Search results for " Dissection"
showing 10 items of 225 documents
Penn classification in acute aortic dissection patients
2016
Objective The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgery in acute type A aortic dissection patients. Methods We evaluated 58 patients (42 men and 16 women; mean age 62.17 ± 10.6 years) who underwent emergency surgery for acute type A aortic dissection between September 2003 and June 2010 in our department. We investigated the correlation between the pre-operative malperfusion and in-hospital outcome after surgery. Results Twenty-eight patients (48%) were Penn class Aa (absence of branch vessel malperfusion or circulatory collapse), 11 (19%) were Penn class Ab (branch vessel malperfusion with ischaemi…
Vitamin D Receptor Activation Reduces Angiotensin-II–Induced Dissecting Abdominal Aortic Aneurysm in Apolipoprotein E–Knockout Mice
2015
Objective— Abdominal aortic aneurysm (AAA) is a vascular disorder characterized by chronic inflammation of the aortic wall. Low concentrations of vitamin D 3 are associated with AAA development; however, the potential direct effect of vitamin D 3 on AAA remains unknown. This study evaluates the effect of oral treatment with the vitamin D 3 receptor (VDR) ligand, calcitriol, on dissecting AAA induced by angiotensin-II (Ang-II) infusion in apoE −/− mice. Approach and Results— Oral treatment with calcitriol reduced Ang-II–induced dissecting AAA formation in apoE −/− mice, which was unrelated to systolic blood pressure or plasma cholesterol concentrations. Immunohistochemistry and reverse-tran…
Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection
2014
Item does not contain fulltext Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year). Minor cervical traumas, infection, migraine and hypertension are putative risk factors, and inverse associations with obesity and hypercholesterolemia are described. No confirmed genetic susceptibility factors have been identified using candidate gene approaches. We performed genome-wide association studies (GWAS) in 1,393 CeAD cases and 14,416 controls. The rs9349379[G] allele (PHACTR1) was associated with lower CeAD risk (odds ratio…
Detection of a Dissecting Aortic Aneurysm by Renal Transplant Imaging
1997
After 2 years with a normal post-transplant course a 45-year-old man showed an elevated creatinine level (4.5 mg/dL). Transplantation had been neccessary because of progressive glomerulonephritis. Renal transplant imaging was obtained with 150 Mbq Tc-99m MAG3. The perfusion images showed radionuclide accumulation in the area of the upper abdominal aorta and delayed perfusion of the right iliac artery. Accumulation of Tc-99m MAG3 in the transplant was slow and no filling of the bladder could be observed. Immediately after imaging, the patient developed acute hemorrhagic shock. At emergency surgery, a long dissecting and ruptured aneurysm of the abdominal aorta was seen causing delayed and re…
Bilateral Hypoglossal Nerve Palsy in an Adult Patient With Repaired Tetralogy of Fallot
2018
Introduction Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young and middle-aged adults, but the occurrence of multiple sCADs could suggest the presence of an underlying arteriopathy. Bilateral hypoglossal nerve palsy caused by extracranial internal carotid artery dissections have been rarely described. We present the case of a 3-vessel sCAD in a patient with repaired tetralogy of Fallot (ToF). Case report A 50-year-old man was admitted to our stroke unit for a sudden onset of left cervical pain, mild left ptosis, dysarthria, and dysphagia. His medical history was remarkable for surgically repaired ToF. Neurological examination showed left Claude-Berna…
Pneumomediastinum and pneumopericardium due to malignant subcarinal lymphadenopathy: CT demonstration
1997
A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection on the right and cervical irradiation (60 Gy). Two months after therapy he presented with dysphagia and hemoptysis. Admission chest X-ray revealed a pneumopericardium. It was caused by a bronchomediastinal fistula due to necrotic metastatic lymph nodes as shown by CT, which also revealed a concomitant pneumomediastinum. The patient died 10 days later from pneumonia. The CT findings were confirmed at autopsy. We conclude that malignant mediastinal lymphadenopathy is a potential cause of pneumopericardium and pneumomediastinum.
Endovascular Treatment of Spontaneous Internal Carotid Artery Dissection with Proximal Embolic Protection Device
2019
Background The aim of this study was to report the feasibility and outcomes with the endovascular treatment of spontaneous internal carotid artery dissections (ICADs) using a proximal embolic protection device (EPD). Methods This is a retrospective analysis of patients treated for spontaneous symptomatic ICAD using a proximal EPD from January 2017 to December 2018. Indication for treatment was the presence of neurologic symptoms. Early outcomes measured included technical success, perioperative mortality, and major cardiovascular or cerebrovascular complications. Late outcomes were recurrent neurologic symptoms, patency, and reinterventions. Results A total of 4 male patients with ICAD were…
Indication and technique for the reconstruction of nerve defects in head and neck.
1974
Summary Although the results of peripheral nerve repair have been greatly improved in the last years following the introduction of microsurgery and increased application of free autologous nerve transplants, the use of restorative neuroplasty in maxillofacial surgery has been limited. Prompted by the successful reports on modern neuroplasty, we have introduced the use of autologous nerve transplant to bridge lesions of various cranial nerves. Our experience is based on the treatment of traumatic and tumour-induced defects of the facial nerve, inferior alveolar nerve, accessory and lingual nerve. The anastomosis of nerve was accomplished exclusively under the surgical microscope and microsur…
Repair of TEVAR-Associated Type A Dissection in the Elderly Is Possible With Reasonable Morbidity and Mortality.
2018
Background: Type A aortic dissection (AAD) is a devastating complication of thoracic endovascular repair (TEVAR). In elderly patients, surgery for AAD carries considerable morbidity and mortality. Repair of AAD after previous TEVAR is an even greater challenge as it usually requires the arch to be addressed and a preexisting stent graft to be included into the aortic repair. Methods: A case series of 5 elderly patients who presented with acute AAD after previous TEVAR was reviewed. In 4 cases, there was retrograde AAD with involvement of the arch and stent graft. In 1 patient, intraoperative inspection showed no involvement of the arch. Three underwent ascending and subtotal arch replacemen…
Aortic intramural hemorrhage visualized by transesophageal echocardiography: Findings and prognostic implication
1994
Abstract Objectives. This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. Background. Localized aortic intramural hemorrhage resulting in layered thickening of the aortic wall seems to represent a variant of acute aortic dissection without communication or a typical moving intimal flap. In autopsy studies this variant, attributed to a rupture of the van vasorum, has been described in 5% to 10% of patients with dissection. Methods. In a prospective transesophageal echocardiographic study in patients with aortic dissection performed between 1986 and 1991, the diagnosis of intramural hemorrhage was established in 15 of…