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The New England Journal of Medicine Oct 2021
Review
Topics: Aorta, Abdominal; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Computed Tomography Angiography; Endovascular Procedures; Guidelines as Topic; Humans; Male; Middle Aged; Ultrasonography, Doppler, Duplex; Vascular Grafting; Watchful Waiting
PubMed: 34706173
DOI: 10.1056/NEJMcp2108504 -
La Revue de Medecine Interne Feb 2023Chronic periaortitis (CP) is a rare disease characterised by the presence of a fibro-inflammatory tissue typically enveloping the abdominal aorta, the iliac arteries... (Review)
Review
Chronic periaortitis (CP) is a rare disease characterised by the presence of a fibro-inflammatory tissue typically enveloping the abdominal aorta, the iliac arteries and, in some cases, the nearby structures, such as the ureters and the inferior vena cava. Imaging plays a key role in the diagnosis and follow-up: computed tomography and magnetic resonance imaging scans are used to define the extension of the pathological tissue, whereas fluorodeoxyglucose positron emission tomography is the gold standard to establish the degree of its metabolic activity. CP must be distinguished from secondary forms of periaortic infiltration, which include malignant, infectious, and drug-related aetiologies. This review focuses on the clinical aspects of CP and the differential diagnosis with secondary cases, and aims to provide the clinician with a guide through this challenging clinical approach.
Topics: Humans; Retroperitoneal Fibrosis; Aorta, Abdominal; Tomography, X-Ray Computed; Diagnosis, Differential; Magnetic Resonance Imaging
PubMed: 36697342
DOI: 10.1016/j.revmed.2022.11.009 -
Journal of Minimally Invasive Gynecology Oct 2021
Topics: Aorta; Aorta, Abdominal; Humans
PubMed: 33933658
DOI: 10.1016/j.jmig.2021.04.015 -
Current Cardiology Reviews 2023Pseudocoarctaion of the aorta is a rare congenital anomaly occurring in isolation or with other congenital heart diseases. The anatomical basis of the condition is... (Review)
Review
Pseudocoarctaion of the aorta is a rare congenital anomaly occurring in isolation or with other congenital heart diseases. The anatomical basis of the condition is linked to an elongated, redundant aorta which may affect the arch, or the abdominal aorta rarely giving rise to kink and buckling without causing any significant functional stenosis. It should be carefully differentiated from the common true coarctation of the aorta. No clinical features are specific to pseudo coarctation and are often diagnosed incidentally. Although asymptomatic in the majority, few patients can have nonspecific symptoms and complications due to aneurysm formation, dissection, or rupture of the aorta. Hence Pseudocoarctaion should be closely followed for the onset of symptoms or possible complications. Without recommendations, no specific therapy is indicated in asymptomatic patients, although symptoms and complications warrant definitive treatment. As the natural history of the disease is unknown, the condition, when diagnosed, should be closely followed up for the occurrence of any complications. This article reports a pseudo aortic coarctation involving the arch and a brief literature review of this rare congenital anomaly.
Topics: Humans; Aorta, Abdominal; Aortic Coarctation; Heart Defects, Congenital
PubMed: 36999416
DOI: 10.2174/1573403X19666230329135028 -
Journal of Vascular Surgery Aug 2022Abdominal aortic coarctation and hypoplasia are uncommon diseases, recognized most often in pediatric-aged individuals. Comprehensive studies regarding the pathologic... (Review)
Review
OBJECTIVES
Abdominal aortic coarctation and hypoplasia are uncommon diseases, recognized most often in pediatric-aged individuals. Comprehensive studies regarding the pathologic spectrum of these aortopathies are nonexistent. This investigation was undertaken to better define the histologic and morphologic character of abdominal aortic narrowings affecting children and assess its potential relevance to contemporary clinical practice.
METHODS
Aortic specimens obtained during open operations in children being treated for symptomatic, noninflammatory abdominal aortic narrowings at the University of Michigan were subjected to histologic study after hematoxylin and eosin, Movat, Verhoeff Van Gieson, and Masson's trichrome preparations. Microscopic findings were correlated with the anatomic aortic images. In addition, a detailed review was completed of all prior reports in the English literature that included images depicting the histologic character of noninflammatory abdominal aortic narrowings in children.
RESULTS
Among a series of 67 pediatric-aged individuals undergoing open surgical interventions for abdominal aortic narrowings, eight children ranging in age from 9 months to 18 years, had adequate aortic tissue available for study. The loci of the specimens paralleled the anatomic sites of segmental coarctations observed in the entire series, with involvement of the suprarenal abdominal aorta (n = 3), intrarenal aorta (n = 2), and infrarenal aorta (n = 1). Diffusely hypoplastic abdominal aortas (n = 2) included one case of a de facto aortic duplication, represented by a channel that paralleled the narrow native aorta and gave origin to celiac artery branches, as well as the superior mesenteric and renal arteries. Concentric or eccentric intimal fibroplasia was observed in every aorta, often with internal elastic fragmentation and duplication (n = 4). Media abnormalities included elastic tissue disorganization (n = 3) and focal medial fibrosis (n = 1). Organizing luminal thrombus occurred in two infants. Coexistent ostial stenoses of the celiac, superior mesenteric, or renal arteries were observed in all but the only child who had an infrarenal aortic coarctation. Neurofibromatosis type 1 affected one child whose histologic findings were indistinguishable from those of the other children. A review of prior published histologic images of abdominal aortic coarctation and hypoplasia affecting children from other centers revealed a total of 14 separate reports, each limited to single case photomicrographs, of which 11 exhibited intimal fibroplasia.
CONCLUSIONS
Intimal fibroplasia is a common accompaniment of developmental abdominal aortic coarctation and hypoplasia. It is posited that intimal fibroplasia, which is likely progressive in instances of abnormal shear stresses in these diminutive vessels, may contribute to less salutary outcomes after endovascular and certain open reconstructions of pediatric abdominal aortic narrowings.
Topics: Adolescent; Aorta, Abdominal; Aortic Coarctation; Child; Child, Preschool; Humans; Infant; Plastic Surgery Procedures
PubMed: 35149163
DOI: 10.1016/j.jvs.2022.01.121 -
Atherosclerosis Mar 2020Abdominal aortic aneurysms (AAA) pose a considerable health burden and at present are only managed surgically since there is no proven pharmacotherapy that will retard... (Review)
Review
Abdominal aortic aneurysms (AAA) pose a considerable health burden and at present are only managed surgically since there is no proven pharmacotherapy that will retard their expansion or reduce the incidence of fatal rupture. This pathology shares several pathophysiological mechanisms with atherosclerosis, such as macrophage infiltration, inflammation, and degradation of extracellular matrix. Therefore, therapeutic targets proven effective in the treatment of atherosclerosis could also be considered for treatment of AAA. Different members of the nuclear receptor (NR) superfamily have been extensively studied as potential targets in the treatment of cardiovascular disease (CVD) and therefore might also be suited for AAA treatment. In this context, this review summarizes the role of different NRs in CVD, mostly atherosclerosis, and discusses in detail the current knowledge of their implications in AAA. From this overview it becomes apparent that NRs that were attributed a beneficial or adverse role in CVD have similar roles in AAA. Together, this overview provides compelling evidence to consider several NRs as attractive targets for future treatment of AAA.
Topics: Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Atherosclerosis; Cardiovascular Agents; Humans; Receptors, Cytoplasmic and Nuclear; Signal Transduction
PubMed: 32105947
DOI: 10.1016/j.atherosclerosis.2020.02.009 -
Vascular Aug 2022To elucidate the epidemiology, anatomical, presentation, classification, pathology, investigative modalities, management and prognosis of primary angiosarcoma of the...
PURPOSE
To elucidate the epidemiology, anatomical, presentation, classification, pathology, investigative modalities, management and prognosis of primary angiosarcoma of the aorta.
MATERIAL AND METHODS
A systematic review of literature from the database inception to January 2021 in PubMed and Embase, CINAHL and Cochrane Library in accordance to PRISMA was conducted. Retrieval and extraction was performed by two independent reviewers. The hierarchy of the evidence was assessed through the National Institute for Health and Care Excellence Checklist. Data were subjected to pooled prevalence analysis, Kaplan-Meier survival and test of probability using log-rank analysis. This review is registered with International Prospective Register of Systematic Reviews: RD42021231314.
RESULTS
82 studies with = 123 cases met the inclusion criterion. Abdominal (45%) aorta was the commonest anatomical site with female predominance in ascending aorta (4:1) and aortic arch (2:1). The longest survival was in the ascending aorta and the shortest in the abdominal aorta [540 (interquartile range [IQR], 7-1560 days vs. 180 (IQR, 1-5730 days)], respectively. The overall median survival was 210 days (IQR, 1-5730 days) or 7 months. Lack of metastasis (47%) was a marker of longer survival ( < 0.03) irrespective of other attributes.
CONCLUSION
The pathophysiology appears to be a trend of increasing fatigue, fever and weight loss associated with segmental dysfunction of the aorta projecting occlusive or destructive phenotypes. Computed tomography angiography features of volume-occupying, bulky, polypoid (intraluminal), protrusive vegetation, hyper vascular without atherosclerotic lesions are extremely suggestive of PA of the aorta at 5th and 6th decades of life.
Topics: Aorta, Abdominal; Aorta, Thoracic; Computed Tomography Angiography; Female; Hemangiosarcoma; Humans; Male; Tomography, X-Ray Computed
PubMed: 34238080
DOI: 10.1177/17085381211026491 -
Tidsskrift For Den Norske Laegeforening... Dec 2020
Topics: Aorta; Aorta, Abdominal; Humans
PubMed: 33322885
DOI: 10.4045/tidsskr.20.0921 -
Infection Dec 2019Non-typhoidal Salmonella (NTS) spp. causes about 40% of all infective aortitis and it is characterized by high morbidity and mortality. Human infection occurs by...
Non-typhoidal Salmonella (NTS) spp. causes about 40% of all infective aortitis and it is characterized by high morbidity and mortality. Human infection occurs by fecal-oral transmission through ingestion of contaminated food, milk, or water (inter-human or zoonotic transmission). Approximately 5% of patients with NTS gastroenteritis develop bacteremia and the incidence of extra-intestinal focal infection in NTS bacteremia is about 40%. The organism can reach an extra-intestinal focus through blood dissemination, direct extension from the surrounding organs and direct bacterial inoculation (e.g. invasive medical procedures). Medical and surgical interventions are both needed to successfully control the infection. Here, we report a case of abdominal sub-renal aortitis caused by Salmonella enterica serovar Enteritidis in an 80-year-old man.
Topics: Aged, 80 and over; Aorta, Abdominal; Aortitis; Humans; Italy; Male; Salmonella Infections; Salmonella enteritidis; Treatment Outcome
PubMed: 31321641
DOI: 10.1007/s15010-019-01344-z -
Anatomia, Histologia, Embryologia Nov 2022The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk,...
The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk, abdominal aorta, renal artery and lumbar artery. These are classified into three types: cranial, middle and caudal adrenal branches. It is also known that the adrenal vein flows into the phrenicoabdominal vein. However, individual differences in the branching pattern of adrenal vessels have not been systematically analysed. We evaluated adrenal vessels in dogs that underwent contrast-enhanced abdominal computed tomography (CT). There were 255 arteries travelling to the adrenal glands in 47 cases, with 1-6 arteries travelling per adrenal gland. The arteries included 67 caudal phrenic arteries, 62 aortic arteries, 60 cranial abdominal arteries, 39 renal arteries, 12 phrenicoabdominal trunks, 8 cranial mesenteric arteries, 6 celiac arteries and 1 lumbar artery. Most of the branches were from the aorta and caudal phrenic artery on the left side, and the cranial abdominal and caudal phrenic artery on the right side. A total of 110 adrenal veins were identified. Inflow into the phrenicoabdominal vein and into the right and left renal veins was observed, and we identified no inflow into other veins. This study demonstrated two points: laterality and individual differences in adrenal blood vessels. When evaluating adrenal blood vessels with abdominal contrast-enhanced CT, it is recommended to take images under general anaesthesia with breath-holding and observe them using multiplanar reconstruction.
Topics: Dogs; Animals; Renal Artery; Abdomen; Aorta, Abdominal; Renal Veins; Adrenal Glands
PubMed: 36047693
DOI: 10.1111/ahe.12858