scholarly journals Multilayer bare stent technique in treating intact mycotic suprarenal aortic aneurysm: a case report

2020 ◽  
Author(s):  
Chao Song ◽  
Qing Cai ◽  
Yi Huang ◽  
Qingsheng Lu
Keyword(s):  
Blood Flow ◽  
Aortic Aneurysm ◽  
Thrombus Formation ◽  
Graft Infection ◽  
Immunocompetent Patient ◽  
Joint Effusion ◽  
Abdominal Aortic ◽  
Close Observation ◽  
Mycotic Aneurysms ◽  
Aneurysm Thrombosis

Abstract Background Invasive aspergillosis (IA) related mycotic aortic aneurysm is rare in immunocompetent patient. The endovascular therapy remains controversial due to potential risk of graft infection, while the suprarenal cases might face catastrophic complications during open surgery. Case summary We presented an IA case with suprarenal abdominal aortic aneurysm confirmed by joint effusion. Multilayer bare stent technique was performed to preserve visceral blood flow and promote aneurysmal thrombus formation, along with antifungal treatment. Two years of follow-up revealed complete aneurysm thrombosis without evidence of infection. Discussion Fungal infection that affects the aorta is difficult to recognize due to often negative blood cultures. Close observation is recommended in case of suspicion of mycotic aneurysms. Multilayer bare stent technique can restore luminal laminar blood flow and reduce the risk of infection in intact mycotic suprarenal aortic aneurysm.

scholarly journals Alterations of blood flow pattern after triple stent endovascular treatment of saccular abdominal aortic aneurysm: a porcine model.

2016 ◽  
Vol 43 (3) ◽  
pp. 154-159
Author(s):  
JAHIR RICHARD DE OLIVEIRA ◽  
MAURÍCIO DE AMORIM AQUINO ◽  
SVETLANA BARROS ◽  
GUILHERME BENJAMIN BRANDÃO PITTA ◽  
ADAMASTOR HUMBERTO PEREIRA
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Flow Pattern ◽  
Blood Flow Pattern ◽  
Large White ◽  
Abdominal Aortic ◽  
Before And After ◽  
Infrarenal Abdominal Aorta

ABSTRACT Objective: to determine the blood flow pattern changes after endovascular treatment of saccular abdominal aortic aneurysm with triple stent. Methods: we conducted a hemodynamic study of seven Landrace and Large White pigs with saccular aneurysms of the infrarenal abdominal aorta artificially produced according to the technique described. The animals were subjected to triple stenting for endovascular aneurysm. We evaluated the pattern of blood flow by duplex scan before and after stent implantation. We used the non-paired Mann-Whitney test for statistical analysis. Results: there was a significant decrease in the average systolic velocity, from 127.4cm/s in the pre-stent period to 69.81cm/s in the post-stent phase. There was also change in the flow pattern from turbulent in the aneurysmal sac to laminate intra-stent. Conclusion: there were changes in the blood flow pattern of saccular abdominal aortic aneurysm after endovascular treatment with triple stent.

Endovascular Management of Ruptured, Mycotic Abdominal Aortic Aneurysm

2005 ◽  
Vol 71 (6) ◽  
pp. 515-517 ◽  
Author(s):  
J. Eduardo Corso ◽  
Karthikeshwar Kasirajan ◽  
Ross Milner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Mortality Rate ◽  
Aortic Aneurysm ◽  
High Mortality ◽  
Endovascular Repair ◽  
Good Condition ◽  
Endovascular Management ◽  
Abdominal Aortic ◽  
Mycotic Aneurysms

Patients with mycotic aneurysms have a high mortality rate. The standard surgical approach can be exceptionally difficult and fraught with complications. There has been reluctance to insert an endograft into an infected field. We believe that this thought should be challenged and present a case of a successful endovascular repair of a ruptured, mycotic abdominal aortic aneurysm. The patient is a 63-year-old man with severe medical comorbidities and methicillin-sensitive Staphylococcus aureus. He required 6 units of red blood cells on admission. Magnetic resonance angiography (MRA) showed a contained rupture of his distal abdominal aorta, and he underwent emergent endovascular repair. An aortomono-iliac device (12 mm x 10 cm iliac extension limb) was inserted along with coil embolization of his right common iliac artery and a femoral-femoral bypass. He did not require additional transfusions after the procedure and was discharged in good condition. He is on antibiotics and doing well 1 year post-op. Endovascular management of ruptured, mycotic aneurysms is feasible. In fact, it is an attractive approach for a medically compromised patient subset that would carry an exceptionally high mortality rate with traditional surgical repair. Further follow-up is necessary to determine its long-term efficacy.

Computational Modeling of the Effects of Transient Blood Flow Characteristics and Wall Thickness on the Rupture of Abdominal Aortic Aneurysm

2014 ◽  
Author(s):  
Pinaki Pal
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Wall Thickness ◽  
Flow Model ◽  
Wall Stress ◽  
Flow Transition ◽  
Abdominal Aortic ◽  
Sst Model ◽  
Peak Wall Stress

Precise estimation of wall stress distribution within an abdominal aortic aneurysm (AAA) is clinically useful for prediction of its rupture. In this paper a computational fluid dynamic model incorporating two-way coupled fluid-structure interaction is employed to investigate the role of laminar-turbulent flow transition and wall thickness in altering the distribution and magnitude of wall stress in an AAA. Blood flow in axially symmetric aneurysm models governed by a compliant wall mechanics was simulated. Menter’s hybrid k-epsilon/k-omega shear stress transport (SST) model with a correlation-based transition model was used to capture laminar-turbulent transition in the blood flow. Realistic physiological transient boundary conditions were prescribed. The numerical model was validated against experimental data available from the literature. Fluid flow analysis showed the formation of recirculating vortices at the proximal end of the aneurysm after the peak systole which then, moved towards the distal end of the aneurysm along with the bulk flow and were dissipated eventually due to viscous effects. These vortices interacted with the aortic wall and led to local pressure rise. Von Mises stress distribution on the aneurysm wall and location of its peak value were computed and compared with those of a separate numerical simulation performed using a laminar viscous flow model. The predicted peak wall stress was found to be significantly higher for the SST model as compared to the laminar flow model. The location of maximum stress shifted more towards the posterior end of the aneurysm when laminar-turbulent flow transition was considered. In addition, a small reduction of 0.4 mm in wall thickness resulted in the elevation of peak wall stress by a factor of 1.4. The present study showed that capturing flow transition in an AAA is essential to accurate prediction of its rupture. The proposed numerical model provides a robust computational framework to gain more insight into AAA biomechanics and to accurately estimate wall stresses in realistic aneurysm configurations.

Three-Dimensional Simulation of Blood Flow in an Abdominal Aortic Aneurysm—Steady and Unsteady Flow Cases

1994 ◽  
Vol 116 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Tad W. Taylor ◽  
Takami Yamaguchi
Keyword(s):  
High Pressure ◽  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Unsteady Flow ◽  
Three Dimensional ◽  
Reynolds Numbers ◽  
Abdominal Aortic ◽  
Flow Cycle ◽  
Flow Case

Atherosclerosis and atherosclerotic aneurysms can occur in the abdominal aorta. Steady and unsteady three-dimensional flow cases were simulated in abdominal aortic aneurysm using a flow simulation package on a graphics workstation. In the steady case, three aneurysm models of 8.0 cm length were simulated using Reynolds numbers of 350 and 700. In the unsteady case, blood flow in a single asymmetric aneurysm of 8.0 cm length was simulated at Reynolds numbers of 350 and 700 and 1400. In the aneurysm center, two symmetric vortices were formed, and flow separation started at the aneurysm inlet. In the unsteady flow case, the main vortex appeared and disappeared and changed position in the unsteady flow case and induced vortices were formed. Although the centerline view shows the vortices change position with time, cross-sectional views show that two symmetric vortices are present or partially formed throughout the entire flow cycle. Regions of high pressure were observed at the aneurysm exit caused by the symmetric vortices that were formed, implying that this high-pressure region could be an area where rupture is most likely. In the unsteady case, regions of maximum pressure moved depending on the flow cycle time; at peak flow, local pressure maximums were observed at the distal aneurysm; these oscillated, tending to put an additional strain on the distal portion of the aneurysm. The shear stress was low in the aneurysm portion of the vessel, and local maximum values were observed at the distal aneurysm constriction.

The blood flow channel index as novel predictor of abdominal aortic aneurysm impending rupture based on the intraluminal thrombus angio-CT study

2015 ◽  
Vol 84 (4) ◽  
pp. 662-667 ◽  
Author(s):  
Ireneusz Wiernicki ◽  
Pawel Szumilowicz ◽  
Arkadiusz Kazimierczak ◽  
Aleksander Falkowski ◽  
Donald Rutkowski ◽  
...  
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Flow Channel ◽  
Intraluminal Thrombus ◽  
Impending Rupture ◽  
Abdominal Aortic ◽  
Angio Ct

scholarly journals A Stent Graft Infection after Abdominal Aortic Aneurysm Repair

2011 ◽  
Vol 40 (3) ◽  
pp. 125-129
Author(s):  
Masakazu Aoki ◽  
Kenichi Kamiya ◽  
Shinji Ogawa ◽  
Hiroshi Baba ◽  
Yasuhide Okawa
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Graft Infection ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Volumetric Flow at the Supraceliac and Infrarenal Levels in Patients With Abdominal Aortic Aneurysm: Waveforms and Allometric Scaling Relationships

2009 ◽  
Author(s):  
Andrea S. Les ◽  
Janice J. Yeung ◽  
Phillip M. Young ◽  
Robert J. Herfkens ◽  
Ronald L. Dalman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Boundary Conditions ◽  
Computational Simulation ◽  
Critical Role ◽  
Healthy Person ◽  
Patient Specific ◽  
Hemodynamic Forces ◽  
Abdominal Aortic

Hemodynamic forces are thought to play a critical role in abdominal aortic aneurysm (AAA) formation and growth, as well as in the migration and failure of aortic stent grafts. Computational simulation of blood flow enables the study of such hemodynamic forces; however, these simulations require accurate geometries and boundary conditions, usually in the form of flow and pressure data at specific locations. Although hundreds of computed tomography (CT) and magnetic resonance (MR) imaging studies of AAA geometry are performed daily in the clinical setting, flow information is difficult to obtain: It is not possible to reliably measure flow using CT, and while phase-contrast MRI (PC-MRI) can measure velocities, it is rarely used clinically for AAA patients. As a result, many AAA blood flow simulations use highly resolved patient-specific geometries, but may utilize literature-derived flows for inlet boundary conditions from a single, unrelated, sometimes healthy person of dissimilar body mass.

“Silent” thrombosis of an abdominal aortic aneurysm not producing acute limb ischemia

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 265-267 ◽  
Author(s):  
Moulakakis ◽  
Maras ◽  
Bountouris ◽  
Pomoni ◽  
Georgakis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Mortality Rate ◽  
Aortic Aneurysm ◽  
Acute Pain ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Acute Limb Ischemia ◽  
Abdominal Aortic ◽  
Flow Through

Thrombosis of an abdominal aortic aneurysm is a rare devastating complication with an estimated mortality rate of 50%. Simultaneous acute pain, pallor and coldness of the lower limbs, mottling from the level of iliac crests or umbilicus, paraplegia and absence of femoral pulses are all manifestations of a sudden and acute interruption of blood flow through the aneurysmatic aorta. We report a case of an occlusion of an abdominal aortic aneurysm during hospitalization which was not manifested with symptoms of limb ischemia. In this case we feature the rare and unusually “silent” presentation of the event.

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