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abdominal aortic dissection

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https://www.readbyqxmd.com/read/29668804/morphology-of-the-diaphragm-muscle-in-southern-tamandua-tamandua-tetradactyla-and-its-importance-in-cases-of-traumatic-hernia
#1
Érica F S Azevedo, Daniela R Costa E Silva, Tamires V S Natividade, Elane G Giese, Ana Rita DE Lima, Paola C Soares, Érika Branco
The wall of the diaphragm can be affected by changes caused by physical trauma, allowing the passage of viscera between the abdominal cavity and thoracic cavity, thus reducing the space for pulmonary expansion, leading to the formation of hernia and possible death. Thus, we aimed to characterize, size and determine the topography of the diaphragmatic muscle in the Southern Tamandua, since clinical and surgical activities in wild animals have become a reality more and more present in veterinary medicine. We used six adult animals, x-rayed and dissected, followed by collection of fragments of muscular portions for histological analysis...
April 16, 2018: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/29665666/-early-results-of-fenestrated-endovascular-aortic-repair-for-the-treatment-of-patients-with-thoracoabdominal-pathologies
#2
J C Zhu, X C Dai, Y D Luo, H L Fan, Z Feng, Y W Zhang, F G Hu
Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) ( n =12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation ( n =3), thoracoabdominal aortic aneurysm (TAAA) ( n =1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck ( n =2) and type Ⅰ endoleak after EVAR for AAA( n =1)...
March 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29660577/value-and-best-way-for-detection-of-sentinel-lymph-node-in-early-stage-endometrial-cancer-selective-lymphadenectomy-algorithm
#3
Ahmed Samy El-Agwany, Mahmoud Hanafy Meleis
INTRODUCTION: The cornerstone of treatment for endometrial carcinoma is total abdominal hysterectomy and bilateral salpingo-oophoprectomy. Pelvic lymphadenectomy, with or without para-aortic lymphadenectomy, plays an important role in the surgical staging of endometrial carcinoma, and provides more accurate prognostic information. AIMS: We aimed to evaluate the value and techniques for SLN mapping in early stage endometrial cancer with low risk for lymph node metastasis and whether selective or systematic lymphadenectomy is needed according to the results of proposed algorithm...
March 23, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29657948/early-results-of-the-petticoat-technique-for-the-management-of-acute-type-a-aortic-dissection
#4
Vamshi Krishna Kotha, Zlatko I Pozeg, Eric J Herget, Michael C Moon, Jehangir J Appoo
Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29657039/should-the-distal-tears-of-aortic-dissection-be-treated-the-risk-of-distal-tears-after-proximal-repair-of-aortic-dissection
#5
Simeng Zhang, Yanqing Chen, Yongxue Zhang, Dongchen Shi, Yu Shen, Junmin Bao, Zhiqing Zhao, Xiang Feng, Rui Feng, Jian Zhou, Qingsheng Lu, Zaiping Jing
BACKGROUND: Patients with distal residual after proximal repair of aortic dissection (AD) have shown unsatisfactory long-term prognosis. However, possible mechanisms and risk factors for distal aortic segmental enlargement (DSAE) have been poorly understood. METHODS: We analyzed 962 AD patients repaired to the descending aorta between 1999 and 2014. Aortic morphological characteristics of 419 patients (including 75 DSAE and 344 non-DSAE patients) were investigated and compared...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29656146/genetics-of-the-extracellular-matrix-in-aortic-aneurysmal-diseases
#6
REVIEW
Chien-Jung Lin, Chieh-Yu Lin, Nathan O Stitziel
Aortic aneurysms are morbid conditions that can lead to rupture or dissection and are categorized as thoracic (TAA) or abdominal aortic aneurysms (AAA) depending on their location. While AAA shares overlapping risk factors with atherosclerotic cardiovascular disease, TAA exhibits strong heritability. Human genetic studies in the past two decades have successfully identified numerous genes involved in both familial and sporadic forms of aortic aneurysm. In this review we will discuss the genetic basis of aortic aneurysm, focusing on the extracellular matrix and how insights from these studies have informed our understanding of human biology and disease pathogenesis...
April 12, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29628463/-vascular-smooth-muscle-cell-response-to-cyclic-mechanical-stretch-and-aortic-dissection
#7
Masanori Yoshizumi, Jing Zhao, Yoji Kyotani
Acute aortic dissection is the most common life-threatening vascular disease, with sudden onset of severe pain and a high fatality rate. The pulsatile nature of blood flow exposes vascular smooth muscle cells (VSMCs) in the vessel wall to cyclic mechanical stretch (CMS), which evokes VSMC death, phenotypic switching, and migration, leading to aortic dissection. We have revealed that CMS of rat aortic smooth muscle cells (RASMCs) caused JNK- and p38-dependent cell death and that a calcium channel blocker, azelnidipine and an angiotensin II receptor antagonist, olmesartan decreased the phosphorylation of JNK and p38 and, subsequently, decreased cell death by CMS...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
https://www.readbyqxmd.com/read/29625025/ltbp3-pathogenic-variants-predispose-individuals-to-thoracic-aortic-aneurysms-and-dissections
#8
Dong-Chuan Guo, Ellen S Regalado, Amelie Pinard, Jiyuan Chen, Kwanghyuk Lee, Christina Rigelsky, Lior Zilberberg, Ellen M Hostetler, Micheala Aldred, Stephanie E Wallace, Siddharth K Prakash, Suzanne M Leal, Michael J Bamshad, Deborah A Nickerson, Marvin Natowicz, Daniel B Rifkin, Dianna M Milewicz
The major diseases affecting the thoracic aorta are aneurysms and acute dissections, and pathogenic variants in 11 genes are confirmed to lead to heritable thoracic aortic disease. However, many families in which multiple members have thoracic aortic disease do not have alterations in the known aortopathy genes. Genes highly expressed in the aorta were assessed for rare variants in exome sequencing data from such families, and compound rare heterozygous variants (p.Pro45Argfs∗ 25 and p.Glu750∗ ) in LTBP3 were identified in affected members of one family...
April 5, 2018: American Journal of Human Genetics
https://www.readbyqxmd.com/read/29606568/satisfactory-short-term-outcomes-of-the-stabilise-technique-for-type-b-aortic-dissection
#9
Germano Melissano, Luca Bertoglio, Enrico Rinaldi, Daniele Mascia, Andrea Kahlberg, Diletta Loschi, Monica De Luca, Fabrizio Monaco, Roberto Chiesa
OBJECTIVE: The aim of this study was to evaluate the perioperative and short-term results in a cohort of patients treated during the last year at our institution with the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique for acute complicated aortic dissection. METHODS: Between June 2016 and June 2017, 10 patients (all male; mean age, 62.6 ± 7.4 years) received treatment for acute complicated aortic dissection with the STABILISE technique...
March 29, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29589594/mercaptoethanol-protects-the-aorta-from-dissection-by-inhibiting-oxidative-stress-inflammation-and-extracellular-matrix-degeneration-in-a-mouse-model
#10
Lei Zhang, Changtian Wang, Zhilong Xi, Demin Li, Zhiyun Xu
BACKGROUND The aims of this study were to investigate the effects of mercaptoethanol treatment on the expression of mediators of oxidative stress, inflammation, and extracellular matrix (ECM) degeneration in a mouse aortic dissection (AD) model. MATERIAL AND METHODS Twenty-four 8-month-old C57BL/6J mice were divided into three groups and studied for two weeks: 1) the aortic dissection (AD) Model group (N=8) underwent intraperitoneal injection of angiotensin II (Ang II) (5 ml/kg) three times every 24 h; 2) the mercaptoethanol Treated group (N=8) were given oral mercaptoethanol (2...
March 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29579473/intraoperative-insertion-of-paravertebral-catheter-for-postoperative-analgesia-in-retroperitoneal-aortic-aneurysm-repair
#11
Samuel Jessula, Christine R Herman, Kwesi Kwofie, Min S Lee, Matthew Smith, Patrick Casey
Paravertebral catheters are a well-established analgesic modality in thoracic surgery but have not been described in abdominal aortic surgery. We describe a simple, safe, and effective technique of paravertebral catheter insertion by the operative surgeon after a retroperitoneal abdominal aortic aneurysm repair. Once the aneurysm repair is complete, an extrapleural plane between the parietal pleura and the twelfth rib is created through blunt dissection. A catheter is advanced into the space percutaneously under direct vision, and a continuous infusion of local anesthetic is administered...
April 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29569149/-aortic-diseases-modern-diagnostic-and-therapeutic-strategies
#12
R Erbel
Aortic diseases include not only the thoracic but also the abdominal part of the aorta. In the etiology cardiovascular risk factors, such as hypertension, smoking and hyperlipoproteinemia play a major role, but more and more genetic diseases with familiar predisposition are being identified. Even large aneurysms remain asymptomatic as long as other organs in the neighborhood are not damaged and no acute aortic event occurs including aortic dissection, intramural hematoma, penetrating aortic ulcer, and traumatic aortic injury...
March 22, 2018: Herz
https://www.readbyqxmd.com/read/29556589/blunt-multifocal-aortic-injury-with-abdominal-aortic-intimointimal-intussusception
#13
Richa Kalsi, Charles B Drucker, Jose H Salazar, Lauren I Luther, Jose J Diaz, Rishi Kundi
Blunt abdominal aortic injury is an infrequent occurrence after blunt trauma. The majority of these injuries result from deceleration forces sustained in motor vehicle collisions. Effects of these forces on the thoracic aorta are well described, but associated spinal compression or distraction can also lead to injury of the affixed abdominal aorta. We present a case of multifocal blunt thoracic and abdominal aortic injury with circumferential abdominal aortic dissection, resulting in aortoaortic intussusception associated with a thoracolumbar spinal injury...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29549415/carbon-dioxide-angiography-guided-renal-related-interventions-in-patients-with-takayasu-arteritis-and-renal-insufficiency
#14
Sujith Chacko, George Joseph, Viji Thomson, Paul George, Oommen George, Debashish Danda
BACKGROUND: Use of iodinated contrast agents for angiography in patients with renal insufficiency risks further deterioration of renal function and its adverse sequelae. OBJECTIVE: To study the effectiveness and safety of carbon dioxide (CO2 ) angiography in guiding percutaneous renal-related interventions in patients with Takayasu arteritis and renal insufficiency. METHODS: Data on CO2 angiography-guided interventions were obtained from a 23-year database of 692 Takayasu arteritis patients who underwent percutaneous interventions and were analyzed retrospectively...
March 16, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29544503/fatal-thoracic-aortic-aneurysm-and-dissection-in-a-large-family-with-a-novel-mylk-gene-mutation-delineation-of-the-clinical-phenotype
#15
Adel Shalata, Mohammad Mahroom, Dianna M Milewicz, Gong Limin, Fadi Kassum, Khader Badarna, Nader Tarabeih, Nimmer Assy, Rona Fell, Hector Cohen, Munir Nashashibi, Alejandro Livoff, Muhammad Azab, George Habib, Dan Geiger, Omer Weissbrod, William Nseir
BACKGROUND: Thoracic and abdominal aortic aneurysms and dissection often develop in hypertensive elderly patients. At higher risk are smokers and those who have a family history of aortic aneurysms. In most affected families, the aortic aneurysms and dissection is inherited in an autosomal dominant manner with decreased penetrance and variable expressivity. Mutations at two chromosomal loci, TAA1 at 11q23 and the TAA2 at 5q13-14, and eight genes, MYLK, MYH11, TGFBR2, TGFBR1, ACTA2, SMAD3, TGFB2, and MAT2A, have been identified as being responsible for the disease in 23% of affected families...
March 15, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29541693/ruptured-abdominal-aortic-aneurysm-repair-in-pediatric-marfan-syndrome-patient
#16
Joyce J Lu, Jason D Slaikeu, Peter Y Wong
Marfan syndrome is a well-described autosomal dominant connective tissue disorder with a constellation of anatomic characteristics including aortic degeneration as a result of the spontaneous mutation of the fibrillin gene, FBN1 . Whereas life-threatening dissection and ascending aneurysmal rupture have been thoroughly documented in the literature, aneurysms of the abdominal aorta and those present in the pediatric population have only rarely been reported. In this case report, we describe presentation, successful open surgical repair, and recovery of a pediatric Marfan syndrome patient with a ruptured abdominal aortic aneurysm...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29529630/can-aortic-balloon-occlusion-reduce-blood-loss-during-resection-of-sacral-tumors-that-extend-into-the-lower-lumber-spine
#17
Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29526427/-acute-aortic-syndromes
#18
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29519940/cd40l-deficiency-protects-against-aneurysm-formation
#19
Pascal J H Kusters, Tom T P Seijkens, Linda Beckers, Dirk Lievens, Holger Winkels, Vivian de Waard, Adriaan Duijvestijn, Moritz Lindquist Liljeqvist, Joy Roy, Alan Daugherty, Andrew Newby, Norbert Gerdes, Esther Lutgens
OBJECTIVE: The mechanisms underlying formation of arterial aneurysms remain incompletely understood. Because inflammation is a common feature during the progressive degeneration of the aortic wall, we studied the role of the costimulatory molecule CD40L, a major driver of inflammation, in aneurysm formation. APPROACH AND RESULTS: Transcriptomics data obtained from human abdominal aortic aneurysms and normal aortas revealed increased abundance of both CD40L and CD40 in media of thrombus-free and thrombus-covered human abdominal aortic aneurysms samples...
March 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29510243/the-anatomy-of-the-thoracic-duct-at-the-level-of-the-diaphragm-a-cadaver-study
#20
Ingmar L Defize, Bernadette Schurink, Teus J Weijs, Tom A P Roeling, Jelle P Ruurda, Richard van Hillegersberg, Ronald L A W Bleys
BACKGROUND: Injury and subsequent leakage of unrecognized thoracic duct tributaries during transthoracic esophagectomy may lead to chylothorax. Therefore, we hypothesized that thoracic duct anatomy at the diaphragm is more complex than currently recognized and aimed to provide a detailed description of the anatomy of the thoracic duct at the diaphragm. BASIC PROCEDURES: The thoracic duct and its tributaries were dissected in 7 (2 male and 5 female) embalmed human cadavers...
March 3, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
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