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Veterinary Radiology & Ultrasound : the... Jul 2023Double aortic arch (DAA) is a rare, congenital anomaly in small animals, resulting in a complete vascular ring encircling the esophagus and trachea, and subsequent...
Double aortic arch (DAA) is a rare, congenital anomaly in small animals, resulting in a complete vascular ring encircling the esophagus and trachea, and subsequent compression of these organs. Few studies have reported utilizing CT angiography (CTA) for diagnosing DAA in dogs; thus, the imaging features are currently lacking in the literature. The objectives of this retrospective, multicenter, descriptive case series were to report the clinical and CTA characteristics of DAA in surgically treated cases. Medical records and CTA images were reviewed. Six juvenile dogs met the inclusion criteria (median age: 4.2 months; range: 2-5 months). The most common clinical signs included chronic regurgitation (100%), decreased body condition (67%), and coughing (50%). Common CTA features of DAA included a dominant left aortic arch (median diameter: 8.1 mm) and minor right aortic arch (median diameter: 4.3 mm; 83%), an aberrant right subclavian artery arising directly from the right aortic arch (83%), segmental esophageal constriction (100%), and variable degrees of dilation cranial to the heart base, and marked tracheal luminal compression (median percent change: -55%; 100%) and leftward curvature of the trachea at the level of the bifurcation of the aortic arches (100%). All dogs underwent successful surgical correction with only minor postoperative complications. Due to the similarity of clinical and imaging characteristics described to that of other forms of vascular ring anomalies (VRA), CTA is vital for the specific diagnosis of DAA in dogs.
Topics: Dogs; Animals; Vascular Ring; Retrospective Studies; Aorta, Thoracic; Tomography, X-Ray Computed; Dog Diseases
PubMed: 37296077
DOI: 10.1111/vru.13257 -
The Journal of Thoracic and... Sep 2020
Topics: Aorta; Aorta, Thoracic; Humans; Tracheobronchomalacia; Vascular Ring
PubMed: 32381335
DOI: 10.1016/j.jtcvs.2020.03.125 -
Gaceta Medica de Mexico 2016Right aortic arch with aberrant left subclavian artery from a Kommerell's diverticulum is a very rare variant of the incomplete vascular ring. Associated symptoms are...
Right aortic arch with aberrant left subclavian artery from a Kommerell's diverticulum is a very rare variant of the incomplete vascular ring. Associated symptoms are caused due to tracheal or esophagus compression. Magnetic resonance is the gold standard for diagnosis. Surgical treatment is recommended for symptomatic patients or asymptomatic patients with a large diverticulum. We report three consecutive cases of patients with Kommerell's diverticulum, aberrant left subclavian artery, and right-sided aortic arch.
Topics: Aneurysm; Aorta, Thoracic; Cardiovascular Abnormalities; Child, Preschool; Deglutition Disorders; Diverticulum; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Subclavian Artery
PubMed: 27335200
DOI: No ID Found -
BMC Pregnancy and Childbirth May 2023Vascular rings (VRs) exhibit complex and diverse forms that are difficult to conceptualize using traditional two-dimensional (2D) schematic. Inexperienced medical...
BACKGROUND
Vascular rings (VRs) exhibit complex and diverse forms that are difficult to conceptualize using traditional two-dimensional (2D) schematic. Inexperienced medical students and parents who lack a medical technology background face significant challenges in understanding VRs. The purpose of this research is to develop three-dimensional (3D) printing models of VRs to provide new technical imaging support for medical education and parental consultation.
METHODS
This study included 42 fetuses diagnosed as VRs. Foetal echocardiography, modeling and 3D printing were performed, and the dimensional accuracy of models was analyzed. The value of 3D printing in the teaching of VRs was analyzed based on comparing the test results before and after the teaching intervention of 48 medical students and the satisfaction survey. A brief survey was conducted to 40 parents to assess the value of the 3D printed model in prenatal consultations.
RESULTS
Forty models of VRs were successfully obtained, which reproduced the anatomical shape of the VRs space with high dimensional accuracy. No differences in the prelecture test results were noted between the 3D printing group and the 2D image group. After the lecture, the knowledge of both groups improved, but the postlecture score and the change in the prelecture versus postlecture score were greater in the 3D printing group, and the subjective satisfaction survey feedback in the 3D printing group was also better (P < 0.05). Similar results were observed from the parental questionnaire, the vast majority of parents have an enthusiastic and positive attitude towards the use of 3D printed models and suggest using them in future prenatal consultations.
CONCLUSIONS
Three-dimensional printing technology providing a new tool for effectively displaying different types of foetal VRs. This tool helps physicians and families understand the complex structure of foetal great vessels, positively impacting medical instruction and prenatal counselling.
Topics: Female; Humans; Pregnancy; Education, Medical; Feasibility Studies; Fetus; Printing, Three-Dimensional; Vascular Ring
PubMed: 37194003
DOI: 10.1186/s12884-023-05683-6 -
Radiology Case Reports Mar 2023In this paper, we describe a rare case of double aortic arch with dominant right arch with focal narrowing of the distal left arch and descendent aorta's dilatation,...
In this paper, we describe a rare case of double aortic arch with dominant right arch with focal narrowing of the distal left arch and descendent aorta's dilatation, associated with pulmonary embolism and left subclavian steal syndrome, found in a 59-year-old woman with a history of dysphagia, chest discomfort, and left arm claudication. Diagnosis of this condition was made with a sub-optimal pulmonary CT-angiography with a combination of characteristic features of double aortic arch and vascular rings. Being aware of these conditions is crucial to avoid misclassification and surgical and endovascular complications.
PubMed: 36636482
DOI: 10.1016/j.radcr.2022.11.040 -
World Journal For Pediatric &... May 2024Circumflex aorta is described as a retroesophageal aortic arch, with opposite-sided descending aorta forming a true vascular ring with ligamentum arteriosum. We report...
Circumflex aorta is described as a retroesophageal aortic arch, with opposite-sided descending aorta forming a true vascular ring with ligamentum arteriosum. We report two cases of right-sided circumflex aorta with varied clinical presentation. Computed tomography diagnosed this vascular ring anomaly. The patients were managed with the aortic uncrossing procedure as a primary surgical strategy. Preoperative diagnosis and thorough planning were essential for the successful outcome. The patients did not have any residual symptoms of tracheal and esophageal compression on follow up.
Topics: Humans; Aorta, Thoracic; Tomography, X-Ray Computed; Male; Vascular Ring; Female; Vascular Surgical Procedures
PubMed: 37769607
DOI: 10.1177/21501351231196500 -
Current Problems in Diagnostic Radiology 2015Airways compression by vascular structures is one of the important comorbidities of congenital heart disease with incidence of approximately 1%-2% in children. Airways... (Review)
Review
Airways compression by vascular structures is one of the important comorbidities of congenital heart disease with incidence of approximately 1%-2% in children. Airways compression is a consequence of abnormal configuration of the great vessels producing a vascular ring with enlargement of normal structures (pulmonary arteries or cardiac chambers) or because of surgery. A high index of suspicion for vascular airway compression is important in children with recurrent respiratory complaints. Early diagnosis and management are essential, as chronic airway compression causes significant morbidity. As the underlying anatomical patterns tend to be highly complex, presurgical imaging assessment is essential.
Topics: Airway Obstruction; Cardiovascular System; Child; Diagnostic Imaging; Heart Defects, Congenital; Humans
PubMed: 25998073
DOI: 10.1067/j.cpradiol.2015.04.005 -
Seminars in Thoracic and Cardiovascular... 2021
Topics: Humans; Vascular Ring
PubMed: 33181300
DOI: 10.1053/j.semtcvs.2020.10.013 -
Annals of Medicine and Surgery (2012) Sep 2021Congenital vascular rings are rare in adults. The management is challenging when vascular rings present with concomitant aortic aneurysm and Kommerall's diverticulum.
INTRODUCTION AND IMPORTANCE
Congenital vascular rings are rare in adults. The management is challenging when vascular rings present with concomitant aortic aneurysm and Kommerall's diverticulum.
CASE PRESENTATION
We present a 68year old patient with a congenital vascular ring in the form of right sided aortic arch, with a retroesophageal left subclavian artery arising from an aneurysmal Kommerell's diverticulum. In addition, the patient had aneurysmal distal aortic arch and proximal descending aorta, causing severe symptomatic tracheal compression. The patient was successfully managed by debranching and reimplantation of head neck vessels to the ascending aorta through a median sternotomy, and concurrent endovascular stenting of the aneurysmal aorta.
CLINICAL DISCUSSION
A combination of complete vascular rings and aortic arch aneurysm poses a potentially higher surgical risk. The use of the less invasive endovascular stenting of the aorta as well as a limited open surgical approach offers a lesser risk, especially in poor pre-operative states.
CONCLUSION
A multidisciplinary team effort is key. Hybrid management of aneurysmal congenital vascular rings in high risk adults offers an attractive management alternative to conventional surgery.
PubMed: 34527233
DOI: 10.1016/j.amsu.2021.102778 -
Materials Today. Bio Dec 2022The tumor microenvironment (TME), consisting of extracellular matrix, proteins, stromal cells, and a vascular system, is reported to have a key role in cancer...
The tumor microenvironment (TME), consisting of extracellular matrix, proteins, stromal cells, and a vascular system, is reported to have a key role in cancer progression and prognosis. Thereby, the interaction between the vascular network and tumor mass is an important feature of the TME since the anticancer agents which are delivered to the TME can trigger the vascular response and influence the therapeutic outcome of the treatment. To identify and develop new therapeutic strategies, 3D models that recapitulate the complexity of the TME are urgently needed. Among them, vascularized tumor models are a promising approach, allowing to target tumor angiogenesis and reduce tumor growth. By using sound patterning, cells can be condensed locally into highly reproducible patterns through the action of mild hydrodynamic forces. Here, we use a soundwave-driven cell assembly approach to create a ring-shaped microcapillary network in fibrin hydrogel. Then, we generate a 3D vascularized tumor model by combining a tumor heterotypic spheroid, consisting of fibroblasts and Malignant Pleural Mesothelioma (MPM) cells, with the surrounding vascular ring. Based on its shape, we name it Saturn-like vascularized Tumor Model (STM). The growth of the microcapillary network is monitored over time by fluorescence imaging. The area covered by the microcapillary network, and its continuous increase in presence of the heterotypic tumor spheroid was monitored. Interestingly, this effect is enhanced when treating the STM with the anticancer agent Cisplatin. Overall, we show the use of sound patterning as a fast and cell-friendly approach to spatially organize and condense cells, to generate a 3D platform from which simple readouts of drug tests can be extracted by image analysis, with the potential to provide a model system for tailored tumor therapy.
PubMed: 35880098
DOI: 10.1016/j.mtbio.2022.100357