A 64-year-old woman was complicated with acute type A dissection arising from the left main trunk during percutaneous coronary angiography. As the extent of dissection was localized in the ascending aorta, a bare-metal stent was inserted into the left main trunk to cover the entry of dissection. Two days after ...

Without emergency surgical management, acute type A aortic dissection carries a high risk of death. Controversy exists as to whether extreme age remains a contraindication to surgery. We describe successful repair of type A aortic dissection with ascending aortic graft replacement, aortic valve repair, hemiarch reconstruction, and ablation of atrial ...

Aortic aneurysm and dissection cause significant morbidity and mortality. There are several known single gene disorders that predispose to isolated aortic disease and eventually aneurysm and dissection. FBN1 mutations are associated with multiple clinical phenotypes, including Marfan syndrome (MFS), MASS phenotype, and familial ectopia lentis, but rarely with isolated aortic ...

Although patho-physiology of spontaneous internal carotid artery dissection (sICAD) is largely unknown, an association with migraine has been suggested but not proven. Migraine is a condition which is worth considering while one is hunting a possible cause for internal carotid artery dissection (ICAD) and it may be found more often ...

Aortic dissection is a life-threatening condition with a 50% mortality rate in the first 48 hours and a 3-month mortality rate of 90% in untreated patients. Aortic dissection is a rare complication of pregnancy, but there is significant morbidity and mortality for the mother and infant. A 43-year-old woman with ...

BACKGROUND/PURPOSE: To describe the clinical characteristics and imaging findings of craniocervical dissection in childhood ischemic stroke, in a tertiary medical center. METHODS: In this retrospective study, we investigated children (aged 1 month to 18 years) with symptoms and radiographic confirmation of ischemic stroke from January 1996 to January 2007. Stroke ...

SUMMARY: We present a unique case of multiple sCADs occurring after a ruptured intracranial aneurysm embolization. We discuss the impact of head extension during embolization as the prevailing factor in multiple artery dissections in this case and point out another cause of new-onset neurologic deficit in patients with aneurysmal SAH.

Three patients had severe abdominal pain of sudden onset. Computed tomography showed localized dissection in the superior mesenteric artery in two patients and in the celiac artery in one. With conservative therapy abdominal symptoms were self-remitted. All patients were successfully treated with medication and have been doing well during follow-up.

We present our experience with an acute Stanford type B aortic dissection in a 25-year-old, 26-week gravid patient without a known connective tissue disorder and discuss a literature-based treatment strategy. After failed conservative treatment manifest by aneurysm rupture, emergency cesarean section delivery and immediate repair of her thoracic aorta was ...

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 ...

A 51-year-old man presented with an extremely rare case of intracranial subarachnoid hemorrhage caused by rupture of an anterior spinal artery aneurysm manifesting as disturbance of consciousness following sudden onset of neck pain and numbness of the extremities. Cranial computed tomography revealed subarachnoid hemorrhage, mainly in the posterior fossa. Cerebral ...

Brain-supplying arterial dissection is considered one of the most common vascular causes of stroke in younger patients. Dissections are usually preceded by trauma or mechanical stress; the vascular stressor may be trivial as this condition has been described in association with manipulation and stretching the neck. Here we describe a ...

The objective of our study was to estimate the incidence of posttraumatic dissections of cervical arteries in patients with whiplash injury acquired in a car accident. We performed a retrospective analysis of medical records of 500 patients with whiplash injury acquired in car accidents between 1996 and 2005 and searched ...

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 ...

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 technical factors and surgical methods employed in carotid endarterectomy are controversial. In particular, whether or not to use an indwelling arterial shunt during carotid endarterectomy remains a source of conflict. We describe a rare case in which uncomplicated carotid endarterectomy was followed by distal internal carotid artery dissection and ...

Acute thoracic aortic pathology is a relatively new term. The experience gained in treatment of thoracic aorta pathology has shown the importance of early diagnosis of the disease of this localization. Improved resolution of modern diagnostic medical equipment has made it possible to recognize early forms of aortic lesions and ...

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 ...

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 ...

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 ...

Spontaneous cervicocephalic arterial dissection (SCAD) has been recognized as an uncommon cause of cerebral stroke. Although it has been viewed as an important cause of stroke, especially in juvenile cases, its natural course and pathophysiology have yet to be fully clarified, and no treatment criteria have been established. Recent studies ...

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, ...

Purpose: Headache is recognized as one of the specific signs of intracranial arterial dissection (ICrAD). We clarified the incidence of ICrAD in non-emergency outpatients complaining of headache and the nature of headache observed in case of ICrAD. Patient population and methods: Consecutive non-emergency outpatients coming to the neurological and neurosurgical ...

The management and follow-up of chronic type B aortic dissections continues being a clinical challenge. Patients with chronic type B dissection have high mid/long term mortality mainly due to progressive aortic dilatation and subsequent rupture.

Coronary artery stents mechanically buttress the arterial wall and prevent negative remodeling, leading to increased lumen gain and less angiographic and clinical restenosis as compared with balloon angioplasty alone. Although stents prevent negative remodeling, they do not eliminate restenosis, as they cause complex arterial injury triggering responses that culminate in ...

A 48-year-old man presented with a rare dissection of the anterior cerebral artery (ACA) causing simultaneous subarachnoid hemorrhage (SAH) and cerebral infarction manifesting as sudden onset of headache and left hemiparesis. Computed tomography and magnetic resonance imaging showed SAH localized in the interhemispheric fissure and cerebral infarction in the territory ...

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 ...

The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB) for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic ...

Isolated spontaneous dissection of celiac trunk is a rare entity. The spontaneous dissection of the visceral artery occurs without aortic dissection. The most consistent presenting symptom is acute onset abdominal pain. Complications consist of ischemia, aneurysm formation, and rupture. We report an exceptional case of an isolated spontaneous dissection of ...

The most common treatment of acute type A aortic dissection is immediate surgical repair. However, early surgery for acute dissections with peripheral vascular compromise carries a high mortality rate. Herein, we report a case in which we placed percutaneous endovascular stents in a type A dissection patient before proceeding with ...

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 ...

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 ...

Bleeding related to inadvertent femoral catheter insertion is an infrequent but morbid complication. We report two cases of acute life-threatening bleeding after attempts at femoral vein catheterization. Both patients were morbidly obese, had multiple comorbidities, and were at high risk for surgical intervention. Aggressive resuscitation failed to stabilize the patients. ...

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 ...

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 ...

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 ...

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 ...

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. ...

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 ...

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 ...

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 ...

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.

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. ...

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 ...

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 ...

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 ...