scholarly journals Socioeconomic disparities in surveillance and follow‐up of patients with thoracic aortic aneurysm

2021 ◽  
Author(s):  
Michael Shang ◽  
Gabe Weininger ◽  
Makoto Mori ◽  
Arianna Kahler‐Quesada ◽  
Ellelan Degife ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Socioeconomic Disparities

Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection

2005 ◽  
Vol 13 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Yukio Kuniyoshi ◽  
Kageharu Koja ◽  
Kazufumi Miyagi ◽  
Tooru Uezu ◽  
Satoshi Yamashiro ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Thoracoabdominal Aorta ◽  
Omental Wrapping ◽  
Hospital Deaths

Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 ± 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.

Endovascular repair of a descending thoracic aortic aneurysm: one-year follow-up results

2020 ◽  
Vol 26 (3) ◽  
pp. 102
Author(s):  
A. N. Kazantsev ◽  
A. N. Kokov ◽  
N. N. Burkov ◽  
B. L. Khaes ◽  
R. S. Tarasov
Keyword(s):  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Thoracic Aortic Aneurysm ◽  
Descending Thoracic Aortic Aneurysm ◽  
One Year

scholarly journals A Case Based Approach to Clinical Genetics of Thoracic Aortic Aneurysm/Dissection

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Betti Giusti ◽  
Stefano Nistri ◽  
Elena Sticchi ◽  
Rosina De Cario ◽  
Rosanna Abbate ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
State Of The Art ◽  
Genetic Profile ◽  
Clinical Genetics ◽  
Clinical Genetic ◽  
Increased Risk ◽  
Rising Incidence ◽  
Aneurysm Dissection

Thoracic aortic aneurysm/dissection (TAAD) is a potential lethal condition with a rising incidence. This condition may occur sporadically; nevertheless, it displays familial clustering in >20% of the cases. Family history confers a six- to twentyfold increased risk of TAAD and has to be considered in the identification and evaluation of patients needing an adequate clinical follow-up. Familial TAAD recognizes a number of potential etiologies with a significant genetic heterogeneity, in either syndromic or nonsyndromic forms of the manifestation. The clinical impact and the management of patients with TAAD differ according to the syndromic and nonsyndromic forms of the manifestation. The clinical management of TAAD patients varies, depending on the different forms. Starting from the description of patient history, in this paper, we summarized the state of the art concerning assessment of clinical/genetic profile and therapeutic management of TAAD patients.

scholarly journals A case of a highly tortuous descending thoracic aortic aneurysm treated by surgical exclusion

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092644
Author(s):  
Koji Tsutsumi ◽  
Hideyuki Shimizu
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Prosthetic Graft ◽  
Late Complications ◽  
Main Body ◽  
Descending Aorta ◽  
Descending Thoracic Aortic Aneurysm ◽  
Aorta Replacement ◽  
The Right

The patient was a 76-year-old woman with an atypical descending thoracic aortic aneurysm due to a highly tortuous descending aorta. The surgical approach in this case required special consideration because of the aneurysm’s location. The main body of the aneurysm was in the right thoracic cavity. Descending thoracic aorta replacement with a prosthetic graft and aneurysmal total exclusion were performed through a left curvilinear thoracoabdominal incision. The patient’s postoperative course was uneventful. Surgical exclusion of a thoracic aortic aneurysm may be a useful technique in this special situation. Postoperative follow-up is needed to prevent early and late complications.

P5604Combining aortic size with measures of aortic stiffness and pulsatile hemodynamics enhances prediction of future thoracic aortic aneurysm expansion

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Zhu ◽  
M Boodhwani ◽  
L Beauchesne ◽  
K Chan ◽  
C Dennie ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Linear Regression ◽  
Aortic Stiffness ◽  
Thoracic Aortic Aneurysm ◽  
Imaging Modality ◽  
Linear Regression Models ◽  
Arterial Function ◽  
Function Measure ◽  
Aortic Size

Abstract Introduction Thoracic aortic aneurysm (TAA) is a clinically silent disease which can lead to significant morbidity when complicated by an acute aortic syndrome. Although TAA size is the only variable used in decision-making, it is an imperfect predictor of risk. Conversely, hemodynamic measures that reflect the aorta's function, such as aortic stiffness and pulsatile hemodynamics, may provide additional insights into risk of TAA expansion. Purpose We hypothesized that combining aortic size with measures of arterial function (stiffness and pulsatile hemodynamics) would improve prediction of TAA expansion, as compared to aortic size alone. Methods 105 unoperated participants with TAA were recruited between 2014 and 2017 and followed prospectively for ≥1 yr. TAA size was measured at enrolment and at the latest imaging study according to published consensus; TAA expansion was calculated as mm/year. Arterial function was non-invasively assessed at baseline with validated methods that integrate arterial tonometry with echocardiography. Multivariable linear regression assessed independent associations of baseline TAA size and each arterial function measure, initially separately and then in combination (by multiplying them when direction of association was the same, and dividing them when direction of association was opposite), with future TAA expansion. Standardized beta coefficients were calculated to allow direct comparisons. Models were adjusted for age, sex, body size, aneurysm location and etiology, type of imaging modality, follow-up time, mean arterial pressure, and history of hypertension, diabetes and smoking. Results Seventy-seven percent of participants were men, and the ratio of degenerative to heritable TAAs was 62/43. Mean ± SD age, baseline TAA size, and follow-up time were 62.8±11.3yrs, 46.3±3.9cm, and 2.2±0.7 years, respectively. Results of the multivariable linear regression models are summarized in the Table. While baseline TAA size and each arterial function measure were independently associated with TAA expansion, some of the arterial function measures were superior in predicting TAA growth (Table, left). In addition, combining aortic size and function further improved the prediction of TAA growth beyond each variable alone (Table, right). Conclusion(s) Combining aortic size with arterial function improved prediction of TAA expansion over any individual variable alone, independently of confounders. Assessing arterial function may confer a clinical advantage, when compared to current practice, in determining TAA disease activity and estimating one's TAA-related risk. Acknowledgement/Funding Canadian Institute of Health Research, Canadian Vascular Network, and Heart and Stroke Foundation of Canada

Predictive Factors for Endoleaks and Aneurysm Enlargement after Thoracic Endovascular Aortic Repair of Thoracic Aortic Aneurysm

2021 ◽  
Vol 104 (5) ◽  
pp. 733-739
Keyword(s):  
Aortic Aneurysm ◽  
Ct Angiography ◽  
Predictive Factors ◽  
Thoracic Aortic Aneurysm ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Neck Length ◽  
Aortic Repair ◽  
Type Ia

Objective: To analyze the incidence and predictive factors of endoleaks and associated increased aneurysm size after thoracic endovascular aortic repair (TEVAR). Materials and Methods: The medical records and computed tomography (CT) angiography imaging of 69 patients with thoracic aortic aneurysm that underwent thoracic endovascular aortic repair at a single institute between June 2012 and May 2019 were reviewed. The incidences of endoleak were calculated. The patients’ demographic data, operative details, and imaging data were collected. The risk factors of endoleak occurrence were analyzed between endoleak and non-endoleak groups. The association between endoleak and aneurysm enlargement was also evaluated. Results: Endoleaks were noted in twenty-nine cases (42.0%) including four type Ia (5.8%), six type Ib (8.7%), seventeen type II (24.6%), and two type III (2.9%). Fifty-nine percent of the patients with endoleak were found with aneurysm enlargement. The predictive factors of endoleak were bird beak configuration and distal neck length of less than 20 mm (p=0.014 and 0.019, respectively). For type Ia, endoleak presented with short proximal neck length (p=0.031). Short distal neck and angulation of distal stent less than 160 degrees were the predictive factors of type Ib endoleak (p=0.045 and <0.001, respectively). Increased number of intercostal arteries is the only significant risk factor of type II endoleak (p=0.005). The other complications were endograft migration in about 5.8%, endograft infection in 2.9%, cerebrovascular complications in 5.8%, and ruptured aortic aneurysm in 2.9%. Conclusion: Interval follow up CT angiography is recommended to detect endoleak and other late complications after TEVAR. Special considerations are noted in the underlying renal insufficiency and the young patient for radiation dose in long term follow up. Keywords: Endoleak, Thoracic endovascular aortic repair, Thoracic aortic aneurysm, CT angiography, Aneurysm enlargement

Chronic Traumatic Thoracic Aortic Aneurysm: 40-Year Follow-Up

2015 ◽  
Vol 30 (7) ◽  
pp. 586-588
Author(s):  
Adam Iddriss ◽  
Bulat A. Ziganshin ◽  
Maryann Tranquilli ◽  
John A. Elefteriades
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm

scholarly journals Challenges of endovascular tube graft repair of thoracic aortic aneurysm: midterm follow-up and lessons learned

2003 ◽  
Vol 38 (4) ◽  
pp. 676-683 ◽  
Author(s):  
Sharif H Ellozy ◽  
Alfio Carroccio ◽  
Michael Minor ◽  
Tikva Jacobs ◽  
Kristina Chae ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Lessons Learned
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