scholarly journals The chest pain in neurological practice. Non deesset...

2019 ◽  
Vol 10 (2) ◽  
pp. 91-96
Author(s):  
Elena V. Shirshova ◽  
O. Y. Annenkova ◽  
E. V. Ekusheva ◽  
V. N. Petrov
Keyword(s):  
Chest Pain ◽  
Aortic Aneurysm ◽  
Clinical Manifestations ◽  
Routine Clinical Practice ◽  
Aortic Aneurysms ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Threatening Condition ◽  
Life Threatening ◽  
Thoracic Aorta Aneurysm

Chest pain can be a “mask” of a life-threatening condition, which the practitioner must remember. One of such life-threatening condition is aortic aneurysm, which diagnosis presents significant difficulties in routine clinical practice. Clinical manifestations of thoracic aortic aneurysms are extremely variable and non-specific and are mainly depends on the size of the aneurysmal sac, its localization and extent, as well as the etiology of the disease. Here we present a clinical case report of a 48 y.o. patient who died because of the acute cardiac tamponade as a complication of dissecting thoracic aorta aneurysm. The lack of symptoms and clinical instrumental data, initially suggesting the presence of life-threatening disease did not allow the physician to suspect aortic aneurysm and urgently take action regarding it.

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

scholarly journals Custom-made fenestrated stent for mycotic aortic aneurysms: a report of two cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Siting Li ◽  
Mengyin Chen ◽  
Yuehong Zheng ◽  
Zhili Liu ◽  
Rong Zeng
Keyword(s):  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Aortic Aneurysms ◽  
Case Presentation ◽  
Aorta Aneurysm ◽  
Custom Made ◽  
Visceral Arteries ◽  
Life Threatening ◽  
Feasible Alternative ◽  
Mycotic Aortic Aneurysm

Abstract Background Mycotic aortic aneurysm is a rare and potentially life-threatening lesion, and endovascular repair has become increasingly accepted for intervention. Fenestrated endografts are available options to treat aneurysms involving visceral arteries. Here, we first report two patients with mycotic aortic aneurysm involving paraviscereal aorta who were successfully treated with custom-made fenestrated endograft. Case presentation Two patients were presented with mycotic aortic aneurysm. Due to their comorbidities and the involvement of the renal arteries, company-manufactured fenestrated stents were designed. Meanwhile, antibiotic therapy was administrated for 2 months before endovascular repair. Patients improved well without complications. Conclusions Custom-made fenestrated endovascular stent is an effective and feasible alternative solution to mycotic paravisceral aorta aneurysm.

scholarly journals Thoracic aorta aneurysm- a rare cause of chronic backache with mediastinal shadow: case report

2018 ◽  
Vol 4 (12) ◽  
pp. 296
Author(s):  
Akash Mathur ◽  
Devleena Gangopadhyay ◽  
Ashutosh Daga ◽  
Puneet Saxena ◽  
Hemant Malhotra
Keyword(s):  
Case Report ◽  
Thoracic Aorta ◽  
Beta Blockers ◽  
Left Lung ◽  
Lower Lobe ◽  
Symptomatic Treatment ◽  
Aortic Aneurysms ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Thoracic Aorta Aneurysm

<p class="abstract">Thoracic aortic aneurysms (TAA) are rarely symptomatic. A 55 year old male presents with longstanding chronic backache. CXR showed left hilar shadow with collapse of left lung. Considering the CXR findings and with the patient being chronic smoker a strong possibility of carcinoma lung with bony metastasis was kept and further CECT chest was done. The CECT chest was suggestive of a thoracic aorta aneurysm with thrombosis compressing left principal bronchus and its lower lobar branch resulting in distal area of collapse and consolidation of left lower lobe. These findings were further confirmed on CT angiography. The patient was thus diagnosed as a case of descending thoracic aorta aneurysm probably of atherosclerotic etiology with thrombosis. Patient was started on beta blockers and ACE inhibitors along with supportive and symptomatic treatment and was further transferred to the department of CTVS for surgical intervention. Thus, this case report here signifies that possibility of thoracic aorta aneurysm should always be considered in a patient with chronic backache specially in presence of mediastinal shadow on CXR.</p>

Staged Repair of a Ruptured Thoracic Aortic Aneurysm Having an Aorto-Parenchymal Fistula

2017 ◽  
Vol 12 (5) ◽  
pp. e13-e15 ◽  
Author(s):  
Akihiro Yoshitake ◽  
Kazuma Okamoto ◽  
Mio Kasai ◽  
Hideyuki Shimizu
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Thoracic Endovascular Aortic Repair ◽  
Aortic Aneurysms ◽  
Treatment Results ◽  
Term Survival ◽  
Thoracic Aortic Aneurysms ◽  
Second Stage ◽  
Life Threatening

Ruptured thoracic aortic aneurysms, having aorto-bronchial or pulmonary parenchymal fistulations, are life-threatening conditions, and current surgical treatment results are not satisfactory. Herein, we describe a 69-year-old man with a ruptured thoracic aortic aneurysm and aorto-pulmonary parenchymal fistulation that was successfully treated using a staged repair. The first stage involved an emergency thoracic endovascular aortic repair for salvage and the second stage involved radical pulmonary parenchymal repair with removal of the stent graft and aortic reconstruction for long-term survival.

scholarly journals Rolipram Prevents the Formation of Abdominal Aortic Aneurysm (AAA) in Mice: PDE4B as a Target in AAA

Antioxidants ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 460
Author(s):  
Saray Varona ◽  
Lídia Puertas ◽  
María Galán ◽  
Mar Orriols ◽  
Laia Cañes ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Inflammatory Cells ◽  
Progressive Increase ◽  
Phosphodiesterase 4 ◽  
Inflammatory Conditions ◽  
Abdominal Aortic ◽  
Threatening Condition ◽  
Life Threatening ◽  
Effective Therapeutic Strategy

Abdominal aortic aneurysm (AAA) is a common life-threatening condition characterized by exacerbated inflammation and the generation of reactive oxygen species. Pharmacological treatments to slow AAA progression or to prevent its rupture remain a challenge. Targeting phosphodiesterase 4 (PDE4) has been verified as an effective therapeutic strategy for an array of inflammatory conditions; however, no studies have assessed yet PDE4 in AAA. Here, we used angiotensin II (AngII)-infused apolipoprotein E deficient mice to study the involvement of the PDE4 subfamily in aneurysmal disease. PDE4B but not PDE4D was upregulated in inflammatory cells from both experimental and human AAA. The administration of the PDE4 selective inhibitor rolipram (3 mg/kg/day) to AngII-challenged mice (1000 ng/kg bodyweight/min) protected against AAA formation, limiting the progressive increase in the aortic diameter without affecting the blood pressure. The drug strongly attenuated the rise in vascular oxidative stress (superoxide anion) induced by AngII, and decreased the expression of inflammatory markers, as well as the recruitment of macrophages (MAC3+), lymphocytes (CD3+), and neutrophils (ELANE+) into the vessel wall. Rolipram also normalized the vascular MMP2 expression and MMP activity, preserving the elastin integrity and improving the vascular remodelling. These results point to PDE4B as a new therapeutic target for AAA.

Thoracic Aortic Aneurysm Repair with Endovascular Stent-Grafts

1997 ◽  
Vol 2 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Charles P Semba ◽  
R Scott Mitchell ◽  
D Craig Miller ◽  
Noriyuki Kato ◽  
Stephen T Kee ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortic Aneurysms ◽  
Stent Grafts ◽  
Thoracic Aortic Aneurysms ◽  
Risk Patients ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Endoluminal Stent

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22–24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.

scholarly journals Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique

2021 ◽  
Vol 24 (6) ◽  
pp. E1054-E1056
Author(s):  
Mazen Shamsaldeen Faden ◽  
Nada Ahmed Noaman ◽  
Osman Osama Osman Osama ◽  
Ahmed Abdelrahman Elassal ◽  
Arwa Mohammed Al-ghamdi ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Ascending Aorta ◽  
Accurate Diagnosis ◽  
Aortic Aneurysms ◽  
Cutis Laxa ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Valvular Insufficiency ◽  
New Surgical Technique

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

Anaphylaxis in the OR—Causes, Recognition, and Treatment

2018 ◽  
pp. 199-206
Author(s):  
Surangama Sharma ◽  
Lovkesh Arora
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Operating Room ◽  
Clinical Manifestations ◽  
Preventative Measures ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Elective Laparoscopic Cholecystectomy

Anaphylaxis in the operating room is a life-threatening condition that can evolve rapidly. As an anesthesiologist, it is important to understand the pathophysiology, diagnose the condition, recognize the inciting agent/agents, and manage it appropriately. It is equally important to confirm the diagnosis for preventing a catastrophic event from happening in future. This chapter defines anaphylaxis, discusses the clinical manifestations and most common causes, and describes ways it can be diagnosed. It also considers treatment and preventative measures. The chapter uses a case study of a 55-year-old female, weighing 85 kg and a body mass index of 36 with no other known comorbidities, who is scheduled to undergo elective laparoscopic cholecystectomy.

P6500Genetics links abdominal and thoracic aorta aneurysm

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A S Ijpma ◽  
D Heijsman ◽  
J W Roos-Hesselink ◽  
H J M Verhagen ◽  
S Ter Raa ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Aortic Aneurysms ◽  
Abdominal Aneurysm ◽  
Aorta Aneurysm ◽  
Family Screening ◽  
First Degree Relatives ◽  
Whole Exome ◽  
Increased Risk ◽  
Thoracic Aorta Aneurysm

Abstract Introduction Familial disease, with a genetic cause, occurs in at least 20–30% of the families of patients with an aortic aneurysm. In these families there is an increased risk for relatives. Therefor family screening is recommended around the age of 50–60 years for first degree relatives of patients with an abdominal aneurysm (AAA) and relatives of patients with thoracic aorta aneurysms (TAA). However current guidelines do not specify the extend of aorta screening for relatives of patients with AAA and patients with TAA. Current practice is that first degree relatives of AAA patients are offered abdominal echo screening for AAA and relatives of TAA patients cardiologic echo for TAAA. Although co- occurrence of AAA with TAAA in rare genetic disease is well known, for other familial aneurysm disease, the frequency of the co-occurrence of AAA and TAAA has not been established. Purpose To improve family screening for familial aneurysm, and identify the role of underlying genetic defects. Methods To determine the genetics of AAA, whole exome sequencing and CT family screening of the complete aorta was performed in 391 families with familial aneurysm. These families are nested in a patient cohort ascertained form unselected consecutively diagnosed AAA patients visiting the Vascular Surgery Clinic at the our MC. Results In 391 families, 360 relatives had a dilated aorta. The spectrum of aortic features in the relatives included 210 (58%) relatives with AAA, 102 (28%) relatives with TAA. Co-occurrence of AAA and TAA was noted in 41 (11%) relatives. In addition 66 (18%) and 79 (22%) had a dilation in the arteria iliaca communis sinistra resp. dextra. In 18 families pathogenic mutations in 11 aneurysm genes were detected. Conclusion To reduce underdiagnoses of relatives of AAA patients, CT screening of the total aorta and the iliac arteries is the method of choice, and should replace echo screening of specific parts of the aorta in relatives. Updating the guidelines for family screening for aortic aneurysms is needed to improve early detection and treatment of family members with aorta dilatations. Acknowledgement/Funding Stichting Lijf en Leven

scholarly journals Surgical treatment for secondary aortoesophageal fistula

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Kayo Sugiyama ◽  
Toru Iwahashi ◽  
Nobusato Koizumi ◽  
Toshiya Nishibe ◽  
Toshiki Fujiyoshi ◽  
...  
Keyword(s):  
Open Repair ◽  
Rare Condition ◽  
Aortic Aneurysms ◽  
Total Arch Replacement ◽  
University Hospital ◽  
Aortoesophageal Fistula ◽  
Thoracic Aortic Aneurysms ◽  
Life Threatening ◽  
Tokyo Medical ◽  
Medical University

Abstract Background Aortoesophageal fistula (AEF) is a relatively rare condition that is often life-threatening. Secondary AEF is a complication of previous surgery, which can be more critical and challenging than primary AEF. The number of secondary AEF is increasing due to increase in the number of thoracic endovascular aortic repair (TEVAR). Although TEVAR has become a successful alternative surgical strategy for thoracic aortic aneurysms, secondary AEF after TEVAR might be critical than other secondary AEF because of severe adhesion between the esophagus and residual thoracic aortic wall. Methods This study analyzed six patients with secondary AEF who were treated at Tokyo Medical University Hospital between 2011 and 2016. These participants included four patients who had undergone TEVAR and two who had undergone total arch replacement. Results Although they were subsequently hospitalized for a long period, open surgical repair was completed in two patients who had undergone total arch replacement. TEVAR alone was performed in two patients who had undergone TEVAR and they were discharged without major complications shortly. Combined repair of TEVAR as a bridge to open surgery was planned for two patients who had undergone TEVAR. However, reconstruction of the aorta and esophagus could not be completed in these patients due to severe adhesions, and they died during hospitalization. Conclusions Definitive open repair was successfully performed in patients with secondary AEF after total arch replacement. However, in the patients with secondary AEF after TEVAR, severe adhesion between the aorta and esophagus led to difficulty in performing a successful definitive open repair. The strategy for secondary AEF should, therefore, be decided considering the etiology of secondary AEF. In secondary AEF after TEVAR, definitive open repair is difficult to complete because of catastrophic complication, and palliative treatment using TEVAR without reconstruction of aorta and esophagus can be an alternative.

Sign in / Sign up

Export Citation Format

Share Document