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Results 351 - 400 of 929
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Königsrainer I - - 2005
A 17 year old healthy young man suffered a motor-vehicle accident with severe polytrauma. During the rehabilitation a slight hypertension and a blood pressure difference of 30-40 mmHg between arms and legs was recognized. Mindful of a possible aortic lesion, an angio-magnetic resonance imaging (MRI) showed a 2.7x4.2 cm thoracic ...
Cheung Albert T - - 2005
BACKGROUND: Paraplegia is a recognized complication after endovascular stent repair of descending thoracic aortic aneurysms. A management algorithm employing neurologic assessment, somatosensory evoked potential monitoring, arterial pressure augmentation, and cerebrospinal fluid drainage evolved to decrease the risk of postoperative paraplegia. METHODS: Patients in thoracic aortic aneurysm stent trials from 1999 ...
Khoynezhad Ali - - 2005
OBJECTIVES: To evaluate current strategies to decrease spinal cord and organ dysfunction in patients undergoing repair of descending and thoracoabdominal aneurysms. METHODS: We reviewed 94 consecutive cases of descending and thoracoabdominal aortic aneurysm repairs to determine the impact of modern adjuncts on postoperative neurologic deficit and mortality. The adjuncts used ...
Ballard Jeffrey L - - 2005
Most complications related to thoracoabdominal aortic reconstruction stem from ischemia-induced injury to the viscera, kidneys, and spinal cord. Pioneers in the treatment of thoracoabdominal aortic aneurysms recognized the danger of producing ischemic damage to these vital organs. In addition to adjunctive methods designed to minimize metabolic demands of the spinal ...
Bailine Samuel H - - 2005
We present the case of an 82-year-old man with 2 aortic aneurysms and multiple medical problems. The presentation describes the pre-electroconvulsive therapy (ECT) evaluations of the patient's problems and the measures used to control the possible dangerous fluctuations in blood pressure during the procedure. We hope that the successful outcome ...
Hassoun Heitham T - - 2005
Despite significant improvements in surgical techniques and perioperative management, the repair of descending thoracic aortic aneurysms remains a challenge with the potential for substantial morbidity and mortality. Over the past several years, buoyed by the technical success of endovascular repair of infrarenal abdominal aortic aneurysms, several case series reports of ...
Back Martin R - - 2005
Visceral (mesenteric and/or renal) ischemia/reperfusion phenomena likely contribute to the greater operative risk associated with pararenal and lower thoracoabdominal aortic aneurysm (TAA) repair. To differentiate the relative adverse effects of aortic clamp level, visceral ischemic duration, and various pre- and perioperative factors shared with infrarenal aneurysm patients, a comparative analysis ...
Makkad Benu - - 2005
A review of the literature on the management of thoracic aneurysm is presented. These patients have various comorbid conditions and need thorough work-ups. Aneurysms can be classified according to shapes and locations. Various methods to maintain hemodynamic stability with adequate end-organ perfusion are presented. The success of the operation depends ...
Tang Paul C Y - - 2005
BACKGROUND: Progressive medial degeneration and atrophy is thought to be a cause of ascending thoracic aortic aneurysms in the elderly. Extensive apoptosis of vascular smooth muscle cells (VSMCs) has been demonstrated in the media of abdominal aortic aneurysms. We investigated whether medial atrophy from loss of VSMCs occurs in primary ...
Wolthuis A M - - 2005
The authors wish to describe a combined open and endovascular approach to repair a complex thoracic aortic aneurysm. A 72-year-old man with chronic obstructive pulmonary disease, aortic valvular insufficiency and diffuse thoracic aortic aneurysm underwent aortic valve and ascending aorta replacement by a Bentall-procedure and replacement of arch aneurysm using ...
Minami Hiroya - - 2005
We report a case of thoracoabdominal aortic aneurysm (TAAA) Crawford type I with high-risk factors. A 74-year-old woman, who had a history of myocardial infarction with severe left ventricular dysfunction, asthma, and hypothyroidism, underwent endovascular stent-graft replacement for TAAA and simultaneous surgical reconstruction of the visceral arteries to avoid thoracotomy ...
Roy Nathalie - - 2005
Umbilical artery catheterization is often performed in critically ill neonates. Infection and thromboembolic events are relatively frequent complications, but aneurysm formation is rare. We describe the case of a premature baby who developed a rapidly expanding aneurysm of the descending thoracic aorta, secondary to a highly placed infected umbilical catheter. ...
Karck Matthias - - 2005
OBJECTIVE: The 'frozen' elephant trunk technique allows for single-stage repair of combined aortic arch and descending aortic aneurysms using a 'hybridprosthesis' with a stented and a non-stented end. This report summarizes the operative- and follow-up data (mean follow-up 14 months) with this new treatment. METHODS: Between 09/01 and 4/04, 22 ...
Matsuda Hitoshi - - 2005
Four patients who underwent secondary elephant trunk fixation by endovascular stent grafting are presented and the advantage of this method to treat multiple/extensive thoracic aortic aneurysm is discussed. In two of them, the elephant trunk installation has been performed at another hospital for extensive aortic aneurysm. In two other patients, ...
Tang Paul C Y - - 2005
Arterial pathology manifests as aneurysmal or obstructive disease depending on changes in lumen size due to vascular remodeling (change in vessel external diameter) and/or intimal expansion. Recent clinical and experimental observations in abdominal aortic aneurysms have led to the emerging dogma that Th2-dominant immune responses result in expansive vascular remodeling ...
Fu Wei-guo - - 2005
BACKGROUND: The insufficiency of the proximal landing zone (PLZ) is a frequent factor challenging the applicability and efficacy of endovascular repair (EVR) for thoracic aortic disorders. This study discusses two strategies for conquering this challenge. METHODS: Ten patients underwent EVR for thoracic aortic diseases during a one-year period ending June ...
Klein Deborah G - - 2005
Thoracic aortic aneurysm with dissection is the most common fatal condition involving the aorta. The prevalence of aortic aneurysms appears to be increasing, which may reflect improvements in imaging techniques as well as increased clinical awareness of the condition. Most thoracic aortic aneurysms are caused by atherosclerosis and its associated ...
Nathanson Daniel R - - 2005
PURPOSE: To review our experience with thoracic endografting for type B aortic dissection using the TAG Endoprosthesis. METHODS: A retrospective analysis was performed of data collected prospectively from March 2000 to July 2004 under an investigational device exemption protocol for the TAG thoracic endograft. In this time period, 40 patients ...
Chavan Ajay - - 2005
PURPOSE: At present, a two-step surgical approach is necessary to treat patients with coexistent pathologic conditions involving the proximal and descending thoracic aorta. A hybrid endograft is described here that enables such treatment during a single operation. MATERIALS AND METHODS: The Chavan-Haverich endograft consists of a Dacron vascular prosthesis with ...
Zehr Kenton J - - 2005
BACKGROUND: Giant cell aortitis is a rare cause of ascending aortic aneurysm disease despite giant cell arteritis being a common cause of vasculitis. We evaluated an 8-year experience with surgical repair with regard to preoperative variables, extent of disease, required surgical procedures, and the propensity to develop additional great vessel ...
Sayed Saiqa - - 2005
The purpose was to review outcome data following endovascular repair of the descending thoracic aorta from reports published between 1994 and 2004. To accomplish this task, 1,518 patients underwent endovascular repair for thoracic aortic disease; 810 thoracic aortic aneurysms, 500 type B thoracic aortic dissections, and 106 traumatic ruptures. The ...
Rigatelli Gianluca - - 2005
Due to the aging of the population and the fact that people are living longer, there are increasing numbers of older patients with noncoronary atherosclerosis. Carotid and subclavian arteries are often the first involved vessels in atherosclerosis, and thoracoabdominal aortic involvement is becoming even more frequent. New techniques, such as ...
Marques da Silva Rafael - - 2005
BACKGROUND: Aortic aneurysms affect an increasing number of elderly patients and cause considerable morbidity and mortality. The understanding of the mechanisms involved in the pathogenesis of aortic aneurysms is unclear and little is known about the role of microorganisms in the development of the condition. The aim of the present ...
Porcu Paolo - - 2005
We report a type B aortic dissection treated with stenting of the descending thoracic aorta that subsequently developed an ischemic necrosis of the esophagus with a posterior mediastinum abscess. The surgical treatment consisted of an extra-anatomic bypass to revascularize the supra-aortic trunks and the distal abdominal aorta through a middle ...
Gawenda M - - 2005
For the endovascular therapy of abdominal aortic aneurysm an increasing number of publications deal with the subject of device-related outcome and aneurysm sac behaviour. The present study was designed to investigate whether, and to what extent, aneurysm sac behaviour of thoracic aortic aneurysms and perioperative outcome is influenced by the ...
Suzuki Kazuchika - - 2005
A 44-year-old man, unaffected by Marfan's syndrome, had previously undergone thoracoabdominal replacement for a chronic, type B dissecting aneurysm. Reconstruction of the visceral arteries was performed using an island technique. However, approximately 3 years after the operation, the reconstructed part of the aorta containing the visceral arteries became dilated and ...
Flores Jorge - - 2005
BACKGROUND: Degenerative disease of the aorta usually involves the occlusion of several intercostal and lumbar branches by mural thrombus or atherosclerotic plaques, suggesting that the blood supply to the spinal cord is mainly provided through collateral networks. Patients with previous abdominal aortic aneurysm repair and subsequent thoracoabdominal aortic reconstruction must ...
Kalavrouziotis Dimitri - - 2005
A variety of extracorporeal techniques have been described in surgery of the descending thoracic and thoracoabdominal aorta. We describe an operative approach involving the cannulation of the pulmonary artery for venous drainage in 12 patients undergoing descending thoracic aortic surgery. In-hospital mortality was 17%; there were no in-hospital deaths for ...
Bonardelli Stefano - - 2005
The purpose of this article is to report successful hybrid treatment of a sovraprosthetis type IV thoracoabdominal aneurysm. This technique was used in a 65-year-old man with chronic rupture of a type IV thoracoabdominal aneurysm not suitable for aortic cross-clamping because of a severe cardiopathy (left ventricular ejection fraction 20%); ...
Wahlgren C-M - - 2005
BACKGROUND: Thoracoabdominal aneurysm type IV (TAA IV) represents only a minority of aortic aneurysms, but as it is an entirely abdominally located aneurysm, vascular surgeons are likely to see such aneurysms in their practice. The current surgical management of TAA IV is reviewed. METHODS: A PubMed/Medline-literature search for TAA IV. ...
Tabayashi Koichi - - 2005
Spinal cord injury after thoracoabdominal aortic surgery remains a devastating and unpredictable complication, caused by clamping of the thoracoabdominal aorta, resulting in exclusion of blood flow in critical and essential intercostal arteries. Various protective methods against spinal cord ischemia have been proposed and performed clinically. These include preoperative spinal angiography, ...
Coggia Marc - - 2005
We performed a total videoscopic type IV thoracoabdominal aortic aneurysm repair. The postoperative course was uneventful, and the patient did well 10 months later. To our knowledge, a total videoscopic thoracoabdominal aortic aneurysm repair has not been previously described.
Therasse Eric - - 2005
The recent development of aortic stent-grafts has brought the management of thoracic aortic diseases into the realm of interventional radiology. Stent-graft placement is now an alternative to surgery for the treatment of descending thoracic aortic aneurysms, ulcers, and fistulas and is sometimes indicated in cases of mycotic aneurysm, posttraumatic aortic ...
LeMaire Scott A - - 2005
BACKGROUND: Abnormal matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP) expression contributes to the development of abdominal aortic aneurysms. Recent data suggest that MMP-2 and MMP-9 may also play a role in thoracic aortic disease. We sought to determine (1) whether ascending aortic aneurysms are associated with increased MMP ...
Kawaharada Nobuyoshi - - 2005
OBJECTIVE: The risk of stroke caused by dislodgment of loose atheromatous plaque or mural emboli is increased by cross-clamping of the aorta. Some patients undergo descending thoracic aortic aneurysm repair with proximal aortic cross-clamping between the left common carotid artery and the left subclavian artery. The objective of this study ...
Kunihara T - - 2004
We performed an ascending to descending aorta bypass grafting with exclusion of the descending thoracic aortic aneurysm through a median sternotomy incision without cardiopulmonary bypass in a patient with severe chronic obstructive pulmonary disease. The patient was a 75-year-old man who had undergone endovascular stent-graft placement for a descending thoracic ...
Sodeck G - - 2004
BACKGROUND: The role of Chlamydia pneumoniae in the pathogenesis of aortic aneurysm is controversial. We investigated the presence of C. pneumoniae in tissue samples excised from patients and controls. METHODS: Aortic wall specimens were obtained from 17 patients with acute Stanford type A aortic dissection, 25 patients with thoracic aortic ...
Lee Jason T - - 2004
The advent and success of endovascular repair of abdominal aneurysms had led to the development of catheter-based techniques to treat thoracic aortic pathology. Such diseases, including thoracic aortic aneurysms, acute and chronic type B dissections,penetrating aortic ulcers, and traumatic aortic transection, challenge surgeons to perform complex operative repairs in high-risk ...
Leurs Lina J - - 2004
The objective of this study was to assess the initial and 1-year outcome of endovascular treatment of thoracic aortic aneurysms and dissections collated in the European Collaborators on Stent Graft Techniques for Thoracic Aortic Aneurysm and Dissection Repair (EUROSTAR) and the United Kingdom Thoracic Endograft registries. Four hundred forty-three patients ...
Yamauchi Takashi - - 2004
A 50-year-old man underwent replacement of the descending thoracic aorta for a DeBakey type III-b chronic dissecting aortic aneurysm. During the surgery, lumbar cerebrospinal fluid (CSF) drainage with a 10 cm H2O pop-off pressure was used to protect against spinal cord ischemia. During cardiopulmonary bypass, the patient's pupils were isocoric, ...
Ikonomidis John S - - 2004
OBJECTIVE: The cause of thoracic aortic aneurysms (TAAs) is poorly understood. Previous work has suggested an association between development of aortic aneurysms and matrix metalloproteinase (MMP) activity. We hypothesized that removal of the primary endogenous aortic MMP inhibitor (TIMP) through TIMP-1 gene deletion will increase TAA progression. METHODS AND RESULTS: ...
Edwards Jeff T - - 2004
The incidence of ischemic complications associated with repair of descending and thoracoabdominal aortic aneurysms has been significantly reduced by the use of distal aortic perfusion with moderate hypothermia, cerebral spinal fluid drainage, and segmental sequential clamping techniques. However, because the maintenance of proximal perfusion, the adequacy of left heart bypass ...
Kieffer Edouard - - 2004
From June 1974 to December 2001 we performed operative treatment on 33 patients with descending thoracic or thoracoabdominal aortic aneurysm in association with Takayasu disease. There were 25 men and 8 women with a mean age of 40.2A years (range 16-64A years). Nineteen patients came from North Africa, 6 were ...
Dumont Eric - - 2004
BACKGROUND: Aortic false aneurysms are a rare complication of surgery of the aorta that can occur several months to years after the initial operation. We reviewed our results with false aneurysm repair using deep hypothermia and circulatory arrest. METHODS: Eleven patients were reoperated on for false aneurysm of either the ...
Bossert Torsten - - 2004
Syphilis can lead to saccular aneurysms of the thoracic aorta. Today syphilitic aortic aneurysms are rare. The average time from primary infections to the development of aortic aneurysms is 10 to 15 years. An 83-year-old man was admitted with a giant aneurysm of the descending thoracic aorta. The patient had ...
Cho Yasunori - - 2004
Esophageal perforations of thoracic aortic aneurysms are most likely to be fatal. Patients with aortoesophageal fistula require urgent operation on both the esophageal perforation site and the aortic lesion to avoid terminal exsanguination and uncontrollable mediastinitis. We present a case of 71-year-old woman suffering esophageal perforation of aortic arch aneurysm ...
Flores Jorge - - 2004
Hypothermia is known to protect the myocardium and the spinal cord during ischemia. However the risk of complications increases with lower hypothermic conditions. In this paper we report a 62-year-old male patient with concomitant coronary artery disease who was surgically treated for a thoracoabdominal aortic aneurysm and an abdominal paraanastomotic ...
Quinones-Baldrich William J - - 2004
This review presents the results of surgical repair of descending thoracic (DT) and thoracoabdominal aortic (TAA) aneurysms, using spinal drainage (SD) distal aortic perfusion (DAP), and other adjuncts intended to reduce complications. Records of patients undergoing repair of DT and TAA between 1986 and 2002 were reviewed. Elective operations were ...
Sueda Taijiro - - 2004
OBJECTIVES: Although endovascular stent-grafting is available for atherosclerotic thoracic aneurysms, it is unknown whether the excluded thrombosed aneurysms shrink. We evaluated serial changes in distal aortic arch or proximal descending aortic aneurysms excluded space after transaortic stent-grafting. METHODS: Thirty-four patients with true distal aortic arch or proximal descending thoracic aortic ...
Diehm N - - 2004
We describe the successful endovascular treatment of a traumatic thoracic aortic aneurysm in a 32-year old male presenting with acute critical limb ischemia. The patient's condition arose from embolism growth in an aneurysmal lesion incurred seven years previously in a motorcycle accident.
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