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'Aneurysm Thoracic' (20523)


Feb
2018

Thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder with a strong genetic component. The number of genes implicated in TAA has increased exponentially over the last decade. Approximately 20% of patients with TAA have a positive family history.

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Dec
1969

A 50-year-old African American male presented with abdominal pain and significant weight loss. On physical examination, he had parotid and submandibular gland enlargement associated with right eye proptosis. Computed tomography showed a thoracic paravertebral soft tissue mass, enlarged lymph nodes, and ascending aortic aneurysm.

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Feb
2018

Aneurysm-osteoarthritis syndrome is a recently discovered inherited autosomal dominant connective tissue disease caused by SMAD3 mutations. Aneurysm-osteoarthritis syndrome is responsible for 2% of familial thoracic aortic aneurysms and dissections and is characterised by aneurysms, dissections, and tortuosity throughout the arterial tree in combination with osteoarthritis. Early-onset osteoarthritis is present in almost all patients.

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Feb
2018

A recurrent duplication of chromosome 16p13.1 was associated with aortic dissection as well as with cervical artery dissection. We explore the segregation of this duplication in a family with familial aortic disease.

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Feb
2018

An adolescent patient with a previous history of surgical repair for interrupted aortic arch type B presented with an asymptomatic, saccular pseudoaneurysm of the proximal, common left carotid artery, identified on a follow-up magnetic resonance angiography of the thoracic large vessels. The pseudoaneurysm was successfully excluded with a covered stent. Clinical and radiological follow-up after 2 years was uneventful.

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Feb
2018

Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage.

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Feb
2018

The aim of this study was to evaluate whether ranging values of thiol and disulphide herald a dilatation or impending acute aortic syndrome at thoracic aorta. Results/methodology: Study population consisted of patients with aortic aneurysm (n = 58), with acute aortic syndrome (n = 32) and without aortic aneurysm (control group; n = 61). A spectrophotometric method was used to determine thiol and disulphide.

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Feb
2018

The rupture of an isolated spinal aneurysm is an exceptional occurrence. It might be responsible for a spinal subarachnoid haemorrhage (SSAH) that in rare cases can be complicated by arachnoiditis. Among the former the adhesive type is the most severe leading to the formation of a cyst and/or a syrinx.

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Feb
2018

Endovascular repair is now preferred to open access for the management of aortic diseases. This is typically performed via the femoral artery, however not all patients are eligible for this. This systematic review summaries the current evidence for utilising the carotid artery as an alternative access route.

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Jan
2018

To evaluate the role of quantitative digital subtraction angiography (Q-DSA) with parametric color coding (PCC) in assessing patients with type B chronic thoracic aortic dissection (TBCAD) during thoracic endovascular aortic repair (TEVAR) procedures.
A total of 11 patients electively treated in our Department for a TBCAD were retrospectively enrolled. All cases were treated with TEVAR for false lumen aneurysm of the thoracic descending aorta.

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Feb
2018

Brachiocephalic venous aneurysm is an extremely rare condition, with <20 cases reported in the literature. We present a case of a 72-year-old man who was referred to our department owing to a large aneurysm of the left brachiocephalic vein that was incidentally discovered on computed tomography. Further workup confirmed an isolated saccular aneurysm of the left brachiocephalic vein.

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Feb
2018

Unfavorable anatomy is one of the major limitations of endovascular aortic aneurysm repair (EVAR) with specifically, adverse proximal neck morphology excluding many patients from receiving the standard endograft devices. Thoracic tube endografts have been used to overcome the issue of wide infrarenal necks, either as a sole device (single tubes or double tubes using the trombone technique) or as the proximal part of a bifurcated device fixed to the aortic bifurcation or infrarenally oriented. However, custom-made large proximal diameter bifurcated endograft designs have never been used.

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Feb
2018

We present our experience with one-stage replacement of thoracic aneurysm from the ascending aorta to the thoracoabdominal aorta.
Fourteen patients (10 male and 4 female; mean age 53.6 ± 12.

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Feb
2018

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.

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Feb
2018

To report unconventional use of the resuscitative endovascular balloon occlusion of the aorta (REBOA) technique to restore hemodynamic stability in a patient who was hemorrhaging from aortic injury proximal to the target zone of occlusion.
A 72-year-old woman underwent urgent thoracic stent-graft repair of a ruptured 8×8-cm mycotic pseudoaneurysm. Two months later, follow-up imaging revealed that the proximal aortic stent seal zone had degenerated, so a percutaneous procedure was performed 2 months later to preemptively reinforce the segment of stented aorta.

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Jan
2018

To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair.
Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed.

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Feb
2018

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.
A prospectively maintained database of patients undergoing intervention for AD was reviewed.

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Feb
2018

Duplex ultrasonography (DUS) currently has limited applicability in the diagnosis and surveillance of thoracic aortic pathologies because of associated limitations. This study investigates the feasibility of using an optimised DUS protocol to detect descending thoracic aortic pathology.
Forty patients were scanned (20 cases and 20 controls).

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Dec
2017

In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. We previously introduced the aortic size index (ASI), defined as aortic size/body surface area (BSA), as a predictor of aortic dissection, rupture, and death. However, weight might not contribute substantially to aortic size and growth.

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Jan
2018

The need for intercostal artery (ICA) reattachment in surgery for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA) remains controversial. We reviewed our experience over a 14-year period to assess the effects of ICA management on neurologic outcome after DTAA/TAAA repair.
Intraoperative data were reviewed to ascertain the status of T3-12 ICAs and L1-4 ICAs.

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Feb
2018

The Loeys-Dietz syndrome (LDS) is a connective tissue disorder affecting the cardiovascular, skeletal and ocular system. Most typically, LDS patients present with aortic aneurysms and arterial tortuosity, hypertelorism and bifid/broad uvula or cleft palate. Initially, mutations in transforming growth factor-β (TGF-β) receptors (TGFBR1 and TGFBR2) were described to cause LDS, hereby leading to impaired TGF-β signaling.

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Feb
2018

Herein, we report characteristics ofF-fluorodeoxyglucose (FDG) uptake in abdominal aortic aneurysms (AAAs) during a long-term follow-up. In addition, we investigated the association between FDG uptake and the physician decision to perform an intervention.
We performed a retrospective review of 42 patients with AAAs who underwent FDG positron emission tomography (PET)/computed tomography (CT).

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Jan
2018

This study aimed to reveal the differences in intermediate outcomes between TAR and d-TEVAR in octogenarians and to identify risk factors for adverse events after aortic arch repair in octogenarians.
We reviewed medical records of 125 patients aged > 80 years who underwent surgical intervention for aortic aneurysm between 2008 and 2016. Of these, 60 underwent conventional TAR (43 men; age, 82 ± 2.

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Nov
2017

Cystic medial degeneration Erdheim-Gsell is a vascular pathology mainly of the large vessels, which is mostly associated with Marfan syndrome or Ehlers-Danlos syndrome. The clinical findings of this entity are aneurysms of the aorta or large peripheral arteries which usually present in an acute setting due to rupture of an aneurysm.
We present a case of a 43-year-old Caucasian male with histologically proven cystic medial degeneration of the lower limb vessels mimicking peripheral artery occlusive disease.

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Jan
2018

Endovascular aneurysm repair (EVAR) is a current alternative treatment for thoracic and abdominal aortic aneurysms, but is still sometimes compromised by possible complications such as device migration or endoleaks. In order to assist clinicians in preventing these complications, finite element analysis (FEA) is a promising tool. However, the strong material and geometrical nonlinearities added to the complex multiple contacts result in costly finite-element models.

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Jan
2018

We present a female neonate with a sternal cleft (SC) and additional aortic aneurysm who presented with respiratory failure. Stabilization of the SC was achieved by using the xyphoid process as an autologous graft bridging the upper part of the SC. We conclude that a step-wise correction of the SC with the use of an autologous graft may improve respiratory function, and should be considered when complete surgical correction is not feasible.

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Jan
2018

To study the lengths and diameters of aortic segments in healthy and diseased aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction.
Ectasia and aneurysm were defined by ascending aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD aortas were analysed using curved multiplanar reformats.

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Jan
2018

Two were the aims of this study: first, to translate whole-genome expression profiles into computational predictions of functional associations between signaling pathways that regulate aorta homeostasis and the activity of angiotensin II type 1a receptor (At1ar) in either vascular endothelial or smooth muscle cells and second, to characterize the impact of endothelial cell- or smooth muscle cell-specific At1ar disruption on the development of thoracic aortic aneurysm in fibrillin-1 hypomorphic mice, a validated animal model of early onset progressively severe Marfan syndrome. APPROACH AND RESULTS:andtransgenic mice were used to inactivate the At1ar-coding gene () in either intimal or medial cells of both wild type and Marfan syndrome mice, respectively. Computational analyses of differentially expressed genes predicted dysregulated signaling pathways of cell survival and matrix remodeling inaortas and of cell adhesion and contractility inaortas.

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Jan
2018

Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury in patients undergoing thoracic and thoraco-abdominal aortic aneurysm repair. Although several studies have shown the feasibility of evaluating the artery of Adamkiewicz using multidetector row computed tomography (MDCT), no detailed investigations regarding the collateral circulation to the artery of Adamkiewicz have been performed. The purpose of this study was to investigate the collateral circulation to the artery of Adamkiewicz using MDCT in patients with thoracic and thoraco-abdominal aortic aneurysms.

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Dec
2017

Reversing the disastrous effects spinal cord injury has become the most prominent topic of neuroscience. Although many therapeutic interventions are being examined, there is yet no definitive cure for spinal cord injury (SCI). In view of this, an experimental study on rats after spinal trauma was performed to test the effects of a natural phenol; Resveratrol.

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Jan
2018

The consequences of common carotid artery (CCA) cross-clamping during debranching before thoracic endovascular aortic repair are unclear. We examined the safety of a simple CCA cross-clamping procedure under regional cerebral oxygen saturation monitoring (rSO2) in patients with a complete or incomplete circle of Willis (CoW) anatomy.
Twenty-eight patients with thoracic aneurysm underwent elective debranching thoracic endovascular aortic repair with bilateral frontal rSO2 monitoring at our institution between January 2012 and October 2015.

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Jan
2018

Hybrid procedures are used to treat aneurysms of the transverse aortic arch (TAA), combining debranching of the brachiocephalic vessels with endovascular approaches. Continued enlargement of the aneurysmal sac is a late complication. A 60-year-old man presented with an expanding transverse aortic arch aneurysm after prior hybrid repair and underwent left posterolateral thoracotomy, partial excision of the previous stent graft and replacement with an interposition graft.

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Dec
2017

The aim of this paper is to report a salvage treatment for malpositioned stent graft due to mislabeled product during thoracic endovascular aortic repair (TEVAR) in descending thoracic aneurysm (DTA). A 78-year-old male presented with 6.7×4.

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Dec
2017

This study was performed to compare the treatment outcomes between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) in a South Korean population.
We performed a retrospective review of the medical records of 99 patients with AAAs who were managed at Gyeongsang National University Hospital between January 2005 and December 2014. We reviewed the demographic characteristics and perioperative treatment outcomes of patients with AAA undergoing EVAR or OSR.

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Jan
2018

The aim of the study was to compare the results of David procedure through conventional or minimally invasive approach.
A propensity-matched comparison in patients undergoing a minimally invasive (partial upper sternotomy, n = 103) or complete sternotomy (n = 103) David procedure from 1991 to 2016 was performed. Patients were 57 ± 14 years old on average in both groups.

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Mar
2018

Latent transforming growth factor binding proteins (LTBP) are a family of extracellular matrix glycoproteins that play an important role in the regulation of transforming growth factor beta (TGF-ß) activation. Dysregulation of the TGF-ß pathway has been implicated in the pathogenesis of inherited disorders predisposing to thoracic aortic aneurysms syndromes (TAAS) including Marfan syndrome (MFS; FBN1) and Loeys-Dietz syndrome (LDS; TGFBR1, TGFBR2, TGFB2, TGFB3, SMAD2, SMAD3). While these syndromes have distinct clinical criteria, they share clinical features including aortic root dilation and musculoskeletal findings.

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Dec
2017

An aortic arch banding procedure was performed on an 82-year-old man for treatment of proximal type I endoleaks 2 days after he had undergone emergency thoracic endovascular aortic repair with the chimney technique for a ruptured aortic arch aneurysm. Contrast-enhanced computed tomography after the second procedure demonstrated significant shrinkage of the aneurysmal sac as well as a complete disappearance of the endoleaks. The basic concept of this technique is to treat the type IA endoleak, including possible gutter endoleaks, by creating a new proximal seal zone distal to the chimney graft using a banding technique.

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Dec
2017

Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%).

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Jun
2017

Angulated anatomy in the aorta, such as tortuous infrarenal aortic necks or steep aortic arches, is a significant challenge for endovascular aortic repair because it often causes inadequate sealing and fixation, which may lead to treatment failure. We have developed a technique using off-the-shelf equipment to precisely control the deployment of stent grafts in challenging landing zones. The key of this technique is to create a through-and-through wire between two access sites and to use a guiding device over the wire.

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Dec
1969

Generally, popliteal artery aneurysms have been addressed surgically by a medial, posterior, or lateral approach. We have designed a new posterior approach that exposes the superficial femoral artery and entire popliteal artery without dividing any muscles in a just prone position.
A 72-year old man with huge popliteal aneurysm extended to superficial femoral artery was admitted to our hospital.

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Mar
2018

Novel endovascular techniques hope to offer patients aortic arch repair with reduced morbidity compared to conventional arch surgery; however, current endovascular strategies remain challenged by the proximal seal zone, higher stroke rates, long-term durability and select anatomy. Hybrid arch repair offers patients a less invasive alternative that can treat more distal aorta than conventional arch repair yet still be performed via standard sternotomy. Areas covered: This review will discuss the current evidence and future development of hybrid aortic arch and frozen elephant trunk reconstruction.

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Jan
2018

A 65-year-old gentleman with claudication underwent contrast-enhanced computed tomography. The scan showed occlusion of the infrarenal abdominal aorta and a 6.0 × 3.

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Jan
2018

The predictive value of the neutrophil to lymphocyte ratio (NLR) has been demonstrated in several cardiovascular diseases. The aim of our study was to investigate the association between the preoperative NLR and aneurysm characteristics as well as 30-day postoperative morbidity and mortality in patients with thoracic aortic aneurysm (TAA) undergoing aortic surgical repair. Consecutive patients (n = 75) with TAA were retrospectively included over a 10-year period.

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Feb
2018

The frequency and gender distribution of thoracic aortic aneurysm as a cardiovascular manifestation of loss-of-function (LOF) X-linked FilaminA (FLNA) mutations are not known. Furthermore, there is very limited cardiovascular morbidity or mortality data in children and adults. We analyzed cardiac data on the largest series of 114 patients with LOF FLNA mutations, both children and adults, with periventricular nodular heterotopia (PVNH), including 48 study patients and 66 literature patients, median age of 22.

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Jan
2018

An aorto-cutaneous fistula is a rare complication that occurs after aortic surgery. Due to its rarity, postoperative complications are not normally highlighted in most standard teaching. We report here a case of aorto-cutaneous fistula after surgical treatment of a Stanford type A aortic dissection (AD) in a 67-year-old Chinese male.

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Dec
1969

Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery.

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Jan
2018

Cases of aortic coarctation complicated with rupture and hemorrhage of intracranial aneurysms are not common in clinical practice. This paper reports a case of middle-aged female patient presented with acute severe headache.
Head CT demonstrated her extensive subarachnoid hemorrhage.

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Jan
2018

Thoracic aortic aneurysm (TAA) is progressive fatal aortic pathological dilation, which is characterized by increased proteoglycans and loss of elastic fibers. Recent advances on long non-coding RNAs (lncRNAs), an important regulator in many biological processes, suggested the close correlation between expression patterns and disease progression. In the present study, the ascending aortic tissues were collected from ascending TAA patients (n = 33) and organ donors (n = 16).

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