scholarly journals Fibromuscular dysplasia of aortic aneurysm vasa vasorum (a rare case report)

2020 ◽  
Vol 27 (4) ◽  
pp. 169-178
Author(s):  
S. S. Todorov ◽  
V. Yu. Deribas ◽  
A. S. Kaz’min ◽  
S. S. Todorov
Keyword(s):  
Aortic Aneurysm ◽  
Histological Examination ◽  
Fibromuscular Dysplasia ◽  
Aortic Wall ◽  
Vasa Vasorum ◽  
Wall Thickening ◽  
Elastic Fibres ◽  
Ascending Aortic Aneurysm ◽  
Aneurysm Wall ◽  
Smooth Myocytes

Aim. To describe a rare occurrence of fibromuscular vasa vasorum dysplasia of the aortic aneurysm wall.Materials and methods. Surgical material from the ascending aortic aneurysm wall was examined. Longitudinal strips of the aortic wall were excised for histological examination with subsequent 24-h fixation in 10% buffered formalin. A histological isopropanol assay was performed with an automated Logos microwave tissue processor (Milestone, Italy) with subsequent sample embedding into paraffin. Sections were obtained with a rotary microtome (Leica, Germany). Staining was performed with haematoxylin-eosin, van Gieson’s picrofuchsin, orcein for elastic fibres, Hotchkiss’ PAS reaction with alcian blue for glycosaminoglycans. Histological and histochemical properties of the aortic wall were studied and imaged with a Leica DM 1000 microscope (Germany) equipped with a camera ICC50 E at magnifications 40x, 100x, 200x, 400x.Results. The conducted histological examination of the aortic aneurysm wall revealed most pronounced changes in media and adventitia layers. Elastic fibres in media were swollen, homogeneous, crimped, with pronounced dystrophic and necrobiotic changes in smooth myocytes. Regions of compromised cells and elastic fibres in media contained pockets of alcian-positive glycosaminoglycans. Specific changes were revealed in adventitia vasa vasorum in the form of a pronounced wall thickening and lumen narrowing due to dysplastic fibromuscular tissues.Conclusion. A rare form of fibromuscular dysplasia of the vasa vasorum of the ascending aortic aneurysm wall observed in a 43 years-old woman demonstrated the morbid morphology of smooth myocytes, as well as fibrous collagenous and elastic structures. The described features were likely associated with the aortic wall trophic structure and aneurysm morphogenesis.

scholarly journals Features of Morphogenesis of Aortic Aneurysms on the Background of Hypertension and Associated Risk Factors

2021 ◽  
pp. 62-66
Author(s):  
V. Zakharova ◽  
O. Rudenko ◽  
V. Kravchenko
Keyword(s):  
Risk Factors ◽  
Aortic Aneurysm ◽  
Aortic Wall ◽  
Elevated Pressure ◽  
Aortic Aneurysms ◽  
Vasa Vasorum ◽  
Morphological Examination ◽  
Ascending Aortic Aneurysm ◽  
The Media ◽  
Associated Risk Factors

The aim. To investigate the role of hypertension and associated risk factors in the formation of aortic aneurysms. Material and methods. Retrospective analysis of 196 case histories of patients who were successively operated on for ascending aortic aneurysm at the National Amosov Institute of cardiovascular surgery. The history was analyzed, the duration and degree of hypertension were recorded, as well as other factors that may have influenced the development of ascending aortic aneurysm in some way. A pathomorphological examination of fragments of the aortic wall that were excised during the operation was performed. Out of all 294 examined patients operated for ascending aortic aneurysm, hypertension was reported in 196 (66.7%) patients. The incidence of ascending aortic aneurysm positively correlated with the duration of hypertension. The ma-jority of patients (118 [60.2%]) had signs of hypertension for more than five years. Additional ethiopathogenetic fac-tors were identified in patients with ascending aortic aneurysm and hypertension, with atherosclerosis ranking first (66 [33.6%]). The next factors that demonstrated the same incidence were the inflammatory process in the aorta and AV, and smoking: 45 cases each (22.9%). Then, in descending order, were: xenobiotics exposure (43 [21.9%]), rheumatic stenosis of AV (40 [20.4%]), chest injury (33 [16.8%]), dysplasia of AV (28 [14.3%]), alcohol abuse (13 [6.6%]), Marfan syndrome (9 [4.6%]), other (8 [4.1%]). The results of comparison of the history and pathomorphological findings allowed to develop a scheme of ascending aortic aneurysm pathogenesis in hypertension. The scheme of ascending aortic aneurysm pathogenesis in hypertension is discussed in the work. The results of morphological examination show that hypertension is associated with the dam-age to the aortic endothelium, which leads to fibromuscular proliferation of the intima with subsequent hypoxic damage to the inner layer of the media. Hypoxic damage to the media, which is associated with vasa vasorum remodeling due to hypertension, is also observed in the subventricular layer. Weakening of the aortic wall at elevated pressure causes dila-tation of the aorta, i.e. the formation of an aortic aneurysm. This process may be exacerbated by additional factors, with atherosclerosis being the most common (33.6%)

Abstract 672: Histopathological Comparison of Ascending Aortic Aneurysm: Bicuspid versus Tricuspid Aortic Valve Patients

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Hiroaki Osada ◽  
Katsuaki Meshii ◽  
Motoaki Ohnaka ◽  
Naoki Kanemitsu ◽  
Hiroyuki Nakajima ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Smooth Muscle Cells ◽  
Aortic Wall ◽  
Vasa Vasorum ◽  
Ascending Aortic Aneurysm ◽  
Tricuspid Aortic Valve ◽  
Group B ◽  
Elastic Lamina

Introduction: The pathogenic mechanisms of ascending aortic aneurysm are not fully understood. The aim of this study was to identify the beginning of aortic wall dilatation based on histopathological evaluation by comparison of patients with bicuspid versus tricuspid aortic valves. Methods: Twenty-one patients (9 males, 12 females; mean age, 69±8.9 years) who underwent ascending aortic repair from 2008 to 2014 were divided into bicuspid aortic valve (n=8, Group B) and tricuspid aortic valve (n=13, Group T) subgroups. We compared the histopathological characteristics of the ascending aortic wall in these patients. Results: There were no significant differences between the two groups in age, sex, history of hypertension, and maximum diameter of the ascending aorta (Group B: 51.4±5.1 mm; Group T: 55.5±8.8 mm; p=0.247) at the time of operation. While all Group B cases exhibited aortic stenosis, there was only one case in Group T. Sclerosis or hypertrophy of the vasa vasorum was evident in both groups (Group B: 7 patients, 87.5%; Group T: 10 patients, 76.9%; p=1.000). Group B patients exhibited a much thinner aortic wall, resulting from frail smooth muscle cells of media, which induced a fragile thinner elastic lamina. The histopathological pattern of Group T was variable and included atheroma, inflammatory granulation tissue and a Marfan-like acid mucopolysaccharide pool, which produce severe fragmentation of elastic lamina. Conclusions: Degeneration of the vasa vasorum, which induces chronic ischemia or malnutrition of the aortic wall, is an important emerging substrate for the development of ascending aortic aneurysm. Bicuspid aortic valve patients exhibited congenital maldevelopment of the medial smooth muscle cells and elastic lamina. Tricuspid aortic valve patients exhibited severe fragmentation of elastic lamina, which induced by pathological changes including atheroma, inflammatory granuloma, and a Marfan-like acid mucopolysaccharide pool.

Complete Regional Absence of Vasa Vasorum in an Ascending Aortic Aneurysm

2021 ◽  
Author(s):  
Andre Y. Son ◽  
Nicole M. DeMarais ◽  
S. Chris Malaisrie ◽  
Jon W. Lomasney ◽  
Maurice Pradella ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Vasa Vasorum ◽  
Ascending Aortic Aneurysm

scholarly journals Medial Hypoxia and Adventitial Vasa Vasorum Remodeling in Human Ascending Aortic Aneurysm

2018 ◽  
Vol 5 ◽  
Author(s):  
Marie Billaud ◽  
Jennifer C. Hill ◽  
Tara D. Richards ◽  
Thomas G. Gleason ◽  
Julie A. Phillippi
Keyword(s):  
Aortic Aneurysm ◽  
Vasa Vasorum ◽  
Ascending Aortic Aneurysm

scholarly journals Aortic wall thickness in patients with ascending aortic aneurysm versus acute aortic dissection

2015 ◽  
Vol 49 (3) ◽  
pp. 756-762 ◽  
Author(s):  
Joeri Van Puyvelde ◽  
Eric Verbeken ◽  
Peter Verbrugghe ◽  
Paul Herijgers ◽  
Bart Meuris
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Wall Thickness ◽  
Aortic Wall ◽  
Acute Aortic Dissection ◽  
Ascending Aortic Aneurysm ◽  
Aortic Wall Thickness

On the severity of aortic stenosis in ascending aortic aneurysm: A computational tool to examine ventricular-arterial interaction and aortic wall stress

2020 ◽  
Vol 110 ◽  
pp. 103621
Author(s):  
Federica COSENTINO ◽  
Marzio DI GIUSEPPE ◽  
Valentina AGNESE ◽  
Giovanni GENTILE ◽  
Giuseppe M RAFFA ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Stenosis ◽  
Aortic Wall ◽  
Wall Stress ◽  
Computational Tool ◽  
Ascending Aortic Aneurysm

scholarly journals Evaluation of Distensibility and Stiffness of Ascending Aortic Aneurysm using Magnetic Resonance Imaging

2016 ◽  
Vol 55 (204) ◽  
pp. 67-71
Author(s):  
Kaushal Kishore Tiwari ◽  
Stefano Bevilacqua ◽  
Giovanni Aquaro ◽  
Pierluigi Festa ◽  
Lamia Ait-Ali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Aortic Aneurysm ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Aortic Wall ◽  
Pulse Wave ◽  
Ascending Aorta ◽  
Resonance Imaging ◽  
Ascending Aortic Aneurysm

Introduction: Magnetic resonance imaging emerging as a new tool for the diagnosis and evaluation of ascending aortic aneurysm. The aim of our study is to evaluate in vivo distensibility and pulse wave velocity of the aortic wall using functional magnetic resonance imaging technique.Methods: We enrolled 25 patients undergoing surgery for ascending aortic aneurysm and or aortic valve replacement for a period of 8 months. Preoperatively, all the patients underwent functional MRI study of the aorta. Aortic wall distensibility and pulse wave velocity of ascending aorta was evaluated. Results: Mean age of the patient was 66 years (66.68 ± 5.62 years) with 60% (15) male patients. More than fifty percentages of patients were smoker (52%), hypertensive (64%) and diabetic (56%). We have observed significant decrease of distensibilty in the patients with aortic diameter above 50 mm (p-0.0002). Furthermore, we have found a significant inverse correlation between aortic distensibility and pulse wave velocity (R= -0.650, R2= 0.42, p-0.0004). Similarly, we have found a significant inverse correlation between ascending aortic diameter and distensibility of the aorta (R= -0.785, R2= 0.61, p-0.00001). Statistically significant positive correlation was observed between aortic diameter and pulse wave velocity (R= 0.865, R2= 0.74, p-0.00001).Conclusions: MRI measurement of aortic diameters, distensibility, and flow wave velocity is an easy, reliable and reproducible technique. Distensibility and pulse wave velocity define the elasticity of the aorta. We have observed that elasticity of aortic wall is decreased in ascending aorta aneurysm patients. Keywords: ascending aorta aneurysm; distensibility; pulse wave velocity; MRI. | PubMed

scholarly journals Thoracic Aortic Aneurysm and Factors Affecting Aortic Dissection

2020 ◽  
Vol 10 (4) ◽  
pp. 153 ◽  
Author(s):  
Petr V. Chumachenko ◽  
Anton Yu. Postnov ◽  
Alexandra G. Ivanova ◽  
Olga I. Afanasieva ◽  
Maksim A. Afanasiev ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Vasa Vasorum ◽  
Factors Affecting ◽  
Aneurysm Wall ◽  
Morphometric Investigation ◽  
Monocytes And Macrophages ◽  
Inflammatory Infiltrates ◽  
Von Willebrand

This study is aimed at investigating the relationship between inflammation, the number of vasa vasorum, and the presence of lipoprotein (a) [Lp(a)] in the aortic aneurysm wall, as well as the relationships of these pathological processes with the development of aneurysm wall dissection. To that end, we examined segments of aortic aneurysm wall, consisting of intima, media, and adventitia, collected from patients during aneurysm prosthetics intervention. The material was collected from 23 men and eight women aged from 33 to 69 years. Monoclonal antibodies to Lp(a), markers of monocytes and macrophages (CD68), T cells (CD3, CD4, and CD8), von Willebrand factor, endothelium NO synthase, and smooth muscle α-actin were used for morphological and morphometric investigation. The present study demonstrated that Lp(a) is not often found in biopsies of patients with thoracic aortic aneurysm. Morphological and morphometric investigation shows the connection of aortic dissection with the process of damage to its wall caused by inflammatory infiltrates, medianecroses, and the appearance of newly formed vasa vasorum in media.

scholarly journals Is Abdominal Aortic Aneurysm Behavior after Endovascular Repair Associated with Aneurysm Wall Density on Computed Tomography Angiography?

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 406
Author(s):  
Skrebūnas ◽  
Lengvenis ◽  
Builytė ◽  
Žulpaitė ◽  
Bliūdžius ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Computed Tomography Angiography ◽  
Aortic Wall ◽  
Control Group ◽  
Density Score ◽  
Aneurysm Wall ◽  
Abdominal Aortic ◽  
Aortic Pathology

Background and objectives: Abdominal aortic aneurysm (AAA) growth is unpredictable after the endovascular aneurysm repair (EVAR). Continuing aortic wall degradation and weakening due to hypoxia may have a role in post-EVAR aneurysm sac growth. We aimed to assess the association of aortic wall density on computed tomography angiography (CTA) with aneurysm growth following EVAR. Materials and Methods: A total of 78 patients were included in the study. The control group consisted of 39 randomly assigned patients without aortic pathology. Post-EVAR aneurysm sac volumes on CTA were measured twice during the follow-up period to estimate aneurysm sac behavior. A maximum AAA sac diameter, aortic wall and lumen densities in Hounsfield units (HU) on CTA were measured. A relative aortic wall density (the ratio of aortic wall to lumen densities) was calculated. A statistical data analysis was performed using standard methods. Results: An increase in the AAA sac volume was observed in 12 (30.8%) cases. Median relative aortic wall density on CTA scores in both the patient and the control group at the level of the diaphragm were similar: 0.15 (interquartile range (IQR), 0.11–0.18) and 0.16 (IQR 0.11–0.18), p = 0.5378, respectively. The median (IQR) relative aortic wall density score at the level of the maximum AAA diameter in the patient group was lower than at the level below renal arteries in the control group: 0.10 (0.07–0.12) and 0.17 (0.12–0.23), p < 0.0001, respectively. The median (IQR) relative growing AAA sac wall density score was lower than a relative stable/shrinking AAA sac wall density score: 0.09 (0.06–0.10) and 0.11 (0.09–0.13), p = 0.0096, respectively. Conclusions: A lower aortic aneurysm wall density on CTA may be associated with AAA growth after EVAR.

scholarly journals Computational analysis of aortic haemodynamics in the presence of ascending aortic aneurysm

2021 ◽  
pp. 1-14
Author(s):  
Aleksandra Petuchova ◽  
Algirdas Maknickas
Keyword(s):  
Blood Flow ◽  
Aortic Aneurysm ◽  
Computational Analysis ◽  
Aortic Wall ◽  
Cardiac Cycle ◽  
Vascular Wall ◽  
Blood Velocity ◽  
Oscillatory Shear Index ◽  
Ascending Aortic Aneurysm ◽  
Haemodynamic Parameters

BACKGROUND: The usefulness of numerical modelling of a patient’s cardiovascular system is growing in clinical treatment. Understanding blood flow mechanics can be crucial in identifying connections between haemodynamic factors and aortic wall pathologies. OBJECTIVE: This work investigates the haemodynamic parameters of an ascending aorta and ascending aortic aneurysm in humans. METHODS: Two aortic models were constructed from medical images using the SimVascular software. FEM blood flow modelling of cardiac cycle was performed using CFD and CMM-FSI at different vascular wall parameters. RESULTS: The results showed that highest blood velocity was 1.18 m/s in aorta with the aneurysm and 1.9 m/s in healthy aorta model. The largest displacements ware in the aorta with the aneurysm (0.73 mm). In the aorta with the aneurysm, time averaged WSS values throughout the artery range from 0 Pa to 1 Pa. In the healthy aorta, distribution of WSS values changes from 0.3 Pa to 0.6 Pa. CONCLUSIONS: In the case of an ascending aortic aneurysm, the maximum blood velocity was found to be 1.6 times lower than in the healthy aorta. The aneurysm-based model demonstrates a 45% greater wall displacement, while the oscillatory shear index decreased by 30% compared to healthy aortic results.

Sign in / Sign up

Export Citation Format

Share Document