Renal artery stenosis (RAS) is a common finding in patients undergoing coronary angiography. We designed this study to look for the frequency and any predictors of renal artery stenosis in patients with coronary artery disease (CAD). A total of 201 consecutive patients with CAD confirmed by coronary angiography underwent an ...

The aortic arch presents specific challenges to endovascular repair. Hybrid repair is increasingly evolving as an alternative option for selected patients, and promising initial results have been reported. The aim of this study was to introduce our experiences and evaluate mid-term results of supra aortic transpositions for extended endovascular repair ...

A 34-year-old female presented with subarachnoid hemorrhage caused by the rupture of a right vertebral artery (VA) dissecting aneurysm. The affected site, including the aneurysm and parent artery, was successfully occluded with detachable coils. Follow-up angiography performed 28 days after the endovascular treatment revealed recanalization of the parent artery. We ...

As opposed to iatrogenic coronary dissection, spontaneous dissection is an extremely rare clinical condition. Typically seen in a single coronary vessel of peripartum women presenting with acute coronary syndrome, there are isolated case reports of men presenting multivessel involvement for this life-threatening condition. We describe a 54-year-old male with a ...

We describe three rare cases of dissecting aneurysms in the anterior cerebral artery (ACA) treated by surgical reconstruction, and reviewed 79 previously reported cases with the ACA dissecting aneurysm. We found that 35 (77.8%) of 45 patients with ischemic event and 15 (40.5%) of 37 patients with hemorrhagic event were ...

Ulnar artery aneurysms in children younger than 10 years of age are rare, with fewer than 10 reported cases worldwide. Unlike adult arterial aneurysms, the etiology of these lesions in children is not well understood, and there is no accepted method for treating these lesions. The method of diagnosis and ...

The present study enrolling a total of eighty-eight 4-to-16-year-old children and adolescents was aimed at detailed elaboration and formalization of clinical signs of the internal carotid artery pathological kinking syndrome. To achieve these objectives, the authors carried out a comparative analysis of clinical manifestations of the disease in the surgically ...

We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) with false lumen rupture and acute right lower limb ischemia treated with fenestration at the aortic bifurcation followed by a hybrid approach, consisting of an elephant trunk procedure and the placement of endoluminal stent graft ...

Acute type A aortic dissection can be complicated by visceral malperfusion and is associated with a significant surgical morbidity and mortality. We describe a case of successful management of a complex acute type A dissection with mesenteric and lower limb ischemia treated with endovascular thoracic stenting and femoro-femoral crossover bypass ...

Data suggests that hemorrhagic presentations occur in 20% of internal carotid artery dissections and 50% of vertebral artery dissections. A Finnish study has reported favorable outcomes in only 32% of patients. We aimed to review the epidemiology and management outcomes in a Chinese population. We reviewed the aneurysmal subarachnoid hemorrhage ...

A 69-year-old man while being treated for type B aortic dissection was also found to have acute myocardial infarction. The patient initially was treated conservatively. Prophylactic anticoagulant treatment of potential thrombosis was not given because of aortic dissection. Stent-graft implantation to the thoracic aorta was considered at the time. Unexpectedly, ...

The impact of meteorological conditions on the occurrence of various cardiovascular events has been reported. The aim of this work was to study the correlations between weather conditions and the occurrence of type A acute aortic dissections (AADs). Between 1997 and 2007, all the medical records of patients who underwent ...

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) represents a novel concept for type B aortic dissection. Although life-saving in acute emergencies, outcomes and survival of TEVAR in stable dissection are unknown. METHODS AND RESULTS: One hundred forty patients in stable clinical condition at least 2 weeks after index dissection were randomly ...

Carotid arterial dissections may result from spontaneous or traumatic causes. Postcoital arterial dissections have been reported in both the vertebral and coronary arteries. We report a rare case of spontaneous dissection from the common carotid artery to the internal and external carotid arteries after sexual intercourse, leading to fulminant middle ...

The elephant trunk technique is a novel staged procedure for the treatment of an extensive thoracic aortic aneurysm. Occasionally, entrapment or obstruction in the smaller lumen occurs with the use of the elephant trunk technique in aortic dissection. The general procedure is to excise a generous portion of the dissecting ...

Primary spontaneous coronary artery dissection may appear in young women during the peripartum period or as a result of atherosclerosis. We present a patient with familial hypercholesterolemia who developed a giant aneurysm of the right coronary artery in the setting of atherosclerotic spontaneous coronary dissection over an 8 year period. ...

PURPOSE: To describe clinical and computed tomography (CT) findings of isolated dissection of the visceral arteries (IDVA). MATERIALS AND METHODS: We retrospectively analyzed clinical presentation and abdominal CT findings of 38 patients who were diagnosed as having an IDVA. IDVA were classified into three types based on CT findings: patent ...

OBJECTIVE: To determine the anatomical course of descending genicular artery and to identify a safety zone for minimidvastus approach. MATERIAL AND METHOD: Forty-eight knees from twenty-four fresh cadavers were dissected to identify the descending genicular artery, and to measure the distance between such artery and superomedial pole of the patella ...

The authors present the case report of effective conservative treatment in a patient with spontaneous, self-limiting, non-atherosclerotic dissection of the superior mesenteric artery (SMA) without fixed obstruction of the vessel lumen and signs of intestinal ischemia. Treatment with both anti-coagulant and anti-hypertensive agents succeeded in limiting the progression of intimal ...

Carotid stenting has become an accepted alternative in patients with carotid stenosis. The purpose of this article is to review the relevant trials, describe the different devices available for stenting, the devices for cerebral protection, as well as describe techniques and tricks for successful carotid artery stenting. Understanding how to ...

Oxidized low-density lipoprotein receptor 1 (LOX1) is a critical factor for atherosclerosis in a variety of vascular diseases; however, its major role in cerebral arterial dissecting aneurysm is unclear. We present a case of remarkable contrast of LOX1 expression in ruptured and unruptured multiple middle cerebral artery dissections and discuss ...

Generally, sympathetic distribution in the pterygopalatine fossa (PPF) is considered to be via the pterygopalatine ganglion (PPG) sympathetic root and branches. We hypothesized that there may be a dual sympathetic path within the PPF, through the vidian nerve and the PPG and through the periarterial plexuses. We dissected 10 human ...

BACKGROUND: Isolated and spontaneous dissection of mesenteric arteries is a rare entity; a little more than 50 cases have been reported in medical literature. There is no therapeutic consensus concerning this type of lesion. METHODS: In this study, we report the results of our treatment based on a conservative approach. ...

The dissecting aortic aneurysm (DAA) is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

Isolated dissection of the origin of both celiac and superior mesenteric arteries is a rare vascular pathology with limited management guidelines. The presentation is generally nonspecific, most often manifesting with epigastric pain radiating to the back. A high diagnostic index of suspicion and stepwise management are essential for a successful ...

A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve ...

This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at ...

Background: Headaches associated with sexual intercourse (coital cephalgia) have many different causes and are often divided in the literature into pre-orgasmic and orgasmic headaches. Objective: To present a case of orgasmic headache caused by a basilar artery dissection and to present a literature-based guide to the diagnosis and management of ...

PURPOSE: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms. METHODS: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, ...

Dissection of the innominate artery is extremely rare and is associated with a high in-hospital mortality rate. We present the case of a 44-year-old man who presented with syncope and cardiovocal syndrome as the result of a spontaneous innominate artery dissection with an extension to the right common carotid.

The development of vertebral artery (VA) dissecting aneurysm after trapping of the contralateral VA is rare, and rupture of angiographically occult VA dissecting aneurysms immediately after trapping is even less common. A 39-year-old man suffered subarachnoid hemorrhage caused by rupture of a left VA dissecting aneurysm. The VA was trapped ...

Chronic aortic dissections are complex lesions with a fairly predictable natural history depending on factors such as baseline aortic diameter, the degree of false lumen thrombosis, the presence of a persistent communication, an underlying connective tissue disorder, and the control of hypertension. Medical management with antihypertensive therapy including beta-blockers is ...

Distal reoperations for aortic dissection are associated with high morbidity rates. We describe distal aortic enlargement that was treated using our surgical strategy. From January 1997 to April 2008, 63 patients underwent ascending aortic replacement for acute type A aortic dissection. Four patients (7.4%; 3 males, 1 female; mean age, ...

BACKGROUND: Late survival and freedom from retreatment on the descending aorta was evaluated after ascending aortic repair for type A acute aortic dissection (TAAAD). METHODS: Between March 1992 and January 2006, 189 TAAAD patients (mean age, 52 +/- 11; range, 17 to 83 years) were included; of these, 58 had ...

A 65-year-old man with chronic aortic dissection experienced two massive subcutaneous hemorrhages. Laboratory data indicated disseminated intravascular coagulation, whereas a contrast computed tomographic scan revealed a dilatated aortic arch with a partial thrombosis at the false lumen. Because disseminated intravascular coagulation can be caused by chronic aortic dissection, and the ...

A 59-year-old woman was transferred to our institution with a diagnosis of acute type A aortic dissection. During aortic replacement surgery, the dissection had not extended to the orifice of the left coronary artery. However, ST segment elevation was observed on an electrocardiogram monitor immediately postoperatively. An emergent coronary angiogram ...

Intramural hematoma (IMH) is defined as localized hemorrhage within the aortic wall and is included in the acute aortic syndrome spectrum with aortic dissection and penetrating aortic ulcer. The mortality from IMH is similar to classic aortic dissection (21%). 16% of patients with IMH will evolve to classic aortic dissection ...

BACKGROUND: The site of cannulation for repair of ascending aortic dissection remains controversial. We present our experience with ascending aortic cannulation for acute aortic dissection type A. METHODS AND RESULTS: From January 1988 to September 2007, we operated on 242 patients for acute aortic dissection type A. Medical records of ...

Objectives: To provide anatomical data to help identify and locate the anterior ethmoidal artery (AEA) precisely during endoscopic procedures. Method: We dissected 15 adult cadaver heads, which provided 30 specimens, to study morphological characteristics, courses, and several types of variations. Results: We found the average diameter of the AEA to ...

Background. Cervicocephalic arterial dissection (CCAD) is rare in the postpartum period. To our knowledge this is the first reported case of postpartum angiopathy (PPA) presenting with ischemic stroke due to intracranial arterial dissection. Case. A 41-year-old woman presented with blurred vision, headache, and generalized seizures 5 days after delivering twins. ...

Spontaneous coronary artery dissection is a rare pathology that has no exact incidence, etiology, pathogenesis and evolution in literature. We report two cases of two women with coronary artery dissection, uncommon clinical presentation of acute coronary syndrome and without identifiable risk factors. A review of the literature and the management ...

Intracranial vertebral artery (VA) dissecting aneurysms often present with severe subarachnoid hemorrhage (SAH) and a subsequent high rate of mortality. We retrospectively studied the treatment efficacy and outcomes of 26 patients with ruptured VA dissecting aneurysms treated with endovascular surgery. Twenty-six patients with ruptured VA dissecting aneurysms were enrolled. Fifteen ...

Aortitis is typically a chronic, progressive disease manifestation associated with large vessel vasculitidies, most notably giant cell, Takayasu arteritis, and a newly described entity, isolated aortitis. The aortitis may lead to aneurysm formation and symptoms associated with branch vessel occlusion in these diseases, but aortic dissection is rare and usually ...

OBJECTIVE: To improve the surgical results of aortic dissection, we used a novel vascular ring connector for anastomosis. METHODS: The vascular ring connector is a titanic ring used as a stent in the vascular graft to achieve a quick, blood-sealed, and sutureless anastomosis. From November 2007 to December 2008, 19 ...

A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH) presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with ...

Aneurysm and dissection of the ascending aorta carry the risk of life-threatening complications. The anti-protease alpha 1 antitrypsin plays an important role in the tissue protease - anti-protease equilibrium. We aim to investigate the molecular pathology of these diseases by differential proteomics and mass-spectrometric analysis. From ascending aortic wall specimens ...

Free and pedicled flaps are frequently used in reconstruction of the lower two-thirds of the face. For these reconstructions, the submandibular facial vessels are extensively used as a receptor site. In this anatomic study, we investigate if the facial vessels in the nasolabial fold can be used as a receptor ...

We report successful surgical treatment of coronary artery disease (CAD) in a 53-year-old man. The man was admitted to our hospital due to severe anterior chest pain. He had a surgical history of total arch replacement for acute type A dissection 10 years previously. Angiography showed triple-vessel disease and partial ...

OBJECTIVE: To establish an animal model of Stanford type B aortic dissection using a two-end intimal flap suturing. DESIGN: Twelve adult mongrel dogs of either sex were studied and followed up, at intervals, up to 1 year. MATERIALS AND METHODS: A lateral clamp was placed on the proximal descending aorta ...

BACKGROUND: The relation between cardiovascular diseases and the seasons is well known; however, only a few reports have addressed the seasonal aspects of acute aortic dissections. We investigated whether presentation of acute aortic dissection has monthly/seasonal variations. METHODS: From February 1985 to January 2006, 165 consecutive patients with aortic dissection ...