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Jonker F H W - - 2010
To investigate the impact of hypovolaemic shock on the aortic diameter in a porcine model, and to determine the implications for the endovascular management of hypovolaemic patients with traumatic thoracic aortic injury (TTAI). The circulating blood volume of seven Yorkshire pigs was gradually lowered in 10% increments. At 40% volume ...
Lam Cuong H - - 2010
Paralysis and paraparesis are dreaded complications of thoracic endovascular aortic repair (TEVAR) that occur with an incidence of 2%-6%. Risks factors include the type of thoracic aortic pathology treated, coverage of the left subclavian artery origin without revascularization, concomitant infrarenal abdominal aortic aneurysm repair, extent of stent graft coverage of ...
Kuratani Toru - - 2010
Thoracic aortic aneurysms are extremely burdensome to treat owing to their surgical complexity. In particular, major postoperative complications lower significantly patients' quality of life. Surgical treatment has recently shifted to thoracic endovascular aortic repair (TEVAR) to respect the patients' needs and improve postoperative quality of life. This procedure is radical ...
Kasashima Satomi - - 2010
Immunoglobulin G4-related sclerosing disease (IgG4-SD) has recently been reported to occur in the cardiovascular system and manifest as inflammatory abdominal aortic aneurysm. Thoracic aortic lesions are often associated with aortitis in several divergent etiologies. Thus, this study was performed to review thoracic aortic lesions from the aspect of IgG4-SD and ...
Ohtake H - - 2010
The position of thoracic endovascular aortic repair (TEVAR) compared to open surgery of the thoracic aorta has changed. This study evaluates outcomes after TEVAR performed electively using our original Matsui-Kitamura stent graft (MKSG) to treat descending thoracic aortic aneurysms (dTAA) and chronic type-B aortic dissection (type-B AD), and elucidates the ...
Qureshi M A - - 2010
Aneurysmal disease of the arterial vasculature has been reported since ancient times. Regarding aneurysms of the aorta, a steady progress has been made ranging from making such pathology amenable to surgical treatment to making the procedure much less invasive. There have been a number of stent grafts, introduced by different ...
Schindera Sebastian T - - 2010
PURPOSE: To assess the effect of beam hardening on arterial enhancement in thoracoabdominal computed tomographic (CT) angiography in various body sizes in a phantom and in a clinical study. MATERIALS AND METHODS: An abdominal aortic phantom was placed in three cylindrical water containers simulating a small, an intermediate, and a ...
Roselli Eric E - - 2010
BACKGROUND: Thoracic aortic disease involving the aortic arch presents a challenge to cardiovascular surgeons. The purpose of this study was to establish the safety and efficacy of antegrade delivery techniques of aortic stent grafting for the treatment of high-risk, complex thoracic aortic disease. METHODS: From April 2007 to December 2009, ...
Matsuda Hitoshi - - 2010
This article discusses the multidisciplinary approach to prevent spinal cord ischemia (SCI) with reference to the incidence of SCI after thoracic endovascular aneurysm repair (TEVAR) associated with closure of the intercostal-lumbar artery that supplies the Adamkiewicz artery (ICA-AKA). We reviewed 60 patients [49 men, 57 to 89 years old] who ...
De Cecco Carlo Nicola - - 2010
We report the case of an ascending aorta aneurysm with intramural haematoma (IMH) in a patient with severe hypotension without history of thoracic pain or hypertension. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) demonstrated the presence of subacute IMH and also revealed sacciform aneurysm of the aortic arch. ...
Tromp Gerard - - 2010
Aortic aneurysms occur in the thoracic and abdominal sections of the aorta and are a deadly late-age-at-onset disease with complex pathobiology. Currently, the number of published genome-wide analyses including microarray-based expression profiling, DNA linkage studies, and genetic association studies is still limited and it is difficult to make generalizations about ...
Charitos Efstratios I - - 2010
A 48-year-old patient with Marfan syndrome presented with an ascending aortic and arch periprosthesis hematoma (14.0 x 9.0 cm) and a descending aortic aneurysm (8.7 x 9.1 cm) developed over the last 2.5 years, after several operations on the ascending aorta and arch as well as stent-graft placement in the ...
Jim Jeffrey - - 2010
A 72-year-old man presented with thoracic pain. Nine years earlier, a descending aortic dissection with aneurysmal degeneration had been treated by thoracoabdominal aortic graft placement with reimplantation of a visceral patch and an intercostal patch. A separate left aortorenal bypass had also been performed with the bypass originating from the ...
Brinster Clayton J - - 2010
Thoracic endovascular aortic repair (TEVAR) has emerged as an alternative for patients at prohibitive risk for open thoracic or thoracoabdominal surgery, decreasing perioperative morbidity and mortality. Aneurysms that involve both the left subclavian artery (LSA) proximally and the celiac artery (CA) distally present a unique challenge to the use of ...
Ilic Nikola - - 2011
Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor ...
Jo Colleen O - - 2010
BACKGROUND: The objective of this study was to define a simple method of measuring thoracic aortic pulse-wave velocity (PWV) using only an aortic length regression equation based on the subject's height and two pulsed Doppler recordings of the aorta. METHODS: The thoracic aortas of 80 subjects (age range, 0-20 years) ...
Etz Christian D - - 2010
OBJECTIVE: Paraplegia remains a devastating, and still too frequent, complication after repair of extensive thoracoabdominal aortic aneurysms. Strategies to prevent ischemic spinal cord damage after extensive segmental artery sacrifice-or occlusion, essential for endovascular repair-are still evolving. METHODS: Ninety patients who underwent extensive segmental artery sacrifice (median, 13; range, 9-15) during ...
Jatene Fabio Biscegli - - 2010
The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California) is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal ...
Pizon Anthony - - 2012
A ruptured thoracic aortic aneurysm is a life-threatening condition and can lead to a tension hemothorax. To describe the presentation and management of a case of a tension hemothorax. An 84-year-old woman presented in respiratory distress and was found to have a tension hemothorax. The cause was the rupture of ...
Yamamoto Hiroshi - - 2010
We describe a rare case of an arteriosclerotic aneurysm in the right-sided descending thoracic aorta with a left-sided aortic arch and concomitant aberrant right subclavian artery. A 76-year-old woman, who was found to have an aneurysm of the right-sided descending thoracic aorta, was referred to our hospital for surgical treatment. ...
Baril Donald T - - 2010
The treatment of thoracic aortic disease has changed radically with the advances made in endovascular therapy since the concept of thoracic endovascular aortic repair was first described 15 years ago. Currently, there is a diverse array of endografts that are commercially available to treat the thoracic aorta. Multiple studies, including ...
Shah Urmil - - 2010
The percutaneous transradial approach for cardiac catheterization has been shown to be a safe alternative to femoral artery approach, owing to the favorable anatomical relation of the radial artery to surrounding structures and the dual blood supply to the hand. Selection of guide catheter is elementary but an issue of ...
Gerber Jaime - - 2010
The death of a young athlete is a particularly devastating moment in any society because these individuals represent our strengths and physical prowess as human beings. For this reason, the concept of preparticipation screening has captured attention. A routine screening program applied nonselectively to a particular population in the hopes ...
Elefteriades John A - - 2010
This article examines the supporting evidence for the widespread use of beta-blocker therapy for chronic thoracic aortic aneurysms and for acute aortic dissection. The historical literature and recent studies are critically reviewed. It concludes that this therapy's usefulness lies in its ability to blunt the severity of the pressure spikes ...
Koeppel T A - - 2010
Paraplegia is one of the most severe complications of the repair of open descending thoracic aortic aneurysms and thoracoabdominal aortic aneurysms. To reduce these complications, a comprehensive strategy for spinal cord protection is mandatory. Motor evoked potentials provide the surgeon with important information about spinal cord integrity throughout the operation. ...
Danyi Peter - - 2010
Thoracic aortic aneurysm is a major health problem with multiple causes and potentially devastating consequences. At present, no large randomized trial has shown that medical therapy can significantly slow or halt the progressive dilatation that eventually leads to dissection and rupture. Surgical therapy, on the other hand, is very effective ...
Botta Donald M DM - - 2010
Identification of biomarkers for thoracic aortic aneurysm (TAA) disease is important because complications of TAAs are common. Preemptive operative repair of TAAs is effective in improving survival. However, elective surgical repair for asymptomatic aneurysms remains a clinical decision that must be based on the patient's operative risk and the risk ...
Farkas Emily A - - 2010
The fundamental requirements for a meaningful biomarker have not been met in the prediction of the aneurysm trait, the progression of the aneurysm disease state, or the prevention of catastrophic aortic complications. Aortic aneurysm is a worthy opponent on all fronts, and clinicians should continue actively to evaluate all potential ...
Dahm Johannes B - - 2010
Transradial access is associated with enhanced patients' comfort, significant lower complication rates in diagnostic coronary angiography and better immediate and long-term outcomes after transradial percutaneous coronary interventions. Access failure has been reported to occur in less than 3-7% of cases due to anatomical circumstances (e.g., anomalous radial branching patterns, tortuosity ...
Da Rocha Marcio - - 2010
Thoracic endografting has been proposed as an effective alternative to open repair to treat several aortic pathologies. Cranial migration is one of the critical issues concerning long-term durability. The scalloped thoracic endograft was proposed to improve distal sealing and fixation crossing the diaphragm. The objective of this study was to ...
Mutsuga Masato - - 2010
This study evaluated the clinical advantage of a novel technique to reconstruct a true lumen with aortic wall tailoring for aortic repair (aortic tailoring) or the reimplantation of intercostal arteries (vascular tube) in a chronic type B aortic dissection. Thirty-three consecutive extended thoracoabdominal aortic repairs have been performed for chronic ...
Fukui Sumio - - 2010
Descending thoracic aorta to femoral artery bypass is an effective and safe procedure for the treatment of aortoiliac occlusive disease when an approach to the abdominal aorta is undesirable. The major limitation of this technique has resulted from the morbidity rate associated with thoracotomy in a relatively high-risk vascular surgery ...
Haldar Saptarsi M - - 2010
Current therapies for diseases of heart muscle (cardiomyopathy) and aorta (aortopathy) include inhibitors of the renin-angiotensin system, beta-adrenergic antagonists, and the statin class of cholesterol-lowering agents. These therapies have limited efficacy, as adverse cardiovascular events continue to occur with some frequency in patients taking these drugs. Although cardiomyopathy and aortopathy ...
Shimizu Hideyuki - - 2010
We developed a method of regional spinal cord cooling by using an epidural catheter containing cold saline in its isolated counter-current lumen. We describe the clinical application of this innovative procedure to the prevention of paraplegia during surgery for thoracic and thoracoabdominal aortic aneurysms.
Setacci F - - 2010
Spinal cord ischemia (SCI) is one of the most devastating complications undergoing surgical or endovascular repair of the thoracic aorta. The incidence of SCI after thoracic aorta open repair varies from 2% to 21%, depending on the extent of the descending thoracic aorta replacement compared with as high as 12% ...
Jones Marisa M - - 2010
In patients who have undergone coronary artery bypass with a left internal thoracic artery graft, clamping the aorta proximal to the left subclavian artery during descending thoracic and thoracoabdominal aortic aneurysm repair can precipitate major cardiac complications. Many centers use hypothermic circulatory arrest to obviate the need for aortic clamping ...
Torsello Giovanni B - - 2010
PURPOSE: To assess early and midterm outcomes after thoracic endovascular aortic repair (TEVAR) with the Valiant Thoracic Stent Graft. METHODS: Data were reviewed retrospectively for 92 patients (69 men; mean age 65+/-14.5 years) who underwent TEVAR in 52.2% elective and 47.8% urgent/emergent procedures for treatment of 56 degenerative aneurysms, 32 ...
Martin Z - - 2012
The repair of thoracic aortic pathology by open techniques is associated with high morbidity and mortality. We describe the first case of hybrid thoracic aortic repair performed in Ireland for a symptomatic thoracic intramural haematoma. Hybrid repair with extra-anatomical aortic visceral revascularisation and subsequent thoracic endograft exclusion offers an attractive ...
Kawaharada Nobuyoshi - - 2010
Open repair of aortic aneurysm causes spinal cord perfusion pressure to decrease due to the steal phenomenon from the bleeding of intercostal arteries and cross-clamping of the aorta. We attempted to perfuse the intercostal arteries for preoperative detection of the artery of Adamkiewicz using newly developed catheters. Fifteen patients underwent ...
Ormezzano Olivier - - 2010
Plasma levels of PIIINP a marker of extracellular matrix metabolism activity have been linked to abdominal aortic aneurysm growth rate, but its relationship with thoracic aortic aneurysm (TAA) growth has never previously been studied. To demonstrate the value of assay of "aminoterminal propeptide of type III procollagen" (PIIINP) to predict ...
Jones Jeffrey A - - 2010
Thoracic aortic aneurysms result from dysregulated remodeling of the vascular extracellular matrix, which may occur as a result of altered resident cellular function. The present study tested the hypothesis that aortic fibroblasts undergo a stable change in cellular phenotype during thoracic aortic aneurysm formation. Primary murine aortic fibroblasts were isolated ...
Kanematsu Yasuhisa - - 2010
Aortic aneurysms are common among the elderly population. A large majority of aortic aneurysms are located at two distinct aneurysm-prone regions, the abdominal aorta and thoracic aorta involving the ascending aorta. In this study, we combined two factors that are associated with human aortic aneurysms, hypertension and degeneration of elastic ...
Elefteriades John A - - 2010
This paper addresses clinical controversies and uncertainties regarding thoracic aortic aneurysm and its treatment. 1) Estimating true aortic size is confounded by obliquity, asymmetry, and noncorresponding sites: both echocardiography and computed tomography/magnetic resonance imaging are necessary for complete assessment. 2) Epidemiology of thoracic aortic aneurysm. There has been a bona ...
Chung Jonathan H - - 2010
Patients with thoracic aortic diseases may be completely asymptomatic (as in thoracic aortic aneurysms) or present acutely with severe chest pain (as in acute aortic dissections). Thoracic aortic disease is often occult until a life-threatening complication occurs or the disease is discovered incidentally on imaging. Multidetector-row computed tomography (MDCT) can ...
Yang H H Clarice - - 2010
OBJECTIVE: Losartan potassium (INN losartan), an antihypertensive drug, has been shown to prevent thoracic aortic aneurysm in Marfan syndrome through the inhibition of transforming growth factor beta. Recently we reported that doxycycline, a nonspecific inhibitor of matrix metalloproteinases 2 and 9, normalized aortic vasomotor function and suppressed aneurysm growth. We ...
Watson Daniel R - - 2010
We investigated a unique method utilising a Heartport bifurcated arterial cannula and an aortic occlusion balloon to provide both distal perfusion and bloodless, distal arterial exposure during repair of thoracic and thoracoabdominal aortic pathology. Between February 2002 and September 2008, 21 patients underwent thoracic or thoracoabdominal aortic repair with this ...
Hales S L - - 2011
Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet ...
Takahashi Yosuke - - 2010
A 59-year-old man presented with a three-month history of back pain, and enhanced computed tomography demonstrated an acutely expanding aneurysm of the descending thoracic aorta with slight erosion of the corresponding vertebrae. Because of suspected infectious or inflammatory etiology, he was managed with a combination of emergency aortic repair using ...
Eagleton M J - - 2010
With the evolution of endovascular therapy, there is a broader application of this technology for the treatment of aortic disease. The span of treatment is no longer limited to the descending thoracic aorta and the infrarenal abdominal aorta. The development of branched aortic endograft therapies has allowed stent graft treatment ...
Andersen Nicholas D - - 2010
A 53-year-old woman with no classic risk factors for aneurysm disease presented with the sudden onset of chest pain and dyspnea. A large descending thoracic aortic aneurysm with focal type B dissection was identified and excluded by emergency thoracic endografting. Further postoperative evaluation revealed a history of epistaxis, perioral telangiectasias, ...
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