Descending thoracic aneurysm

INTRODUCTION: Thoracic aortic aneurysms (TAAs) are an increasingly prevalent pathology with significant associated morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) is the primary line of treatment. The purpose of this study was to analyse a single center's experience in the treatment of TAAs and identify possible risk factors for worse outcomes. METHODS: A retrospective review of our institutional database was done to identify all patients treated for TAAs in a 10-year period, from 1 January 2012 to 31 December 2022...

OBJECTIVE: To investigate the association between intracranial aneurysms (IA) and thoracic aortic diameter. METHODS: This observational cohort study examined thoracic aortic diameters in IA patients. Patients were categorized by IA size (<7mm and ≥7mm) and IA status (ruptured / unruptured) based on radiological findings. We investigated the association between thoracic aortic diameter and IA size and status using binary and linear regression as univariate and multivariable analyses...

Aortic dissection, a potentially fatal event, usually presents with acute intense chest or back pain. Painless aortic dissections constitute about 10% of all cases. High blood pressure is a common finding in both painless and painful aortic dissections. During the coronavirus disease (COVID-19) pandemic, various anti-COVID vaccines have been massively used. Although these vaccines are generally safe, there is a small risk of adverse effects which are mostly mild and transient, but sometimes they could be life-threatening...

We describe the case of a 55-year-old man with a pseudocoarctation of the descending aorta following a conventional elephant trunk technique. The patient underwent aortic arch replacement with the conventional elephant trunk technique. After the operation, he had developed an increasing creatinine level, hemolysis, and cyanosis of his toes. Femoral arterial line placement confirmed a 50-mm Hg systolic pressure gradient between his radial and femoral arteries. Computed tomography angiography revealed that the elephant trunk graft within the true lumen was compressed, resulting in a pseudocoarctation...

BACKGROUND: The pathophysiology and behavior of acute type B intramural hematoma (TBIMH) is poorly understood. The purpose of this study is to characterize the pathophysiology, fate and outcomes of TBIMH in the endovascular era. METHODS: A retrospective analysis of a U.S. Aortic Database identified 70 patients with TBIMH from 2008-2022. Patients were divided into groups and analyzed based upon subsequent management: early thoracic endovascular aortic repair(TEVAR; Group 1) or hospital discharge on OMT(Group 2)...

OBJECTIVES: In this cohort study, we aimed to assess the 1-year clinical outcomes of using the E-vita Open NEO™ hybrid prosthesis for total arch replacement with frozen elephant trunk to repair extensive aortic pathologies. METHODS: A total of individuals who underwent thoracic aortic surgery between April 2021 and March 2023 were identified from the review of the Gangnam Severance Aortic Registry. Exclusion criteria included ascending aortic replacement, 1 or 2 partial arch replacement, descending aortic replacement, and total arch replacement without a frozen elephant trunk...

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BACKGROUND: Primary aortic thrombus (PAT) in the absence of underlying aortic pathology such as atherosclerosis or aneurysm is quite rare and presents with various symptoms related to distal embolization. Treatment options include anticoagulation alone, open surgical thrombectomy, endovascular repair, and a combination of these approaches. The optimal management strategy remains controversial. METHODS: Between 2016 and 2020, 10 patients (6 females; mean age, 49...

OBJECTIVE: The study objective was to evaluate the midterm outcome of thoracic endovascular aortic repair compared with open repair in patients with descending thoracic aortic aneurysm. METHODS: From August 1993 to February 2023, 499 patients with descending thoracic aortic aneurysms underwent open repair (n = 221) or thoracic endovascular aortic repair (n = 278). Of these, 120 matched pairs were identified using propensity score matching based on age, sex, chronic lung disease, stroke, coronary artery disease, diabetes, ejection fraction, dialysis, peripheral vascular disease, prior cardiac surgery, connective tissue disease, and chronic dissection...

Campylobacter fetus (C. fetus) demonstrates a preference for vascular tissue and is an infrequent etiology of mycotic aortic arteritis (MAA), mostly occurring in the abdominal aorta. MAA characteristically has a rapid progression to aneurysm formation and subsequently, to aortic rupture. We present a 73-year-old woman with non-aneurysmal mycotic thoracic aortic arteritis (MTAA) complicated with a rupture caused by C. fetus. She presented after four days of pain in the lower abdomen. Contrast-enhanced computed tomography revealed non-aneurysmal descending thoracic aorta arteritis and an abdominal aorta aneurysm, and the blood cultures were positive for C...

BACKGROUND: Aortic aneurysm as a presenting feature in Takayasu's arteritis is very rare. Here, we report three cases of extensive thoracoabdominal aortic aneurysm in Takayasu's arteritis as initial presentation. CASE SUMMARY: All three cases were males and presented with complaints of abdominal pain and refractory hypertension. The diagnosis was made from the finding of thickened and calcified aortic wall, stenosis of visceral arteries, and age < 40 years at diagnosis...

Aortic diseases, such as aneurysms, atherosclerosis, and dissections, demonstrate a preferential development and progression around the aortic circumference, resulting in a highly heterogeneous disease state around the circumference. Differences in the aorta's structural composition and mechanical properties may be partly responsible for this phenomenon. Our goal in this study was to analyze the mechanical and structural properties of the human aorta at its lateral, anterior, posterior, and medial quadrants in two regions prone to circumferentially inhomogeneous diseases, descending Thoracic Aorta (TA) and Infrarenal Aorta (IFR)...

BACKGROUND: Acute type B aortic dissection is a cardiovascular emergency with considerable mortality and morbidity risk. Male-female differences have been observed in cardiovascular disease; however, literature on type B aortic dissection is scarce. METHODS AND RESULTS: A retrospective cohort study was conducted including all consecutive patients with acute type B aortic dissection between 2007 and 2017 in 4 tertiary hospitals using patient files and questionnaires for late morbidity...

A 46-year-old male developed a Stanford type B aortic dissection. At age 48, he underwent left open thoracic descending aorta replacement because of the enlargement of the descending thoracic aorta. At 51 years old, he underwent abdominal aorta replacement because of ischemia in the right lower extremity and the enlargement of an abdominal aortic aneurysm. The septum between the true and false lumens was submitted to histopathological examination, which revealed bilateral intimal tissue with the tunica media lying in between...

Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder. Vessel tortuosity and aneurysms throughout the vasculature are unique to LDS. Aortic root enlargement is ubiquitous, with most patients undergoing root replacement at some point in their lifetime. Multiple vascular procedures are required to prolong life expectancy. We describe a staged hybrid approach to a 17-year-old patient with LDS presenting with ascending aorta, arch, and bilateral subclavian artery aneurysms and prominent tortuosity. Transposition of the left vertebral and subclavian arteries onto the common carotid artery was performed...

BACKGROUND: Repair of thoracic aortic aneurysms with either endovascular repair (TEVAR) or open surgical repair (OSR) represents major surgery, is costly and associated with significant complications. The aim of this study was to establish accurate costs of delivering TEVAR and OSR in a cohort of UK NHS patients suitable for open and endovascular treatment for the whole treatment pathway from admission and to discharge and 12-month follow-up. METHODS: A prospective study of UK NHS patients from 30 NHS vascular/cardiothoracic units in England aged ≥18, with distal arch/descending thoracic aortic aneurysms (CTAA) was undertaken...

We report a case of a pregnant woman with a history of ascending arch replacement for aortic dissection who still had a residual descending aortic dissection. She underwent urgent genetic testing to identify hereditary aortic-related diseases that might be useful in perinatal management. A mutation in the myosin heavy chain gene (MYH11), indicating a high risk of aortic dissection but a low impact on other vascular systems and organs, was identified. Due to concerns about the development of residual aortic dissection, cesarean delivery with combined spinal-epidural anesthesia was selected...

A 64-year-old female with a diagnosis of Crawford typeⅡ thoracoabdominal aortic aneurysm( TAAA) including enlargement of the ascending aorta underwent a staged hybrid repair including visceral artery debranching thoracic endovascular aortic repair( TEVAR). First, total arch replacement with elephant trunk method was performed, followed by TEVAR for the descending thoracic aorta, and finally visceral artery debranching TEVAR for the thoracoabdominal aorta. Complications such as spinal cord infarction did not occur throughout the procedure...

Durable left ventricular assist devices (LVADs) are a cornerstone therapy for patients with end-stage heart failure, and thus efforts to develop techniques that facilitate their use in an expanded population of patients are critical. Although the preferred outflow graft anastomosis site is the ascending aorta, alternative sites have been described including the descending thoracic and supraceliac abdominal aorta, as well as the innominate and axillary arteries. However, these vessels can be unfavorable targets in the setting of atherosclerosis, aneurysm, insufficient caliber, dissection, or complicated anatomy due to prior interventions...

OBJECTIVE: To evaluate the association between sex and outcomes following TEVAR for intact isolated descending thoracic aortic aneurysms (iiDTAA). SUMMARY BACKGROUND DATA: Data regarding sex-related long-term outcomes after TEVAR for iiDTAA are limited and conflicting results regarding perioperative outcomes have been reported. METHODS: We included all TEVAR for iiDTAA between 2014-2019 in the Vascular Quality Initiative linked to Medicare claims, allowing reliable assessment of long-term outcome data...