Endovascular Management of Stenosis of the Infrarenal Aorta Secondary to Blunt Abdominal Aortic Trauma in a Multiply Injured Patient

2009 ◽  
Vol 66 (6) ◽  
pp. E81-E85 ◽  
Author(s):  
Joe T. Huang ◽  
Jason T. Heckman ◽  
Yilmaz Gunduz ◽  
Takao Ohki
Keyword(s):  
Injured Patient ◽  
Infrarenal Aorta ◽  
Endovascular Management ◽  
Abdominal Aortic ◽  
Multiply Injured Patient ◽  
Aortic Trauma

scholarly journals Initial Clinical Experience With a New Conformable Abdominal Aortic Endograft: Aortic Neck Coverage and Curvature Analysis in Challenging Aortic Necks

2021 ◽  
pp. 152660282199672
Author(s):  
Alice Finotello ◽  
Richte Schuurmann ◽  
Sara Di Gregorio ◽  
Gian Antonio Boschetti ◽  
Nabil Chakfé ◽  
...  
Keyword(s):  
Aortic Wall ◽  
Surface Coverage ◽  
Infrarenal Aorta ◽  
Technical Success ◽  
Curvature Analysis ◽  
Average Curvature ◽  
Aortic Neck ◽  
Abdominal Aortic ◽  
Shortest Distance ◽  
New Generation

Objectives: Aim of this work was to investigate precision of deployment and conformability of a new generation GORE EXCLUDER Conformable Endoprosthesis with active control system (CEXC Device, W.L. Gore and Associates, Flagstaff, AZ, USA) by analyzing aortic neck coverage and curvature. Methods: All consecutive elective patients affected by abdominal aortic aneurysm or aortoiliac aneurysm treated at our institution between November 2018 and June 2019 with the new CEXC Device were enrolled. Validated software was adopted to determine the available apposition surface area into the aortic neck, apposition of the endograft to the aortic wall, shortest apposition length (SAL), shortest distance between the endograft fabric and the lowest renal arteries (SFD) and between the endograft fabric and the contralateral renal artery (CFD). Pointwise centerline curvature was also computed. Results: Twelve patients (10 men, median age 78 years (71.75, 81.0)) with available pre- and postoperative computed tomography angiography (CTA) were included. Technical success was obtained in all the cases. Preoperative median length of the proximal aortic neck was 16.1 mm (10.7, 21.7) and suprarenal (α) and infrarenal (β) neck angulation were, respectively, 28.9° (15.7°, 47.5°) and 75.0° (66.9°, 81.4°). Postoperative median apposition surface coverage was 79% (69.25%, 90.75%) of the available apposition surface. SFD and CFD were 1.5 mm (0.75, 5.25) and 7 mm (4.5, 21.5), respectively. Average curvature over the infrarenal aorta decreased from 25 m−1 (21.75, 29.0) to 22.5 m−1 (18.75, 24.5) postoperatively (p=0.02). Maximum curvature did not decrease significantly from 64.5 m−1 (54.25, 92.0) to 62 m−1 (41.75, 71.5) (p=0.1). Conclusions: Our early experience showed that deployment of the CEXC Device is safe and effective for patients with challenging proximal aortic necks. Absence of significant changes between pre- and postoperative proximal aortic neck angulations and curvature confirms the high conformability of this endograft.

scholarly journals Endovascular Management of Inflammatory Abdominal Aortic Aneurysms

2011 ◽  
Vol 54 (6) ◽  
pp. 1858
Author(s):  
Grant T. Fankhauser ◽  
William M. Stone ◽  
Thomas C. Bower ◽  
Gustavo S. Oderich ◽  
W. Andrew Oldenburg ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Endovascular Management ◽  
Abdominal Aortic

The time and place for treatment of the multiply injured patient

1978 ◽  
Vol 18 (1) ◽  
pp. 78
Author(s):  
H. J. Hernandez-Richter ◽  
Mercklin g ◽  
F. J. von Mutius
Keyword(s):  
Injured Patient ◽  
Multiply Injured Patient

scholarly journals Endovascular management of a mycotic group A streptococcal abdominal aortic dissection

2017 ◽  
Vol 3 (1) ◽  
pp. 20150332
Author(s):  
John Colville ◽  
Manmohan Madan ◽  
Khalid Bashaeb ◽  
Riza Ibrahim ◽  
Abysinia Sibanda
Keyword(s):  
Aortic Dissection ◽  
Endovascular Management ◽  
Abdominal Aortic ◽  
Group A ◽  
Abdominal Aortic Dissection

The multiply injured patient

1987 ◽  
Vol 81 (5) ◽  
pp. 119-127
Author(s):  
Steven Sterner
Keyword(s):  
Injured Patient ◽  
Multiply Injured Patient

scholarly journals Ligation of the aorta for a mycotic abdominal aortic aneurysm in an infant

2018 ◽  
Vol 6 ◽  
pp. 2050313X1876130
Author(s):  
Zahira Zouizra ◽  
Soukaina Benbakh ◽  
Gaël Biaou ◽  
Drissi Boumzebra
Keyword(s):  
Mycotic Aneurysm ◽  
Aortic Aneurysms ◽  
Infrarenal Aorta ◽  
Limited Data ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Mycotic aortic aneurysms are exceedingly uncommon in infants and they have a high risk of rupture. Their surgical management is extremely challenging. We report a case of a 22-month-old girl who presented with abdominal pain and fever revealing a ruptured mycotic aneurysm of the infrarenal aorta. The surgical treatment consisted of a ligature of the proximal and distal ends of the aneurysm. Postoperative course was significant for hypertension. A year and a half follow-up showed no other complications. Limited data are available concerning our chosen technique, but the reported cases showed a good short-term outcome.

Abstract 15228: Role of Sympathetic Innervation in the Pathogenesis of Abdominal Aortic Aneurysm

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bin JIANG ◽  
Yugang Liu ◽  
Guillermo A Ameer
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Sympathetic Innervation ◽  
Nerve Fibers ◽  
Elastic Fibers ◽  
Surgical Removal ◽  
Infrarenal Aorta ◽  
Abdominal Aortic ◽  
Nerve Bundles

Introduction: The objective of this study is to understand the role of neurological factors, specifically those from the perivascular sympathetic nervous system (SNS), on the initiation and development of Abdominal Aortic Aneurysm (AAA). Hypothesis: We hypothesize that the formation of AAA is associated with the loss of perivascular SNS-induced vasoconstriction specific to the aneurysm region. Methods: We developed a rat Abdominal Aortic Denervation (AAD) model, where the infrarenal aorta of Spauge Dawley rats was denervated with surgical removal of nerve fibers and chemical denervation with 10% phenol ( Figure. A ). A sham control group was included where the infrarenal aorta was treated with PBS. The arteries were harvested at 1 month after the surgeries for histological assessment. Results: The denervated aortas exhibited significant thinning of the aortic wall including the media and the adventitia, compared to the sham controls ( Figure. B ). Moreover, degradation of elastin, demonstrated by the fragmentation of elastic fibers and the decreased number of lamellar units, was also observed in the dennervated aortas in comparison to the sham controls. While the control aortas were well innervated with perivascular nerve bundles adjacent to the adventitia, no nerves were found surrounding the denervated aortas, suggesting successful denervation. Conclusions: We generated an AAD model that could be used for mechanistic understanding and therapeutic development of AAA. The preliminary data suggest a direct link between the lack of aortic sympathetic innervation and AAA formation. Long-term studies are currently underway to further characterize changes in the aortic walls after sympathetic denervation. Figure. (A) Illustration of the denervated region on the rat infrarenal aorta. ( B ) Histological staining of control and denervated rat abdominal aortas at 1 month after surgery. Yellow stars: para-aortic nerve bundles. Scale bar = 200 μm.

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