Abdominal aortic aneurysmal disease may lead to serious or fatal complications. Recent publications have noted the presence of aneurysms in as many as 14% of male patients older than 60 years with a history of cigarette smoking and peripheral vascular disease. To identify the prevalence of abdominal aortic aneurysm in ...

Aortocaval fistula is a rare complication of abdominal aortic aneurysm involving less than 1% of all abdominal aortic aneurysms. The diagnosis is difficult, and preoperative identification can be challenging. We describe an interesting case of a 72-year-old man presenting with acute-onset dyspnea who was found to have an aortocaval fistula ...

Spondylitis is one of the most frequent osteoarticular complications of Brucella infection in adults. Occasionally it gives rise to soft tissue paravertebral or epidural masses, which can compress surrounding structures. A patient with thrombosis of the abdominal aortic artery secondary to Brucella lumbar spondylitis is presented here, a complication that ...

OBJECTIVE: To investigate features of the smoking habit and other cardiovascular risk factors associated with the development of abdominal aortic aneurysm in smokers. DESIGN AND SETTING: Case control study of smokers recruited, between 1989 and 1992, in a London teaching hospital. SUBJECTS: Consecutive smokers referred with abdominal aortic aneurysm (cases ...

A 78-year-old man with a history of recent unexplained lower gastrointestinal bleeding presented to the emergency department with the acute onset of abdominal pain, tenesmus, and shock. Computed tomography of the abdomen showed a fistula between a common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm ...

The creation of a temporary axillofemoral bypass in a patient undergoing surgery for an 8.1 cm symptomatic infrarenal aortic aneurysm is described. This adjunctive procedure, rarely used in abdominal aortic surgery, may have contributed to minimizing variations in afterload in a patient with a 20% ejection fraction and severe mitral ...

Radionuclide angiogram (RNA) and aortogram may underestimate external aneurysmal diameter. Photon deficient areas are not uncommon along the abdominal aortic aneurysm (AAA) on RNA. To determine whether or not photon deficient areas along the aneurysm could represent a large thrombus, we studied radionuclide aortic angiography in thirty-eight patients during a ...

OBJECTIVES: To determine the degree of neovascularisation in the wall of abdominal aortic aneurysms in comparison to atherosclerotic control aortas, and to correlate the angiogenic response with the extent of the cellular inflammatory infiltrate. DESIGN: Histopathological study. MATERIALS: Aortic samples were obtained from patients with abdominal aortic aneurysms and from ...

Childhood sarcoidosis is a rare disease with multisystemic organ involvement. A wide spectrum of vasculitides, including large vessel involvement, have been reported in childhood sarcoidosis. We describe a 7-year-old boy with childhood sarcoidosis who presented with prolonged fever, iritis, and abdominal aortic aneurysm. He underwent successful surgical repair of the ...

We report the case of a boy with a gigantic aneurysm in the thoraco-abdominal region which was detected by a chest X-ray taken prior to surgical correction of ptosis of the eyelids at 11 months of age. At 18 months, he successfully underwent aneurysm exclusion and bypass grafting. A biopsy ...

OBJECTIVE: To determine, for abdominal aortic aneurysm surgery, whether a previously reported relationship between hospital case volume and mortality rate was observed in Ontario hospitals and to assess the potential impact of age on the mortality rate for elective surgery. DESIGN: Population based observational study using administrative data. SETTING: All ...

Ultrasound is a very accurate and cost-effective method for evaluating the aorta and identifying abdominal aortic aneurysms. It is also valuable for following aneurysms for expansion. In the future, the use of color flow Doppler imaging may further prevent the risk of rupture by identifying specific high risk flow patterns. ...

Atherosclerosis and its complications are associated with high morbidity and mortality in the elderly. One of these complications is abdominal aortic aneurysm which may be prevented from rupturing if diagnosed early. Screening for aortic aneurysm was carried out in Jeddah, which is in the western region of Saudi Arabia, to ...

OBJECTIVE: To evaluate tissue protection by PGE1 during leg ischemia in patients undergoing aortic surgery. DESIGN: Randomized, controlled prospective clinical trial. SETTING: Single university hospital. PARTICIPANTS: 19 consecutive patients undergoing abdominal aortic aneurysm repair. INTERVENTIONS: Patients received infusions of 30 ng/kg/min of PGE1 or saline. MEASUREMENTS AND MAIN RESULTS: Hemodynamic ...

Background: In our previous canine model of abdominal aortic aneurysm, although aneurysm growth was observed, the aneurysms did not rupture. This prompted us to develop a swine model, which has the advantage of fibrinolytic and coagulation systems similar to those found in humans. Methods: We simulated aneurysms by connecting fascia ...

To evaluate the influence of the technical problems experienced when scanning transabdominally, a comparison was made between transabdominal and intra-abdominal Doppler parameters of the aorta and the splanchnic arteries. Peroperative color duplex sonography of the abdominal aorta and the splanchnic arteries was performed on 25 patients who were undergoing abdominal ...

Chronic contained rupture of an abdominal aortic aneurysm is rare. These aneurysms are small and affected patients are usually normotensive. The resultant pseudoaneurysmal sac may cause extensive vertebral erosion. Diagnosis is often delayed as the condition may present with symptoms referable to the lumbar spine. This report is of two ...

We describe a case of complete embolization of an aortic valve prosthesis to the abdominal aorta. To our knowledge, this patient is the 1st asymptomatic long-term survivor of this catastrophic event. In such cases, we recommend emergency surgery on the basis of echocardiographic results alone. Delay for more complete diagnostic ...

OBJECTIVE - To analyse the benefits of screening older men for abdominal aortic aneurysms. METHODS - A hospital based screening trial concerning 13 500 65-73 year old men using B-mode ultrasonographic scanning. To improve the response rate the invited men could change their appointment, and nonresponders were reinvited. RESULTS - ...

To stabilize the hemodynamics before and during ruptured abdominal aortic aneurysmal repair, a mass-infusion system was developed and successfully employed in the treatment of two patients. The system consists of a combination of devices used in cardiopulmonary bypass, namely: suction, a reservoir, a heat exchanger, a bubble trap, and an ...

The aim of the study was to assess the surgical outcome of elective infrarenal abdominal aortic aneurysm (AAA) repair and the clinical and surgical factors that may predict this outcome. The series comprises 174 consecutive patients who underwent elective surgery for infrarenal AAA. Factors found to be predictive of early ...

Operative morbidity and mortality are elevated in patients with inflammatory abdominal aortic aneurysm. Preoperative identification of inflammatory abdominal aortic aneurysm. the detection of the proximal level and of adhesions to adjacent structures are important for surgical management. The sensitivity and specificity of ultrasonography and computed tomography (CT) for identification and ...

Inflammatory aneurysm of the abdominal aorta (IAAA) is a variant of atherosclerotic aneurysm that is characterized by inflammatory and/or fibrotic changes in the periaortic regions of the retroperitoneum [1, 2]. These inflammatory and/or fibrotic changes are probably the result of a local autoallergic reaction to certain components of atherosclerotic plaques ...

A case of a 50-year-old man with chronic back pain, an abdominal aortic aneurysm and bony erosion of the lumbar spine due to a chondrosarcoma is reported. This report shows that the lumbar erosion seen in association with an aneurysm is unlikely to be a result of pressure erosion of ...

An increasing number of inflammatory abdominal aortic aneurysms are reported today, although it is not clear whether these are nosologically independent lesions or a particular evolution of atherosclerotic aneurysms with enhanced phlogistic processes and fibrous reaction. Several pathogenetic theories have been proposed (microfissuration, autoimmunity, lymphatic stasis); clinical symptoms are characterised ...

A case is reported of contained rupture of an infected abdominal aortic aneurysm as a result of vascular catheter-associated candidiasis. Candida was identified in the mural thrombus taken from the aneurysm during surgery. Since Candida has played an important role in nosocomial infection and catheter-associated sepsis during the past decade, ...

OBJECTIVE: To compare the dimensions of the infrarenal aorta and the prevalence of undiagnosed infrarenal abdominal aortic aneurysms in the siblings of patients operated on for either infrarenal abdominal aortic aneurysm or aortoiliac occlusive disease. DESIGN: Prospective screening study. SETTING: University hospital, Finland. SUBJECTS: 220 siblings of patients operated for ...

Recent apparent increases in occurrence of aortic aneurysm were reported for abdominal aortic aneurysm from several countries. In order to assess U.S. trends, an analysis of mortality and hospitalization data from the National Center for Health Statistics for aortic aneurysm in the United States in 1979-1992 was performed. In 1991, ...

Acute lower extremity ischemia secondary to fecal impaction has not been previously reported. Herein, we report the case of an elderly man who was referred to our medical center with an acutely ischemic right lower extremity and a possible abdominal aortic aneurysm. The suspicious abdominal mass noted by his local ...

A 46-year-old patient who presented with an abdominal mass and gastrointestinal bleeding associated with an extra-adrenal pheochromocytoma is discussed. He had no history of hypertension. An ill-defined mass was felt at the upper abdomen. CT and arteriography confirmed the presence of a large mass with calcifications in the right paravertebral ...

After emergency repair of a ruptured abdominal aortic aneurysm associated with an aortocaval fistula, Clostridium septicum sepsis prompted evaluation for colon cancer. Adenocarcinoma of the right colon ultimately required hemicolectomy, after which the patient had development of recurrent C. septicum bacteremia. Computed tomography scanning demonstrated a large fluid collection surrounding ...

Seasonality in ischaemic coronary artery disease is well documented with a winter/summer variation the commonest pattern. The influence of seasonal variation on events in other vascular territories is less well documented. The incidence of ruptured abdominal aortic aneurysm and emergency lower-limb ischaemia was analysed on a monthly basis over a ...

The risk of rupture of an abdominal aortic aneurysm increases with aortic diameter. To obtain insight into the pathological processes associated with the vascular remodeling that accompanies aortic dilatation, we compared the histological features and the activity of matrix metalloproteinases (MMPs) in biopsies from 21 small (4.0 to 5.5 cm ...

BACKGROUND: Abdominal aortic aneurysm and renal neoplasm are occasionally discovered concurrently. Simultaneous operative therapy may be an effective alternate management strategy to a staged procedure. PATIENTS AND METHODS: The medical records of 10 consecutive patients undergoing abdominal aortic aneurysm repair and nephrectomy for renal neoplasm were reviewed. Data collected included ...

Abdominal aortic aneurysms (AAAs) have traditionally been attributed to atherosclerosis, although there is increasing epidemiological, biochemical and genetic evidence that aneurysmal arterial disease is different from occlusive atherosclerosis. One of the most consistent biochemical findings in the aneurysmal aorta is a significant reduction in elastin protein; the cause, for this ...

The proper management of patients with asymptomatic abdominal aortic aneurysms and significant coexistent coronary artery disease is still debatable. The most common approach has been to perform the coronary artery bypass surgery some weeks before the abdominal aortic aneurysm repair in the hope of reducing the cardiac morbidity and mortality. ...

Rheumatoid vasculitis, an extra-articular component of rheumatoid arthritis, causes a wide spectrum of manifestations that range from clinically insignificant to life-threatening disease. As a systemic necrotizing arteritis, rheumatoid vasculitis is usually characterized by end-organ ischemia. Herein we describe a patient with abdominal pain and syncope due to intra-abdominal hemorrhage from ...

Among several other atypical clinical presentations, back and leg pain may ensue from a contained ruptured abdominal aortic aneurysm. The present case concerns a patient whose back and leg pain were primarily thought to be orthopaedic or neurologic in origin. Computed tomography with small field of view, performed for the ...

The purpose of this study was to characterize the distribution of aortic wall microvessels in normal aorta, atheroocclusive disease (AOD), and abdominal aortic aneurysms (AAA) and to evaluate whether medial neovascularization (MNV) is a reliable histopathologic marker of aneurysmal degeneration. Aortic tissue specimens (9 normal, 10 AOD, and 10 AAA) ...

We describe five cases of segmental arterial mediolysis (SAM), formerly known as segmental mediolytic arteritis. SAM occurs in epicardial coronary arteries and in the abdominal splanchnic arteries. Patients with abdominal SAM are generally elderly, whereas coronary SAM presents in neonates, children, and young adults. SAM is initiated by mediolysis of ...

The operative treatment of chronic contained rupture of a saccular abdominal aortic aneurysm (AAA) with retroperitoneal haematoma is reported. A 62-year-old man presented with a painless abdominal mass and intermittent claudication. He had an episode of severe abdominal pain about 2 years before admission. A giant retroperitoneal neoplasm was initially ...

Spontaneous aortic thrombosis in the neonate is a rare entity with a high mortality rate. The present patient, who was diagnosed after showing haematuria and cyanosis, underwent aortic thrombectomy with a Fogarty catheter through a left thoracotomy, but died of sepsis, disseminated intravascular coagulation and multiple organ failure. Autopsy revealed ...

Aortocaval fistula caused by rupture of an abdominal aneurysm was diagnosed before surgery and treated successfully using cardiopulmonary bypass, which effectively controlled the massive bleeding. Rupture of the false lumen of a dissecting aneurysm limited to the abdominal aorta was responsible for the aortocaval fistula. The defect of the inferior ...

Inflammatory abdominal aortic aneurysm is an uncommon disorder characterized by marked thickening and extensive inflammatory changes of the aneurysmal wall. The appearances of an inflammatory abdominal aortic aneurysm on dynamic Gd-DTPA enhanced magnetic resonance imaging are described and the value of this modality in achieving a pre-operative diagnosis is emphasized.

We present two cases of patients with coincidental pancreatic disease and abdominal aortic aneurysm. Initial pancreaticoduodenectomy was followed by staged abdominal aortic aneurysm repair via a retroperitoneal approach in both cases. We recommend the retroperitoneal approach over the transperitoneal approach as an easier and safer method of aortic aneurysmorrhaphy after ...

Atherosclerotic disease appears to be more severe in black patients than in white patients, but abdominal aortic aneurysms, which have traditionally been believed to have an atherosclerotic cause, are reported to be less common in black patients than in white patients. Our goals were to compare and contrast factors associated ...

A traumatic pseudoaneurysm of the abdominal aorta eluded detection at initial laparotomy, but was later detected serendipitously. Early abdominal x-ray film and appreciation of paraspinal bullet fragments could have led to its earlier detection. A portable abdominal x-ray film should be a routine part of the preoperative resuscitation of abdominal ...

An exclusion technique for the treatment of abdominal aortic aneurysm was used in six patients considered to be at high operative risk mainly because of chronic pulmonary disease. There were no deaths or immediate major complications. Thrombosis of the aneurysm was achieved in four of the six patients. However, in ...

A giant aneurysm of the abdominal aorta presented with a 2-3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the ...

In order to determine any possible influence of climatic variables on the incidence of abdominal aortic aneurysm rupture, we reviewed 49,144 autopsies performed in two major hospitals in Rome, Italy, from January 1956 to March 1986. There were 297 subjects who were found to be sufferers of atherosclerotic abdominal aortic ...