#18
Muhammad Yasir, Muhammad Qamarul Hoda, Tauseef Ahmed
Abdominal compartment syndrome (ACS) is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29393228/the-effect-of-a-high-fat-diet-on-the-development-of-abdominal-aortic-aneurysm-in-a-vascular-hypoperfusion-induced-animal-model
#19
Keisuke Hashimoto, Hirona Kugo, Hiroki Tanaka, Kazuko Iwamoto, Chie Miyamoto, Tetsumei Urano, Naoki Unno, Kohsuke Hayamizu, Nobuhiro Zaima, Tatsuya Moriyama
Abdominal aortic aneurysm (AAA) is a vascular disease characterized by chronic inflammation in the infrarenal aorta. Most cases of AAA remain asymptomatic until rupture, and the mortality rate of patients with AAA rupture is very high. Currently, the relation between dietary habits and AAA development remains unknown. In this study, we evaluated the effects of a high-fat diet on the development of AAA in a vascular hypoperfusion-induced animal model. The risk of AAA rupture and AAA diameter in the high-fat group significantly increased compared with those in the control group...
January 29, 2018: Journal of Vascular Research
https://www.readbyqxmd.com/read/29384470/the-uk-endovascular-aneurysm-repair-evar-randomised-controlled-trials-long-term-follow-up-and-cost-effectiveness-analysis
#20
Rajesh Patel, Janet T Powell, Michael J Sweeting, David M Epstein, Jessica K Barrett, Roger M Greenhalgh
BACKGROUND: Short-term survival benefits of endovascular aneurysm repair (EVAR) compared with open repair (OR) of intact abdominal aortic aneurysms have been shown in randomised trials, but this early survival benefit is soon lost. Survival benefit of EVAR was unclear at follow-up to 10 years. OBJECTIVE: To assess the long-term efficacy of EVAR against OR in patients deemed fit and suitable for both procedures (EVAR trial 1; EVAR-1); and against no intervention in patients unfit for OR (EVAR trial 2; EVAR-2)...
January 2018: Health Technology Assessment: HTA
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