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abdominal aortic dissection

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https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#1
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
August 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28815188/painless-aortic-dissection-diagnostic-dilemma-with-fatal-outcomes-what-do-we-learn
#2
Saeeda Fatima, Konika Sharma
Aortic dissection is the most catastrophic clinical condition that involves the aorta. It has a high mortality as well as high rate of misdiagnosis due to frequent unusual presentation. Typically, it presents with acute chest, back, and tearing abdominal pain. However, it can present atypically with minimal or no pain, making diagnosis difficult. Physicians should always suspect acute aortic dissection in patients with certain clinical conditions like difficult-to-control hypertension, giant cell arteritis, bicuspid aortic valve, intracranial aneurysms, simple renal cysts, family history of aortic disease, and Marfan syndrome, especially when a patient presents with ischemic symptoms involving multiple organ without an obvious cause...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#3
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28814170/a-novel-reverse-branch-technique-for-reconstruction-of-a-renal-artery-perfused-by-the-false-lumen-after-thoracic-endovascular-aortic-repair
#4
Jie Jin, Jun Bai, Yongfa Wu, Kangkang Zhi, Xiaomin Wang, Xingzhu Wen, Jianjin Wu, Lefeng Qu
PURPOSE: To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28795434/concomitant-antegrade-stent-grafting-of-the-descending-thoracic-aorta-during-transverse-hemiarch-reconstruction-for-acute-debakey-i-aortic-dissection-repair-improves-aortic-remodeling
#5
Ibrahim Sultan, Tyler J Wallen, Andreas Habertheuer, Mary Siki, George J Arnaoutakis, Joseph Bavaria, Wilson Y Szeto, Rita Milewski, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Concomitant endovascular stent grafting of the descending thoracic aorta during open repair for acute DeBakey I aortic dissection can be performed in patients with extensive dissection and malperfusion. We analyzed the effects of this strategy on distal aortic remodeling. METHODS: From 2006-2014, acute DeBakey I dissection patients without primary aortic arch tear undergoing open distal hemiarch reconstruction (Standard group) versus those undergoing hemiarch with descending thoracic aorta (DTA) thoracic endovascular aortic repair (TEVAR group) were retrospectively reviewed...
August 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28790276/-acute-leg-ischemia-at-acute-aortic-dissection
#6
Yukio Kuniyoshi
Legs ischemia might be associated with acute aortic dissection, in acute phase or even in subacute phase. In general, immediate central repair for acute aortic dissection is mandatory prior to intervention of leg ischemia because central repair might improve leg ischemia. Depending on condition of leg ischemia, revascularization of occluded artery should be considered. The perfusion to ischemic leg during central repair is useful to diminish leg injury. There are some useful modalities for revascularization such as some route of extra-anatomical bypass, placing of stent graft for closing entry site of dissected aortic wall...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790249/-triple-stage-endovascular-treatment-for-chronic-type-b-aortic-dissection-including-hybrid-procedure-report-of-a-case
#7
Takayuki Nishimoto, Yukihiro Bonkohara, Takashi Azuma, Masaki Iijima
A 66-year-old man developed an extended chronic type B dissection involving the thoraco-abdominal aorta with a large entry at the aortic arch and a patent false lumen. We performed triple-stage endovascular repair which included the vascular plug, endovascular aortic repair and hybrid thoracic endovascular aortic repair. His postoperative course was uneventful and the false lumen was finally thrombosed.
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28777155/a-splenic-igg4-sclerosing-angiomatoid-nodular-transformation-sant-treated-by-hemisplenectomy-a-radiologic-histochemical-and-immunohistochemical-study
#8
Raffaele Gaeta, Francescamaria Donati, Emanuele F Kauffmann, Daniela Campani
INTRODUCTION: Sclerosing angiomatoid nodular transformation (SANT) is a rare benign lesion of unknown origin for which total splenectomy is the standard treatment. CASE PRESENTATION: A 54-year-old man with a history of recurrent pancreatitis, bicuspid aortic valve, and aortic dissection underwent abdominal ultrasound, Computed tomography and magnetic resonance imaging, which revealed a 6-cm hypoechoic splenic mass diagnosed as cavernous hemangioma. Owing to his relevant past history, he was considered eligible for emisplenectomy and not for total excision, which is associated with long-term risks, especially infections...
August 2, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28765187/non-atherosclerotic-aortic-mural-thrombus-a-rare-source-of-embolism
#9
Julian A Marin-Acevedo, Andree H Koop, Jose L Diaz-Gomez, Pramod K Guru
A 54-year-old man presented to the emergency department with acute left-sided chest pain and left upper quadrant abdominal pain. He had a significant history of squamous cell carcinoma of the lung previously treated with right pneumonectomy who ; is currently receiving adjuvant chemotherapy with cisplatin. Physical examination was remarkable for tachycardia, hypertension and mild abdominal tenderness. CT angiography revealed an aortic mural thrombus in the ascending aorta and aortic arch without dissection, aneurysm or tortuosity of the aorta...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#10
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28760628/laparoscopic-minimally-invasive-approach-to-sentinel-lymph-node-mapping-of-the-ovary-using-the-near-infrared-fluorescent-s1-hd-pinpoint-system-with-indocyanine-green-dye
#11
Alessandro Buda, Paolo Passoni, Claudio Reato, Giampaolo Di Martino
STUDY OBJECTIVE: To show a novel minimally invasive approach to sentinel lymph node (SLN) detection of the ovary with the near-infrared guided-surgery using indocyanine green (ICG). DESIGN: step by step description of the technique with video and figures (educational video). SETTING: The standard surgical staging of early stage I-II ovarian cancer include systematic pelvic and aortic lymphadenectomy, even in the absence of clear evidence regarding the survival benefits associated with comprehensive retroperitoneal staging...
July 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28754428/mid-term-results-of-chimney-and-periscope-grafts-in-supra-aortic-branches-in-high-risk-patients
#12
F Pecoraro, M Lachat, N S Cayne, D Pakeliani, Z Rancic, G Puippe, F J Criado, T Pfammatter, F J Veith, B Krüger, T A Neff
PURPOSE: Report mid-term outcomes of thoracic endovascular aneurysm repair (TEVAR) with chimney and periscope grafts (CPG) in supra-aortic branches (SAB). METHODS: Retrospective analysis, from October 2009 to May 2014, of patients with aneurysms requiring TEVAR with zone 0/1/2 proximal landing in association with at least one CPG in the SAB. All patients were considered at high risk for conventional surgery. Peri-operative mortality and morbidity, retrograde type A dissection, maximum aortic transverse diameter (TD) and its post-operative evolution, endoleak, survival, freedom from cardiovascular re-interventions, and CPG freedom from occlusion during the follow-up were analysed...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28739470/iliac-stent-migration-during-tevar-resulting-in-functional-coarctation
#13
Jamie Clementi, Sungho Lim, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
Iliac arterial disease, unfavorable anatomy, and prior stenting all pose challenges to access in endovascular abdominal aortic repair (EVAR) and thoracic aortic repair (TEVAR). Iliac access injury during T/EVAR may lead to rupture, dissection, thrombosis, or distal ischemia. Some have advocated iliac stent prior to T/EVAR in patients with suboptimal iliac access. The rate of complication and iliac stent migration during subsequent T/EVAR is undocumented. This case report describes a unique instance of self expanding iliac stent migration during TEVAR which pinched the thoracic aortic endograft causing functional aortic coarctation...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28736120/aneurysmal-degeneration-of-type-b-aortic-dissections-after-thoracic-endovascular-aortic-repair-a-systematic-review
#14
REVIEW
Marissa Famularo, Karol Meyermann, Joseph V Lombardi
BACKGROUND: Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment of TBAD has yet to mature. In this review, we evaluated the available data to investigate whether longer term TEVAR warrants enthusiasm for all comers with TBAD. METHODS: A systematic review of the literature was performed searching specifically for studies assessing medium- and long-term outcomes after TEVAR for the treatment of TBAD...
July 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28734943/deficits-in-col5a2-expression-result-in-novel-skin-and-adipose-abnormalities-and-predisposition-to-aortic-aneurysms-and-dissections
#15
Arick C Park, Noel Phan, Dawiyat Massoudi, Zhenjie Liu, John F Kernien, Sheila M Adams, Jeffrey M Davidson, David E Birk, Bo Liu, Daniel S Greenspan
Classic Ehlers-Danlos syndrome (cEDS) is characterized by fragile, hyperextensible skin and hypermobile joints. cEDS can be caused by heterozygosity for missense mutations in genes COL5A2 and COL5A1, which encode the α2(V) and α1(V) chains, respectively, of collagen V, and is most often caused by COL5A1 null alleles. However, COL5A2 null alleles have yet to be associated with cEDS or other human pathologies. We previously showed that mice homozygous null for the α2(V) gene Col5a2 are early embryonic lethal, whereas haploinsufficiency caused aberrancies of adult skin, but not a frank cEDS-like phenotype, as skin hyperextensibility at low strain and dermal cauliflower-contoured collagen fibril aggregates, two cEDS hallmarks, were absent...
July 19, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28715511/endovascular-treatment-of-genetically-linked-aortic-diseases
#16
D Böckler, K Meisenbacher, A S Peters, C Grond-Ginsbach, M S Bischoff
BACKGROUND: The most important structural proteins of the vascular wall are collagen and elastin. Genetically linked connective tissue diseases lead to degeneration, aneurysm formation and spontaneous dissection or rupture of arteries. The most well-known are Marfan syndrome, vascular Ehlers-Danlos syndrome (type IV), Loeys-Dietz syndrome and familial aortic aneurysms and dissections. OBJECTIVE: This review article addresses the current status of endovascular treatment options for important connective tissue diseases...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/28700467/early-and-midterm-outcomes-of-thoracic-endovascular-aortic-repair-tevar-for-acute-and-chronic-complicated-type-b-aortic-dissection
#17
Min-Hong Zhang, Xin Du, Wei Guo, Xiao-Ping Liu, Xin Jia, Yang-Yang Ge
Thoracic endovascular aortic repair (TEVAR) in the current era has been chosen as a dominant and minimally invasive treatment for complicated aorta dissection. This study aimed to assess safety and feasibility of TEVAR in acute and chronic type B aortic dissection.Between January 2011 and December 2013, 85 patients with complicated type B aortic dissection undergoing TEVAR were divided into acute aortic dissection (AAD) (n = 60) group and chronic aortic dissection (CAD) group (n = 25). Computed tomography was used to evaluate postoperative changes in maximal aortic diameter and true and false lumen diameters at 3 levels during a mean follow-up period of 26...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28693381/a-meta-analysis-of-weekend-admission-and-surgery-for-aortic-rupture-and-dissection
#18
Hisato Takagi, Tomo Ando, Takuya Umemoto
We performed a meta-analysis to determine whether weekend admission and surgery for ruptured abdominal/thoracic aortic aneurysm (RAAA/RTAA) and acute aortic dissection (AAD) is associated with increased mortality. MEDLINE and EMBASE were searched from January 1946 to December 2016 using PubMed and OVID. Eligible studies were prospective or retrospective, comparative or cohort studies enrolling patients admitting or undergoing surgery for RAAA/RTAA/AAD and reporting mortality after weekend (including holiday) versus weekday admission/surgery...
July 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28687502/endovascular-treatment-of-distal-tears-located-in-the-reno-viseceral-segment-with-bare-metal-stents-and-coils-in-a-complicated-type-b-aortic-dissection
#19
Qingsheng Lu, Yanqing Chen, Yongxue Zhang, Hongfei Wang, Hanyan Li, Jiaxuan Feng, Huajuan Mao, Zaiping Jing
PURPOSE: To provide an endovascular strategy of treating patent re-entries adjacent to visceral branches in the management of aortic dissections. CASE REPORT: A 45-year-old male who had received endovascular treatment for a type B aortic dissection was again admitted for his intermittent abdominal pain. Distal tears located in the reno-visceral segment was left untreated in the initial procedure, and was thought to be related to the expansion of the false lumen during follow-up...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28673864/analysis-of-endometrial-carcinoma-in-young-women-at-a-high-volume-cancer-center
#20
Alper Biler, Ulas Solmaz, Selcuk Erkilinc, Mehmet Gokcu, Mustafa Bagci, Orhan Temel, Tugba Karadeniz, Muzaffer Sanci
OBJECTIVE: To investigate the clinicopathological characteristics, treatment, survival, and prognosis of endometrial cancer in women aged ≤40 years. METHODS: Women who underwent surgery for endometrial cancer at a single high-volume cancer center between January 1995 and December 2014 were retrospectively reviewed. Women aged >40, patients with missing data, and those who did not undergo surgical staging were excluded. Univariate and multivariate regression models were used to identify the risk factors for overall survival and progression-free survival...
June 30, 2017: International Journal of Surgery
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