-
Anatomia, Histologia, Embryologia Nov 2023Understanding the cardiovascular system is fundamental in diagnosing pathologies and interpreting exams, such as contrast radiographs. In this context, the present study...
Understanding the cardiovascular system is fundamental in diagnosing pathologies and interpreting exams, such as contrast radiographs. In this context, the present study describes the collateral abdominal aorta artery branches of red-rumped agouti. Ten red-rumped agoutis, six males and four females, were assessed. The vascular system was perfused with Neoprene 450 latex coloured with a yellow pigment, dissected and analysed. Three euthanized animals were perfused with a barium sulfate solution (1 g mL ) associated with latex Neoprene 450 at a 1:3 ratio to obtain contrast-enhanced radiographs. The abdominal aorta emitted the celiac artery, which in turn originated the left gastric, hepatic and splenic arteries. The second collateral branch comprised the cranial mesenteric artery, followed by the renal arteries, which emitted the adrenal arteries, with the caudal emergence of the gonadal arteries. The caudal mesenteric artery appeared in a caudal direction. The abdominal aorta divided after reaching the pelvic cavity entrance, originating the right and left common iliac arteries. Before its bifurcation, the abdominal aorta dorsocaudally emitted its last collateral branch, the median sacral artery. The collateral branches of the aorta, therefore, resemble previously described rodent patterns, with few variations.
Topics: Male; Female; Animals; Dasyproctidae; Latex; Neoprene; Aorta, Abdominal; Renal Artery; Rodentia; Cuniculidae; Contrast Media
PubMed: 37649409
DOI: 10.1111/ahe.12957 -
European Journal of Preventive... May 2022
Ultrasound screening of the abdominal aorta: is it time to include it in the standard echocardiographic evaluation of men aged ≥60 years with clinical manifest vascular diseases?
Topics: Aorta, Abdominal; Aortic Aneurysm, Abdominal; Echocardiography; Humans; Male; Mass Screening; Ultrasonography
PubMed: 33624019
DOI: 10.1093/eurjpc/zwaa025 -
Autoimmunity Reviews Mar 2023Abdominal aortic aneurysm (AAA) occupies a large part of aorta aneurysm, and if there's no timely intervention or treatment, the risks of rupture and death would rise... (Review)
Review
Abdominal aortic aneurysm (AAA) occupies a large part of aorta aneurysm, and if there's no timely intervention or treatment, the risks of rupture and death would rise sharply. With the depth of research in AAA, more and more evidence showed correlations between AAA and autoimmune injury. Currently, a variety of bioactive peptides and cells have been confirmed to be related with AAA progression. Despite the tremendous progress, more than half researches were sampling from lesion tissues, which would be difficult to obtain. Given that the intrusiveness and convenience, serological test take advantages in initial diagnosis. Here we review blood biomarkers associated with autoimmune injury work in AAA evolution, aiming to make a profile on blood immune substances of AAA and provide a thought for potential clinical practice.
Topics: Humans; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Biomarkers
PubMed: 36563768
DOI: 10.1016/j.autrev.2022.103258 -
The Journal of Cardiovascular Surgery Aug 2023Open aortic reconstruction for complex aortoiliac occlusive disease is a time-honored and durable solution. Symptoms manifest as disabling claudication or chronic limb... (Review)
Review
Open aortic reconstruction for complex aortoiliac occlusive disease is a time-honored and durable solution. Symptoms manifest as disabling claudication or chronic limb threatening ischemia in patients with multilevel disease. Advanced endovascular techniques have supplanted a large volume of aortic surgery. Nonetheless, it is essential for surgeons-in-training to learn and hone their skills in open aortic surgery. Comprehensive literature review over the past 50 years was conducted on the topics of "aortic occlusive disease," "aortic bypass," and "iliofemoral bypass." Pertinent articles were selected for inclusion as references. The technical aspects of the various aortoiliac exposures are described and selected case images were chosen from the senior author's experience. This review paper details the various operative approaches to open aortoiliac revascularization with emphasis on "tips and tricks" for the learner.
Topics: Humans; Arterial Occlusive Diseases; Aorta, Abdominal; Intermittent Claudication; Endovascular Procedures; Aortic Diseases; Iliac Artery; Treatment Outcome; Retrospective Studies; Vascular Patency
PubMed: 37162241
DOI: 10.23736/S0021-9509.23.12680-2 -
Journal of Ultrasound in Medicine :... Nov 2021The four-dimensional ultrasound (4D-US) enables imaging of the aortic segment and simultaneous determination of the wall expansion. The method shows a high spatial and...
OBJECTIVES
The four-dimensional ultrasound (4D-US) enables imaging of the aortic segment and simultaneous determination of the wall expansion. The method shows a high spatial and temporal resolution, but its in vivo reliability is so far unknown for low-measure values. The present study determines the intraobserver repeatability and interobserver reproducibility of 4D-US in the atherosclerotic and non-atherosclerotic infrarenal aorta.
METHODS
In all, 22 patients with non-aneurysmal aorta were examined by an experienced examiner and a medical student. After registration of 4D images, both the examiners marked the aortic wall manually before the commercially implemented speckle tracking algorithm was applied. The cyclic changes of the aortic diameter and circumferential strain were determined with the help of custom-made software. The reliability of 4D-US was tested by the intraclass correlation coefficient (ICC).
RESULTS
The 4D-US measurements showed very good reliability for the maximum aortic diameter and the circumferential strain for all patients and for the non-atherosclerotic aortae (ICC >0.7), but low reliability for circumferential strain in calcified aortae (ICC = 0.29). The observer- and masking-related variances for both maximum diameter and circumferential strain were close to zero.
CONCLUSIONS
Despite the low-measured values, the high spatial and temporal resolution of the 4D-US enables a reliable evaluation of cyclic diameter changes and circumferential strain in non-aneurysmal aortae independent from the observer experience but with some limitations for calcified aortae. The 4D-US opens up a new perspective with regard to noninvasive, in vivo assessment of kinematic properties of the vessel wall in the abdominal aorta.
Topics: Aorta, Abdominal; Humans; Imaging, Three-Dimensional; Observer Variation; Reproducibility of Results; Ultrasonography
PubMed: 33452839
DOI: 10.1002/jum.15622 -
Journal of Visualized Experiments : JoVE Feb 2022Abdominal aortic aneurysm (AAA), although primarily asymptomatic, is potentially life-threatening as the rupture of AAA usually has a devastating outcome. Currently,...
Abdominal aortic aneurysm (AAA), although primarily asymptomatic, is potentially life-threatening as the rupture of AAA usually has a devastating outcome. Currently, there are several distinct experimental models of AAA, each emphasizing a different aspect in the pathogenesis of AAA. The elastase-induced AAA model is the second most used rodent AAA model. This model involves direct infusion or application of porcine pancreatic elastase (PPE) to the infrarenal segment of the aorta. Due to technical challenges, most elastase-induced AAA model nowadays is performed with the external application rather than an intraluminal infusion of PPE. The infiltration of elastase will cause degradation of elastic lamellae in the medial layers, resulting in the loss of aortic wall integrity and subsequent dilation of the abdominal aorta. However, one disadvantage of the elastase-induced AAA model is the inevitable variation of how the surgery is performed. Specifically, the surgical technique of isolating the infrarenal segment of the aorta, the material used for aorta wrapping and PPE incubation, the enzymatic activity of PPE, and the time duration of PPE application can all be important determinants that affect the eventual AAA formation rate and aneurysm diameter. Notably, the difference in these factors from different studies on AAA can lead to reproducibility issues. This article describes a detailed surgical process of the elastase-induced AAA model through direct application of PPE to the adventitia of the infrarenal abdominal aorta in the mouse. Following this procedure, a stable AAA formation rate of around 80% in male and female mice is achievable. The consistency and reproducibility of AAA studies using an elastase-induced AAA model can be significantly enhanced by establishing a standard surgical procedure.
Topics: Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Disease Models, Animal; Female; Male; Mice; Mice, Inbred C57BL; Pancreatic Elastase; Reproducibility of Results; Swine
PubMed: 35225256
DOI: 10.3791/63608 -
VASA. Zeitschrift Fur Gefasskrankheiten Mar 2023The aim of this retrospective cross-sectional observational study was to determine differences of patients with multiple arterial aneurysms to patients with single... (Observational Study)
Observational Study
The aim of this retrospective cross-sectional observational study was to determine differences of patients with multiple arterial aneurysms to patients with single arterial aneurysms. Patients with the diagnosis of an arterial aneurysm from January 2006 to January 2016 in the department of vascular surgery Heidelberg were investigated. Excluded were patients with hereditary disorders of connective tissue or systemic inflammatory disease, as well as other arterial pathologies than true aneurysms. Patients with multiple aneurysms (defined by at least four aneurysms) were compared to patients with single aneurysms concerning age at initial diagnosis, sex and affected arterial site. To verify the findings, a replication of the study was performed at a comparable institution. Of 3107 patients with arterial aneurysms, 918 were excluded. Of the resulting 2189 patients, 1238 (56.6%) patients had a single, 808 (36.9%) two or three, and 143 (6.5%) at least four aneurysms (group ). Nine hundred seventy-two patients (44.4%) had a single abdominal aortic aneurysm (group ). Age at initial diagnosis differed between (66.7±9.5 y) and (69.1±8.6 y) (p=0.0338). Within , 138 patients (96.5%) were male, compared with 865 patients (89.0%) in (p=0.0041). The most frequent aneurysm localization shifted from the abdominal aorta and its branches in patients with a single aneurysm (n=1029; 83.1%) to pelvic and leg arteries in patients with at least four aneurysms (n=318; 63.2%). The replication of the study at the department of vascular surgery Frankfurt confirmed the younger age at initial diagnosis in (67.3±12.5 y) compared to (70.9±9.6 y) (p=0.0259) and the distribution shift toward the arteries below the aortic bifurcation in Patients with multiple aneurysms are younger at initial diagnosis and differ concerning aneurysm localization compared to patients with a single aneurysm.
Topics: Humans; Male; Female; Retrospective Studies; Cross-Sectional Studies; Aortic Aneurysm, Abdominal; Aorta, Abdominal; Arteries
PubMed: 36601699
DOI: 10.1024/0301-1526/a001050 -
Journal of Computer Assisted Tomography 2020To evaluate the agreement and correlation between attenuation values and vascular calcification volume for intra-abdominal structures from true noncontrast (TNC) images...
Abdominal Organs Attenuation Values and Abdominal Aortic Calcifications on Virtual and True Noncontrast Images Obtained With Third-Generation Dual-Source Dual-Energy Computed Tomography.
PURPOSE
To evaluate the agreement and correlation between attenuation values and vascular calcification volume for intra-abdominal structures from true noncontrast (TNC) images and those from virtual noncontrast (VNC) images obtained by dual-source dual-energy computed tomography (CT) using a quadriphasic dynamic protocol.
METHODS
Seventy-six patients who underwent quadriphasic abdominal CT were retrospectively reviewed. An arterial, portal venous, and 5-minute delayed phase postcontrast series was obtained using dual-source dual-energy CT. Virtual noncontrast images were processed from the arterial, portal venous, and 5-minute delayed phase series. Attenuation values for the liver, pancreas, kidneys, muscle, fat, vertebra, gallbladder, aorta, inferior vena cava, portal vein, and aortic calcification volumes were recorded. Attenuation values for the liver, pancreas, vertebra, and muscle obtained from VNC were adjusted using linear regression.
RESULTS
Repeated-measures analysis of variance and Bonferroni multiple-comparison post hoc correction revealed significant differences between TNC and VNC attenuation values for the organs. There was an excellent correlation between the TNC and VNC attenuation values for the liver, pancreas, muscle, vertebra, and fat. The calcification volume was significantly smaller on VNC than on TNC. The adjusted attenuation values estimated by regression equations afforded better approximation.
CONCLUSIONS
Abdominal VNC images obtained with third-generation dual-source dual-energy CT cannot replace TNC images without adjustment of the attenuation values.
Topics: Adult; Aged; Aged, 80 and over; Aorta, Abdominal; Contrast Media; Female; Humans; Linear Models; Liver; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Radiography, Dual-Energy Scanned Projection; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Vascular Calcification
PubMed: 32697520
DOI: 10.1097/RCT.0000000000001057 -
Annali Italiani Di Chirurgia 2023The surgical approach to the pararenal aorta can be performed through a midline laparotomy or retroperitoneal approach. The current paper reports the techniques for the...
AIM
The surgical approach to the pararenal aorta can be performed through a midline laparotomy or retroperitoneal approach. The current paper reports the techniques for the suprarenal aortic approach, through the review of technical literature on this topic.
METHODS
Forty-six out of 82 technical papers regarding the surgical approach to the suprarenal aorta were reviewed, focusing on relevant technical details, such as the position of patient, type of incision, aortic approach and anatomical limitations.
RESULTS
The left retroperitoneal abdominal approach offers numerous advantages, mainly observing some modifications of the original technique (9th intercostal space incision, short radial frenotomy, section of the inferior mesenteric artery). The traditional transperitoneal access, through a midline or bilateral subcostal incision with retroperitoneal medial visceral rotation, is best indicated when an unrestricted approach to the right iliac arteries is needed, but it can be more challenging in patients with "hostile abdomen", for which a retroperitoneal route is probably more appropriate. A more aggressive surgical approach through a 7th-9th space thoracolaparotomy, combined with semicircunferential frenotomy, should be strongly recommended to provide a safe suprarenal aortic aneurysm repair in high risk patients, who often require adjunctive procedures, such as selective visceral perfusion and left heart bypass.
CONCLUSIONS
Many technical options can be used to approach the suprarenal aorta, but none can be "radicalized". The surgical strategy must be individualized according to the anatomo-clinical characteristics of the patient and aneurysm morphology as well.
KEY WORDS
Abdominal aorta, Aortic aneurysm, Surgical approach.
Topics: Humans; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Abdomen; Aortic Aneurysm; Abdominal Muscles; Treatment Outcome
PubMed: 37203238
DOI: No ID Found -
Annals of Vascular Surgery Jul 2020Midaortic syndrome (MAS) is a rare congenital or acquired condition marked by segmental or diffuse stenosis of the distal thoracic and/or abdominal aorta and its...
BACKGROUND
Midaortic syndrome (MAS) is a rare congenital or acquired condition marked by segmental or diffuse stenosis of the distal thoracic and/or abdominal aorta and its branches. The optimal approach to medical or interventional management of MAS and long-term outcomes in adults are not well defined. We reviewed MAS cases to characterize the natural history of aortic disease, identify prognostic factors, and evaluate the durability of invasive interventions.
METHODS
We conducted a retrospective review of patients with MAS who presented to Memorial Hermann Hospital and Baylor College of Medicine between 1997 and 2018. We categorized cases according to demographic and clinical manifestations, etiologies, the extent of aortic involvement, interventions, and vascular outcomes.
RESULTS
We identified a cohort of 13 patients with MAS. The etiology of MAS was identified in 6 cases, including genetic syndromes (neurofibromatosis type 1 (2/13), Williams syndrome (1/13), fibromuscular dysplasia (2/13), and Takayasu arteritis (1/13)). Mean age at first documented clinical event was 25.2 (2-67) years, but cases with genetic etiologies presented significantly younger (18.2 years). The most common primary anatomic site was the suprarenal and infrarenal aorta (zones 5-8). Extra-aortic locations involved the renal (4/13), celiac (3/13), and superior mesenteric (3/13) arteries. Clinical manifestations included hypertension (13/13), claudication (9/13), and postprandial abdominal pain (5/13). All patients with available follow-up data underwent at least one surgical or endovascular intervention (range: 1-8). Postoperative complications included renal failure requiring postdischarge hemodialysis and respiratory failure. There were no deaths in long-term follow-up.
CONCLUSIONS
MAS is a complex vasculopathy with substantial variability in clinical presentation and anatomic distribution. Extensive disease frequently requires multiple invasive interventions and results in refractory hypertension, which may predict subsequent clinical events. A multidisciplinary approach with long-term monitoring is essential for preservation of end-organ function and quality of life in this debilitating disease.
Topics: Adolescent; Adult; Aged; Aorta, Abdominal; Aorta, Thoracic; Aortic Diseases; Arterial Occlusive Diseases; Child; Child, Preschool; Constriction, Pathologic; Endovascular Procedures; Female; Humans; Male; Middle Aged; Postoperative Complications; Reoperation; Retrospective Studies; Risk Factors; Syndrome; Time Factors; Treatment Outcome; Vascular Surgical Procedures; Young Adult
PubMed: 31923594
DOI: 10.1016/j.avsg.2019.12.039