scholarly journals Enigma of aortic aneurysms continues to be enigmatic!

2022 ◽  
Author(s):  
Om Prakash Yadava
Keyword(s):  
Aortic Aneurysms

The molecular mechanism of mechanotransduction in vascular homeostasis and disease

2020 ◽  
Vol 134 (17) ◽  
pp. 2399-2418
Author(s):  
Yoshito Yamashiro ◽  
Hiromi Yanagisawa
Keyword(s):  
Shear Stress ◽  
Blood Vessels ◽  
Vessel Wall ◽  
Vascular Diseases ◽  
Cell Interactions ◽  
Aortic Aneurysms ◽  
Cyclic Stretch ◽  
Mechanical Stimuli ◽  
Vascular Homeostasis ◽  
Matrix Cell

Abstract Blood vessels are constantly exposed to mechanical stimuli such as shear stress due to flow and pulsatile stretch. The extracellular matrix maintains the structural integrity of the vessel wall and coordinates with a dynamic mechanical environment to provide cues to initiate intracellular signaling pathway(s), thereby changing cellular behaviors and functions. However, the precise role of matrix–cell interactions involved in mechanotransduction during vascular homeostasis and disease development remains to be fully determined. In this review, we introduce hemodynamics forces in blood vessels and the initial sensors of mechanical stimuli, including cell–cell junctional molecules, G-protein-coupled receptors (GPCRs), multiple ion channels, and a variety of small GTPases. We then highlight the molecular mechanotransduction events in the vessel wall triggered by laminar shear stress (LSS) and disturbed shear stress (DSS) on vascular endothelial cells (ECs), and cyclic stretch in ECs and vascular smooth muscle cells (SMCs)—both of which activate several key transcription factors. Finally, we provide a recent overview of matrix–cell interactions and mechanotransduction centered on fibronectin in ECs and thrombospondin-1 in SMCs. The results of this review suggest that abnormal mechanical cues or altered responses to mechanical stimuli in EC and SMCs serve as the molecular basis of vascular diseases such as atherosclerosis, hypertension and aortic aneurysms. Collecting evidence and advancing knowledge on the mechanotransduction in the vessel wall can lead to a new direction of therapeutic interventions for vascular diseases.

Ruptured abdominal aortic aneurysms: Clinical presentation in Auckland 1993-1997

2001 ◽  
Vol 71 (6) ◽  
pp. 341-344
Author(s):  
Johanna Rose ◽  
Ian Civil ◽  
Timothy Koelmeyer ◽  
David Haydock ◽  
Dave Adams
Keyword(s):  
Clinical Presentation ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Ruptured Abdominal Aortic Aneurysms

Automated software supported versus manual aorto-iliac diameter measurements in CT angiography of patients with abdominal aortic aneurysms: Assessment of inter- and intraobserver variation

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Diehm ◽  
Baumgartner ◽  
Silvestro ◽  
Herrmann ◽  
Triller ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Iliac Artery ◽  
Automatic Measurement ◽  
Random Order ◽  
Aortic Aneurysms ◽  
Intraobserver Variability ◽  
Automatic Method ◽  
Left Common Iliac Artery ◽  
Abdominal Aortic ◽  
Intraobserver Variation

Background: Open surgical or endovascular abdominal aortic aneurysm (AAA) relies on precise preprocedual imaging. Purpose of this study was to assess inter- and intraobserver variation of software-supported automated and manual multi row detector CT angiography (MDCTA) in aortoiliac diameter measurements before AAA repair. Patients and methods: Thirty original MDCTA data sets (4 times 2mm collimation) of patients scheduled for endovascular AAA repair were studied on a dedicated software capable of creating two-dimensional reformatted planes orthogonal to the aortoiliac center-line. Measurements were performed twice with a four-week interval between readings. Data were analysed by two blinded readers at random order. Two different measurement methods were performed: reader-assisted freehand wall-to-wall measurement and semi-automatic measurement. Results: Aortoiliac diameters were significantly underestimated by the semi-automatic method as compared to reader-assisted measurements (p < 0.0031). Intraobserver variability of AAA diameter calculation was not significant (p > 0.15) for reader-assisted measurements except for the diameter of the left common iliac artery in reader 2 (p = 0.0045) and it was not significant (p > 0.14) using the semi-automatic method. Interobserver variability was not significant for AAA diameter measurements using the reader-assisted method and for proximal neck analysis with the semi-automatic method (p > 0.27). Relevant interobserver variation was observed for semi-automatic measurement of maximum AAA (p = 0.0007) and iliac artery diameters (p = 0.024). Conclusions: Dedicated MDCTA software provides a useful tool to minimize aortoiliac diameter measurement variation and to improve imaging precision before AAA repair. For reliable AAA diameter analysis the reader-assisted freehand measurement method is recommended to be applied to a set of reformatted CT data as provided by the software used in this study.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

Statin therapy for patients with abdominal aortic aneurysms

VASA ◽  
2012 ◽  
Vol 41 (1) ◽  
pp. 3-4
Author(s):  
Diehm ◽  
Diehm ◽  
Dick
Keyword(s):  
Statin Therapy ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Glutathione system participation in thoracic aneurysms from patients with Marfan syndrome

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Alejandra María Zúñiga-Muñoz ◽  
Israel Pérez-Torres ◽  
Verónica Guarner-Lans ◽  
Elías Núñez-Garrido ◽  
Rodrigo Velázquez Espejel ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Marfan Syndrome ◽  
Aortic Aneurysms ◽  
Aortic Dilatation ◽  
Glutathione S Transferase ◽  
Reduced And Oxidized Glutathione ◽  
Total Antioxidant ◽  
Elevated Activity ◽  
Acute Dissection ◽  
Thoracic Aneurysms

Abstract. Background: Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients. Spectrophotometrical determination of activity of glutathione peroxidase (GPx), glutathione-S-transferase (GST), glutathione reductase (GR), lipid peroxidation (LPO) index, carbonylation, total antioxidant capacity (TAC), and concentration of reduced and oxidized glutathione (GSH and GSSG respectively), was performed in the homogenate from aortic aneurysm tissue. Results: LPO index, carbonylation, TGF-β1, and GR activity were increased in MFS patients (p < 0.04), while TAC, GSH/GSSG ratio, GPx, and GST activity were significantly decreased (p < 0.04). Conclusions: The depletion of GSH, in spite of the elevated activity of GR, not only diminished the activity of GSH-depend GST and GPx, but increased LPO, carbonylation and decreased TAC. These changes could promote the structural and functional alterations in the thoracic aorta of MFS patients.

Gender differences in abdominal aortic aneurysm therapy – a systematic review

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 267-272 ◽  
Author(s):  
Konstanze Stoberock ◽  
Tilo Kölbel ◽  
Gülsen Atlihan ◽  
Eike Sebastian Debus ◽  
Nikolaos Tsilimparis ◽  
...  
Keyword(s):  
Gender Differences ◽  
Abdominal Aortic Aneurysm ◽  
Survival Rate ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Aortic Aneurysms ◽  
Lower Survival Rate ◽  
Lower Survival ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abstract. This article analyses if and to what extent gender differences exist in abdominal aortic aneurysm (AAA) therapy. For this purpose Medline (PubMed) was searched from January 1999 to January 2018. Keywords were: “abdominal aortic aneurysm”, “gender”, “prevalence”, “EVAR”, and “open surgery of abdominal aortic aneurysm”. Regardless of open or endovascular treatment of abdominal aortic aneurysms, women have a higher rate of complications and longer hospitalizations compared to men. The majority of studies showed that women have a lower survival rate for surgical and endovascular treatment of abdominal aneurysms after both elective and emergency interventions. Women receive less surgical/interventional and protective medical treatment. Women seem to have a higher risk of rupture, a lower survival rate in AAA, and a higher rate of complications, regardless of endovascular or open treatment. The gender differences may be due to a higher age of women at diagnosis and therapy associated with higher comorbidity, but also because of genetic, hormonal, anatomical, biological, and socio-cultural differences. Strategies for treatment in female patients must be further defined to optimize outcome.

Endovascular management of ruptured abdominal aortic aneurysms and acute aortic dissections

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 35-46
Author(s):  
Stephen Hofmeister ◽  
Matthew B. Thomas ◽  
Joseph Paulisin ◽  
Nicolas J. Mouawad
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Rapid Identification ◽  
Aortic Aneurysms ◽  
Endovascular Interventions ◽  
Current State ◽  
Technological Advances ◽  
Abdominal Aortic ◽  
Ruptured Abdominal Aortic Aneurysms ◽  
Vascular Emergencies ◽  
Aortic Dissections

Abstract. The management of vascular emergencies is dependent on rapid identification and confirmation of the diagnosis with concurrent patient stabilization prior to immediate transfer to the operating suite. A variety of technological advances in diagnostic imaging as well as the advent of minimally invasive endovascular interventions have shifted the contemporary treatment algorithms of such pathologies. This review provides a comprehensive discussion on the current state and future trends in the management of ruptured abdominal aortic aneurysms as well as acute aortic dissections.

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