Takayasu's Disease with Aneurysm of Right Common Iliac Artery and Iliocaval Fistula in a Young Infant: Case Report and Review of the Literature

Takayasu's arteritis or nonspecific arteritis is a term used to designate a primary arteritis of unknown etiology involving the aorta and its major branches at any level. Generally, the lesions are obliterative; however, aneurysms and saccular dilations have also been described. The arteritis was originally believed to be limited to the aortic arch; however, involvement of the descending thoracic and abdominal aorta has been reported. In fact, the majority of cases of Takayasu's disease in children involve the descending thoracic and abdominal aorta. A case of Takayasu's disease in a 7-month-old black male infant involving the right common iliac artery with development of a large aneurysm and an iliocaval fistula is reported. This child is the youngest to be affected by the disease as reported in the literature. Although Takayasu's disease is rare, it should be considered in the differential diagnosis of children with an abdominal mass.

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Morphologic and epidemiologic differences between Asian and European population in aneurismatic disease of abdominal aorta

Acta chirurgica iugoslavica ◽

10.2298/aci1502025m ◽

2015 ◽

Vol 62 (2) ◽

pp. 25-32

Author(s):

Ana Mladenovic

Keyword(s):

Risk Factors ◽

Abdominal Aorta ◽

Iliac Artery ◽

Protective Factor ◽

Common Iliac Artery ◽

European Population ◽

Transverse Diameter ◽

Aorta Aneurysm ◽

Control Subjects ◽

Asian Patients

Background: In this study, we analyzed epidemiologic characteristics and morphologic differences between Asian and European population in patients with abdominal aorta aneurysm (AAA). Method: We conducted concomitant study in Japan and Europe , in 31 Asian patients (AP) with AAA and 130 control subjects of the same population, and in 30 European patients with AAA and 126 control subjects (EP). We observed various demographic and anthropologic parameters. Aortography was performed in all patients at the same type of CT-scanners using the same examination protocol and postprocessing. For data analysis, various statistical models were used. Results: There are statistically significant differences in multiple epidemiologic and morphologic findings in AAA patients, as well as in comparison with controls in both groups. This is most distinct in terms of anthropologic characteristics and number of risk-factors, and in terms of morphologic findings, in the length of neck of the aneurysm, transverse diameter of abdominal aorta (AA) and common iliac artery (c.i.a), and volumes of c.i.a. We obtained paradoxical results considering diabetes mellitus, which presented itself as a protective factor for AAA. Conclusion: Demographic-epidemiologic analysis accompanied with morphologic measurements using modern imaging modalities enables obtaining new information on pathology of AAA in different races. There are differences in number of risk-factors, and in terms of morphologic findings, in the length neck, angle of the aneurysm, transverse diameters of abdominal aorta (AA) and in the length of common iliac artery (c.i.a), and volume of c.i.a.

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Ureteral iliac artery fistula in idiopathic retroperitoneal fibrosis: A case report

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2020.2.107 ◽

2020 ◽

Vol 92 (2) ◽

Author(s):

Eugenio Di Grazia ◽

Tiziana La Malfa ◽

Gherardo Gasso

Keyword(s):

Iliac Artery ◽

Retroperitoneal Fibrosis ◽

Common Iliac Artery ◽

Unknown Etiology ◽

Gross Hematuria ◽

Idiopathic Retroperitoneal Fibrosis ◽

First Case ◽

Life Threatening ◽

Uncommon Condition ◽

The Right

Ureter-arterial fistula (UAF) is an uncommon condition. The presentation is usually a life-threatening intermittent massive gross hematuria and the diagnosis is still a challenge for urologist. Idiopathic Retroperitoneal fibrosis (IRF) is a condition of unknown etiology characterized by a highly fibrotic retroperitoneal mass that frequently causes ureteral obstruction. To our knowledge we report the first case describing the UAF in a patient suffering from IRF. We hypothesize that inflammation and fibrosis resulted in fixation of the ureter to the adjacent artery causing a fistulous path. UAF was managed by deploying a 10 x 59 mm endo-graft at the intersection of common iliac artery bifurcation with the right ureter. Post treatment course was uneventful.

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Chimney Stent Graft Technique for Endovascular Repair of Penetrating Atherosclerotic Ulcers of Abdominal Aorta with Bilateral Common Iliac Artery Aneurysms and Ectopic Right Renal Artery Stenosis

Annals of Vascular Surgery ◽

10.1016/j.avsg.2019.06.046 ◽

2020 ◽

Vol 62 ◽

pp. 499.e9-499.e14

Author(s):

Zhiyong Zhang ◽

Jiaxin Ye ◽

Tao Fu ◽

Zhenjiang Li

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Stent Graft ◽

Abdominal Aorta ◽

Iliac Artery ◽

Endovascular Repair ◽

Common Iliac Artery ◽

Artery Stenosis

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Vasodilatory properties of recombinant maxadilan

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1996.271.3.h924 ◽

1996 ◽

Vol 271 (3) ◽

pp. H924-H930 ◽

Cited By ~ 2

Author(s):

T. S. Jackson ◽

E. Lerner ◽

R. M. Weisbrod ◽

M. Tajima ◽

J. Loscalzo ◽

...

Keyword(s):

Salivary Gland ◽

Carotid Artery ◽

Intracellular Calcium ◽

Abdominal Aorta ◽

Iliac Artery ◽

Time Dependent ◽

Sand Fly ◽

Arterial Relaxation ◽

Potent Vasodilator ◽

Thoracic And Abdominal

Maxadilan is a peptide from the salivary gland of the sand fly Lutzomyia longipalpis, a vector for leishmaniasis. Cutaneous injection of femtomolar quantities of maxadilan produces long-lasting erythema, making it the most potent vasodilator known. Isolated rabbit thoracic and abdominal aorta, carotid artery, and iliac artery demonstrated dose-dependent arterial relaxation in response to maxadilan with a mean effective concentration (EC50) of 2.7 +/- 1.5, 2.1 +/- 0.5, 2.6 +/- 0.4, and 1.9 +/- 0.5 nM, respectively. Maxadilan proved to be at least sevenfold more potent than nitroglycerin in each arterial bed (EC50 = 25 +/- 12, 32 +/- 9, 37 +/- 10, and 22 +/- 13 nM, respectively; P < 0.05 for each vs. maxadilan). Arterial relaxation to maxadilan was independent of endothelium and was equipotent in the thoracic and abdominal aorta, carotid artery, and iliac artery. Arterial relaxation to maxadilan was not inhibited by K(+)-channel antagonists, methylene blue, quinacrine, or ouabain. Maxadilan-mediated arterial relaxation was found to be adenosine 3',5'-cyclic monophosphate (cAMP) dependent, as it was potentiated by the phosphodiesterase inhibitors 3-isobutyl-1-methylxanthine and theophylline, and it was inhibited by the protein kinase A inhibitor H-89. Consistent with this observation, incubation of thoracic aorta with maxadilan (0.1 microM) produced a time-dependent increase in arterial cAMP content coincident with arterial relaxation. Using rabbit aortic smooth muscle cells, we also observed a time-dependent reduction in intracellular calcium in response to maxadilan. Thus these data indicate that maxadilan, a peptide from the sand fly salivary gland, is a potent vasodilator that reduces intracellular calcium through a cAMP-dependent mechanism.

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Aortoiliac Diameter and Length in a Healthy Cohort

10.21203/rs.3.rs-287327/v1 ◽

2021 ◽

Author(s):

Hyangkyoung Kim ◽

Tae-Won Kwon ◽

Eol Choi ◽

Seonjeong Jeong ◽

Hong-Kyu Kim ◽

...

Keyword(s):

Lower Extremity ◽

Surface Area ◽

Body Surface Area ◽

Abdominal Aorta ◽

Body Surface ◽

Iliac Artery ◽

Common Iliac Artery ◽

Mean Diameter ◽

Healthy Cohort ◽

The Mean

Abstract Objective: Diameter is currently the only screening and diagnostic criterion for asymptomatic aneurysms. Therefore, aortic and lower-extremity arterial diameter has diagnostic, therapeutic, and prognostic importance. We aimed to determine aortic and lower-extremity arterial reference diameters in a general population and compare them according to age, sex, and other characteristics.Methods: We evaluated consecutive 3,692 patients who underwent computed tomography as part of a general health checkup from 2015–2019 in a single tertiary center. Aortic and lower-extremity arterial diameters and the most important factor related to arterial diameters were evaluated.Results: The mean diameter of the abdominal aorta was 17.490 ± 2.110 mm, while that of the common iliac artery was 10.851 ± 1.689 mm. The mean diameter of the abdominal aorta was 18.377 ± 1.766 mm in men and 15.884 ± 1.694 mm in women. Significant intersex differences were observed for all mean diameters and lengths. Multilinear regression analysis showed that age, sex, and body surface area impacted mean diameters of all measured sites except aorta and common iliac artery length. Between male and female patients matched for body surface area, there were significant intersex differences for all measured sites, except for common iliac artery length.Conclusions: The mean diameter of the abdominal aorta in this healthy cohort was 17.490 ± 2.110 mm overall, 18.377 ± 1.766 mm in men, and 15.884 ± 1.694 mm in women. Arterial diameter increased with male sex, older age, and increased body surface area, and aortic diameters were larger in men than in women with the same body surface area.

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Unusual Representation of a Common Iliac Artery Double Aneurysm

Journal for Vascular Ultrasound ◽

10.1177/154431671704100305 ◽

2017 ◽

Vol 41 (3) ◽

pp. 129-134

Author(s):

Janine Oliveri

Keyword(s):

Abdominal Aorta ◽

Iliac Artery ◽

Coil Embolization ◽

Common Iliac Artery ◽

Artery Aneurysm ◽

Ultrasound Screening ◽

Vascular Surgeon ◽

Ultrasound Study ◽

Internal Iliac ◽

The Right

This case discusses an unusual representation of a 3.1-cm double aneurysm of the right common iliac artery with an ectatic distal abdominal aorta. The patient was a 64-year-old asymptomatic male who participated in a routine ultrasound screening at his church. On the basis of the findings, a full ultrasound study was ordered and conducted at the request of his primary physician. The patient's history included smoking cessation in 1975. He currently had hypertension and hyperlipidemia. He was physically active and ran 40 miles per week until developing right Achilles tendonitis. Because of this injury, the patient biked daily. The patient's medications included atenolol and daily vitamins. The ultrasound findings revealed two aneurysms of the right common iliac artery. Both areas were fusiform and measured 3.1 and 2.9 cm, respectively. The dilation extended to the right internal iliac artery. The left common iliac was mildly dilated and kinked to the left. There was mild enlargement of the distal abdominal aorta measuring 3.4 cm by ultrasound and 3.1 cm by computed tomography angiogram. There is no evidence of internal thrombus. Usually asymptomatic, iliac artery aneurysms can be lethal if large (above 3.0 cm) and undetected. With appropriate, timely intervention the aneurysm can be safely repaired before rupture. Various aneurysm treatment options include conventional open abdominal surgery or endovascular stent graft placement with coil embolization. This patient discussed options with the vascular surgeon and was scheduled to have a cardiac catheterization with right internal iliac coil embolization. Staging of the endovascular graft was planned to follow. This case presents the uncommon finding of a large iliac artery aneurysm. This patient's disease was made more unusual by the presence of two distinct aneurysms present within the same vessel. It further reinforces the common practice of fully examining patients with aneurismal disease bilaterally and over multiple levels as a significant portion of patients have multilevel disease.

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P1262VASCULAR CALCIFICATION OF ABDOMINAL AORTA AND COMMON ILIAC ARTERY AFTER KIDNEY TRANSPLANTATION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1262 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Kentaro Nakai ◽

Shutaro Yamamoto ◽

Haruka Tomooka ◽

Megumi Inoue ◽

Chiaki Kohara ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Vascular Calcification ◽

Abdominal Aorta ◽

Iliac Artery ◽

Common Iliac Artery ◽

Aortic Calcification ◽

Dialysis Modality ◽

Dialysis Vintage ◽

Maximal Thickness

Abstract Background and Aims Vascular calcification is a risk factor for cardiovascular disease and mortality in dialysis and transplant patients. Previous studies have shown that coronary artery calcification correlates with cardiovascular mortality. However, it is not known whether vascular calcification of the abdominal aorta and common iliac artery (CIA) may impact clinical outcomes after kidney transplantation. The aim of this study was to identify the risk factors of vascular calcification after kidney transplantation. Method In this retrospective study, we assessed 100 patients who underwent kidney transplantation between 2008 and 2017. Of these, 62 patients received a computed tomography (CT) scan of the abdomen twice with an interval of at least 6 months. We examined the characteristics of vascular calcification of the abdominal aorta and iliac artery and divided the patients into three groups based on dialysis modality before transplantation: hemodialysis (HD group), peritoneal dialysis (PD group) and preemptive kidney transplantation (PEKT group). Then, we identified the risk factors for the progression of calcification. Abdominal aortic calcification was assessed based on the aortic calcification index (ACI), and calcification of CIA was assessed based on the maximal thickness of calcification. Results At baseline, abdominal aortic calcification was present in 66% of patients, and the median ACI was 10 [0-30]. Calcification of the CIA was present in 62% of patients, and maximal thickness of the CIA was 2.4 mm [0-4.6]. The mean duration of follow-up was 68 ± 29 months, and the mean interval of CT was 40 ± 29 months. After kidney transplantation, the progression rate of ACI and maximal thickness of CIA were 1.6 ± 2.5 per year and 0.17 ± 0.41 mm per year, respectively. The maximal thickness of CIA calcification was significantly higher, and ACI tended to be higher in the HD group than in the PEKT group. Age, male gender, diabetes mellitus and dialysis vintage were the independent variables related to both ACI and maximal thickness of CIA calcification. The progression rates of ACI and maximal thickness of CIA were comparable among the three groups in terms of dialysis modality. Age and rejection within the first 6 months were independent risk factors for ACI progression, and diabetes mellitus was an independent risk factor for progression of maximal thickness of CIA. No significant association was found between the progression of vascular calcification and dialysis-related parameters, including dialysis modality and vintage. Conclusion This study suggests that dialysis vintage was the independent variable related to calcification of the abdominal aorta and common iliac artery, whereas dialysis modality was not a significant predictor of vascular calcification and its progression in these blood vessels.

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