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Sun Tucheng - - 2009
The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection. Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed. The elective operations were performed in 107 patients while emergency surgery was ...
Fukunaga Naoto - - 2009
A 69-year-old woman with a history of graft replacement of descending aortic aneurysm was referred to our hospital due to massive hematemesis with shock status. Additionally, the deterioration of respiratory status made us start the management under mechanical ventilation. The emergent gastrointestinal endoscopy by a general practitioner showed ulcer-like lesion ...
Toshkezi Gentian - - 2009
Long thoracic nerve palsy has been reported to have traumatic, iatrogenic, and idiopathic causes. The authors describe the case of a 62-year-old man who presented with progressively worsening right shoulder pain, winging of the scapula, and Horner syndrome. A chest CT scan revealed an apical pulmonary mass. To the authors' ...
Kahlberg Andrea - - 2009
PURPOSE: To report an unusual case of dysphagia that developed immediately after stent-grafting of a thoracoabdominal aortic aneurysm. CASE REPORT: A 79-year-old woman was submitted to a staged hybrid repair of a thoracoabdominal aortic aneurysm and developed new onset dysphagia and regurgitation early after stent-grafting of the thoracic aorta. Esophageal ...
Tamori Yuiichi - - 2009
BACKGROUND: Aortic aneurysms are found in 5-20% of patients with acute aortic dissection (AAD). Coexisting aortic aneurysms might potentially influence the incidence of AAD. The purpose of this study was to elucidate the role of coexistent aortic aneurysms in AAD. METHODS AND RESULTS: A total of 140 patients with AAD ...
Nakai M - - 2009
Paraplegia is one of the most tragic complications following endovascular aneurysm repair (EVAR) for descending thoracic aortic aneurysm (DTAA). Collateral circulation to the artery of Adamkiewicz (AA) is important to avoid spinal cord ischaemia. We report a case in which the thoracodorsal artery had become a collateral source to the ...
Kulik Alexander - - 2009
OBJECTIVE: The reimplantation of intercostal arteries during the repair of descending thoracic aortic or thoracoabdominal aortic aneurysms preserves spinal cord perfusion and might reduce the risk of spinal cord ischemic injury. However, the retained cuff of native aortic tissue around the intercostal vessels might become aneurysmal. We reviewed our experience ...
Agarwal Prachi P - - 2009
Thoracic aortic aneurysms (TAAs) can be broadly divided into true aneurysms and false aneurysms (pseudoaneurysms). True aneurysms contain all three layers of the aortic wall (intima, media, and adventitia), whereas false aneurysms have fewer than three layers and are contained by the adventitia or periadventitial tissues. Multidetector computed tomographic (CT) ...
Ghazi Payam - - 2009
We describe successful closure of a persistently patent arterial duct, using an Amplatzer occluder, in the presence of a large thoracic aortic aneurysm in the area of the ductal ampulla. Although percutaneous closure is more difficult in this setting, because of the risk of traumatising the fragile tissues, it can ...
Riesenman Paul J - - 2009
Thoracic aortic anomalies are rare and may be associated with pathologic vascular conditions necessitating intervention. We present a case of a patient with a left aortic arch, right descending thoracic aorta, and a Kommerell's diverticulum giving rise to an aberrant right subclavian artery. The Kommerell's diverticulum was successfully managed with ...
Murayama Taichi - - 2010
In some four-dimensional images acquired by electrocardiogram (ECG)-gated multislice computed tomography (MSCT) of thoracic aortic dissection (AD), true lumen (TL) gets larger (pulsating-type), whereas in others, TL and false lumen (FL) do not change (static-type) in a cardiac cycle. We have characterized these types. Twenty subjects (10 with a double-barrel ...
Chen Wei-Chun - - 2009
Aortic aneurysm is usually a potentially life-threatening medical problem, with a 5-year survival rate of 20% if there is no surgical repair. Upper airway compression due to aortic aneurysm usually presents with wheezing, coughing, hemoptysis, dyspnea, or pneumonitis. We report a 78-year-old male patient with a history of chronic obstructive ...
Kunihara Takashi - - 2009
OBJECTIVE: Despite the recognition of importance to avoid visceral ischemia during thoracoabdominal aortic aneurysm (TAAA) repair, the methodology of visceral perfusion seems still controversial and its pathophysiology has not been clearly understood. We investigated hepatosplanchnic metabolism during visceral perfusion/shunt in TAAA repair. METHODS: Seventeen patients (10 male, 64+/-15 years old) ...
Modi Shreyas A - - 2009
Rupture of an aortic aneurysm into the pulmonary artery is a rare and often a fatal event. This complication results in the development of an acute left to right shunt, volume overload, and rapid right heart deterioration. We describe a case of thoracic aortic aneurysm in whom the diagnosis of ...
Akin I - - 2009
Endovascular management concepts have recently emerged as valuable treatment options for both simple and complex disorders involving both the distal arch and descending thoracic aorta. With growing use of endovascular stent-grafts the technique has generated broad interest. Nevertheless, an ideal device for different thoracic aortic conditions is not available yet. ...
Yuan Shi-Min - - 2009
Aortic aneurysm is a rare cause of disseminated intravascular coagulopathy (DIC). We present the developmental course of DIC in a 70-year-old male patient who had a thoracoabdominal aortic aneurysm characterized by a progressive descending aortic aneurysm presenting as subcutaneous hemorrhage of acute onset. He was diagnosed as having aortic aneurysm-induced ...
El-Osta Bassel - - 2009
Spinal "stroke" is an uncommon cause of paraplegia. Spinal cord infarction from unruptured aortic aneurysm is rare. When encountered it poses diagnostic challenge to the clinician due to its rarity, which may lead to incorrect or delayed diagnosis. We report a case of 62-year-old man presenting to casualty as caudaequina ...
Ting Albert C W - - 2009
OBJECTIVE: To assess the early and midterm results of endovascular stent graft repair in patients with thoracic aortic pathologies. METHODS: Between March 2000 and December 2005, 44 consecutive patients undergoing endovascular repair for 45 thoracic aortic lesions were studied. Follow-up protocol includes regular clinical examination and computed tomographies. RESULTS: There ...
Belov Iuri V - - 2009
A modified muscle-sparing high approach to the thoracoabdominal aorta is described, which improves surgical access for thoracoabdominal aortic aneurysm repair. Since 2000, 16 patients with type I and II thoracoabdominal aortic aneurysms have undergone aortic graft replacement using this approach via the 3(rd) intercostal space. There were no hospital deaths. ...
Kokotsakis John - - 2009
Revascularization of the visceral arteries during thoracoabdominal aneurysm repair is usually performed sequentially by an anastomosis between a prosthetic graft and an aortic patch. There are immediate operative risks such as bleeding and distortion. In the longer term, aneurysm, pseudo-aneurysm and rupture may occur. These require reoperation and are associated ...
Tochii Masato - - 2008
A 73-year-old man presented with DeBakey type IIIa chronic aortic dissection. The aneurysm of the descending aorta was replaced using an open proximal technique with hypothermic circulatory arrest. For cerebrospinal protection, the left axillary artery was cannulated, which perfuses the vertebral artery and affects the Willis arterial circle, the anterior ...
Feezor Robert J - - 2008
BACKGROUND: Risk factors for spinal cord ischemia (SCI) after thoracic endovascular aneurysm repair (TEVAR) remain unclear. Aortic coverage was examined as a risk factor for SCI using quantitative three-dimensional computed tomography angiography (CTA) analysis. METHODS: The medical records, radiographic imaging studies, and a prospectively maintained database of all TEVAR procedures ...
Elefteriades John A - - 2008
At the Yale University Center for Thoracic Aortic Disease, we have been using our clinical experience and laboratory investigations to shed light on the pathophysiology of thoracic aortic aneurysm (TAA), the clinical behavior of thoracic aortic aneurysm, and the optimal clinical management. The Yale database contains information on 3,000 patients ...
Hughes G Chad - - 2008
Diseases of the thoracic aorta remain among the most lethal and difficult to treat conditions. In 2005, the US Food and Drug Administration approved the first endoprosthesis for the treatment of aneurysms of the descending thoracic aorta; at present, there are 3 thoracic devices approved by the US Food and ...
Bean Marchelle J - - 2008
Indications for and experience with placement of endovascular stent-grafts in the thoracic aorta are still evolving. Common pathologic conditions of the thoracic aorta that are amenable to stent placement include penetrating ulcers, aortic dissection, aortic aneurysms, aortic rupture, and congenital abnormalities. Advances in multidetector computed tomography (CT) permit high-quality two-dimensional ...
Kokotsakis John - - 2008
OBJECTIVE: The frozen elephant trunk technique has been recently presented in the literature and has been considered as a novel surgical option for single-stage repair of complex aortic pathology such as combined arch and descending thoracic aortic aneurysms. PATIENTS AND METHODS: The first patient, a 74-year-old male, was admitted severely ...
Hughes G Chad - - 2008
BACKGROUND: The Gore TAG thoracic endoprosthesis (W. L. Gore and Associates, Flagstaff, AZ) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of thoracic aortic aneurysms on March 23, 2005, and remains the only FDA approved thoracic device to date. We present our experience with the ...
Lew Wesley K - - 2009
Although uncommon, hoarseness can be a presenting symptom of a thoracic aneurysm. We present a case of a 67-year-old man with hoarseness, subsequently found to have left vocal paralysis. On workup, a computed tomography scan demonstrated a saccular thoracic aneurysm compressing the recurrent laryngeal nerve at the aortopulmonary window. About ...
Marín-Manzano E - - 2009
A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study ...
van Prehn Joffrey - - 2009
The purpose of this study was to utilize dynamic computed tomographic angiography (CTA) on pre- and postoperative thoracic endovascular aneurysm repair (TEVAR) patients to characterize cardiac pulsatility-induced aortic motion on essential TEVAR proximal sealing zones and to study the influence of endograft placement. Six pre- and six postoperative dynamic CTA ...
Weber Tim F - - 2009
PURPOSE: The purpose of this study was to characterize the heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B (CADB). MATERIALS AND METHODS: Electrocardiogram-gated computed tomography angiography was performed during inspiratory breath-hold in 11 patients with CADB: Collimation 16 mm x 1 mm, pitch 0.2, ...
Iliopoulos Dimitrios C - - 2009
OBJECTIVE: We sought to examine in age-matched subjects the biomechanical and compositional remodeling associated with ascending thoracic aortic aneurysms according to region and direction. METHODS: Whole, fresh, degenerative ascending thoracic aortic aneurysms were taken from 26 patients (age, 69 +/- 2 years; maximum aortic diameter, 5.9 +/- 0.3 cm) during ...
Saratzis Nikolaos - - 2008
INTRODUCTION: We report mid-term results from the endovascular treatment of acute thoracic aortic pathologies in a single center. METHODS: We retrospectively interrogated our clinical database and identified the following patients who were treated for an acute thoracic aortic pathology during a 3-year period (January 2003 to February 2006) with the ...
Shrivastav Vivek - - 2008
Aortic aneurysms and pseudo-aneurysms are a rare occurrence in the pediatric age group. True aneurysms are usually related to infection or to inherited disorders while pseudo-aneurysms occur following trauma or infection. We present a case of a pseudo-aneurysm of the descending thoracic aorta in a 13-month-old child, who presented with ...
Harlander Matevz - - 2008
We describe a case of acute monoparesis of a lower limb due to asymmetric spinal cord infarction in a patient with previously unrecognized thoracoabdominal aneurysm. The clinical course suggested that the likely reason for the spinal cord infarction was thromboembolism originating from the aneurysm's mural thrombi. This rare entity should ...
Gutsche Jacob T - - 2008
In 2005, the findings of the multicenter Gore Tag study led to United States Food and Drug Administration approval for endovascular repair of thoracic aortic aneurysms (TEVAR). TEVAR provides a therapeutic option for patients who have thoracic aortic aneurysm and for the treatment of type B aortic dissection with malperfusion. ...
Hnath Jeffrey C - - 2008
Although endovascular repair of thoracic aortic aneurysm has been shown to reduce the morbidity and mortality rates, spinal cord ischemia remains a persistent problem. We evaluated our experience with spinal cord protective measures using a standardized cerebrospinal fluid (CSF) drainage protocol in patients undergoing endovascular thoracic aortic repair. From 2004 ...
Saiki Yoshikatsu - - 2008
Mechanical circulatory support can be difficult for patients with thoracoabdominal aortic disease. We herein describe a counterpulsation technique using an intra-graft balloon pump that can be safely used in the setting of thoracoabdominal aortic aneurysm remaining immediately after aortic root and arch replacement coupled with coronary artery bypass grafting.
Lee W Anthony - - 2008
Controlled hypotension is sometimes necessary for accurate endograft deployment and adjunctive ballooning and stenting near the arch and proximal descending thoracic aorta. This article describes a technique in which a compliant occlusion balloon inflated in the right atrium is used to occlude the inflow from the inferior vena cava and ...
Riesenman P J PJ Department of Surgery, Division of Vascular Surgery, University of North Carolina Hospitals, Chapel Hill, NC, - - 2008
Thoracic aortic aneurysms and other thoracic aortic lesions may become life-threatening conditions if they remain untreated. Conventional open surgical reconstruction with placement of an interposition graft is regarded as a definitive form of treatment, but is associated with considerable operative morbidity and mortality. Thoracic aortic lesions involving the aortic arch ...
Giovannelli A - - 2008
The isthmic aortic rupture represents the main cause of death in car crash accidents, because of closed chest trauma. Early medical and surgical care and endovascular prosthesis treatment with semi-invasive method can improve short and mid term survival. Nine patients with traumatic isthmic aortic rupture underwent endoprosthesis aortic implantation. All ...
Lin Ming-Pin - - 2008
PURPOSE: To characterize imaging findings from computed tomography, magnetic resonance imaging, and angiogram in patients with infected aortic aneurysm. METHODS: We retrospectively reviewed the records of 21 patients (men, 17; women, 4) with proven infected aortic aneurysms and compared the imaging findings (computed tomography scans, n = 21; magnetic resonance ...
Schlösser Felix J V - - 2008
Risk factors are similar for the development of both thoracic aortic aneurysms (TAA) and other cardiovascular diseases. Coronary artery disease is highly prevalent in patients with TAA, with a reported prevalence of 30% to 70%. Knowledge of the underlying cardiac pathology can minimize perioperative risk and improve patient selection. This ...
Mell Matthew W - - 2009
OBJECTIVE: The purpose of this study is to describe a new approach for addressing the intraoperative management of intercostal arteries during thoracoabdominal aortic aneurysm (TAAA) repair, using preoperative spinal MRA for detection of intercostal arteries supplying the anterior spinal artery. METHODS: Patients undergoing TAAA repair from August 2005 to September ...
Backes Walter H - - 2008
Preservation of spinal cord blood supply during descending thoracic (TAA) and thoracoabdominal aortic aneurysm (TAAA) surgery is mandatory to prevent neurologic complications. Although collateral arteries have been identified occasionally and are considered crucial for maintaining spinal cord function in the individual patient, their critical functionality is poorly understood and very ...
He Rumin R Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Texas 77030, - - 2008
This study sought to characterize the inflammatory infiltrate in ascending thoracic aortic aneurysm in patients with Marfan syndrome, familial thoracic aortic aneurysm, or nonfamilial thoracic aortic aneurysm. Thoracic aortic aneurysms are associated with a pathologic lesion termed "medial degeneration," which is described as a noninflammatory lesion. Thoracic aortic aneurysms are ...
Weigang Ernst - - 2008
OBJECTIVE: Pathological aortic flow patterns differ significantly from haemodynamics within the healthy aorta. Development and impact of pathological flow is largely unknown and might affect pathogenesis and the progression of thoracic aortic diseases. This study presents pathological blood-flow patterns within a series of six patients suffering from ascending aortic aneurysms ...
Dake Michael D - - 2008
Thoracic endograft technology was initially designed and used clinically for descending thoracic aortic aneurysms. These devices have now been applied to more varied and complex thoracic aortic pathologic processes. Newer devices are being developed with the aim of improved suitability for these new challenges. This article provides a review of ...
van Prehn Joffrey - - 2008
A patient with traumatic thoracic injury and hypovolemic shock is presented to stress important differences in preoperative and postoperative aortic diameters. The patient had a blood pressure of 80/40 mm Hg. A diagnostic computed tomography angiography revealed a rupture of the thoracic aorta, and a thoracic endograft was sized based ...
Saxena Pankaj - - 2009
Inflammatory aneurysms of thoracic aorta are rare. Of all the aneurysms, only 5-10% are inflammatory in nature and are almost exclusively confined to the infrarenal segment of the aorta. We hereby present a patient with a large inflammatory aneurysm involving the thoracic aorta in association with mediastinal fibrosis and idiopathic ...
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