Increased common carotid artery intima-media thickness has been associated with an increased risk of vascular ischemic events. We investigated the relationship between common carotid artery intima-media thickness and extracranial vascular events (coronary heart disease and peripheral arterial disease) or stroke recurrence in a cohort of transient ischemic attack patients from ...

OBJECTIVE: The radial artery wall structure can be measured with non-invasive very high-resolution ultrasound with great feasibility and high accuracy. In the present study, we aim to explore clinical correlates of radial artery intima-media thickness (rIMT), in a relatively large patient cohort with suspected coronary artery disease, and further compare ...

Pulsus bisferiens is Latin for 'beat twice'. This describes the pulse where two systolic beats are palpated each cardiac cycle with an interposed mid-systolic dip. The earliest reference to the pulsus bisferiens is an edition of Galen's de Pulsibus, published in 1532. Galen was insistent that the pulsus bisferiens is ...

To the Editor: Polak et al. (July 21 issue)(1) state that the mean intima-media thickness of the common carotid artery "is believed to be better suited for cardiovascular risk assessment" than the intima-media thickness of the internal carotid artery. To be clear, the American Society of Echocardiography consensus statement that ...

To the Editor: Polak et al. (July 21 issue)(1) state that the mean intima-media thickness of the common carotid artery "is believed to be better suited for cardiovascular risk assessment" than the intima-media thickness of the internal carotid artery. To be clear, the American Society of Echocardiography consensus statement that ...

To the Editor: Polak et al. (July 21 issue)(1) state that the mean intima-media thickness of the common carotid artery "is believed to be better suited for cardiovascular risk assessment" than the intima-media thickness of the internal carotid artery. To be clear, the American Society of Echocardiography consensus statement that ...

The main purpose of this study was to investigate the relation between carotid intima-media thickness (CIMT) and coronary artery disease (CAD) complexity. Consecutive patients (n = 360) with CAD confirmed by coronary angiography were enrolled. Mean CIMT and the overall SYNTAX score (SXscore) were 0.87 ± 0.12 mm and 15 ...

Intima-media thickness of the walls of the common carotid artery and internal carotid artery may add to the Framingham risk score for predicting cardiovascular events. We measured the mean intima-media thickness of the common carotid artery and the maximum intima-media thickness of the internal carotid artery in 2965 members of ...

ABSTRACT: BACKGROUND: Preoperative radiotherapy and chemotherapy in patients with head and neck cancer result in changes to the vessels that are used to construct microsurgical anastomoses. The aim of the study was to investigate quantitative changes and HSP70 expression of irradiated neck recipient vessels and transplant vessels used for microsurgical ...

Epicardial coronary injury is by far the most feared complication of epicardial ablation. Little information is available regarding the chronic effects of delivering radiofrequency in the vicinity of large coronary vessels, and the long-term impact of this approach for mapping and ablation on epicardial vessel integrity is poorly understood. Therefore, ...

INTRODUCTION:: Increased intima-media thickness of carotid arteries is considered as an early indicator of atherosclerosis. The authors here aimed to assess whether tinnitus is associated with such thickening by a cross-sectional approach. METHODS:: A total of 820 male (53.5 ± 9.6 years) and 528 female (54.5 ± 9.7 years) Japanese ...

Computed tomographic pulmonary angiography (CTPA) may improve detection of life-threatening pulmonary embolism (PE), but this sensitive test may have a downside: overdiagnosis and overtreatment (finding clinically unimportant emboli and exposing patients to harms from unnecessary treatment). To assess the impact of CTPA on national PE incidence, mortality, and treatment complications, ...

The objective of our study was to evaluate the impact of incorporating a mandatory clinical decision rule and selective d-dimer use on the yield of pulmonary CT angiography (CTA). Guidelines incorporating a clinical decision rule (Wells score: range, 0-12.5) and a highly sensitive d-dimer assay as decision points were placed ...

Recent studies have suggested that endoscopic vein harvest (EVH) compromises graft patency. To test whether the learning curve for EVH alters conduit integrity owing to increased trauma compared with an open harvest, we analyzed the quality and early patency of conduits procured by technicians with varying EVH experience. During coronary ...

Gestural motions of the hands and fingers are powerful tools for expressing meanings and concepts, and the nervous system has the capacity to retain multiple long-term motor memories, especially including movements of the hands. We developed many sets of successive movements of both hands, referred to as "digit anatomy," and ...

Abstract A totally endovascular approach to complex aortic aneurysms using fenestrated and branched stent-grafts is a technically demanding alternative to open surgical repair of thoracoabdominal and pararenal aneurysms. Complications of these complex endovascular reconstructions are varied, from dislocation of the stent-graft to occlusion of the target vessels. Based on our ...

INTRODUCTION: The initial management of suspected pulmonary embolism (PE) is commonly done in respiratory departments, but is based on clinical prediction rules developed in other settings. OBJECTIVE: To determine the accuracy of established prediction rules for PE in patients with respiratory emergencies. DESIGN: A prospective study MATERIALS AND METHODS: Patients ...

We have begun development of an interactive, multi-player serious game for the purpose of training cardiac surgeons, fellows, and residents the series of steps comprising the Off-Pump Coronary Artery Bypass grafting (OPCAB) surgical procedure. It is hypothesized that by learning the OPCAB procedure in a "first-person-shooter gaming environment", trainees will ...

Medial degeneration is a key feature of aneurysm disease and aortic dissection. In a murine aneurysm model we investigated the structural and functional characteristics of aortic wall degeneration in adult fibulin-4 deficient mice and the potential therapeutic role of the angiotensin (Ang) II type 1 (AT(1)) receptor antagonist losartan in ...

Our study aimed to demonstrate the efficacy of preoperative intraarterial computed tomographic angiography to identify the Adamkiewicz artery (AKA). We also aimed to investigate the impact of identification of the AKA on the strategy for preventing spinal cord injury. Thirty-seven patients (24 cases of descending aortic aneurysms and 13 cases ...

The purpose of this study was to evaluate clinical outcomes of combined endovascular and open techniques to eradicate false lumen dilatation in the visceral aortic segment after type B aortic dissection associated with aortic aneurysm. We reviewed eight patients with distal thoracic and abdominal false lumen dilatation treated with a ...

To study the pathophysiology of esophageal necrosis after endoprosthesis was performed for a ruptured aneurysm and to define preventive measures and possible treatment options. A 72-year-old man with thoracoabdominal aneurysm type I and dysphagia underwent an emergent carotico-carotid bypass in combination with thoracic endovascular aortic aneurysm repair starting at a ...

Abdominal aortic aneurysms occasionally occur concomitantly with an intracranial artery aneurysm (ICA). The association of an ICA with a thoracoabdominal aortic aneurysm (TAAA) is relatively rare. A patient with this condition is presented. Coiling of the ICA was not an option preoperatively because of the dissected false lumen of the ...

BACKGROUND: Aortic false aneurysm is a rare complication after cardiac surgery. Aortic dissection, infection, arterial wall degeneration, and poor surgical technique are recognized as risk factors for the occurrence of postsurgical false aneurysm. Despite some recent reports about percutaneous false aneurysm exclusion, a complex surgical reoperation is needed in most ...

We investigated the surgical results of secondary thoracic endovascular aneurysm repair (TEVAR) using the elephant trunk graft after total aortic arch replacement (TAR) for extensive thoracic aortic lesions. The subjects comprised 16 patients who underwent TEVAR as a staged procedure following TAR at our institution between 1997 and 2007. Long-term ...

BACKGROUND: Endovascular repair of descending thoracic and thoracoabdominal aortic aneurysms is an appealing alternative to the standard surgical approach, but precludes revascularization of segmental arteries (SAs). For safer surgical and endovascular repairs, an accurate prediction of the risk of paraplegia in relation to the extent of SA sacrifice is needed. ...

Pseudoaneurysms and patch aneurysms are life-threatening late complications after thoracoabdominal aortic aneurysm (TAAA) repair. We treated four patients who presented with a pseudoaneurysm or patch aneurysm involving the descending thoracic portion of a previously implanted TAAA graft. In each patient, stent grafts were placed within the existing graft to cover ...

We performed transesophageal echocardiography (TEE) and computed tomography (CT) on patients with aortic pathology to describe a more anatomically coherent marker on TEE studies by using the celiac artery as a reference. As there are no anatomic markers for the eight-vertebrae long descending thoracic aorta, aortic disease (AD) is routinely ...

Recent studies have suggested that inflammation actively participates in ascending aortic aneurysm formation. The aim of the present study was to evaluate the expression changes of adhesion molecules and MMPs in an experimental model of ascending aortic aneurysm induced by ascending aorta banding in Wistar rats. Twelve rats developed aortic ...

Historically, tertiary syphilis infection has been the most common cause of thoracic aortic aneurysm, resulting in 5% to 10% of cardiovascular deaths until the era of antibiotics. A 49-year-old Caucasian man presented to our institution with progressive dysphagia, weight loss, incomplete bladder emptying, alcohol and tobacco consumption, systemic arterial hypertension, ...

Corrective surgery for scoliosis often results in a lengthening of the spinal column and relative change of the position of the adjacent anatomical structures such as the aorta. The extent of these anatomical changes could be affected by the presence of a rigid aortic stent graft in the descending thoracic ...

Endovascular technologies represent major advancements in treating descending thoracic aortic aneurysms (DTAA). We compared hospital charges of open thoracic aortic replacement (OTAR) with endovascular repair of thoracic aortic aneurysms (TEVAR). Retrospective analysis of hospital charges related to repair of DTAA (2000-2009). Charges were inflation adjusted for dollars in 2009. There ...

Right descending aortas have been correlated with an increased risk of congenital heart disease. Nevertheless, the aortic position remains a largely overlooked diagnostic tool in second-trimester sonography because no formal system for assessing the position exists. By developing a method of assigning the position of the aorta relative to the ...

The following is a case of a 22-year-old male with recurrent thoracic aneurysms with several constitutional symptoms, including gastrointestinal discomfort, irritable bowel syndrome, lactose intolerance, and a 2-week history of severe lower back pain. The patient underwent an initial thoracoabdominal repair of a visceral aneurysm followed by endovascular repair of ...

Shortly after the first extracranial to intracranial (EC-IC) carotid artery bypass was performed by Yasargil in 1967 for internal carotid artery occlusion, cerebral revascularization became widely accepted in the neurosurgical field, and the procedures became increasingly used as practitioners began to master the technical aspects of the surgery. The procedures ...

Surgical management of extensive aneurysms of the aorta still remains demanding. Herein, we describe the successful treatment of a 59-year-old Marfan patient with extensive aneurysm of the aorta complicated by bronchomalacia.

Cross-clamping the main pulmonary artery (PA) is a risky, stressful procedure for the general thoracic surgeon performing video-assisted thoracic major pulmonary resection (VATS). However, converting VATS to thoracotomy each time PA clamping is planned is a poor tactic. We present a simpler technique for VATS than the traditional method involving ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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, ...

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. ...

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 ...

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 ...

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 ...