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abdominal aortic aneurysm, imaging

Wojciech Kazimierczak, Zbigniew Serafin, Natalia Kazimierczak, Przemysław Ratajczak, Waldemar Leszczyński, Łukasz Bryl, Adam Lemanowicz
Abdominal aortic aneurysm (AAA) is defined as a localized enlargement of the aortic cross-section where the diameter is greater than 3 cm or more than 50% larger than the diameter in a normal segment. The most important complication of AAA is rupture, which, if untreated, results in mortality rates of up to 90%. Conventional open surgical repair is associated with significant 30-day mortality. Endovascular aneurysm repair (EVAR) is a significantly less invasive procedure; it is related to a lower early mortality rate and a lower number of perioperative complications...
January 2019: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Yousif A Algabri, Sorracha Rookkapan, Vera Gramina, Daniel M Espino, Surapong Chatpun
Aneurysms are considered as a critical cardiovascular disease worldwide when they rupture. The clinical understanding of geometrical impact on the flow behaviour and biomechanics of abdominal aortic aneurysm (AAA) is progressively developing. Proximal neck angulations of AAAs are believed to influence the hemodynamic changes and wall shear stress (WSS) within AAAs. Our aim was to perform pulsatile simulations using computational fluid dynamics (CFD) for patient-specific geometry to investigate the influence of severe angular (≥ 60°) neck on AAA's hemodynamic and wall shear stress...
February 14, 2019: Australasian Physical & Engineering Sciences in Medicine
Gergana T Taneva, Alejandro González García, Ana Begoña Arribas Díaz, Yasmina Baquero Yebra, Konstantinos P Donas, César Aparicio Martínez
OBJECTIVE: Data in literature suggest iliac artery dilatation and endograft retraction as complications after endovascular aneurysm repair. However, mainly older generation endografts were included. Therefore, we sought to evaluate the distal sealing zone chronological changes after endovascular aneurysm repair with newer generation stent-grafts. METHODS: Clinical and radiological data of patients with abdominal aortic aneurysms treated with endovascular aneurysm repair between January 2010 and December 2013 were reviewed...
February 12, 2019: Vascular
Matthew J Grima, Alan Karthikesalingam, Peter J Holt
OBJECTIVE: Surveillance imaging is considered mandatory after endovascular aneurysm repair (EVAR), but many patients are lost to follow up and the impact of this is poorly understood. This study aimed to examine compliance with post-operative surveillance in the UK and the impact of mal-/non-compliance on endograft re-interventions and survival. METHODS: EVAR-SCREEN centres reported EVAR for intact infrarenal abdominal aortic aneurysms (AAA) from 1 January 2007 to 31 December 2010, with follow up included up to 31 July 2014...
February 6, 2019: European Journal of Vascular and Endovascular Surgery
Fabien Lareyre, Juliette Raffort, Joseph Carboni, Julien Chikande, Nicolas Massiot, Audrey Voury-Pons, Emilien Umbdenstock, Réda Hassen-Khodja, Elixène Jean-Baptiste
INTRODUCTION: Fenestrated endovascular aortic repair (FEVAR) of complex aneurysm can require the coverage of polar renal artery. The aim of this study was to investigate the impact of the procedure on post-operative outcomes in patients with juxta-renal or thoraco-abdominal aortic aneurysms. MATERIAL AND METHODS: Patients who had FEVAR for juxta-renal or type IV thoraco-abdominal aortic aneurysm were retrospectively included between January 2010 and October 2017...
February 6, 2019: Annals of Vascular Surgery
Justyna A Niestrawska, Peter Regitnig, Christian Viertler, Tina U Cohnert, Anju R Babu, Gerhard A Holzapfel
Arterial walls can be regarded as composite materials consisting of collagen fibers embedded in an elastic matrix and smooth muscle cells. Remodeling of the structural proteins has been shown to play a significant role in the mechanical behavior of walls during pathogenesis of abdominal aortic aneurysms (AAA). In this study, we systematically studied the change in the microstructure, histology and mechanics to link them to AAA disease progression. We performed biaxial extension tests, second-harmonic generation imaging and histology on 15 samples from the anterior part of AAA walls harvested during open aneurysm surgery...
February 5, 2019: Acta Biomaterialia
Liangliang Zhang, Zhenxiang Jiang, Jongeun Choi, Chae Young Lim, Tapabrata Maiti, Seungik Baek
Translating recent advances in abdominal aortic aneurysm (AAA) growth and remodeling (G&R) knowledge into a predictive, patient-specific clinical treatment tool requires a major paradigm shift in computational modelling. The objectives of this study are to develop a prediction framework that 1) first calibrates the physical AAA G\&R model using patient-specific serial computed tomography (CT) scan images, 2) predicts the expansion of an AAA in the future, and 3) quantifies the associated uncertainty in the prediction...
January 30, 2019: IEEE Journal of Biomedical and Health Informatics
Niels J Petterson, Emiel M J van Disseldorp, Marc R H M van Sambeek, Frans N van de Vosse, Richard G P Lopata
OBJECTIVES: In this study the influence of surrounding tissues including the presence of the spine on wall stress analysis and mechanical characterization of abdominal aortic aneurysms using ultrasound imaging has been investigated. METHODS: Geometries of 7 AAA patients and 11 healthy volunteers were acquired using 3-D ultrasound and converted to finite element based models. Model complexity of externally unsupported (aorta-only) models was complemented with inclusion of both soft tissue around the aorta and a spine support dorsal to the aorta...
January 19, 2019: Journal of Biomechanics
M A Waduud, B Wood, P Keleabetswe, J Manning, E Linton, M Drozd, C J Hammond, M A Bailey, D J A Scott
BACKGROUND: The effect of sarcopenia based on the total psoas muscle area (TPMA) on CT is inconclusive in patients undergoing abdominal aortic aneurysm (AAA) intervention. The aim of this prospective cohort study was to evaluate morphometric sarcopenia as a method of risk stratification in patients undergoing elective AAA intervention. METHODS: TPMA was measured on preintervention CT images of patients undergoing elective endovascular aneurysm repair (EVAR) or open aneurysm repair...
January 31, 2019: British Journal of Surgery
Jun Nitta, Katsuyuki Hoshina, Toshihiko Isaji
This study aimed to compare the pelvic cavity vasculature before and after the interventional occlusion of a hypogastric artery (IOHA) and to reveal the protective mechanism of the collateral vessels against pelvic ischaemia.Sixty-nine patients with abdominal aortic or aortoiliac aneurysms who underwent endovascular aneurysm repair accompanied with IOHA were retrospectively analysed. Patients were divided into those who complained of buttock claudication (BC) group and asymptomatic patients (non-BC group).Two analyses were performed...
February 2019: Medicine (Baltimore)
Chengcheng Zhu, Joseph R Leach, Bing Tian, Lizhen Cao, Zhaoying Wen, Yan Wang, Xinke Liu, Qi Liu, Jianping Lu, David Saloner, Michael D Hope
BACKGROUND: Intraluminal thrombus (ILT) signal intensity on MRI has been studied as a potential marker of abdominal aortic aneurysm (AAA) progression. PURPOSE: 1) To characterize the relationship between ILT signal intensity and AAA diameter; 2) to evaluate ILT change over time; and 3) to assess the relationship between ILT features and AAA growth. STUDY TYPE: Prospective. SUBJECTS: Eighty AAA patients were imaged, and a subset (n = 41) were followed with repeated MRI for 16 ± 9 months...
January 29, 2019: Journal of Magnetic Resonance Imaging: JMRI
Graeme McFarland, Kenneth Tran, Whitt Virgin-Downey, Michael D Sgroi, Venita Chandra, Matthew W Mell, E John Harris, Ronald L Dalman, Jason T Lee
OBJECTIVE: Endovascular aneurysm repair (EVAR) has become the standard of care for infrarenal aneurysms. Endografts are commercially available in proximal diameters up to 36 mm, allowing proximal seal in necks up to 32 mm. We sought to further investigate clinical outcomes after standard EVAR in patients requiring large main body devices. METHODS: We performed a retrospective review of a prospectively maintained database for all patients undergoing elective EVAR for infrarenal abdominal aortic aneurysms at a single institution from 2000 to 2016...
February 2019: Journal of Vascular Surgery
ZiMian Gao, Kaiyi Zhao, Hao Pan, Kui Chen, JiHang Zheng
PURPOSE: Spinal cord ischemia is a rare complication of endovascular repair of abdominal aortic aneurysm (AAA) that is attributed to the variable anatomy of the artery of Adamkiewicz, embolization of the collateral circulation, or hypoperfusion of cord structures secondary to hypotension. CASE REPORT: A hypertensive 83-year-old male with chronic obstructive pulmonary disease presented with a 2.3 cm right iliac artery dissecting aneurysm. Paraplegia occurred on the first day after endovascular repair of iliac artery aneurysm...
January 23, 2019: Annals of Vascular Surgery
George Kouvelos, George Antoniou, Konstantinos Spanos, Athanasios Giannoukas, Miltiadis Matsagkas
INTRODUCTION: The aim was to investigate the impact of wide proximal aortic diameter on outcome after standard endovascular repair (sEVAR) of infrarenal abdominal aortic aneurysms. EVIDENCE ACQUISITION: A systematic search of the literature was undertaken using the PUBMED, EMBASE, and Cochrane databases for articles comparing outcome after sEVAR in patients with large versus small diameter aortic neck. The prognostic factor of interest was large diameter proximal aortic neck and the results were reported as odds ratio (OR) or mean difference (MD) and 95% confidence interval (CI)...
January 18, 2019: Journal of Cardiovascular Surgery
Saptarshi Paul, Suraj Wasudeo Nagre
Rupture of an abdominal aortic aneurysm is readily diagnosed when the triad of abdominal or back pain, shock and a pulsatile abdominal mass are present. However in a few cases, a chronic contained ruptured abdominal aortic aneurysm can present in a multitude of manners rather than as life threatening haemorrhage. In our case we are reporting a 41 year old hypertensive female who developed claudication pain in both her lower limbs. Imaging later revealed that she had a contained ruptured abdominal aortic aneurysm, a thing she was previously unaware of, with collaterals from the bilateral subclavian arteries supplying her femorals...
April 2019: Journal of the Saudi Heart Association
Sun Young Chae, Tae-Won Kwon, Soyoung Jin, Sun U Kwon, Changhwan Sung, Seung Jun Oh, Sang Ju Lee, Jungsu S Oh, Youngjin Han, Yong-Pil Cho, Narae Lee, Ji Young Kim, Norman Koglin, Mathias Berndt, Andrew W Stephens, Dae Hyuk Moon
BACKGROUND: 18 F-GP1 is a novel positron emission tomography (PET) tracer that targets glycoprotein IIb/IIIa receptors on activated platelets. The study objective was to explore the feasibility of directly imaging acute arterial thrombosis (AAT) with 18 F-GP1 PET/computed tomography (PET/CT) and to quantitatively assess 18 F-GP1 uptake. Safety, biodistribution, pharmacokinetics and metabolism were also evaluated. METHODS: Adult patients who had signs or symptoms of AAT or had recently undergone arterial intervention or surgery within 14 days prior to 18 F-GP1 PET/CT were eligible for inclusion...
January 7, 2019: EJNMMI Research
Maaz B J Syed, Alexander J Fletcher, Marc R Dweck, Rachael Forsythe, David E Newby
Inflammation affects the aortic wall through complex pathways that alter its biomechanical structure and cellular composition. Inflammatory processes that predominantly affect the intima cause occlusive disease whereas medial inflammation and degeneration cause aneurysm formation. Aortic inflammatory pathways share common metabolic features that can be localized by smart contrast agents and radiolabelled positron emission tomography (PET) tracers. 18 F-Fluorodeoxyglucose (18 F-FDG) is a non-specific marker of metabolism and has been widely used to study aortic inflammation in various diseased aortic states...
December 27, 2018: Trends in Cardiovascular Medicine
Silvia Loggi, Nicoletta Mininno, Elisa Damiani, Benedetto Marini, Erica Adrario, Claudia Scorcella, Roberta Domizi, Andrea Carsetti, Simona Pantanetti, Gabriele Pagliariccio, Luciano Carbonari, Abele Donati
BACKGROUND: In vascular surgery with aortic cross-clamping, ischemia/reperfusion injury induces systemic haemodynamic and microcirculatory disturbances. Different anaesthetic regimens may have a varying impact on tissue perfusion. The aim of this study was to explore changes in microvascular perfusion in patients undergoing elective open abdominal aortic aneurysm repair under balanced or total intravenous anaesthesia. METHODS: Prospective observational study. Patients undergoing elective open infrarenal abdominal aortic aneurysm repair received balanced (desflurane + remifentanil, n = 20) or total intravenous anaesthesia (TIVA, propofol + remifentanil using target-controlled infusion, n = 20) according to the clinician's decision...
January 5, 2019: BMC Anesthesiology
Anna Drelich-Zbroja, Michał Sojka, Maryla Kuczyńska, Łukasz Światłowski, Ewa Kuklik, Jan Sobstyl, Krzysztof Pyra, Andrzej Wolski, Elżbieta Czekajska-Chehab, Maciej Pech, Maciej Powerski, Tomasz Jargiełło
INTRODUCTION Endovascular treatment of abdominal aortic aneurysms (AAA) constitutes an alternative to the classical surgical approach. The procedure may be complicated by specific complications including persistent flow within the aneurysm sac, otherwise known as endoleak. OBJECTIVES To assess the utility of ultrasonographic contrast agents in diagnosis of endoleaks after endovascular abdominal aortic aneurysm repair. PATIENTS AND METHODS 198 patients with AAA were treated endovascularly. All subjects underwent follow-up examinations at 6 and 12 months after the procedure, including pre- and post-contrast ultrasound, followed by CT angiography (CTA) as a reference...
December 29, 2018: Polish Archives of Internal Medicine
Annalise M Panthofer, Sydney L Olson, Donald G Harris, Jon S Matsumura
OBJECTIVE: Sarcopenia, as assessed by computed tomography (CT)-based measurements of muscle mass, is an objective and patient-specific indicator of frailty, which is an important predictor of operative morbidity and mortality. Studies to date have primarily focused on psoas-defined sarcopenia, which may not be valid among patients with thoracic aortic disease. Using psoas sarcopenia as the reference for sarcopenia, the purpose of this study was to create and to validate a new thoracic-level method of measuring sarcopenia as a novel method to assess frailty among patients undergoing thoracic endovascular aortic repair...
December 28, 2018: Journal of Vascular Surgery
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