-
European Journal of Vascular and... May 2022Brucellosis is the most common zoonosis worldwide. Although cardiovascular complications in human brucellosis comprise only 3% of morbidity, they are the principal cause... (Review)
Review
OBJECTIVE
Brucellosis is the most common zoonosis worldwide. Although cardiovascular complications in human brucellosis comprise only 3% of morbidity, they are the principal cause of death. Endocarditis covers the majority of these cases. Infected aneurysms and ulcerative processes of the aorta are rare but can be life threatening as well. Currently, limited information is available about aortic and iliac involvement in brucellosis.
METHODS
A PubMed, Web of Science, and AccessMedicine search (without restriction on language or year of publication) was performed to identify relevant articles on aortic and iliac involvement in brucellosis. Case reports were eligible for inclusion if they reported on thoracic, abdominal, or iliac aortic pathology caused by Brucella.
RESULTS
Seventy-one cases were identified over the last 70 years, with an overall mortality rate of 22%. Most of the patients were male (86%) and had a history of Brucella exposure (66%). Approximately one quarter (23%) contracted Brucella while travelling in a (hyper)endemic region. Almost half of the infections were located in the abdominal aorta (49%), followed by the ascending (37%) and descending (13%) thoracic aorta. Infected aneurysms (61%) and ulcerative processes (16%) were seen most frequently. Aortic rupture was present in 31% of cases and occurred mainly in the abdominal (49%) and descending thoracic aorta (44%). The majority of all patients (59%) underwent open surgery combined with long term antibiotics. Over the past 15 years, a trend towards endovascular treatment was observed.
CONCLUSION
Although aortic and iliac involvement in brucellosis is rare, it can be a life threatening manifestation. Due to low awareness, this infection may represent an under reported disease. The therapeutic cornerstone in these cases remains open surgery combined with antibiotics. The role of endovascular treatment is yet to be decided, in which the condition of the patient and the risks of long term complications need to be considered.
Topics: Aneurysm, Infected; Anti-Bacterial Agents; Aorta, Abdominal; Aortic Rupture; Brucellosis; Female; Humans; Male
PubMed: 35282998
DOI: 10.1016/j.ejvs.2022.02.004 -
Arteriosclerosis, Thrombosis, and... Dec 2019
Review
Topics: Animals; Aorta, Abdominal; Cell Movement; Cell Proliferation; Cells, Cultured; Gene Expression Regulation; Humans; MicroRNAs; Muscle, Smooth, Vascular; Nuclear Proteins; Phenotype; Signal Transduction; Trans-Activators; Transcription, Genetic; Vascular Diseases; Vascular Remodeling
PubMed: 31770033
DOI: 10.1161/ATVBAHA.119.312581 -
Cirugia Espanola Oct 2021Access to the abdominal aorta and its visceral trunks is possible through several approaches. Dissections of five cadavers performed during three National Surgical...
Access to the abdominal aorta and its visceral trunks is possible through several approaches. Dissections of five cadavers performed during three National Surgical Anatomy courses applied to Aorta, Hepatobiliopancreatic and Digestive Surgery. Videos and pictures were taken throughout the dissections and showed different abdominal aorta approaches. Abdominal aorta and visceral trunks approaches: longitudinal inframesocolic access, supraceliac clamping, celiac trunk dissection, superior mesenteric artery approaches (retroperitoneal after Kocher menoeuvre, supramesocolic or inframesocolic), Cattell-Braasch manoeuvre and mattox manoeuvre: retrorenal and prerenal. Correct knowledge of the intraabdominal anatomy is necessary to perform all the abdominal aorta surgical approaches. Cadaveric dissection could help to achieve this objective. Cardiovascular and digestive surgeons need to know the possible strategies in order to choose the one which is best suited for each patient.
Topics: Aorta, Abdominal; Cadaver; Celiac Artery; Dissection; Humans; Mesenteric Artery, Superior
PubMed: 34538636
DOI: 10.1016/j.cireng.2021.08.002 -
American Journal of Physiology. Heart... Apr 2021The surface of vascular endothelial cells (ECs) is covered by a protective negatively charged layer known as the endothelial glycocalyx. Herein, we hypothesized its...
The surface of vascular endothelial cells (ECs) is covered by a protective negatively charged layer known as the endothelial glycocalyx. Herein, we hypothesized its transport barrier and mechanosensory role in transmural water flux and low-density lipoprotein (LDL) transport in an isolated rat abdominal aorta perfused under 85 mmHg and 20 dyn/cm ex vivo. The endothelial glycocalyx was digested by hyaluronidase (HAase) from bovine tests. Water infiltration velocity () was measured by a graduated pipette. LDL coverage and mean maximum infiltration distance (MMID) in the vessel wall were quantified by confocal laser scanning microscopy. EC apoptosis was determined by the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) technique, and leaky junction rates were evaluated by electron microscopy. The results showed that a 42% degradation of the endothelial glycocalyx by HAase treatment increased , LDL coverage, and MMID. Shear stress increased , which cannot be inhibited by HAase treatment. Four hour-shear application increased about fourfolds of LDL coverage, whereas exerted no significant effects on its MMID, EC apoptosis, and the leaky junctions. On the contrary, 24-h shear exposure has no significant effects on LDL coverage, whereas increased 2.74-folds of MMID and about 53% of EC apoptotic rates that could be inhibited by HAase treatment. These results suggest endothelial glycocalyx acts as a transport barrier by decreasing water and LDL transport, as well as a mechanosensor of shear to regulate EC apoptosis, thus affecting leaky junctions and regulating LDL transport into the vessel wall. A 42% degradation of the endothelial glycocalyx by hyaluronidase of the isolated rat abdominal aorta facilitated water and LDL transport across the vessel wall, suggesting endothelial glycocalyx as a transport barrier. A 24-h shear exposure increased LDL mean maximum infiltration distance, and enhanced EC apoptosis, which could be both inhibited by hyaluronidase treatment, suggesting endothelial glycocalyx may also act as a mechanosensor of shear to regulate EC apoptosis, thus affecting leaky junctions and regulating LDL transport.
Topics: Animals; Aorta, Abdominal; Apoptosis; Biological Transport; Endothelial Cells; Glycocalyx; Hyaluronoglucosaminidase; In Vitro Techniques; Lipoproteins, LDL; Male; Mechanotransduction, Cellular; Permeability; Rats, Sprague-Dawley; Regional Blood Flow; Stress, Mechanical; Water; Rats
PubMed: 33710913
DOI: 10.1152/ajpheart.00861.2020 -
Annals of Nuclear Medicine Aug 2022To analyze the characteristics of blood flow perfusion images at different injection levels to establish an evaluation standard for renal dynamic imaging injection...
OBJECTIVE
To analyze the characteristics of blood flow perfusion images at different injection levels to establish an evaluation standard for renal dynamic imaging injection quality and reduce misdiagnosis.
METHODS
Data from 140 single-photon emission computed tomography renal dynamic imaging, collected in our hospital, were retrospectively analyzed. The scans were divided into four groups according to the injection quality: total leakage of the imaging agent (group A), partial leakage (group B), poor bolus injection quality (group C), and good bolus injection quality (group D). The time of appearance and regression of the pulmonary blood perfusion phase, the peak time in the abdominal aorta, and the ratio between peak count and actual drug injection count were analyzed. The renal dynamic imaging was repeated in low-quality examinations, and the comparison between the two exams provided the misdiagnosis rate caused by inadequate injections.
RESULTS
The images of the lungs and abdominal aorta in group A were blurred and indistinguishable; thus, these exams were unreliable. Both appearance and fading time of the bilateral lung shadows were significantly different between groups B, C, and D (p = 0.002 and p = 0.003, respectively). The peak time and peak counting ratio in the abdominal aorta were also significantly different between these groups (p = 0.002 and p < 0.001, respectively). The misdiagnosis rates of renal dynamic imaging in groups A, B, and C due to the different injection levels were significantly different at 94.29%, 77.14%, and 18.29%, respectively.
CONCLUSIONS
The times of appearance and regression of the lung shadows and the peak time and peak count ratio in the abdominal aorta in the dynamic renal imaging perfusion phase can help assess the imaging agent injection quality and identify the need for a repeated examination. Improving the imaging agent injection quality can effectively reduce the renal function misdiagnosis rate.
Topics: Aorta, Abdominal; Contrast Media; Humans; Kidney; Lung; Retrospective Studies; Tomography, Emission-Computed, Single-Photon
PubMed: 35729486
DOI: 10.1007/s12149-022-01750-8 -
The Journal of Trauma and Acute Care... Sep 2020Rapid control of abdominal hemorrhage is a potentially life-saving surgical skill. Although open exposure and control of the abdominal aorta and its visceral branches is...
BACKGROUND
Rapid control of abdominal hemorrhage is a potentially life-saving surgical skill. Although open exposure and control of the abdominal aorta and its visceral branches is a fundamental part of surgical training, familiarity with the anatomy and spacial relationships of the surrounding structures can be challenging for even the experienced surgeon.
CONTENT (DESCRIPTION OF VIDEO)
Using a fresh perfused cadaver, this video provides a step by step visual guide for aortic exposure from the diaphragmatic hiatus to the iliac bifurcation. Key maneuvers including control of the supraceliac aorta, left medial visceral rotation with identification of superior mesenteric and celiac arteries, and exposure of the perirenal aorta and proximal renal vessels are outlined. Damage control and definitive management strategies are discussed and potential tips and pitfalls in addressing intraabdominal hemorrhage are highlighted.
CONCLUSION
The critical application of aortic exposure for hemorrhage control is a life-saving intervention if done rapidly and effectively. This requires a sound understanding of aortic anatomy and necessary steps for adequate exposure and subsequent repair. This video outlines the necessary steps to perform these interventions.
Topics: Abdomen; Aorta, Abdominal; Cadaver; Hemorrhage; Humans; Rotation; Viscera
PubMed: 32833414
DOI: 10.1097/TA.0000000000002803 -
Methods in Molecular Biology (Clifton,... 2022Arterial bypass grafts are a standard preclinical model for evaluating physiology and pathophysiology at graft-material interfaces. Implantations of vascular grafts are...
Arterial bypass grafts are a standard preclinical model for evaluating physiology and pathophysiology at graft-material interfaces. Implantations of vascular grafts are commonly done as end-to-end grafts in small animal models. Here we detail bilateral end-to-side aortoiliac graft implantation, which requires open surgery and the creation of vascular anastomoses between the graft material and the infrarenal aorta and iliac artery in a nonhuman primate model. In this model, the aortoiliac graft configuration is created using two 4 mm inner diameter vascular grafts (e.g., ePTFE). After exposure and control of the infrarenal aorta and bilateral common iliac arteries and heparinization, the proximal aortic-graft anastomosis is sewn on the lateral wall of the aorta, and subsequently the distal graft-common iliac anastomosis is sewn on the anterior wall of the common iliac artery with one tube graft. Another tube graft is sewn on the contralateral side in the same manner.
Topics: Anastomosis, Surgical; Animals; Aorta, Abdominal; Blood Vessel Prosthesis; Iliac Artery
PubMed: 34591310
DOI: 10.1007/978-1-0716-1708-3_17 -
Clinical Radiology May 2024To explore the possibility of a neural network-based method for quantifying calcifications of the abdominal aorta and its branches.
AIM
To explore the possibility of a neural network-based method for quantifying calcifications of the abdominal aorta and its branches.
MATERIALS AND METHODS
In total, 58 computed tomography (CT) angiography volumes were selected from a dataset of 609 to represent different stages of sclerosis. The ground truth segmentations of the abdominal aorta, coeliac trunk, superior mesenteric artery, renal arteries, common iliac arteries, and their calcifications were delineated manually. Two V-Net ensemble models were trained, one for segmenting arteries of interest and another for calcifications. The branches of interest were shortened algorithmically. The volumes of calcification were then evaluated from the arteries of interest.
RESULTS
The results indicate that automatic detection is possible with a high correlation to the ground truth. The scores for the ensemble calcification model were dice score of 0.69 and volumetric similarity (VS) of 0.80 and for the arteries of interest segmentations: aorta: dice 0.96, VS 0.98; aortic branches: dice 0.74, VS 0.87; and common iliac arteries: dice 0.72, VS 0.91.
CONCLUSIONS
The presented neural network model is the first to be capable of automatically segmenting, in addition to calcification, both the aorta and its branches from contrast-enhanced CT angiography. This technology shows promise in addressing limitations inherent in earlier methods that relied solely on plain CT.
Topics: Humans; Aorta, Abdominal; Deep Learning; Calcinosis; Computed Tomography Angiography; Renal Artery
PubMed: 38365540
DOI: 10.1016/j.crad.2024.01.023 -
Surgical and Radiologic Anatomy : SRA Mar 2022Although lumbar discectomy is the most common procedure in spine surgery, reports about anatomical relations between discs and prevertebral vessels are limited. Aim of...
PURPOSE
Although lumbar discectomy is the most common procedure in spine surgery, reports about anatomical relations between discs and prevertebral vessels are limited. Aim of this research was to investigate morphometric of the lumbar region and the relations between intervertebral discs (IVDs) and abdominal aorta.
METHODS
557 abdominal computed tomography scans were assessed. For each spinal column level from Th12/L1 down to L4/L5, we investigated: intervertebral disc's and vertebra's height, width, length, and distance from aorta or common iliac artery (CIA). Those arteries were also measured in two dimensions and classified based on location.
RESULTS
54.58% of patients were male. There was a significant difference in arterial-disc distances (ADDs) between genders at the levels: L1/L2 (1.32 ± 1.97 vs. 0.96 ± 1.78 mm; p = 0.0194), L2/L3 (1.97 ± 2.16 vs. 1.15 ± 2.01 mm; p < 0.0001), L3/L4 (2.54 ± 2.78 vs. 1.71 ± 2.61 mm; p = 0.0012), also for both CIAs (left CIA 3.64 ± 3.63 vs. 2.6 ± 3.06 mm; p = 0.0004 and right CIA: 7.96 ± 5.06 vs. 5.8 ± 4.57 mm; p < 0.001)-those ADDs were higher in men at all levels. The length and width of IVD increased alongside with disc level with the maximum at L4/L5.
CONCLUSION
Bifurcations of the aorta in most cases occurred at the L4 level. Collected data suggest that at the highest lumbar levels, there is a greater possibility to cause injury of the aorta due to its close anatomical relationship with discs. Females have limited, in comparison to males, ADD at L1/L2, L2/L3, and L3/L4 levels what should be taken into consideration during preoperative planning of surgical intervention.
Topics: Aorta, Abdominal; Female; Humans; Intervertebral Disc; Lumbar Vertebrae; Lumbosacral Region; Male; Tomography, X-Ray Computed
PubMed: 34874459
DOI: 10.1007/s00276-021-02865-9 -
Ethiopian Journal of Health Sciences Oct 2022Mean aortic and common iliac artery diameters are the best indicators for the diagnosis of aortic and iliac ectasia and aneurysm, as well as the appropriate selection of...
BACKGROUND
Mean aortic and common iliac artery diameters are the best indicators for the diagnosis of aortic and iliac ectasia and aneurysm, as well as the appropriate selection of angiographic catheter size and grafts for endovascular procedures. Currently, there is a lack of evidence regarding the normal abdominal aortic and common iliac artery diameters in Ethiopian adults. This study aimed to assess the mean diameter and associated factors of the abdominal aorta and common iliac arteries on abdominal CT scans of Ethiopian adults visiting Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
METHODS
Institution-based prospective cross-sectional study was conducted. A convenience sampling method was employed. Data were collected from consecutive eligible adults who came for abdominal CT scans during the study period, using interviewer-administered structured questionnaires. The data was cleaned and analyzed using SPSS version 22. Student t-test and Pearson correlation were used to perform statistical analysis and the results were presented using tables and figures.
RESULTS
There were a total of 136 study participants of whom eighty-one(59.6%) were females and fifty-five (40.4%) were males. The mean age was 48.5 ± 13 with a range of 23 to77 years. The mean transverse diameter of the aorta at the aortic hiatus (T12)level was 2.30 ± 0.25cm in males and 2.03±0.19cm in females. The mean transverse diameter of the suprarenal aorta was 2.04 ± 0.21cm in males and 1.83 ± 0.21 cm in females while the infrarenal one was 1.77 ± 0.16cm in males and 1.54 ± 0.15cm in females. Participants who are male and older with large body Surface Area were found to have relatively larger aortic and iliac diameters.
CONCLUSION
In this study, the mean diameter of the aorta and common iliac artery was significantly associated with age, sex, and BSA.
Topics: Adult; Female; Male; Humans; Young Adult; Aorta, Abdominal; Iliac Artery; Cross-Sectional Studies; Ethiopia; Prospective Studies; Tomography, X-Ray Computed
PubMed: 36339953
DOI: 10.4314/ejhs.v32i1.4S