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Singapore Medical Journal May 2012Knowledge of anatomical variations of the great vessels of the abdomen, including the coeliac trunk, is important for clinicians planning surgical intervention and... (Comparative Study)
Comparative Study
INTRODUCTION
Knowledge of anatomical variations of the great vessels of the abdomen, including the coeliac trunk, is important for clinicians planning surgical intervention and radiological imaging. The present study aimed to record the prevalence of variations in the vascular pattern of branches of the coeliac trunk in cadavers.
METHODS
A total of 50 properly embalmed and formalin-fixed cadavers from the Indian population were selected for the study. Dissection included surgical incision, followed by mobilisation of the anatomical viscera, to observe and record the branching pattern of the coeliac trunk.
RESULTS
The left gastric, common hepatic and splenic arteries were found to arise from the coeliac trunk in 86% of cadavers. In 76% of cadavers, the origin of the gastric artery was proximal to the bifurcation of the coeliac trunk into the common hepatic and splenic arteries. In one case, all three branches arose directly from the abdominal aorta, and the origin of the splenic artery was 1 cm distal to the origin of the left gastric and common hepatic arteries. In another case, the common hepatic and left gastric arteries arose from the coeliac trunk, and the origin of the splenic artery was 1.5 cm distal to the abdominal aorta.
CONCLUSION
Vessel ligation and anastomosis are important in surgical procedures like liver transplantation, and background knowledge of the different vascular patterns of branches of the coeliac trunk is vital. The findings of our study could help to minimise complications related to abdominal surgery, including bleeding and necrosis, and facilitate better and more accurate radiological interpretations.
Topics: Adult; Aged; Anastomosis, Surgical; Aorta, Abdominal; Cadaver; Celiac Artery; Female; Hepatic Artery; Humans; Liver; Liver Transplantation; Male; Middle Aged; Splenic Artery; Vascular Surgical Procedures; Young Adult
PubMed: 22584973
DOI: No ID Found -
Scientific Reports Aug 2021To investigate the feasibility of using ICAM-1-targeted nano ultrasonic contrast to evaluate the degree of inflammatory injury at different stages in the abdominal aorta...
To investigate the feasibility of using ICAM-1-targeted nano ultrasonic contrast to evaluate the degree of inflammatory injury at different stages in the abdominal aorta of rabbits with atherosclerosis (AS). Twenty-five experimental rabbits were assigned to five groups: the control group (A); the week-4 after modeling group (B); the week-8 after modeling group (C); the week-12 after modeling group (D); the week-16 after modeling group (E). All groups were given 2D ultrasonography, conventional ultrasonic contrast (SonoVue), and ICAM-1-targeted nano ultrasonic contrast, respectively. Signal intensity of vascular perfusion was evaluated. Signal intensity of ICAM-1-targeted nano ultrasonic contrast was substantially enhanced and prolonged in the vascular wall of the abdominal bubble aorta increased in B, C, D, and E groups (all P < 0.05). A positive linear correlation between intensity and the expression of ICAM-1 (r = 0.895, P < 0.001). The intensity of outer membrane was enhanced from week 4 to week 12, and both the intima-media membrane and outer membrane were enhanced with double-layer parallel echo at week 16, which was in line with the progression of atherosclerotic plaque inflammatory injury. ICAM-1-targeted nano contrast agent would be possibly a novel non-invasive molecular imaging method for plaque inflammatory injury and site high expression of specific adhesion molecules in early atherosclerotic lesions.
Topics: Animals; Aorta, Abdominal; Atherosclerosis; Contrast Media; Inflammation; Intercellular Adhesion Molecule-1; Male; Nanostructures; Rabbits; Ultrasonography
PubMed: 34389762
DOI: 10.1038/s41598-021-96042-y -
Annals of Biomedical Engineering Jul 2021Tissue-level biomechanical properties and function derive from underlying cell signaling, which regulates mass deposition, organization, and removal. Here, we couple two...
Tissue-level biomechanical properties and function derive from underlying cell signaling, which regulates mass deposition, organization, and removal. Here, we couple two existing modeling frameworks to capture associated multiscale interactions-one for vessel-level growth and remodeling and one for cell-level signaling-and illustrate utility by simulating aortic remodeling. At the vessel level, we employ a constrained mixture model describing turnover of individual wall constituents (elastin, intramural cells, and collagen), which has proven useful in predicting diverse adaptations as well as disease progression using phenomenological constitutive relations. Nevertheless, we now seek an improved mechanistic understanding of these processes; we replace phenomenological relations in the mixture model with a logic-based signaling model, which yields a system of ordinary differential equations predicting changes in collagen synthesis, matrix metalloproteinases, and cell proliferation in response to altered intramural stress, wall shear stress, and exogenous angiotensin II. This coupled approach promises improved understanding of the role of cell signaling in achieving tissue homeostasis and allows us to model feedback between vessel mechanics and cell signaling. We verify our model predictions against data from the hypertensive murine infrarenal abdominal aorta as well as results from validated phenomenological models, and consider effects of noisy signaling and heterogeneous cell populations.
Topics: Animals; Aorta, Abdominal; Biomechanical Phenomena; Computer Simulation; Mice; Models, Cardiovascular; Signal Transduction; Stress, Mechanical
PubMed: 33415527
DOI: 10.1007/s10439-020-02713-8 -
Annals of Surgery Dec 1981This review of 27 cases of blunt injury of the abdominal aorta includes 24 cases reported in the literature and three new cases. Automobile accidents were the cause of...
This review of 27 cases of blunt injury of the abdominal aorta includes 24 cases reported in the literature and three new cases. Automobile accidents were the cause of this condition in 19 patients (70%). Clinical presentation was acute in 70% of the cases, and consisted of either acute arterial insufficiency or an acute abdomen. Intimal disruption occurred in 15 patients (55%) and was the most common anatomic lesion. Atherosclerotic involvement of the aorta was found in ten patients (37%), and in four it contributed directly to the development of this condition. The infrarenal aorta was the most affected segment (92%). The mortality rate was 29% (8/27 patients). Associated trauma occurred in 55% of the cases, but did mot increase the mortality rate. Prompt recognition and proper surgical treatment are essential in the management of this condition.
Topics: Aorta, Abdominal; Female; Humans; Male; Wounds, Nonpenetrating
PubMed: 7305489
DOI: 10.1097/00000658-198112000-00014 -
European Journal of Vascular and... May 1997To study the correlation between wall shear stress and early atherosclerotic lesions in the abdominal aorta. (Comparative Study)
Comparative Study
OBJECTIVES
To study the correlation between wall shear stress and early atherosclerotic lesions in the abdominal aorta.
DESIGN
Blinded histomorphometric studies. Comparison with in vitro data.
MATERIALS
Abdominal aortic haemodynamics were simulated in a realistic pulsatile flow model. Abdominal aortas from 10 young adults with no signs of atherosclerotic disease were obtained during autopsy.
METHODS
Quantitative wall shear stresses were measured at rest and exercise in one suprarenal and two infrarenal positions using laser Doppler anemometry. Intimal thickening indices were measured blindly at the corresponding locations using histomorphometric methods, and compared to wall shear stress variables using linear regression analysis.
RESULTS
Intimal thickness index increased significantly with age. Intimal thickness index was significantly lower in the suprarenal than the infrarenal aorta, and higher at the distal posterior vessel wall compared to the anterior wall. Intimal thickness index correlated significantly with mean, minimum and oscillating wall shear stresses measured at rest.
CONCLUSION
Intimal thickness in the undiseased abdominal aorta correlated significantly with mean, minimum and oscillating wall shear stresses at rest measured in a pulsatile flow model. No correlations were found with maximum shear stress parameters. Exercise changed the local wall shear stresses away from the characteristics associated with intimal thickness index.
Topics: Adolescent; Adult; Aging; Algorithms; Aorta, Abdominal; Aortic Diseases; Arteriosclerosis; Cadaver; Female; Hemodynamics; Hemorheology; Humans; Laser-Doppler Flowmetry; Linear Models; Male; Models, Cardiovascular; Physical Exertion; Pulsatile Flow; Rest; Single-Blind Method; Stress, Mechanical; Tunica Intima
PubMed: 9166266
DOI: 10.1016/s1078-5884(97)80171-2 -
Arteriosclerosis, Thrombosis, and... Jul 2024Most abdominal aortic aneurysms (AAAs) are small with low rupture risk (<1%/y) when diagnosed but slowly expand to ≥55 mm and undergo surgical repair. Patients and... (Review)
Review
CLINICAL PROBLEM
Most abdominal aortic aneurysms (AAAs) are small with low rupture risk (<1%/y) when diagnosed but slowly expand to ≥55 mm and undergo surgical repair. Patients and clinicians require medications to limit AAA growth and rupture, but drugs effective in animal models have not translated to patients.
RECOMMENDATIONS FOR INCREASING TRANSLATION FROM MOUSE MODELS
Use models that simulate human AAA tissue pathology, growth patterns, and rupture; focus on the clinically relevant outcomes of growth and rupture; design studies with the rigor required of human clinical trials; monitor AAA growth using reproducible ultrasound; and perform studies in both males and females.
SUMMARY OF STRENGTHS AND WEAKNESSES OF MOUSE MODELS
The aortic adventitial elastase oral β-aminopropionitrile model has many strengths including simulating human AAA pathology and modeling prolonged aneurysm growth. The Ang II (angiotensin II) model performed less well as it better simulates acute aortic syndrome than AAA. The elastase plus TGFβ (transforming growth factor-β) blocking antibody model displays a high rupture rate, making prolonged monitoring of AAA growth not feasible. The elastase perfusion and calcium chloride models both display limited AAA growth.
Topics: Animals; Aortic Aneurysm, Abdominal; Disease Models, Animal; Humans; Aortic Rupture; Pancreatic Elastase; Mice; Aorta, Abdominal; Female; Disease Progression; Male
PubMed: 38924435
DOI: 10.1161/ATVBAHA.124.320823 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... Nov 2023To evaluate the effect of an abdominal aortic aneurysm (AAA) animal model established in beagles by way of vascular patch angioplasty combined with elastase infusion.
OBJECTIVE
To evaluate the effect of an abdominal aortic aneurysm (AAA) animal model established in beagles by way of vascular patch angioplasty combined with elastase infusion.
METHODS
A total of 60 beagle dogs were included in this study. Among them, 10 beagles were assigned to a control group to obtain normal abdominal aortic wall tissue, while the other 50 underwent vascular patch angioplasty combined with elastase infusion in order to establish the AAA disease model. In order to evaluate the outcome of modeling, abdominal vascular ultrasonography was performed 14 days after the modeling surgery was performed and ultrasound and computed tomographic angiography (CTA) were performed 28 days after the modeling surgery. The criterion for evaluating modeling success is that the maximum diameter of the abdominal aortic aneurysm is 50% greater than the diameter of the normal abdominal aorta below the renal artery. A total of 20 beagles of the modelling group and 5 control beagles were sacrificed 35 days after the modeling surgery and infrarenal abdominal aortic wall tissues were harvested. Then, hematoxylin and eosin (H&E) staining, Masson's trichrome staining, and elastic van Gieson (EVG) staining were conducted to observe the pathology features of abdominal aortic wall tissues.
RESULTS
A total of 50 beagles underwent the AAA modeling procedures, with the average operative and anesthesia time being (119.4±18.9) and (137.4±15.8) minutes, respectively, the average blood loss volume being (43.6±7.7) mL, the average abdominal aorta block time being (39.7±5.3) minutes during the modeling surgery, and the average abdominal aorta diameter measured during the surgery being (6.5±0.4) mm. Intraoperative mortality was 0%. Mortality within 30 days after the surgery was 2% (1 out of the 50 beagles). Postoperative ultrasound and CTA results revealed that the success rate of AAA modeling was 100%. Pathology examination suggested that the animal model rather successfully simulated the pathophysiologic changes associated with human AAA in regard to the morphological and pathological changes.
CONCLUSION
Vascular patch angioplasty combined with elastase infusion can be used to successfully establish AAA model in beagles. The AAA modeling method described in our report demonstrates stability and reliability in aneurysm formation effect and the surgical procedures are easy to replicate. The method integrates the advantages of previous animal modeling methods and can be used to study the pathogenesis of AAA.
Topics: Humans; Animals; Dogs; Pancreatic Elastase; Reproducibility of Results; Disease Models, Animal; Aortic Aneurysm, Abdominal; Aorta, Abdominal; Angioplasty
PubMed: 38162059
DOI: 10.12182/20231160205 -
Journal of Vascular Surgery Dec 2014The aim of the study was to detect inter-relations between the mechanical conditions and material properties of abdominal aortic aneurysm (AAA) wall and the underlying...
OBJECTIVE
The aim of the study was to detect inter-relations between the mechanical conditions and material properties of abdominal aortic aneurysm (AAA) wall and the underlying local gene expression of destabilizing inflammatory, proteolytic, and structural factors.
METHODS
During open surgery, 51 tissue samples from 31 AAA patients were harvested. Gene expression of collagen types I and III, inflammatory factors CD45 and MSR1, proteolytic enzymes matrix metalloproteinases 2 and 9, and tissue inhibitor of matrix metalloproteinase 1 was analyzed by reverse transcription-polymerase chain reaction. Material properties of corresponding AAA tissue samples were assessed by cyclic sinusoidal and destructive testing. Local mechanical conditions of stress and strain were determined by advanced nonlinear finite element analysis based on patient-specific three-dimensional AAA models derived from preoperative computed tomography data.
RESULTS
In the AAA wall, all parameters analyzed were significantly expressed at the messenger RNA level. With respect to mechanical properties of the aneurysmatic wall, expression of collagen III correlated with the stiffness parameter α (r = -0.348; P = .017), and matrix metalloprotease 2 correlated with the stiffness parameter β and wall strength (r = -0.438 and -0.593; P = .005 and P < .001). Furthermore, significant relationships were observed between local AAA diameter and the expression of CD45, MSR1, and tissue inhibitor of matrix metalloproteinase 1 (r = 0.285, 0.551, 0.328; P < .05). However, we found no inter-relation of local calculated wall stresses and strains with gene expression.
CONCLUSIONS
Our results show for the first time that gene expressions of destabilizing factors within AAA tissue might be correlated to geometric and mechanical properties of the AAA wall. However, we found no influence of local mechanical conditions on gene expression of these factors. Therefore, these preliminary results are still ambiguous.
Topics: Aged; Aged, 80 and over; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortography; Biomechanical Phenomena; Computer Simulation; Female; Finite Element Analysis; Gene Expression Regulation; Genetic Markers; Genetic Predisposition to Disease; Humans; Male; Middle Aged; Models, Cardiovascular; Phenotype; RNA, Messenger; Reverse Transcriptase Polymerase Chain Reaction; Stress, Mechanical; Tomography, X-Ray Computed; Vascular Remodeling
PubMed: 25454106
DOI: 10.1016/j.jvs.2014.08.076 -
Journal of the American College of... Jul 1991Aortic distensibility and aortic stiffness index were measured at the ascending aorta (3 cm above the aortic valve) and the mid-portion of the abdominal aorta from the...
Aortic distensibility and aortic stiffness index were measured at the ascending aorta (3 cm above the aortic valve) and the mid-portion of the abdominal aorta from the changes in echocardiographic diameters and pulse pressure in 14 patients with the Marfan syndrome and 15 age- and gender-matched normal control subjects. The following formulas were used: 1) Aortic distensibility = 2(Changes in aortic diameter)/(Diastolic aortic diameter) (Pulse pressure); and 2) Aortic stiffness index = ln(Systolic blood pressure)/(Diastolic blood pressure)(Changes in aortic diameter)/Diastolic aortic diameter. Pulse wave velocity was also measured. Compared with normal subjects, patients with the Marfan syndrome had decreased aortic distensibility in the ascending and the abdominal aorta (2.9 +/- 1.3 vs. 5.6 +/- 1.4 cm2 dynes-1, p less than 0.001 and 4.5 +/- 2.1, vs. 7.7 +/- 2.5, cm2 dynes-1, p less than 0.001, respectively) and had an increased aortic stiffness index in the ascending and the abdominal aorta (10.9 +/- 5.6 vs. 5.9 +/- 2.2, p less than 0.005 and 7.1 +/- 3.1 vs. 3.9 +/- 1.2, p less than 0.005, respectively). Aortic diameters in the ascending aorta were larger in these patients than in normal subjects, but those in the abdominal aorta were similar in the two groups. Linear correlations for both aortic distensibility and stiffness index were found between the ascending and the abdominal aorta (r = 0.85 and 0.71, respectively). Pulse wave velocity was more rapid in the patients than in the normal subjects (11.6 +/- 2.5 vs. 9.5 +/- 1.4 m/s, respectively, p less than 0.01). Thus, aortic elastic properties are abnormal in patients with the Marfan syndrome irrespective of the aortic diameter, which suggests an intrinsic abnormality of the aortic arterial wall.
Topics: Adult; Aorta; Aorta, Abdominal; Elasticity; Female; Hemodynamics; Humans; Male; Marfan Syndrome; Ultrasonography; Vascular Resistance
PubMed: 2050942
DOI: 10.1016/s0735-1097(10)80218-9 -
Journal of Vascular Surgery Aug 1998Nonarteriosclerotic and nonarteritic descending and abdominal aortic coarctation (DAAC) is a rare disease with a great variety of morphologic findings. The additional...
PURPOSE
Nonarteriosclerotic and nonarteritic descending and abdominal aortic coarctation (DAAC) is a rare disease with a great variety of morphologic findings. The additional affliction of renal and other splanchnic arteries often affords complex corrective procedures. We report on our single-center long-term experiences with operative treatment of this malformation.
METHODS
Over a period of 21 years, 15 patients (10 female and 5 male patients; age range, 8 to 57 years) were operated on for DAAC. Six patients had additional stenoses of eight renal arteries, and three had splanchnic arterial obstructions. At 4 to 25 years after the operation, all surviving patients underwent a clinical and a spiral computed tomography examination.
RESULTS
There was one intraoperative death due to exsanguination after the rupture of a poststenotic aneurysm of the infrarenal aorta. Fourteen patients were discharged free of symptoms. During follow-up, four repeated operations were necessary for renal arterial bypass stenoses or aneurysms. One late death occurred as the result of an unrelated disease.
CONCLUSIONS
Complete operative correction of DAAC usually can be accomplished as a single-stage procedure with low morbidity and mortality rates. The reconstruction of all renal arteries is essential to cure hypertension. Consequent follow-up is recommended for detection of late postoperative complications.
Topics: Adolescent; Adult; Aorta, Abdominal; Aorta, Thoracic; Aortic Coarctation; Aortography; Cause of Death; Child; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Postoperative Complications; Reoperation; Survival Rate; Tomography, X-Ray Computed
PubMed: 9719315
DOI: 10.1016/s0741-5214(98)70156-9