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abdominal aortic dissection

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https://www.readbyqxmd.com/read/28605479/collapsed-stent-graft-and-severe-malperfusion-2%C3%A2-years-after-endovascular-aortic-repair
#1
Yoshihiro Goto, Soh Hosoba, Shinji Ogawa, Yoshihisa Kinoshita
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28603157/anatomical-and-radiological-analyses-of-l-shaped-kidney-with-vascular-anomalies
#2
Joe Iwanaga, Koichi Watanabe, Tsuyoshi Saga, Nobuhiro Tahara, Yoko Tabira, Ayano Sakuragi, Keiko Kaji, Kiyoshi Takahashi, Koh-Ichi Yamaki
L-shaped kidney is a congenital anomaly. The disorder results in the kidney appearing very similar in shape to horseshoe kidney (also a congenital anomaly), but either the right or left kidney is located at a position lower than the other kidney. In this report, we describe a woman with L-shaped kidney, identified during anatomical dissection, and compare the findings with clinical data obtained before her death. We discuss the embryology of L-shaped kidney based on detailed anatomical data on the kidney and its vascular system obtained by means of gross anatomical, radiological, and histological examinations...
June 12, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28597730/early-results-of-the-bolton-treovance-endograft-in-the-treatment-of-abdominal-aortic-aneurysms
#3
Efstratios Georgakarakos, George Pitoulias, Nikolaos Schoretsanitis, Christos Argyriou, Dimitrios M Mavros, Miltos K Lazarides, George S Georgiadis
PURPOSE: To present early results with the Treovance aortic stent-graft in the treatment of abdominal aortic aneurysms (AAAs). METHODS: Between October 2013 and January 2016, 35 consecutive AAA patients (mean age 74±7.7 years; 32 men) were treated with Treovance. The maximum diameter of the treated AAA was 60±9 cm. Nine (25%) patients presented with concomitant iliac aneurysms. Seven (20%) AAAs had infrarenal neck angulation >60°. The infrarenal neck length and diameter were 21...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28594796/hybrid-surgery-in-chronic-thoracoabdominal-aortic-dissection
#4
A M Cherniavskiĭ, D A Sirota, T Caus, D S Khvan, S A Al'sov, M M Liashenko
The authors describe and analyse their experience gained in performing prosthetic repair of the thoracoabdominal portion of the aorta, combined with open aortic stenting using the Djumbodis uncovered metal stent. Over the period from 2013 to 2015 we performed a total of 16 hybrid interventions. All patients were found to have type B aortic dissection, with their false and true lumens patent. All patients underwent reconstruction of the thoracoabdominal aorta combined with open implantation of the Djumbodis uncovered metal stent into the area of lower thoracic and visceral arteries...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28583733/treatment-strategy-based-on-the-natural-course-of-the-disease-for-patients-with-spontaneous-isolated-abdominal-aortic-dissection
#5
Ji-Hee Kang, Young-Wook Kim, Seon-Hee Heo, Shin-Young Woo, Yang-Jin Park, Dong-Ik Kim, Duk-Kyung Kim
OBJECTIVE: This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD. METHODS: We searched the database of thoracoabdominal computed tomography (CT) performed at a single institution from January 2003 to July 2016 using the keywords "aortic dissection" and "dissection AND aorta." Once a diagnosis of SIAAD was made, we investigated the initial clinical and morphologic features and aorta-related events for all patients and morphologic changes of the aortic dissection (AD) during the follow-up period for the patients who underwent follow-up CT scans...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28582477/gingival-fibroblasts-protect-against-experimental-abdominal-aortic-aneurysm-development-and-rupture-through-timp-1-production
#6
Andreas Giraud, Lynda Zeboudj, Marie Vandestienne, Jérémie Joffre, Bruno Esposito, Stéphane Potteaux, José Vilar, Daniela Cabuzu, Johannes Kluwe, Sylvie Seguier, Alain Tedgui, Ziad Mallat, Antoine Lafont, Hafid Ait-Oufella
Aims.: Abdominal aortic aneurysm (AAA), frequently diagnosed in old patients, is characterized by chronic inflammation, vascular cell apoptosis and metalloproteinase-mediated extracellular matrix destruction. Despite improvement in the understanding of the pathophysiology of aortic aneurysm, no pharmacological treatment is yet available to limit dilatation and/or rupture. We previously reported that human gingival fibroblasts (GFs) can reduce carotid artery dilatation in a rabbit model of elastase-induced aneurysm...
June 5, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28575324/aortic-diameter-remodelling-after-the-frozen-elephant-trunk-technique-in-aortic-dissection-results-from-an-international-multicentre-registry%C3%A2
#7
Mauro Iafrancesco, Nora Goebel, Jorge Mascaro, Ulrich F W Franke, Davide Pacini, Roberto Di Bartolomeo, Gabriel Weiss, Martin Grabenwöger, Sergey A Leontyev, Friedrich-Wilhelm Mohr, Thanos Sioris, Heinz Jakob, Konstantinos Tsagakis
OBJECTIVES: The frozen elephant trunk (FET) technique allows one-stage hybrid repair approach in aortic dissection (AoD). Even if the effect of the FET technique on promoting false lumen (FL) thrombosis has been proved in the past, the relative importance of FL thrombosis on aortic remodelling at different levels of the distal aorta and the magnitude of this effect is not well known. The aim of the study was to evaluate aortic remodelling following a FET technique for AoD. METHODS: A multicentre international registry database was searched to identify all patients who underwent a FET procedure for an AoD...
May 29, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#8
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28540077/role-of-molecular-imaging-with-positron-emission-tomographic-in-aortic-aneurysms
#9
REVIEW
Parmanand Singh, Zaid Almarzooq, Brian Salata, Richard B Devereux
Aortic aneurysms (AA) are often asymptomatic before the occurrence of acute, potentially fatal complications including dissection and/or rupture. Beyond aortic size, the ability to assess aortic wall characteristics and processes contributing to aneurysm development may allow improved selection of patients who may benefit from prophylactic surgical intervention. Current risk stratification for aneurysms relies upon routine noninvasive imaging of aortic size without assessing the underlying pathophysiologic processes, including features such as inflammation, which may be associated with aneurysm development and progression...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28528045/endovascular-fenestration-for-distal-aortic-sealing-after-frozen-elephant-trunk-with-thoraflex
#10
Randolph H L Wong, Peter S Y Yu, Micky W T Kwok, Simon C Y Chow, Jacky Y K Ho, Malcolm J Underwood, Simon C H Yu
We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28503875/a-rare-vascular-complication-in-a-patient-with-essential-thrombocythaemia-spontaneous-abdominal-aortic-dissection
#11
Ye Chen, Xue Han, Fang Wang, Beibei Bai, Yingchun Wang
A 27-year-old woman complained of waist and back pain. Abdominal computed tomography angiography showed abdominal aortic dissection, the blood count revealed a high platelet count of 1655 × 10(9) /L. Negative for JAK2V617F, CALR and MPL mutations (i.e. triple-negative), the patient was diagnosed as essential thrombocythaemia (ET) with abdominal aortic dissection and was treated with cytoreduction and antiplatelet drugs. Cases of abdominal aortic dissection in ET have not been previously reported. As such, we proposed a mechanism of abdominal aortic dissection caused by endothelial dysfunction and further emphasised appropriate management in ET with abdominal aortic dissection...
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28501661/extensive-cerebrovascular-and-visceral-artery-dissection-and-pseudoaneurysm-with-underlying-segmental-arterial-mediolysis
#12
Abhishek Sethi, Jonathan R Hyde, Christina M Thaler, Nedaa Skeik
Segmental arterial mediolysis (SAM) is a non-atherosclerotic, non-hereditary vasculopathy that most commonly involves abdominal aortic branches and predominantly affects middle-age and elderly populations. Lysis of the outer arterial media results in separation of the media from the adventitia leading to dissecting aneurysms and/or pseudoaneurysms. We report a unique case of a 47-year-old man who presented with bilateral internal carotid artery dissection followed by dissections and aneurysms involving multiple visceral arteries...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28493108/percutaneous-septectomy-in-chronic-dissection-with-abdominal-aortic-aneurysm-creates-uniluminal-neck-for-evar
#13
Mark Colin Gissler, Yukihisa Ogawa, Jason T Lee, Venita Chandra, Michael D Dake
PURPOSE: The intent of this report is to describe the technical details and rationale of endovascular septectomy using a wire saw maneuver in cases of chronic aortic dissection and associated infra-renal aortic aneurysm to allow standard endovascular abdominal aortic graft placement; preliminary clinical experience is also retrospectively reviewed. MATERIALS AND METHODS: Between June 2013 and June 2016, four consecutive patients (mean age 55.3 years; range 52-58 years) with chronic type B aortic dissection and isolated infra-renal abdominal aortic aneurysm (AAA) underwent endovascular aneurysm repair (EVAR) following guidewire septectomy to create a suitable proximal aortic landing zone...
May 10, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28485889/mmp-family-polymorphisms-and-the-risk-of-aortic-aneurysmal-disease-a-systematic-review-and-meta-analysis
#14
REVIEW
Tan Li, Zhi Lv, Jing-Jing Jing, Jun Yang, Yuan Yuan
It has been suggested that matrix metalloproteinase (MMP) polymorphisms are associated with the pathogenesis of aortic aneurysmal diseases. In this study, we conducted a systematic review with an update meta-analysis to investigate the relationship between MMP family polymorphisms and aortic aneurysmal diseases. We systematically reviewed 24 polymorphisms in eight MMP genes related to the risk of abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA) or thoracic aortic dissection (TAD). A total of 19 case-control studies with 15 highly studied MMP polymorphisms were included in our meta-analysis...
May 9, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28475566/aortic-remodeling-following-sun-s-procedure-for-acute-type-a-aortic-dissection
#15
Jiawen Luo, Xianming Fu, Yangzhao Zhou, Hao Tang, Guobao Song, Tao Tang, Xiaobo Liao, Xinmin Zhou
BACKGROUND Sun's procedure is a surgical technique widely used in type A aortic dissection. The purpose of this study was to analyze clinical outcomes and morphologic changes in true and false lumen by computed tomography (CT) angiography after Sun's procedure. MATERIAL AND METHODS We retrospectively reviewed 51 patients who underwent Sun's procedure for acute Stanford type A aortic dissection extending down to iliac bifurcation between January 2013 and December 2014. The images of preoperative, one-month, three-month, and six-month follow-up were analyzed by CT angiography to measure the area and diameter of true and false lumen...
May 5, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28472123/inhibition-of-plasmin-mediated-tafi-activation-may-affect-development-but-not-progression-of-abdominal-aortic-aneurysms
#16
Katherine Bridge, Charlotte Revill, Fraser Macrae, Marc Bailey, Nadira Yuldasheva, Stephen Wheatcroft, Roger Butlin, Richard Foster, D Julian Scott, Ann Gils, Robert Ariens
OBJECTIVE: Thrombin-activatable fibrinolysis inhibitor (TAFI) reduces the breakdown of fibrin clots through its action as an indirect inhibitor of plasmin. Studies in TAFI-deficient mice have implicated a potential role for TAFI in Abdominal Aortic Aneurysm (AAA) disease. The role of TAFI inhibition on AAA formation in adult ApoE-/- mice is unknown. The aim of this paper was to investigate the effects of TAFI inhibition on AAA development and progression. METHODS: Using the Angiotensin II model of AAA, male ApoE-/- mice were infused with Angiotensin II 750ng/kg/min with or without a monoclonal antibody inhibitor of plasmin-mediated activation of TAFI, MA-TCK26D6, or a competitive small molecule inhibitor of TAFI, UK-396082...
2017: PloS One
https://www.readbyqxmd.com/read/28468757/relationship-between-fibrillin-1-genotype-and-severity-of-cardiovascular-involvement-in-marfan-syndrome
#17
Romy Franken, Gisela Teixido-Tura, Maria Brion, Alberto Forteza, Jose Rodriguez-Palomares, Laura Gutierrez, David Garcia Dorado, Gerard Pals, Barbara Jm Mulder, Artur Evangelista
BACKGROUND: The effect of FBN1 mutation type on the severity of cardiovascular manifestations in patients with Marfan syndrome (MFS) has been reported with disparity results. OBJECTIVES: This study aims to determine the impact of the FBN1 mutation type on aortic diameters, aortic dilation rates and on cardiovascular events (ie, aortic dissection and cardiovascular mortality). METHODS: MFS patients with a pathogenic FBN1 mutation followed at two specialised units were included...
May 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28447279/multi-modality-molecular-imaging-of-aortic-aneurysms
#18
Brian J Malm, Mehran M Sadeghi
Aneurysms of the thoracic and abdominal aorta are common and can be associated with significant morbidity and mortality when complications, including dissection, rupture, or thrombosis, occur. Current approaches to diagnosis and risk stratification rely on measurements of aneurysm size and rate of growth, often using various imaging modalities, which may be suboptimal in identifying patients at the highest and lowest risk of complications. Targeting the biological processes underlying aneurysm formation and expansion with molecular imaging offers an exciting opportunity to characterize aortic aneurysms beyond size and address current gaps in our approach to diagnosis and treatment...
April 26, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28445810/circulating-cadmium-concentration-and-risk-of-aortic-aneurysms-a-nested-case-control-study-within-the-malm%C3%A3-diet-and-cancer-cohort
#19
Björn Fagerberg, Yan Borné, Gerd Sallsten, J Gustav Smith, Stefan Acosta, Margaretha Persson, Olle Melander, Niklas Forsgard, Anders Gottsäter, Bo Hedblad, Lars Barregard, Gunnar Engström
BACKGROUND AND AIMS: Diet and smoking expose the general population to cadmium (Cd), which is a toxic metal that accumulates in the arterial wall. In experimental studies, Cd causes reductions in proliferation of smooth muscle cells and cellular synthesis of procollagen. The aim of this study was to examine whether blood Cd levels, a valid measure of Cd exposure, are associated with increased risk of abdominal aortic aneurysm (AAA). METHODS: All middle-aged men and women enrolled in the Malmö Diet and Cancer study (n = 30 447) were followed from the baseline examination in 1991-1996 through 2009...
April 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28439427/double-aorta-artifact-in-sonography-a-diagnostic-challenge
#20
REVIEW
Robert Hadzik, Przemysław Bombiński, Michał Brzewski
The double aorta artifact was described and studied thoroughly twenty-five years ago. Despite this, it is still not commonly known today and can cause diagnostic difficulty. Total aortic duplication can be considered an anatomic defect whilst partial duplication mimics aortic dissection. In the literature, this artifact has been compared with a very rare anomaly, i.e. the occurrence of two aortas in one patient. Currently, however, the differentiation of this artifact from abdominal aortic dissection seems to be of greater significance...
March 2017: Journal of Ultrasonography
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