Intracranial Aneurysm: Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841)Aneurysm: Pathological outpouching or sac-like dilatation in the wall of any blood vessel (ARTERIES or VEINS) or the heart (HEART ANEURYSM). It indicates a thin and weakened area in the wall which may later rupture. Aneurysms are classified by location, etiology, or other characteristics.Aneurysm, Infected: Aneurysm due to growth of microorganisms in the arterial wall, or infection arising within preexisting arteriosclerotic aneurysms.Aortic Aneurysm: An abnormal balloon- or sac-like dilatation in the wall of AORTA.Heart Aneurysm: A localized bulging or dilatation in the muscle wall of a heart (MYOCARDIUM), usually in the LEFT VENTRICLE. Blood-filled aneurysms are dangerous because they may burst. Fibrous aneurysms interfere with the heart function through the loss of contractility. True aneurysm is bound by the vessel wall or cardiac wall. False aneurysms are HEMATOMA caused by myocardial rupture.Aortic Aneurysm, Thoracic: An abnormal balloon- or sac-like dilatation in the wall of the THORACIC AORTA. This proximal descending portion of aorta gives rise to the visceral and the parietal branches above the aortic hiatus at the diaphragm.Aneurysm, Dissecting: Aneurysm caused by a tear in the TUNICA INTIMA of a blood vessel leading to interstitial HEMORRHAGE, and splitting (dissecting) of the vessel wall, often involving the AORTA. Dissection between the intima and media causes luminal occlusion. Dissection at the media, or between the media and the outer adventitia causes aneurismal dilation.Iliac Aneurysm: Abnormal balloon- or sac-like dilatation in the wall of any one of the iliac arteries including the common, the internal, or the external ILIAC ARTERY.Embolization, Therapeutic: A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.Coronary Aneurysm: Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.Blood Vessel Prosthesis Implantation: Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.Cerebral Angiography: Radiography of the vascular system of the brain after injection of a contrast medium.Aortic Rupture: The tearing or bursting of the wall along any portion of the AORTA, such as thoracic or abdominal. It may result from the rupture of an aneurysm or it may be due to TRAUMA.Aneurysm, False: Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.Blood Vessel Prosthesis: Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.Aorta, Abdominal: The aorta from the DIAPHRAGM to the bifurcation into the right and left common iliac arteries.Subarachnoid Hemorrhage: Bleeding into the intracranial or spinal SUBARACHNOID SPACE, most resulting from INTRACRANIAL ANEURYSM rupture. It can occur after traumatic injuries (SUBARACHNOID HEMORRHAGE, TRAUMATIC). Clinical features include HEADACHE; NAUSEA; VOMITING, nuchal rigidity, variable neurological deficits and reduced mental status.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Endovascular Procedures: Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY.Angiography, Digital Subtraction: A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues.Aortography: Radiographic visualization of the aorta and its branches by injection of contrast media, using percutaneous puncture or catheterization procedures.Vascular Surgical Procedures: Operative procedures for the treatment of vascular disorders.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Surgical Instruments: Hand-held tools or implements used by health professionals for the performance of surgical tasks.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Angiography: Radiography of blood vessels after injection of a contrast medium.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Prosthesis Design: The plan and delineation of prostheses in general or a specific prosthesis.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery (CAROTID ARTERY, INTERNAL). Branches of the anterior cerebral artery supply the CAUDATE NUCLEUS; INTERNAL CAPSULE; PUTAMEN; SEPTAL NUCLEI; GYRUS CINGULI; and surfaces of the FRONTAL LOBE and PARIETAL LOBE.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Carotid Artery, Internal: Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs.Neurosurgical Procedures: Surgery performed on the nervous system or its parts.Endoleak: Postoperative hemorrhage from an endovascular AORTIC ANEURYSM repaired with endoluminal placement of stent grafts (BLOOD VESSEL PROSTHESIS IMPLANTATION). It is associated with pressurization, expansion, and eventual rupture of the aneurysm.Aortitis: Inflammation of the wall of the AORTA.Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae".Carotid Artery Diseases: Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.Polyethylene Terephthalates: Polyester polymers formed from terephthalic acid or its esters and ethylene glycol. They can be formed into tapes, films or pulled into fibers that are pressed into meshes or woven into fabrics.Splenic Artery: The largest branch of the celiac trunk with distribution to the spleen, pancreas, stomach and greater omentum.Angioplasty: Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.Reoperation: A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.Balloon Occlusion: Use of a balloon CATHETER to block the flow of blood through an artery or vein.Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters.Sinus of Valsalva: The dilatation of the aortic wall behind each of the cusps of the aortic valve.Imaging, Three-Dimensional: The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Vertebral Artery: The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.Pancreatic Elastase: A protease of broad specificity, obtained from dried pancreas. Molecular weight is approximately 25,000. The enzyme breaks down elastin, the specific protein of elastic fibers, and digests other proteins such as fibrin, hemoglobin, and albumin. EC 3.4.21.36.Cerebral Arteries: The arterial blood vessels supplying the CEREBRUM.Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions.Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful.Posterior Cerebral Artery: Artery formed by the bifurcation of the BASILAR ARTERY. Branches of the posterior cerebral artery supply portions of the OCCIPITAL LOBE; PARIETAL LOBE; inferior temporal gyrus, brainstem, and CHOROID PLEXUS.Celiac Artery: The arterial trunk that arises from the abdominal aorta and after a short course divides into the left gastric, common hepatic and splenic arteries.Anastomosis, Surgical: Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries.Mesenteric Artery, Superior: A large vessel supplying the whole length of the small intestine except the superior part of the duodenum. It also supplies the cecum and the ascending part of the colon and about half the transverse part of the colon. It arises from the anterior surface of the aorta below the celiac artery at the level of the first lumbar vertebra.Marfan Syndrome: An autosomal dominant disorder of CONNECTIVE TISSUE with abnormal features in the heart, the eye, and the skeleton. Cardiovascular manifestations include MITRAL VALVE PROLAPSE, dilation of the AORTA, and aortic dissection. Other features include lens displacement (ectopia lentis), disproportioned long limbs and enlarged DURA MATER (dural ectasia). Marfan syndrome is associated with mutations in the gene encoding fibrillin, a major element of extracellular microfibrils of connective tissue.Prosthesis Failure: Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking.Foreign-Body Migration: Migration of a foreign body from its original location to some other location in the body.Circle of Willis: A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.Craniotomy: Any operation on the cranium or incision into the cranium. (Dorland, 28th ed)Microsurgery: The performance of surgical procedures with the aid of a microscope.Equipment Design: Methods of creating machines and devices.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.Cerebral Revascularization: Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.Aorta, Thoracic: The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.Mucocutaneous Lymph Node Syndrome: An acute, febrile, mucocutaneous condition accompanied by swelling of cervical lymph nodes in infants and young children. The principal symptoms are fever, congestion of the ocular conjunctivae, reddening of the lips and oral cavity, protuberance of tongue papillae, and edema or erythema of the extremities.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Popliteal Artery: The continuation of the femoral artery coursing through the popliteal fossa; it divides into the anterior and posterior tibial arteries.Vascular Fistula: An abnormal passage between two or more BLOOD VESSELS, between ARTERIES; VEINS; or between an artery and a vein.Radiography, Interventional: Diagnostic and therapeutic procedures that are invasive or surgical in nature, and require the expertise of a specially trained radiologist. In general, they are more invasive than diagnostic imaging but less invasive than major surgery. They often involve catheterization, fluoroscopy, or computed tomography. Some examples include percutaneous transhepatic cholangiography, percutaneous transthoracic biopsy, balloon angioplasty, and arterial embolization.Models, Cardiovascular: Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.Vertebral Artery Dissection: Splitting of the vessel wall in the VERTEBRAL ARTERY. Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the vertebral artery, aneurysm formation, or THROMBOEMBOLISM. Vertebral artery dissection is often associated with TRAUMA and injuries to the head-neck region but can occur spontaneously.Carotid Artery, Internal, Dissection: The splitting of the vessel wall in one or both (left and right) internal carotid arteries (CAROTID ARTERY, INTERNAL). Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the internal carotid artery and aneurysm formation.Mechanical Thrombolysis: Procedures to cause the disintegration of THROMBI by physical interventions.Recurrence: The return of a sign, symptom, or disease after a remission.Incidental Findings: Unanticipated information discovered in the course of testing or medical care. Used in discussions of information that may have social or psychological consequences, such as when it is learned that a child's biological father is someone other than the putative father, or that a person tested for one disease or disorder has, or is at risk for, something else.Arteriovenous Fistula: An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.Mesenteric Artery, Inferior: The artery supplying nearly all the left half of the transverse colon, the whole of the descending colon, the sigmoid colon, and the greater part of the rectum. It is smaller than the superior mesenteric artery (MESENTERIC ARTERY, SUPERIOR) and arises from the aorta above its bifurcation into the common iliac arteries.Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Aortic Diseases: Pathological processes involving any part of the AORTA.Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery.Glasgow Outcome Scale: A scale that assesses the outcome of serious craniocerebral injuries, based on the level of regained social functioning.Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.Coated Materials, Biocompatible: Biocompatible materials usually used in dental and bone implants that enhance biologic fixation, thereby increasing the bond strength between the coated material and bone, and minimize possible biological effects that may result from the implant itself.Polytetrafluoroethylene: Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron.Intracranial Thrombosis: Formation or presence of a blood clot (THROMBUS) in a blood vessel within the SKULL. Intracranial thrombosis can lead to thrombotic occlusions and BRAIN INFARCTION. The majority of the thrombotic occlusions are associated with ATHEROSCLEROSIS.Tomography, Spiral Computed: Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.Intracranial Arteriovenous Malformations: Congenital vascular anomalies in the brain characterized by direct communication between an artery and a vein without passing through the CAPILLARIES. The locations and size of the shunts determine the symptoms including HEADACHES; SEIZURES; STROKE; INTRACRANIAL HEMORRHAGES; mass effect; and vascular steal effect.Vascular Patency: The degree to which BLOOD VESSELS are not blocked or obstructed.Ligation: Application of a ligature to tie a vessel or strangulate a part.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.ElastinCerebral Hemorrhage: Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA.Equipment Failure Analysis: The evaluation of incidents involving the loss of function of a device. These evaluations are used for a variety of purposes such as to determine the failure rates, the causes of failures, costs of failures, and the reliability and maintainability of devices.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness.Buttocks: Either of two fleshy protuberances at the lower posterior section of the trunk or HIP in humans and primate on which a person or animal sits, consisting of gluteal MUSCLES and fat.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Carotid Artery, Common: The two principal arteries supplying the structures of the head and neck. They ascend in the neck, one on each side, and at the level of the upper border of the thyroid cartilage, each divides into two branches, the external (CAROTID ARTERY, EXTERNAL) and internal (CAROTID ARTERY, INTERNAL) carotid arteries.Loeys-Dietz Syndrome: An autosomal dominant aneurysm with multisystem abnormalities caused by increased TGF-BETA signaling due to mutations in type I or II of TGF-BETA RECEPTOR. Additional craniofacial features include CLEFT PALATE; CRANIOSYNOSTOSIS; HYPERTELORISM; or bifid uvula. Phenotypes closely resemble MARFAN SYNDROME; Marfanoid craniosynostosis syndrome (Shprintzen-Goldberg syndrome); and EHLERS-DANLOS SYNDROME.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Spinal Cord Ischemia: Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.Aorta: The main trunk of the systemic arteries.Arterial Occlusive Diseases: Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.Vascular Grafting: Surgical insertion of BLOOD VESSEL PROSTHESES, or transplanted BLOOD VESSELS, or other biological material to repair injured or diseased blood vessels.Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen.Ophthalmic Artery: Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures.Behcet Syndrome: Rare chronic inflammatory disease involving the small blood vessels. It is of unknown etiology and characterized by mucocutaneous ulceration in the mouth and genital region and uveitis with hypopyon. The neuro-ocular form may cause blindness and death. SYNOVITIS; THROMBOPHLEBITIS; gastrointestinal ulcerations; RETINAL VASCULITIS; and OPTIC ATROPHY may occur as well.Elastic Tissue: Connective tissue comprised chiefly of elastic fibers. Elastic fibers have two components: ELASTIN and MICROFIBRILS.Brachiocephalic Trunk: The first and largest artery branching from the aortic arch. It distributes blood to the right side of the head and neck and to the right arm.Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Esophageal Fistula: Abnormal passage communicating with the ESOPHAGUS. The most common type is TRACHEOESOPHAGEAL FISTULA between the esophagus and the TRACHEA.Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Cranial Nerve Diseases: Disorders of one or more of the twelve cranial nerves. With the exception of the optic and olfactory nerves, this includes disorders of the brain stem nuclei from which the cranial nerves originate or terminate.Prostheses and Implants: Artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically. IMPLANTS, EXPERIMENTAL is available for those used experimentally.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder.Oculomotor Nerve Diseases: Diseases of the oculomotor nerve or nucleus that result in weakness or paralysis of the superior rectus, inferior rectus, medial rectus, inferior oblique, or levator palpebrae muscles, or impaired parasympathetic innervation to the pupil. With a complete oculomotor palsy, the eyelid will be paralyzed, the eye will be in an abducted and inferior position, and the pupil will be markedly dilated. Commonly associated conditions include neoplasms, CRANIOCEREBRAL TRAUMA, ischemia (especially in association with DIABETES MELLITUS), and aneurysmal compression. (From Adams et al., Principles of Neurology, 6th ed, p270)Suture Techniques: Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body.Hematoma: A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue.Aortic Coarctation: A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.Matrix Metalloproteinase 9: An endopeptidase that is structurally similar to MATRIX METALLOPROTEINASE 2. It degrades GELATIN types I and V; COLLAGEN TYPE IV; and COLLAGEN TYPE V.Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.Transducers, Pressure: Transducers that are activated by pressure changes, e.g., blood pressure.Arteries: The vessels carrying blood away from the heart.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Ultrasonography, Doppler, Duplex: Ultrasonography applying the Doppler effect combined with real-time imaging. The real-time image is created by rapid movement of the ultrasound beam. A powerful advantage of this technique is the ability to estimate the velocity of flow from the Doppler shift frequency.Replantation: Restoration of an organ or other structure to its original site.Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Equipment Safety: Freedom of equipment from actual or potential hazards.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Temporal Arteries: Arteries arising from the external carotid or the maxillary artery and distributing to the temporal region.Vasospasm, Intracranial: Constriction of arteries in the SKULL due to sudden, sharp, and often persistent smooth muscle contraction in blood vessels. Intracranial vasospasm results in reduced vessel lumen caliber, restricted blood flow to the brain, and BRAIN ISCHEMIA that may lead to hypoxic-ischemic brain injury (HYPOXIA-ISCHEMIA, BRAIN).Image Processing, Computer-Assisted: A technique of inputting two-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer.Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Constriction: The act of constricting.Echocardiography, Transesophageal: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus.Saphenous Vein: The vein which drains the foot and leg.Radiographic Image Interpretation, Computer-Assisted: Computer systems or networks designed to provide radiographic interpretive information.Surgical Procedures, Minimally Invasive: Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device.Enbucrilate: A tissue adhesive that is applied as a monomer to moist tissue and polymerizes to form a bond. It is slowly biodegradable and used in all kinds of surgery, including dental.Models, Anatomic: Three-dimensional representation to show anatomic structures. Models may be used in place of intact animals or organisms for teaching, practice, and study.Arteritis: INFLAMMATION of any ARTERIES.Intestinal Fistula: An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).Cyanoacrylates: A group of compounds having the general formula CH2=C(CN)-COOR; it polymerizes on contact with moisture; used as tissue adhesive; higher homologs have hemostatic and antibacterial properties.Middle Cerebral Artery: The largest of the cerebral arteries. It trifurcates into temporal, frontal, and parietal branches supplying blood to most of the parenchyma of these lobes in the CEREBRAL CORTEX. These are the areas involved in motor, sensory, and speech activities.Matrix Metalloproteinase 2: A secreted endopeptidase homologous with INTERSTITIAL COLLAGENASE, but which possesses an additional fibronectin-like domain.Vertebrobasilar Insufficiency: Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.Ischemia: A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Cerebrovascular Circulation: The circulation of blood through the BLOOD VESSELS of the BRAIN.Neurologic Examination: Assessment of sensory and motor responses and reflexes that is used to determine impairment of the nervous system.Preoperative Care: Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)Pulsatile Flow: Rhythmic, intermittent propagation of a fluid through a BLOOD VESSEL or piping system, in contrast to constant, smooth propagation, which produces laminar flow.Databases as Topic: Organized collections of computer records, standardized in format and content, that are stored in any of a variety of computer-readable modes. They are the basic sets of data from which computer-readable files are created. (from ALA Glossary of Library and Information Science, 1983)Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures.Tissue Adhesives: Substances used to cause adherence of tissue to tissue or tissue to non-tissue surfaces, as for prostheses.Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; MUSCULAR DISEASES; INTRACRANIAL HYPERTENSION; parasagittal brain lesions; and other conditions.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Stress, Mechanical: A purely physical condition which exists within any material because of strain or deformation by external forces or by non-uniform thermal expansion; expressed quantitatively in units of force per unit area.Kaplan-Meier Estimate: A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)Cardiovascular Surgical Procedures: Surgery performed on the heart or blood vessels.Alloys: A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions.Arterio-Arterial Fistula: Abnormal communication between two ARTERIES that may result from injury or occur as a congenital abnormality.Retroperitoneal Space: An area occupying the most posterior aspect of the ABDOMINAL CAVITY. It is bounded laterally by the borders of the quadratus lumborum muscles and extends from the DIAPHRAGM to the brim of the true PELVIS, where it continues as the pelvic extraperitoneal space.Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery.Laparotomy: Incision into the side of the abdomen between the ribs and pelvis.Takayasu Arteritis: A chronic inflammatory process that affects the AORTA and its primary branches, such as the brachiocephalic artery (BRACHIOCEPHALIC TRUNK) and CAROTID ARTERIES. It results in progressive arterial stenosis, occlusion, and aneurysm formation. The pulse in the arm is hard to detect. Patients with aortitis syndrome often exhibit retinopathy.Doxycycline: A synthetic tetracycline derivative with similar antimicrobial activity.Cerebellum: The part of brain that lies behind the BRAIN STEM in the posterior base of skull (CRANIAL FOSSA, POSTERIOR). It is also known as the "little brain" with convolutions similar to those of CEREBRAL CORTEX, inner white matter, and deep cerebellar nuclei. Its function is to coordinate voluntary movements, maintain balance, and learn motor skills.Tuberculosis, Cardiovascular: Pathological conditions of the CARDIOVASCULAR SYSTEM caused by infection of MYCOBACTERIUM TUBERCULOSIS. Tuberculosis involvement may include the HEART; the BLOOD VESSELS; or the PERICARDIUM.Thromboembolism: Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.Graft Occlusion, Vascular: Obstruction of flow in biological or prosthetic vascular grafts.Hematoma, Subdural, Acute: Accumulation of blood in the SUBDURAL SPACE with acute onset of neurological symptoms. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status.Hemoptysis: Expectoration or spitting of blood originating from any part of the RESPIRATORY TRACT, usually from hemorrhage in the lung parenchyma (PULMONARY ALVEOLI) and the BRONCHIAL ARTERIES.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Popliteal Vein: The vein formed by the union of the anterior and posterior tibial veins; it courses through the popliteal space and becomes the femoral vein.Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Retroperitoneal Fibrosis: A slowly progressive condition of unknown etiology, characterized by deposition of fibrous tissue in the retroperitoneal space compressing the ureters, great vessels, bile duct, and other structures. When associated with abdominal aortic aneurysm, it may be called chronic periaortitis or inflammatory perianeurysmal fibrosis.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Fibromuscular Dysplasia: An idiopathic, segmental, nonatheromatous disease of the musculature of arterial walls, leading to STENOSIS of small and medium-sized arteries. There is true proliferation of SMOOTH MUSCLE CELLS and fibrous tissue. Fibromuscular dysplasia lesions are smooth stenosis and occur most often in the renal and carotid arteries. They may also occur in other peripheral arteries of the extremity.Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Shear Strength: The internal resistance of a material to moving some parts of it parallel to a fixed plane, in contrast to stretching (TENSILE STRENGTH) or compression (COMPRESSIVE STRENGTH). Ionic crystals are brittle because, when subjected to shear, ions of the same charge are brought next to each other, which causes repulsion.Cardiac Surgical Procedures: Surgery performed on the heart.Basal Ganglia Cerebrovascular Disease: A pathological condition caused by impaired blood flow in the basal regions of cerebral hemispheres (BASAL GANGLIA), such as INFARCTION; HEMORRHAGE; or ISCHEMIA in vessels of this brain region including the lateral lenticulostriate arteries. Primary clinical manifestations include involuntary movements (DYSKINESIAS) and muscle weakness (HEMIPARESIS).Observer Variation: The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).Rupture: Forcible or traumatic tear or break of an organ or other soft part of the body.Embolism: Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.

3D angiography. Clinical interest. First applications in interventional neuroradiology. (1/1425)

3D angiography is a true technical revolution that allows improvement in the quality and safety of diagnostic and endovascular treatment procedures. 3D angiography images are obtained by reconstruction of a rotational angiography acquisition done on a C-arm (GE Medical Systems) spinning at 40 degrees per second. The carotid or vertebral selective injection of a total of 15 ml of non-ionic contrast media at 3 ml/sec over 5 seconds allows the selection of the "arterial phase". Four hundred sixty 3D angiographic studies were performed from December 1996 to September 1998 on 260 patients and have been analyzed in MIP (Maximum Intensity Projection) and SSD (Shaded Surface Display) views. The exploration of intracranial aneurysms is simplified and only requires, for each vascular axis, a biplane PA and Lateral run followed by a single rotational angiography run. The 3D angiography image is available on the workstation's screen (Advantage Workstation 3.1, GE Medical Systems) in less than 10 minutes after the acquisition of the rotational run. It therefore allows one to analyze, during the intervention, the aneurysm's angioarchitecture, in particular the neck, and select the best therapeutic technique. When endovascular treatment is the best indication, 3D angiography allows one to define the optimal angle of view and accurately select the microcoils dimensions. 3D angiography replaces the multiple oblique views that used to be required to analyze the complex aneurysms and therefore allows a reduction of the total contrast medium quantity, the patient X-ray dose and the length of the intervention time which is a safety factor. Also, in particular for complex cases, it brings additional elements complementing the results of standard 2D DSA and rotational angiograms. In the cervical vascular pathology, 3D angiography allows for a better assessment of the stenosis level and of dissection lesions. Our current research activities focus on the matching without stereotactic frame between 3D X-ray angiography and volumetric MR acquisition, which should allow us to improve the treatment of intracerebral arterio-venous malformations (AVMs).  (+info)

Rupture mechanism of a thrombosed slow-growing giant aneurysm of the vertebral artery--case report. (2/1425)

A 76-year-old male developed left hemiparesis in July 1991. The diagnosis was thrombosed giant vertebral artery aneurysm. He showed progressive symptoms and signs of brainstem compression, but refused surgery and was followed up without treatment. He died of rupture of the aneurysm and underwent autopsy in March 1995. Histological examination of the aneurysm revealed fresh clot in the aneurysmal lumen, old thrombus surrounding the aneurysmal lumen, and more recent hemorrhage between the old thrombus and the inner aneurysmal wall. The most important histological feature was the many clefts containing fresh blood clots in the old thrombus near the wall of the distal neck. These clefts were not lined with endothelial cells, and seemed to connect the lumen of the parent artery with the most peripheral fresh hemorrhage. However, the diameter of each of these clefts is apparently not large enough to transmit the blood pressure of the parent artery. Simple dissection of the aneurysmal wall by blood flow in the lumen through many clefts in the old thrombus of the distal neck may be involved in the growth and rupture of thrombosed giant aneurysms of the vertebral artery.  (+info)

Facial diplegia complicating a bilateral internal carotid artery dissection. (3/1425)

BACKGROUND AND PURPOSE: We report a case of facial diplegia complicating a bilateral internal carotid artery dissection. CASE DESCRIPTION: A 49-year-old patient presented with unilateral headache and oculosympathetic paresis. Cerebral angiography revealed a bilateral internal carotid artery dissection. A few days later, the patient developed a facial diplegia that regressed after arterial recanalization. An arterial anatomic variation may explain this ischemic complication of carotid dissection. CONCLUSIONS: Double carotid dissection should be included among the causes of bilateral seventh nerve palsy.  (+info)

Surgical transluminal iliac angioplasty with selective stenting: long-term results assessed by means of duplex scanning. (4/1425)

PURPOSE: The safety of iliac angioplasty and selective stenting performed in the operating room by vascular surgeons was evaluated, and the short- and long-term results were assessed by means of serial duplex scanning. METHODS: Between 1989 and 1996, 281 iliac stenotic or occlusive lesions in 235 consecutive patients with chronic limb ischemia were treated by means of percutaneous transluminal angioplasty (PTA) alone (n = 214) or PTA with stent (n = 67, 23.8%). There were 260 primary lesions and 21 restenosis after a first PTA, which were analyzed separately. Stents were implanted in selected cases, either primarily in totally occluded arteries or after suboptimum results of PTA (ie, residual stenosis or a dissection). Data were collected prospectively and analyzed retrospectively. Results were reported in an intention-to-treat basis. Clinical results and patency were evaluated by means of symptom assessment, ankle brachial pressure index, and duplex scanning at discharge and 1, 3, 6, and every 12 months after angioplasty. To identify factors that may affect outcome, 12 clinical and radiological variables, including the four categories of lesions defined by the Standards of Practice Committee of the Society of Cardiovascular and Interventional Radiology, were analyzed separately. The statistical significances of life-table analysis of patency were determined by means of the log-rank test. RESULTS: There were no postoperative deaths or amputations. Local, general, and vascular complications occurred in 2.1%, 1.3% and 4.7% of cases, respectively (total, 8.1%). The mean follow-up period was 29.6 months. The cumulative patency rates +/- SE of the 260 PTAs (including 55 PTAs plus stents) were 92.9% +/- 1.5% at 1 month, 86. 5% +/- 1.7% at 1 year, 81.2% +/- 2.3% at 2 years, 78.8% +/- 2.9% at 3 years, and 75.4% +/- 3.5% at 5 and 6 years. The two-year patency rate of 21 redo PTAs (including 11 PTAs plus stents) was 79.1% +/- 18.2%. Of 12 predictable variables studied in the first PTA group, only the category of the lesion was predictive of long-term patency. The two-year patency rate was 84% +/- 3% for 199 category 1 lesions and 69.7% +/- 6.5% for 61 category 2, 3, and 4 lesions together (P =. 02). There was no difference of patency in the stented and nonstented group. CONCLUSION: Iliac PTA alone or with the use of a stent (in cases of occlusion and/or suboptimal results of PTA) offers an excellent long-term patency rate. Categorization of lesions remains useful in predicting long-term outcome. PTA can be performed safely by vascular surgeons in the operating room and should be considered to be the primary treatment for localized iliac occlusive disease.  (+info)

Plaque area increase and vascular remodeling contribute to lumen area change after percutaneous transluminal angioplasty of the femoropopliteal artery: an intravascular ultrasound study. (5/1425)

OBJECTIVE: The aim of the study was to assess the change in lumen area (LA), plaque area (PLA), and vessel area (VA) after percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery. METHODS: This was a prospective study. Twenty patients were studied with intravascular ultrasound (IVUS) immediately after PTA and at follow-up examination. Multiple corresponding IVUS cross-sections were analyzed at the segments that were dilated by PTA (ie, treated sites; n = 168), including the most stenotic site (n = 20) and the nondilated segments (ie, reference sites; n = 77). RESULTS: At follow-up examination, both the PLA increase (13%) and the VA decrease (9%) resulted in a significant LA decrease (43%) at the most stenotic sites (P =.001). At the treated sites, the LA decrease (15%) was smaller and was caused by the PLA increase (15%). At the reference sites, the PLA increase (15%) and the VA increase (6%) resulted in a slight LA decrease (3%). An analysis of the IVUS cross-sections that were grouped according to LA change (difference >/=10%) revealed a similar PLA increase in all the groups: the type of vascular remodeling (VA decrease, no change, or increase) determined the LA change. At the treated sites, the LA change and the VA change correlated closely (r = 0.77, P <.001). At the treated sites, significantly more PLA increase was seen in the IVUS cross-sections that showed hard lesion or media rupture (P <.05). No relationship was found between the presence of dissection and the quantitative changes. CONCLUSION: At the most stenotic sites, lumen narrowing was caused by plaque increase and vessel shrinkage. Both the treated sites and the reference sites showed a significant PLA increase: the type of vascular remodeling determined the LA change at follow-up examination. The extent of the PLA increase was significantly larger in the IVUS cross-sections that showed hard lesion or media rupture.  (+info)

Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. (6/1425)

BACKGROUND: The modern imaging techniques of transesophageal echocardiography, CT, and MRI are reported to have up to 100% sensitivity in detecting the classic class of aortic dissection; however, anecdotal reports of patient deaths from a missed diagnosis of subtle classes of variants are increasingly being noted. METHODS AND RESULTS: In a series of 181 consecutive patients who had ascending or aortic arch repairs, 9 patients (5%) had subtle aortic dissection not diagnosed preoperatively. All preoperative studies in patients with missed aortic dissection were reviewed in detail. All 9 patients (2 with Marfan syndrome, 1 with Takayasu's disease) with undiagnosed aortic dissection had undergone >/=3 imaging techniques, with the finding of ascending aortic dilatation (4.7 to 9 cm) in all 9 and significant aortic valve regurgitation in 7. In 6 patients, an eccentric ascending aortic bulge was present but not diagnostic of aortic dissection on aortography. At operation, aortic dissection tears were limited in extent and involved the intima without extensive undermining of the intima or an intimal "flap." Eight had composite valve grafts inserted, and all survived. Of the larger series of 181 patients, 98% (179 of 181) were 30-day survivors. CONCLUSIONS: In patients with suspected aortic dissection not proven by modern noninvasive imaging techniques, further study should be performed, including multiple views of the ascending aorta by aortography. If patients have an ascending aneurysm, particularly if eccentric on aortography and associated with aortic valve regurgitation, an urgent surgical repair should be considered, with excellent results expected.  (+info)

Pathogenetic sequence for aneurysm revealed in mice underexpressing fibrillin-1. (7/1425)

Dissecting aortic aneurysm is the hallmark of Marfan syndrome (MFS) and the result of mutations in fibrillin-1, the major constituent of elastin-associated extracellular microfibrils. It is yet to be established whether dysfunction of fibrillin-1 perturbs the ability of the elastic vessel wall to sustain hemodynamic stress by disrupting microfibrillar assembly, by impairing the homeostasis of established elastic fibers, or by a combination of both mechanisms. The pathogenic sequence responsible for the mechanical collapse of the elastic lamellae in the aortic wall is also unknown. Targeted mutation of the mouse fibrillin-1 gene has recently suggested that deficiency of fibrillin-1 reduces tissue homeostasis rather than elastic fiber formation. Here we describe another gene-targeting mutation, mgR, which shows that underexpression of fibrillin-1 similarly leads to MFS-like manifestations. Histopathological analysis of mgR/mgR specimens implicates medial calcification, the inflammatory-fibroproliferative response, and inflammation-mediated elastolysis in the natural history of dissecting aneurysm. More generally, the phenotypic severity associated with various combinations of normal and mutant fibrillin-1 alleles suggests a threshold phenomenon for the functional collapse of the vessel wall that is based on the level and the integrity of microfibrils.  (+info)

Observations on the treatment of dissection of the aorta. (8/1425)

The results are presented of treatment in twenty-three patients with dissection of the thoracic aorta, in four of whom it was acute (less than 14 days' duration), and in nineteen chronic (more than 14 days' duration). Sixteen patients had Type I and II dissection (involving the ascending aorta) and five Type III (descending aorta at or distal to the origin of the left subclavian artery); in two, dissection complicated coarctation of the aorta in the usual site. Thirteen patients had aortic regurgitation. Three of the patients with acute dissection were treated medically; two, both with Type I dissection, died, and the third, with Type III, survived. The remaining acute patient was treated surgically and also died. Of the patients with chronic dissection, eight were treated medically and eleven surgically. None of the medical group died in hospital; three died between 3 months and 1 year, and five have survived from periods of 12-72 months. Eleven patients with chronic dissection were treated surgically; four died in hospital at or shortly after operation; and the remaining seven lived for periods of 12-84 months. The presentation, indications for surgical treatment and results are discussed. It is concluded that surgical treatment of chronic dissection may carry a higher initial mortality than medical, but that there may be slightly better overall long term results in the former. As this series was not selected randomly, because patients with complications were selected for surgery, and there are only a few patients in each group, the results do not permit firm conclusion regarding the relative merits of medical and surgical treatment. It is suggested that all patients should initially be treated medically but that surgical treatment should be considered if the dissection continues, if aortic regurgitation is severe, if an aneurysm develops or enlarges, if cardiac tamponade develops or there is evidence of progressive involvement of the branches of the aorta. Attention is drawn to the important syndrome of chronic dissecting aneurysm of the ascending aorta with severe aortic regurgitation which requires definitive surgical treatment and aortic valve replacement. The importance of adequate visualization of the origin and extent of the dissection as a preliminary to surgical treatment is stressed.  (+info)

TY - JOUR. T1 - Outcome of medical and surgical treatment in patients with acute type B aortic dissection. AU - Hsu, Ron Bin. AU - Ho, Yi Lwun. AU - Chen, Robert J.. AU - Wang, Shoei Shen. AU - Lin, Fang Yue. AU - Chu, Shu Hsun. PY - 2005/1/1. Y1 - 2005/1/1. N2 - Background. Optimal treatment of acute type B aortic dissection remain unclear. The aim of this study was to assess the clinical outcome of acute type B aortic dissection. Methods. In the last 8 years, 107 patients were admitted for acute type B aortic dissection. We medically treated patients at the time of onset with antihypertensives. Surgery was considered if there is intractable pain, uncontrolled hypertension, severe aortic branch malperfusion, or aneurysm expansion. Results. Twenty-nine patients had pleural effusion (27%), 9 patients had leg ischemia (8%), 5 patients had impending rupture, and 2 patients had aneurysm enlargement exceeding 60 mm on repeated imaging studies. A total of 16 patients (15%) underwent surgical ...
The optimal treatment for patients with type B aortic dissection remains a matter of debate. Each cardiologist or surgeon determines the surgical indications for type B aortic dissection according to his or her experience and the surgical results of the institution.. Recently, however, it was advocated that patients who had type B acute aortic dissection without complications, such as rupture or organ ischemia, be treated with hypotensive drugs during the acute phase, because the mortality rate with this treatment is reported to be equal to or slightly better than that for surgical treatment during the acute phase.4 5 12 13 14 15 16 17 Surgical treatment should be selected if the aortic diameter becomes enlarged during the chronic phase; careful observation of aortic enlargement in all patients treated during the chronic phase is very important but very difficult. Unfortunately, some patients who have successfully gone through the acute phase with medical hypotensive therapy suddenly die during ...
The suitable treatment strategy for acute descending aortic dissection has long been a matter of debate and continues to be a challenge [1]. High mortality rates in surgical treatment (25-50%) of complicated acute type B dissections, directed surgeons to search for other treatment modalities. Implementation of endovascular techniques has provided new therapeutic options [5]. Initial series and subsequent multicenter trials demonstrated technical feasibility and a low rate of complications even in high-risk patients with acute type B dissection.. However, treatment of acute aortic dissections by endovascular grafting itself carries some risks. Leakage can occur in approximately 25% of patients. Rarely, the stent graft may not plug the aortic wall adequate and may dislocate. In 8% of patients embolic material may originate from an atherosclerotic basis and corrupt the blood flow of the spinal cord, leading to paraplegia. There is furthermore the risk for abdominal malperfusion. In this situation ...
In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
Ruptured type B acute aortic dissection iAAD jis a life-threatening condition, in which surgical treatment most often yields unsatisfactory results. We report a case of a ruptured type B AAD in a 67-year-old man detected on computed tomography that required a partial aortic arch replacement with reconstruction of the left subclavian artery with adjunct deep hypothermic circulatory arrest iDHCA). Although the patient had a postoperative stroke, he recovered markedly with rehabilitation. DHCA and open proximal anastomosis are useful for the surgical treatment of type B AAD, however, an elaborate strategy to prevent an intraoperative cerebral embolism is especially important ...
Spontaneous abdominal aortic dissection (AAD) with retrograde thoracic extension is an extremely rare occurrence with a high mortality. Abdominal aortic dissection can be associated with an abdominal aortic aneurysm (AAA) and the presence of an AAD w
TY - JOUR. T1 - Patterns of aortic remodelling after total arch replacement with frozen elephant trunk for acute aortic dissection. AU - Iida, Yasunori. AU - Fujii, Susumu. AU - Shimizu, Hideyuki. AU - Sawa, Shigeharu. PY - 2019/12/1. Y1 - 2019/12/1. N2 - OBJECTIVES: We investigated the outcomes of total arch replacement with frozen elephant trunk (FET) for Stanford type A acute aortic dissection and the patterns of postoperative aortic remodelling from computed tomographic (CT) findings. METHODS: From April 2015 to November 2018, we performed total arch replacement with FET for Stanford type A aortic dissection in 30 patients. Postoperative contrast-enhanced CT showed the position of the FET distal end, the number and the site of communications between the lumina and the presence or absence of aortic remodelling. RESULTS: Primary entry tear was found in the ascending aorta (n = 6), proximal arch (n = 6), aortic arch (n = 11) and distal arch (n = 7). The mean diameter and length of FET were 26 ...
Current management and outcome of chronic type B aortic dissection: results with open and endovascular repair since the advent of thoracic endografting
Current management and outcome of chronic type B aortic dissection: results with open and endovascular repair since the advent of thoracic endografting
Aortic dissection, though rare, is an often fatal event.1 A recent population-based study from Oxford showed that women have higher mortality from aortic dissection and are more likely to die before hospital assessment,2 which was also shown by the worlds largest registry of aortic dissection.3 Importantly, most individuals with aortic dissection had inadequately controlled hypertension, suggesting that modifiable risk factors may play a role in prevention.2 Moreover, women have worse outcomes following surgery for aortic dissection,3 and the surgical risk is even higher during pregnancy.4 ,5 The majority of aortic dissections in women of childbearing age occur during pregnancy and have adverse consequences for the mother and the fetus.6 Data from the Swedish National Birth Registry in women ,40 years of age have shown that pregnancy is associated with a 25-fold increased risk of aortic dissection.6 The scientific literature regarding aortic dissection and pregnancy is largely made up of case ...
BACKGROUND: Aortic dissection is a separation of the aortic wall, caused by blood flowing through a tear in the inner layer of the aorta. Aortic dissection is an infrequent but life-threatening condition. The incidence of aortic dissection is 3 to 6 per 10,000 per year in the Western population, and can be up to 43 per 10,000 per year in the Eastern population. Over 20% of people with an aortic dissection do not reach a hospital alive. After admission, the mortality rates for people with an aortic dissection are between 10% and 20% for those who received endovascular treatment, and between 20% and 30% for those who had open surgery. Thoracic endovascular aortic repair (TEVAR) is the standard endovascular method to treat complicated type B aortic dissection (aortic dissections without involvement of the ascending aorta). Although TEVAR is less invasive than open surgery and has a better long-term aortic remodeling effect than conservative medical treatment, favourable aortic remodelling is ...
This 80-year-old man presented to the ED with acute onset of chest pain.. His arterial phase CT shows the typical features of a Stanford type A dissection of the thoracic aorta. The left-hand transverse image shows the dissection flap (arrows) extending through the ascending (A) and descending (D) aorta. The flap is shown more clearly on the middle, sagittal image. On the right, the coronal CT image shows the dissection flap extending into the left common carotid artery, which is outlined by the dashed yellow line.. As you will remember, aortic dissection is stratified into one of two classifications based on the requirement for surgical intervention. Stanford type A dissections involve the ascending thoracic aorta, account for the majority of cases and have a high mortality rate if not treated with emergency surgery1. Stanford type B dissections involve the descending thoracic aorta, distal to the origin of the left subclavian artery. These are typically treated medically with management of ...
OBJECTIVES The purpose of this study is to delineate changes in aortic geometry and diameter due to dissection. BACKGROUND Aortic diameter is the major criterion for elective ascending aortic replacement for dilated ascending aortas to prevent aortic dissection. However, recommendations are made on the basis of clinical experience and observation of diameters of previously dissected aortas. METHODS Six tertiary centers on 2 continents reviewed their acute aortic dissection type A databases, which contained 1,821 patients. Included were all non-Marfan patients with nonbicuspid aortic valves who had undergone computed tomography angiography ,2 years before and within 12 h after aortic dissection onset. Aortic geometry before and after dissection onset were compared. RESULTS Altogether, 63 patients were included (27 spontaneous and 36 retrograde dissections, median age 68 [57; 77] years; 54% were men). In all but 1 patient, maximum ascending aortic diameter was ,55 mm before aortic dissection ...
Introduction : Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic...
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Background. Complete resection of the intimal tear in aortic arch is one of the most complicated tasks in the treatment of aortic dissections. We introduced open stent grafting technique to complete this task with technical easiness. In this study we evaluated the long term efficacy of this procedure from our 12 years experience.. Patients and Method. Form January 1994 to December 2004, 59 aortic dissections with intimal tear in aortic arch or proximal descending aorta were operated with open stent grafting technique (age 61.7yrs, 41 type A and 18 type B). Thirty three (55.9%) were in emergency status. All these cases were morphologically excluded from the indication of transluminal endovascular repair. Under deep hypothermic circulatory arrest with antegrade cerebral perfusion, the hybrid prosthesis was inserted into descending aorta through the transected proximal aortic arch in order to achieve intimal tear exclusion.. Results. Complete exclusion of the aortic arch intimal tear was achieved ...
A 60-year-old man with a history of indigestion and untreated hypertension presented with sudden-onset central chest pain which radiated to his back. Acute coronary syndrome was initially suspected but excluded in the emergency department before the patient was discharged. The pain subsequently abated to mild intermittent episodes and was misdiagnosed as indigestion. A week later the patient developed new shortness of breath and flu-like symptoms with a positive d-dimer test. CT angiography revealed a Stanford type B aortic dissection which was causing hypoperfusion of the right kidney, resulting in an acute kidney injury. Due to uncontrolled hypertension despite rigorous antihypertensive medication and his failing renal function, the patient underwent endovascular repair and made a good recovery postoperatively. ...
Objective: To report on the technical eligibility of patients previously treated for Stanford type A aorta dissection (AAD) for endovascular aortic arch repair based on contemporary anatomical criteria for an arch inner-branched stentgraft (AIBS). Methods: All patients treated for AAD from 2004-2015 at a single aortic centre were identified. Extent of repair and use of circulatory arrest were reported. Survival and reoperation were assessed using Kaplan Meier and competing risk models. Anatomic assessment was performed using 3-dimensional CT-imaging software. Primary outcome was survival ≥ 1 year and fulfilment of the AIBS anatomical criteria. Results: A total of 198 patients were included (158 Debakey I, 32 Debakey II, and 8 Intramural hematoma). Mortality was 30-days: 16.2%, 1-year: 19.2%, 10-years: 45.0%. There were 129 patients with imaging beyond 1 year (mean, 47.8 months), while 89 (69.0%) were AIBS eligible. During follow-up, 19 (14.7%) patients met the threshold criteria for aortic ...
7/11|br />18:50-21:10 Aortic Dissections/ Transection/ Trauma|br />Πρόεδροι: E. Brountzos,M. Khoury,F. Sigala,A. Trikas|br />18:50-19:00 Single stage hybrid repair for De Bakey type I aortic dissection|br /> . Tzilalis|br />19:00-19:10 Innominate artery dissection mimicking saccular aortic rupture|br />C. Kotoulas|br />19:10-19:20 Treatment of a type II post dissection TAAA with one renal artery originating from false lumen|br />T. Bisdas|br />19:20-19:30 Right axillary and left femoral artery perfusion for repair of posttraumatic aortic arch disruption|br />T. Karaiskos|br />19:30-19:40 Endovascular treatment of subacute type B thoracic dissection in a young patient|br />T. Kratimenos |br />19:40-19:50 Urgent endovascular repair of suprarenal aortic perforation during TAVI|br />S. Kalliafas|br />19:50-20:00 Valve sparing procedure (DAVID) in acute Type I Dissection|br />D. Iliopoulos|br />20:00-20:10 Left Carotid Cannulation for acute aortic dissection|br />V. Patris|br />20:10-20:20 Treatment
A 59-year-old man with a history of hypertension who suddenly developed back pain and apoplexy was transferred to our hospital 20 min after the clinical onset. Physical examination showed right conjugate deviation of the eyes and left paralysis, suggesting disorder of the right cerebral hemisphere. Enhance computed tomography showed an aortic dissection from the ascending aorta to bilateral iliac arteries, and the right common cranial artery was compressed by a false lumen. Acute type A aortic dissection complicated with cerebral malperfusion was diagnosed, and an emergency operation was performed 2.5h after the onset. Cardiopulmonary bypass was established with right femoral artery inflow and bicaval venous drainage. We found the dissection entry at the ascending aorta using the distal open technique, and performed hemiarch graft replacement with selective cerebral perfusion. The postoperative course was uneventful without deterioration of neurological function. Postoperative computed ...
Abdominal Pain & Pupillary Abnormality & Thoracic Aortic Dissection Symptom Checker: Possible causes include Thoracic Aortic Aneurysm. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.
This study evidences for the first time the arterial fragility of Col3a1 insufficient mice and their susceptibility to develop thoracic aortic dissections and ruptures in response to AngII. As observed in vEDS patients, in this AngII infusion model, Col3a1+/− mice died prematurely and significantly more when compared with Col3a1+/+ mice. The haploinsufficiency in type III collagen confers an important fragility to the thoracic aortic wall in response to rapid and important rises in SBP induced by a high-dose of AngII. In this model, BP seems to be a major trigger of this fragility since (1) early deceased Col3a1+/− mice had also the highest rises in SBP, and (2) lowering by half the dose of AngII and its associated increases in SBP (26 to 13 mm Hg) rescued the first-week premature deaths observed in Col3a1+/− mice. This is consistent with the contribution of collagen to the mechanical properties of the arterial wall and the preponderance of type III collagen in the media. However, NE ...
Present and future cardiothoracic intensivists will enjoy this talk by Brian Plunkett on thoracic aortic dissection given at Bedside Critical Care Conference 4.. ...
Friday, March 23, 2018 Herberman Conference Center at UPMC Cancer Pavilion, UPMC Shadyside Pittsburgh, Pa. 1 to 8 p.m.* *Times are Tentative Program Goal To provide oncology health care professionals with the knowledge and skills needed to promote evidence-based care to oncology patients and their families throughout the survivorship continuum. Who Should ...
Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character. Also, vomiting, sweating, and lightheadedness may occur. Other symptoms may result from decreased blood supply to other organs such as stroke or mesenteric ischemia. Aortic dissection can quickly lead to death from not enough blood flow to the heart or rupture of the aorta. Aortic dissection is more common in those with a history of high blood pressure, a number of connective tissue diseases that affect blood vessel wall strength such as Marfan syndrome, a bicuspid aortic valve, and previous heart surgery. Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm, inflammation of arteries, and abnormal lipid levels are also associated with an increased risk. The diagnosis is suspected based ...
Objectives At the conclusion of this educational activity, participants should be able to: Define aortic dissection Describe epidemiology of acute aortic dissection State common and uncommon presentations of acute aortic dissection Appreciate that a normal chest radiograph should not be used to rule out acute aortic dissection List three factors leading to a missed diagnosis of aortic dissection List key pitfalls in the management of acute aortic dissection 3
Methods In 11 patients with Stanford B aortic dissection, TEE and TTE were used to determine the parameters for pre-surgery diagnosis and selection of a coated stent. During surgery, TEE and TTE provided real-time and dynamic monitoring and guiding for precise implantation of the coated stent to effectively seal the tear of the aortic dissection. After surgery, clinical efficacy and potential side effects of the implantation of the coated stent were evaluated.. ...
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Acute type B aortic dissection is a potentially life-threatening condition that historically has been treated with either medical therapy or, when necessary, through invasive surgical techniques," explained Joseph Bavaria, professor of Surgery and director of the Thoracic Aortic Surgery Program, University of Pennsylvania, USA, and a national principal investigator for DISSECTION. DISSECTION results. Bavaria presented the results of the trial at the 2014 annual meeting of the Society for Thoracic Surgery. Twelve-month data from 50 patients evaluated in the trial demonstrate safety and efficacy of the Valiant Captivia System in the treatment of dissections, with excellent technical success.. Conducted at 16 US sites, the trial met its primary safety endpoint by achieving an 8% all-cause mortality rate at 30 days, which represents a three- to four-fold mortality improvement over open surgical repair. Additionally, 100% technical success and 100% coverage of the primary entry tear at implant were ...
Special Envoy to Pakistan and Afghanistan Richard Holbrooke died Monday at the age of 69 after suffering an aortic dissection, a small tear in the largest artery of the body. Aortic dissections are uncommon but often fatal, even when patients receive prompt medical attention.
A 65-year-old man presents to the emergency department with increasing back pain. His history includes hypertension, peripheral neuropathy, duodenal ulcer, superior mesenteric vein thrombus, stage IIB colon cancer treated with surgery and adjuvant chemotherapy, renal cell carcinoma treated with surgery, and prostate cancer treated with surgery and radiation.
Purpose To assess the efficacy of deep convolutional neural networks (DCNNs ) in differentiating acute aortic dissections from non-dissected aortas on thoracic CT.
We present a successful case of catheter-directed infusion into the SMA for a patient with NOMI complicated with traumatic type B AD involving the SMA. Vasodilator infusion via arterial catheter has been reported as an effective treatment for NOMI and many reports suggested efficacy of this strategies [4-7]. In 1977, Boley et al. decreased mortality rate from about 70-80% to 40% performing catheter intra-arterial infusion of papaverine [8]. Other recent study revealed vasodilator administration from SMA achieved successful treatment in 64% patients of NOMI after open heart surgery with nonsurgical treatment [7]. The strategy and management of NOMI with type B AD involving the SMA have not yet been established, and research is limited [1]. Thus, there are two overwhelming difficulties: risk from the catheterization of the dissected aorta and the accurate and prompt evaluation of NOMI.. First, the catheterization of and arterial infusion for the dissected aorta are essential, and more safety ...
Type B aortic dissection (AoD) is a disease connected to high blood load on the aortic wall and to a reduced aortic wall resistance. Nowadays, prognosis on type B AoD results to be particularly difficult with an high incidence of patients treated with medical therapy which manifest complication connected with dissection and which should have been treated with surgical repair immediately. This work aims to study those haemodynamical and morphological proprieties of dissected aorta, which can influence the progression or stability of type B AoD. Computational fluid-dynamic analyses were performed on twenty-five patients with type B AoD, whose nine presented an aneurysm evolution and sixteen presented no further complication connected with dissection. Blood flow features showed that the true lumen flow was laminar and uniform while false lumen flow was less homogeneous with a consequent recirculating path. We found that entry point zone proximal to the aortic arch showed both high blood velocity ...
There is a crescentic hyperdensity within the ascending thoracic aorta, likely representing a dissection flap containing previously administered IV contrast. The dissection flap measures approximately 3 mm along the posterior surface of the ascending aorta. There are calcifications along the aortic arch and descending aorta, probably representing atherosclerosis. ...
RADIOLOGY: AORTA: Case# 17: EXAM 1:AORTIC DISSECTION, TYPE B EXAM2:. A 66 year old female with chest pain. The ascending aorta and aortic arch appear normal. There is aortic dissection in the descending thoracic aorta beginning immediately distal to the arch and extending into the proximal abdominal aorta. The true lumen is compressed and false lumen is significantly thrombosed. CT has to a large degree replaced arteriography in diagnosing aortic dissection and determining its type and location. The diagnosis is made by the demonstration of an intimal flap, displaced inward from the edge of the aorta and lying between the true and false channels. In Dailys classification, types A and B are described with type A being more common. Type A involves the ascending aorta and is usually treated surgically because of the potential for retrograde dissection. Type B involves the area distal to the left subclavian artery and is treated medically. CT is used for screening those with suspected aortic dissection
As it is mentioned in the same publication, type I dissections usually have excellent prognosis. In our case, there was initial spontaneous healing of the LMCA dissection, which later progressed into Type III dissection. In 2000, Dunning et al (9) suggested classification of iatrogenic aortic dissection, based on its spread: type 1 was determined when dissection was limited to a sinus of Valsalva, type 2 when it went to ascending aorta but less than 4 cm in length and type 3 exceeding 4 cm. Thus, the patient developed type 3 dissection. However, there were signs of thrombus formation in the false lumen on MDCT angiography and clinically acute myocardial infarction was the culprit for the patients deterioration. Therefore, as well as because of the emergency of terminal condition "only" CABG was performed.. Conclusions Iatrogenic coronary artery dissection can lead to lethal effect despite all medical efforts. In order to prevent such a serious complication during percutaneous coronary ...
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Level C recommendations. In adult patients with suspected nontraumatic thoracic aortic dissection, do not rely on D-dimer alone to exclude the diagnosis of aortic dissection.. Ongoing challenge regarding the role of D-Dimer in TAD, and some assurance to back up our discussion to not rely on D-Dimer in case of suspicious for TAD. Link To Clinical Policy. ...
Is there any kind of organisation in the UK dedicated to raising awareness of Acute Aortic Dissection or to raising funds for research into the condition? Th…
An aortic dissection starts with a tear in the inner layer of the aortic wall of the thoracic aorta. The aortic wall is made up of 3 layers of tissue. When a tear occurs in the innermost layer of the aortic wall, blood is then channeled into the wall of the aorta separating the layers of tissues. This generates a weakening in the aortic wall with a potential for rupture. Aortic dissection can be a life-threatening emergency. The most commonly reported symptom of an acute aortic dissection is severe, constant chest or upper back pain, sometimes described as "ripping" or "tearing." The pain may move from one place to another.. When a diagnosis of aortic dissection is confirmed, immediate surgery or stenting is usually done.. ...
An aortic dissection starts with a tear in the inner layer of the aortic wall of the thoracic aorta. The aortic wall is made up of 3 layers of tissue. When a tear occurs in the innermost layer of the aortic wall, blood is then channeled into the wall of the aorta separating the layers of tissues. This generates a weakening in the aortic wall with a potential for rupture. Aortic dissection can be a life-threatening emergency. The most commonly reported symptom of an acute aortic dissection is severe, constant chest or upper back pain, sometimes described as "ripping" or "tearing." The pain may move from one place to another.. When a diagnosis of aortic dissection is confirmed, immediate surgery or stenting is usually done. ...
Dan Rong, Yangyang Ge, Yan Xue, Feng Liu, Kai Lu, Peng Liu, Lei Zhang, Xiaohu Ge, Jianhang Miu, Linkun Zhong, Weidong Fan, Hongpeng Zhang, Xin Jia, Xiaohui Ma, Jiang Xiong, Xiaoping Liu, Wei Guo ...
Medtronic plc (MDT) recently unveiled favorable three-year clinical outcome of its Valiant Captivia Thoracic Stent Graft System in patients with acute complicated Type B aortic dissection.
Lombardi, global principal investigator of the study, presented study results through 24 months, reflective of data received as of March 2013. The overall 30-day mortality rate was 4.7% (4/86), and Kaplan-Meier estimates of patient survival were 88% at 12 months and 85% at 24 months. During follow-up through two years, five patients experienced aortic rupture and no patient required conversion to open repair. There were seven cases of stroke (six cases within 30 days) and one case of paraplegia (within 30 days). Renal failure occurred in nine patients (none required permanent dialysis) and retrograde dissection occurred in seven patients (two patients died; four underwent re-interventions). Aortic remodeling, indicated by an increase in the true lumen size and a decrease in the false lumen size, was observed in both the descending thoracic aorta and the distal abdominal aorta.. ...
We believe that this patient had symptoms associated with her vasculitis during the months before admission. The aortic dissection may have explained her abdominal pain and diarrhoea (transient intestinal ischaemia) and was presumably responsible for compromised perfusion of the right kidney, which caused high renin, new onset hypertension. The left kidney was atrophic, suggesting longstanding renovascular disease, which had not caused hypertension before she developed aortic disease. Thus, an important lesson is that acute hypertension, in particular with signs of activation of the renin-angiotensin-aldosterone system (hypokalaemia, mild hyponatraemia, hyperreninaemia, strong blood pressure response to ACE inhibition or angiotensin receptor blockade), should trigger suspicion of aortic disease, especially in elderly people. Aortic dissection can present with few symptoms and be easily overlooked. Hypertension occurs in about half of patients with aortic dissection and may be caused by ...
This cohort study examines the presentation and outcomes of women who experience aortic dissection during pregnancy or within 12 weeks post partum.
Learn more about Aortic Dissection at Reston Hospital Center DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
The clinical recognition of dissecting aortic aneurysm. Am. J. Med.. 1976;60(5):625-33. doi:10.1016/0002-9343(76)90496-4. PMID ...
Other causes can include dissecting aneurysms and arterial spasms. The ophthalmic artery branches off into the central retinal ...
His official cause of death was a dissecting aneurysm. Ohtaki was honored with a Lifetime Achievement Award at the 56th Japan ...
Dissecting aneurysms of the vertebral artery constitute 4% of all cerebral aneurysms, and are hence a relatively rare but ... Santos-Franco JA, Zenteno M, Lee A (April 2008). "Dissecting aneurysms of the vertebrobasilar system. A comprehensive review on ... People with an aneurysm of the aortic root and people with a history of migraine may be predisposed to vertebral artery ... Stenting, as well as the insertion of coils by means of angiography, may be performed if there is an aneurysm and/or extension ...
Santos-Franco JA, Zenteno M, Lee A (April 2008). "Dissecting aneurysms of the vertebrobasilar system. A comprehensive review on ... aneurysm size greater than 10 mm; and posterior circulation aneurysm 25 mm or more. Screening for aneurysms is not performed on ... aneurysms in the posterior circulation, and an aneurysm >10 mm in size. If a cerebral aneurysm is identified on angiography, ... When the aneurysm has been located, platinum coils are deployed that cause a blood clot to form in the aneurysm, obliterating ...
Leonard, JC (1979). "Thomas Bevill Peacock and the early history of dissecting aneurysm". Br Med J. 2 (6184): 260-2. doi: ...
About 29% of late deaths following surgery are due to rupture of either a dissecting aneurysm or another aneurysm. In addition ... Leonard JC (July 1979). "Thomas Bevill Peacock and the early history of dissecting aneurysm". Br Med J. 2 (6184): 260-2. doi: ... "dissecting aneurysm". London cardiologist Thomas Bevill Peacock contributed to the understanding of the condition by publishing ... "Surgical management of dissecting aneurysms of the aorta". J Thorac Cardiovasc Surg. 49: 130-49. PMID 14261867. Daily PO, ...
Molson died of complications during an operation for a dissected aortic aneurism. This medical issue first surfaced while Mark ...
... ruptured or dissecting aneurysms; large, especially hemorrhagic, stroke; some untreated congenital heart defects; failed heart ...
Eiichi Ohtaki died on December 30, 2013 from a dissecting aneurysm at the age of 65. For the 2015 tribute album Kazemachi ...
Harman died from a dissecting aortic aneurysm, while driving his car to St Thomas's in 1994, aged 87. His sister, Elizabeth ( ...
He died of a dissecting aneurysm on 13 October 1982 in South Melbourne, and was buried in Warracknabeal. Curtis, Campbell (2007 ...
Collapsing shortly thereafter, he was in intensive care before dying on September 10, 1997, of a dissecting aortic aneurysm. ...
A true aneurysm involves all three layers of the blood vessel. A dissecting aneurysm is when blood from the vessel lumen tracks ... Although aneurysms and left ventricular aneurysms may involve any wall segment, aneurysms in the posterolateral wall are ... A pseudoaneurysm, also known as a false aneurysm, is a collection of blood that forms between the two outer layers of an artery ... Due to being close to the vessel, it can also be pulsatile, and can be mistaken for a pseudoaneurysm or aneurysm. Femoral ...
It is occasionally used to treat a hypertensive crisis and dissecting aortic aneurysm, to treat pulmonary edema, and to reduce ...
... a dissecting aortic aneurism, or porphyria. Prolonged treatment may cause a syndrome similar to lupus which can become fatal if ...
... at his former hospital in Southampton on 18 February 2003 after initially successful treatment for a dissecting aneurysm of the ...
Hickox was taken ill and died in Swansea from a dissecting thoracic aneurysm. He had been scheduled to conduct a new production ...
... dissecting aneurysm, peripheral embolism etc. An unequal pulse between upper and lower extremities is seen in coarctation to ...
... or Death Blow may refer to: death blow Coup de grace Dissecting aortic aneurysm Deathblow (comics) is a fictional ...
110 mm Hg Severe pulmonary hypertension Severe chronic fatigue syndrome Suspected or known dissecting aortic aneurysm Recent ...
... dissecting thoracic aneurysm) Richey Edwards, guitarist (Manic Street Preachers) (legally dead, disappeared in 1995 aged 27) 24 ...
... and dissecting aneurysm of the aorta, or rarely aortic or arterial dilation at a young age. Dissection refers to the actual ...
The main instruments used were: "Two small scalpels, one short grooved director, a tenaculum, two aneurysm needles which may be ... used as retractors, one pair of artery forceps, haemostatic forceps, two pairs of dissecting forceps, a pair of scissors, a ...
... aneurysm, dissecting MeSH C14.907.055.050.150 --- carotid artery, internal, dissection MeSH C14.907.055.050.575 --- vertebral ... aortic aneurysm MeSH C14.907.055.239.075 --- aortic aneurysm, abdominal MeSH C14.907.055.239.125 --- aortic aneurysm, thoracic ... heart aneurysm MeSH C14.907.055.625 --- iliac aneurysm MeSH C14.907.055.635 --- intracranial aneurysm MeSH C14.907.075.280 --- ... aortic aneurysm MeSH C14.907.109.139.075 --- aortic aneurysm, abdominal MeSH C14.907.109.139.125 --- aortic aneurysm, thoracic ...
... damage to the Achilles tendon and a more effective method for applying ligature of the arteries in case of an aneurysm.[54] He ... infection was made in 1847 by the Hungarian doctor Ignaz Semmelweis who noticed that medical students fresh from the dissecting ...
Hypertension with dissecting abdominal aortic aneurysm. Br Med J 1974; 4 :23 ... Hypertension with dissecting abdominal aortic aneurysm.. Br Med J 1974; 4 doi: https://doi.org/10.1136/bmj.4.5935.23 (Published ...
Surgical Significance of Aortic Dissecting Aneurysms Br Med J 1948; 2 :599 ... Surgical Significance of Aortic Dissecting Aneurysms. Br Med J 1948; 2 doi: https://doi.org/10.1136/bmj.2.4577.599 (Published ...
24 had dissecting aneurysms. The patients with dissecting aneurysms were characteristically relatively young males. Twenty-one ... Dissecting aneurysms of the intracranial vertebral artery.. Yamaura A1, Watanabe Y, Saeki N. ... After this period, the aneurysm was whitish gray in color and had become firm. Of 36 other cases of vertebral dissecting ... Among 86 patients with aneurysms arising from the vertebral artery or its branches, ...
DISSECTING ANEURYSM OF AORTA ASSOCIATED WITH TURNERS SYNDROME.. ANABTAWI IN, ELLISON RG, YEH TJ, HALL DP. ...
Intracranial dissecting aneurysm (DA) is much less frequent than berry aneurysm. Such dissection involves mostly the vertebral ... The general procedure is to excise a generous portion of the dissecting septum distally for a chronic dissecting aneurysm of ... Endovascular treatment for cerebral aneurysms has become widespread; however, the dissecting aneurysm is still difficult to ... You are here: Research Topics , diseases , cardiovascular diseases , vascular diseases , aneurysm , dissecting aneurysm ...
18 Studies found for: Recruiting, Not yet recruiting, Available Studies , Aneurysm, Dissecting ... A Registry Study on Genetics and Biomarkers of Thoracic Aortic Aneurysm/Dissection. *Aortic Aneurysm, Thoracic ... Three diameters (mm) of dissecting arterial segment and contralateral segment. *Wall measurement (mm2) of dissecting arterial ... Freedom from aneurysm rupture. 35. All. 18 Years and older (Adult, Senior). NCT00583817. G000101. IRB 3917. May 2001. December ...
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... Clinical History. This dissecting aneurism was found in a 76 year old ... Such self-cure of a dissecting aneurism is rare. The factors which pre-dispose to dissecting aneurism are systemic hypertension ... These patients have an increased incidence of aortic rupture and dissecting aneurism. Dissecting aneurism usually presents with ... The dissecting aneurism communicates with the aortic arch by a split seen at the top of the specimen, and in life, blood re- ...
Endovascular Treatment of Symptomatic Intradural Vertebral Dissecting Aneurysms. J.P.P. Peluso, W.J. van Rooij, M. Sluzewski, G ... Endovascular Treatment of Symptomatic Intradural Vertebral Dissecting Aneurysms. J.P.P. Peluso, W.J. van Rooij, M. Sluzewski, G ... Right vertebral angiogram after internal coil trapping of the aneurysm and dissecting aneurysm demonstrates retrograde filling ... Right vertebral dissecting aneurysm involving the origin of the PICA in a 51-year-old man referred 4 weeks after SAH (patient # ...
CT and MRI revealed a large fusiform aneurysm of the intradural segment of the left vertebral... ... Vertebral Artery Aneurysm: Partially Thrombosed Dissecting Aneurysm, Symptomatic through Brainstem Compression, Treatment with ... Irizoiu M., Aschoff A., Schul C., Taschner C. (2018) Vertebral Artery Aneurysm: Partially Thrombosed Dissecting Aneurysm, ... Treating a dissecting aneurysm with flow diversion is often technically easier than stent-assisted coil occlusion. A potential ...
Dissecting aneurysm Vertebral artery Pseudoaneurysm SAH Flow diverter Telescoping This is a preview of subscription content, ... Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol. 2003;24(7):1421-8.PubMedGoogle Scholar ... Ruptured vertebrobasilar dissecting aneurysms are associated with a poor natural history with high rates of re-rupture, stroke ... Long-term outcome of Tubridge flow diverter(s) in treating large vertebral artery dissecting aneurysms-a pilot study. Clin ...
Chronic dissecting aortic aneurysm and Turners syndrome. Apropos of a case] Arch Mal Coeur Vaiss. 1992 Jul;85(7):1043-6. ... Aneurysm, Dissecting / diagnostic imaging * Aneurysm, Dissecting / etiology* * Aneurysm, Dissecting / surgery * Aortic Aneurysm ...
DISSECTING ANEURYSM OF THE AORTA:: A REVIEW OF 17 AUTOPSIED CASES OF ACUTE DISSECTING ANEURYSM OF THE AORTA ENCOUNTERED AT THE ... DISSECTING ANEURYSM OF THE AORTA WITH PERIPHERAL EMBOLIZATION: A CASE REPORT1 Annals of Internal Medicine; 34 (2): 507-510 ... DISSECTING ANEURYSM OF THE AORTA: TWO CASES WITH UNUSUAL ONSETS1 Annals of Internal Medicine; 35 (3): 728-742 ... Angiocardiographic Study of Dissecting Aneurysm of the Aorta. Annals of Internal Medicine; 54 (5): 1036-1037 ...
Cerebral angiography showed dissecting aneurysm as pearl and string sign in the right vertebral artery (VA). Conservative ... Aneurysm, Dissecting / diagnosis, therapy*. Brain Stem Infarctions / diagnosis, surgery*. Diagnostic Imaging. Embolization, ... Cerebral angiography showed dissecting aneurysm as pearl and string sign in the right vertebral artery (VA). Conservative ... Previous Document: Dissecting aneurysm of the anterior cerebral artery requiring surgical treatment--case report.. Next ...
A dissecting aneurysm of the left gastro-epiploic artery in a 79-year-old woman ruptured spontaneously into the peritoneal ...
Shi L, Xu K, Sun X, Yu J. Therapeutic Progress in Treating Vertebral Dissecting Aneurysms Involving the Posterior Inferior ... Therapeutic Progress in Treating Vertebral Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery Lei Shi1*, ... Keywords: Vertebral artery dissecting aneurysms, posterior inferior cerebellar artery, therapeutic progress. This is an open ... Among the variations of vertebral artery dissecting aneurysms (VDAs), VDAs involving the posterior inferior cerebellar artery ( ...
DISSECTING ANEURYSM OF THE AORTA:: A REVIEW OF 17 AUTOPSIED CASES OF ACUTE DISSECTING ANEURYSM OF THE AORTA ENCOUNTERED AT THE ... DISSECTING ANEURYSM OF THE AORTA: A PRESENTATION OF FIFTEEN CASES AND A REVIEW OF THE RECENT LITERATURE(DISSECTING ANEURYSM OF ... DISSECTING ANEURYSM OF THE AORTA: TWO CASES WITH UNUSUAL ONSETS(DISSECTING ANEURYSM OF THE AORTA: TWO CASES WITH UNUSUAL ONSETS ... DISSECTING ANEURYSM OF THE AORTA WITH PERIPHERAL EMBOLIZATION: A CASE REPORT(DISSECTING ANEURYSM OF THE AORTA WITH PERIPHERAL ...
... dissecting aneurysm. The affected site, including the aneurysm and parent artery, was successfully occluded with detachable ... dissecting aneurysm. The affected site, including the aneurysm and parent artery, was successfully occluded with detachable ... Next Document: Internal trapping of a ruptured vertebral artery dissecting aneurysm followed by recanalization of t.... ... Our case suggests that additional intervention is unnecessary during the chronic stage once the aneurysm has been occluded and ...
Two cases of dissecting aneurysm showed giant-cell aortitis. Mucopolysaccharide `cysts were seen more frequently, but by no ... Sections of the ascending aorta of 27 cases of dissecting aneurysm were compared histologically with the ascending aortae of 27 ... The only abnormality that distinguished the dissecting aortae from the normotensive and hypertensive controls with any ...
Dissecting aortic aneurysm (DAA) is an extended tear in the wall of the aorta along the plane of the vascular media. Our ... and Biophysical Alterations in Vascular Matrix Associated With Dissecting Aortic Aneurysm.. [Zhenping Chen, Ya Xu, Paul ...
Welcome to the Pathology Education Informational Resource (PEIR) Digital Library, a multidisciplinary public access image database for use in medical education. ...
CT diagnosis of hemopericardium in acute dissecting aneurysm of the thoracic aorta ... Dissecting aneurysm of the aorta: A review of 17 autopsied cases of acute dissecting aneurysm of the aorta encountered at the ... Dissecting aneurysm of the aorta; a review of 17 autopsied cases of acute dissecting aneurysm of the aorta encountered at the ... Dissecting aneurysm of the aorta: Review of 17 autopsied cases of acute dissecting aneurysm of the aorta encountered at the ...
Dissecting iliac artery aneurysm can be managed and treated by making certain lifestyle changes, closely monitoring the patient ... and conducting a surgery to repair the aneurysm. ... How is Dissecting Common Iliac Artery Aneurysm Treated?. ... What Are The Causes Of Dissecting Common Iliac Artery Aneurysm?. Dissecting aneurysm of common iliac artery is an uncommon ... What Are The Symptoms Of Dissecting Common Iliac Artery Aneurysm?. The symptoms of dissecting common iliac artery aneurysm may ...
A Case of Repeatedly Recurrent Basilar Trunk Dissecting Aneurysm Successfully Treated by the "Coil Sandwich Technique" ... Flow-diverting stents allow efficient treatment of unruptured, intradural dissecting aneurysms of the vertebral artery: An ... CONCLUSIONS: Endovascular treatment of vertebrobasilar dissecting aneurysms is associated with high rates of complete occlusion ... Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta ...
  • The administration of P8RI after the occurrence of ADIM prevented aneurysmal transformation by promoting the resolution of intramural hematoma and the production of collagen in dissected aortas in vivo, associated with enrichment of M2 macrophages at the site of injury. (lvts.fr)
  • Rebleeding tends to occur during the acute stage because spontaneous healing of the dissecting vascular wall typically occurs within one month after onset. (biomedsearch.com)
  • It was associated with aneurysm formation and presented solely with pulsatile tinnitus. (ispub.com)
  • Our program offers sophisticated diagnosis and innovative treatments for patients with intracranial (brain) aneurysms and rare conditions such as arteriovenous malformations (AVMs) of both the brain and spinal cord. (massgeneral.org)
  • The PRESERVE-Zenith® Iliac Branch System Clinical Study is a clinical trial to study the safety and effectiveness of the Zenith® Branch Endovascular Graft-Iliac Bifurcation in combination with the Zenith® Connection Endovascular Stent/ConnectSX™ covered stent in the treatment of aorto-iliac and iliac aneurysms. (stanford.edu)