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The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair.
To evaluate initial and midterm clinical outcomes of aortic aneurysms involving the proximal anastomotic aneurysm (AAPAA) following initial open repair for infrarenal abdominal aortic aneurysm.
Abdominal aortic aneurysm (AAA) is a common disease seen in vascular units. AAA is defined as transverse diameter greater than 3 cm and affects men more than women. Endovascular aortic aneurysm repair (EVAR) is increasingly being used to treat AAA. Renal dysfunction, graft-related endoleaks, graft limb occlusion, device migration and delayed aneurysm rupture are possible complications that have been encountered after EVAR.
The purpose of this study was to quantify and evaluate the expression response of miRNA-191 and miRNA-455-3p endovascular repair of abdominal aortic aneurysm based in whole blood samples. MethodsThis report describes a prospective study of a single center of 30 patients with abdominal aortic aneurysm (AAA) who underwent endovascular repair. Blood samples were collected preoperatively and 6 months postoperatively. The differential expression of the miRNAs was performed by the real time PCR method, after extr...
Paravertebral catheters are a well-established analgesic modality in thoracic surgery but have not been described in abdominal aortic surgery. We describe a simple, safe, and effective technique of paravertebral catheter insertion by the operative surgeon after a retroperitoneal abdominal aortic aneurysm repair. Once the aneurysm repair is complete, an extrapleural plane between the parietal pleura and the twelfth rib is created through blunt dissection. A catheter is advanced into the space percutaneously ...
We present a case of a type Ia endoleak detected using F-FDG PET/CT 10 years after an abdominal aortoiliac endovascular aneurysm repair in an 83-year-old man. The F-FDG PET/CT scan was performed to evaluate a solitary pulmonary nodule but, in addition, demonstrated unexpected blood pool activity outside the stent graft and within the abdominal aortic aneurysm sac, indicating an endoleak; no FDG activity should be present within the aneurysm sac after stent graft placement. A subsequent CT angiogram confirme...
Readmission after abdominal aortic aneurysm (AAA) repair to a different (non-index) hospital has been shown to be associated with high mortality rates. Factors influencing this association remain unknown. The objective of this study was to determine the impact of hospital teaching status on non-index hospital readmission and mortality.
Abdominal aortic aneurysms are very rare in Marfan syndrome. We present a case with a young non-smoking and normotensive male with Marfan syndrome, who developed an infrarenal abdominal aortic aneurysm that presented with rupture to the retroperitoneal cavity causing life-threatening bleeding shock. The patient had acute aortic surgery and survived. Five months before this incident, the patient had uneventful elective aortic root replacement (a.m David) due to an enlarged aortic root. At that time, his abdo...
Endovascular Aortic Repair (EVAR) is presently the preferred treatment for abdominal aortic aneurysm; however, it requires the injection of contrast medium, which can hamper the renal function. Other non-toxic agents, such as carbon dioxide (CO) have been sporadically tested in this setting with uncertain results. Aim of the study is to investigate the efficacy of a new standardized COinjection method in standard EVAR procedures.
Although the indications for endovascular aneurysm repair for abdominal aortic aneurysm have been expanding, our primary strategy for pararenal and juxtarenal abdominal aortic aneurysm (P/JRAA) is open surgery (OS). One consequence of OS for P/JRAA is transient renal ischemia owing to renal artery clamping, which can be followed by acute kidney injury (AKI). Prior studies referred to the impact of renal ischemia on AKI, but they have rarely evaluated longer-term renal function. This study focused on a chron...
To test the hypothesis that retinal microvascular abnormalities known to predict other cardiovascular diseases are associated prospectively with risk of abdominal aortic aneurysm. The rationale is that aortic aneurysm involves small vessel pathology that parallels, to some degree, retinal vasculopathy.
Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms exposes patients and healthcare professions to the deterministic and stochastic effects of ionization radiation. The study aim was to determine our standard of radiation exposure in infrarenal EVARs and compare it against other published data and national guidelines.
Abdominal aortic aneurysms pose a substantial clinical burden, and a significant proportion are not anatomically suitable for open repair or standard endovascular aneurysm repair (EVAR), instead requiring fenestrated EVAR (fEVAR). We sought to compare clinical outcomes and trends over time in patients undergoing fEVAR in Australia.
In very rare cases, a primary infected abdominal aortic aneurysm (IAAA) is caused by a species of Brucella. In this report, we report such a case that was successfully treated with a novel approach. To the best of our knowledge, this was the first case occurring in China, in which an infection of the abdominal aortic aneurysm was caused by a Brucella species.
The aim of this study was to examine changes in abdominal aortic aneurysm repair and mortality during a period when endovascular aneurysm repair (EVAR) was introduced.Open repair surgery was the mainstay of treatment for abdominal aortic aneurysm (AAA), but EVAR is increasingly utilized. Studies in the Western population have reported improved short-term or postoperative mortality and shorter length of hospital stay with EVAR. However, scant data are available in the Chinese population.We conducted a retros...
Patients undergoing endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms can exhibit variations in sac behavior ranging from complete regression to expansion. We evaluated the impact of sac behavior at 1-year follow-up on late survival.
The NHS abdominal aortic aneurysm screening programme (NAAASP) is now fully operational. Those who have previously been formally investigated for abdominal aortic aneurysm (AAA) are excluded, however many patients undergo radiological investigation of the abdomen for other reasons. Such practices may find incidental AAA which may be eroding the performance of the NAAASP. We investigated the rates of pre-investigation prior to for invitation to screening in our local AAA screening programme.
Very few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution's experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group.
The Rapid Ruptured Abdominal Aortic Aneurysm Score (RrAAAs) was developed from Vascular Study Group of New England (VSGNE) data (649 rAAA patients, repaired both open and endovascularly), using pre-operative age, creatinine, and blood pressure. This study validates that model using the larger National Vascular Quality Initiative (VQI) dataset, and compares its performance to previous models.
We report the results of the operative treatment of synchronous type B acute aortic dissection (TBAAD) and infrarenal abdominal aortic aneurysm (AAA).
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide l...
Abdominal aortic aneurysms are usually asymptomatic. The compressive effects of internal iliac aneurysms are well described in the literature, however, we report what we believe to be the first case of rupture of the renal pelvis caused by compression by an infra-renal abdominal aortic aneurysm. We describe the subsequent management and briefly review the literature.
Shprintzen-Goldberg syndrome is a rare systemic connective tissue disorder characterized by craniosynostosis, skeletal abnormalities, infantile hypotonia, mild-to-moderate intellectual disability and cardiovascular anomalies. To our knowledge, this is the first report of a Shprintzen-Goldberg syndrome patient who developed a thoraco-abdominal aortic aneurysm. The aneurysm grew rapidly necessitating emergent thoraco-abdominal aortic replacement. The postoperative course was uneventful, and a careful lifetime...
The incidence of spinal cord ischaemia (SCI) and subsequent paraplegia after thoracic endovascular aneurysm repair (TEVAR) and thoraco-abdominal endovascular aneurysm repair is estimated to be between 2.5% and 8%. The aim of this review is to provide an overview of SCI preventive strategies in TEVAR and thoraco-abdominal repair and recommend an optimal strategy.