Search results for " thoracic"
showing 10 items of 217 documents
Multiple periscope and chimney grafts to treat ruptured thoracoabdominal and pararenal aortic aneurysms
2011
Purpose: To report midterm outcomes after urgent endovascular repair of ruptured pararenal or thoracoabdominal aortic aneurysms using multiple periscope and chimney grafts to preserve renovisceral branch perfusion and facilitate aneurysm exclusion. Methods: Nine consecutive men (mean age 72614 years, range 40–88) presenting with ruptured thoracoabdominal (n56), pararenal (n52), or infrarenal (n51) aortic aneurysm underwent urgent endovascular repair with at least 1 periscope graft delivered via a transfemoral access; chimney grafts were installed from an axillary access. In all, 17 periscope and 7 chimney grafts were used to reperfuse 11 renal and 13 visceral arteries in the 9 patients. The…
[Tuberculosis epidemiology in area 15 of the Spanish autonomous community of Valencia: evolution from 1987 through 2001].
2005
Objectives TO describe the evolution of tuberculosis epidemiology in Area 15 of the Autonomous Community of Valencia. Material and Methods Cases of tuberculosis were identified by active case finding in Area 15 from January 1987 through December 2001. Clinical and epidemiological data were extracted from case records and a patient interview. Results Four hundred seventy-six diagnosed cases of mycobacterial infection were identified (459 tuberculosis, 16 atypical, and 1 mixed); 423 tuberculosis patients were residents of Area 15. The mean annual incidence rate was 24.6/100 000 population, representing a rate decrease of 41.5% from 1990. The most frequent risk factors were smoking (38%), alco…
Echocardiography in diagnosis of aortic dissection.
1989
In a multicentre study the accuracy of echocardiography was measured in 164 consecutive patients with suspected aortic dissection. The diagnosis was subsequently proven (82 patients) on the basis of transthoracic and transoesophageal echocardiography and additional diagnostic procedures, including computed tomography (CT), aortic angiography, and surgery and/or necropsy. The sensitivity and specificity of echocardiography were 99% and 98%, respectively, with positive and negative predictive values of 98% and 99%. For CT sensitivity was 83%, specificity 100%, and positive and negative predictive values 100% and 86%, respectively. For aortography sensitivity and specificity were 88% and 94%, …
Expanding the clinical spectrum of late-onset Pompe disease: Dilated arteriopathy involving the thoracic aorta, a novel vascular phenotype uncovered
2011
Abstract Purpose Cerebro-vascular arteriopathy has been reported in late-onset Pompe disease (LOPD). Evidence of increased aortic stiffness in some patients and smooth muscle involvement in LOPD raises the possibility of aortic involvement. Our aim was to determine if aortic arteriopathy may be a complication of LOPD. Methods One patient with LOPD was diagnosed with aortic dilatation at Duke Metabolic clinic, 4 others were diagnosed at University of Mainz, Germany, where chest X-ray and echocardiography are routinely done for patients. Other causes of aortic vascular disease were assessed. Results We report evidence of dilated arteriopathy involving primarily the ascending thoracic aorta in…
Prognostic value of initial chest CT findings for clinical outcomes in patients with COVID-19
2020
Rationale: To identify whether the initial chest computed tomography (CT) findings of patients with coronavirus disease 2019 (COVID-19) are helpful for predicting the clinical outcome. Methods: A total of 224 patients with laboratory-confirmed COVID-19 who underwent chest CT examination within the first day of admission were enrolled. CT findings, including the pattern and distribution of opacities, the number of lung lobes involved and the chest CT scores of lung involvement, were assessed. Independent predictors of adverse clinical outcomes were determined by multivariate regression analysis. Adverse outcome were defined as the need for mechanical ventilation or death. Results: Of 224 pat…
Acute Respiratory Distress Syndrome Caused by Pulmonary Nocardiosis in a Patient With Systemic Lupus Erythematosus
2005
Nocardia is a gram-positive bacillus that infects mainly immunodepressed patients. Its association with lupus erythematosus has been described only occasionally and we have found no reports in the literature of an association between lupus and acute respiratory distress syndrome due to pulmonary nocardiosis. We present such a case and discuss the mechanisms that make this lung infection so virulent as well as its epidemiological and microbiological characteristics, clinical presentation, diagnosis, and treatment.
Chimney and periscope grafts to facilitate endovascular treatment of aortic transection in a patient with aberrant right subclavian artery
2014
Purpose: To report the use of parallel grafts to extend the proximal landing zone for stentgraft repair of aortic transection involving an aberrant right subclavian artery (ARSA). Case Report: A 28-year-old patient was referred for treatment of traumatic aortic transection with contained rupture at the level of an ARSA. Immediate thoracic endovascular aortic repair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealing and maintain perfusion to both subclavian arteries, a chimney stent to the left subclavian artery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. After surgical repair of all fractures, the patient was discharged 1 month aft…
Impact of Thoracic Endografting on the Hemodynamics of the Native Aorta: Pre- and Postoperative Assessments of Wall Shear Stress and Vorticity Using …
2021
Purpose To quantify the hemodynamic consequences of thoracic endovascular aortic repair (TEVAR) by comparing the preoperative and postoperative wall shear stress (WSS) and vorticity profiles on computational fluid dynamics (CFD) simulations. Materials and Methods The pre- and postoperative computed tomography (CT) scans from 20 consecutive patients (median age 69 years, range 20–87) treated for different thoracic aortic pathologies (11 aneurysms, 5 false aneurysms, 3 penetrating ulcers, and 1 traumatic aortic rupture) were segmented to construct patient-specific CFD models using a meshless code. The simulations were run over the cardiac cycle, and the WSS and vorticity values measured at th…
Effect of divalent cations on KCl- and noradrenaline-induced contractile responses in rat aorta after nifedipine treatment.
1999
Abstract Nifedipine (1 μM) relaxed the sustained contractile responses induced by 1 μM noradrenaline or 60 mM KCl in rat aortic strips. After washing, a second addition of the spasmogens gave smaller tonic contractions than the first one. Even more, a third addition of KCl also gave a smaller contraction than the first one, but a complete recovery of the contractile response to noradrenaline was obtained by a third addition of this agonist. Application of cumulative amounts of Ca2+ or Ba2+ (2.4–24 mM) on the residual contraction in response to these agents after nifedipine treatment, but in the absence of the blocker, restored the magnitude of the contractile responses. Addition of cumulati…
The 5-HT and alpha-adrenoceptor antagonist effect of four benzylisoquinoline alkaloids on rat aorta.
1998
Abstract The action of four benzylisoquinoline alkaloids (two aporphines—glaucine and apomorphine, a benzylisoquinoline—papaverine and a bisbenzyltetrahydroisoquinoline—antioquine) on 5-HT-induced contraction in rat thoracic aorta has been examined and compared with that of the control drugs: ketanserin, nifedipine, prazosin and phentolamine. The relaxant action on 5-HT-induced contraction was contrasted with that on the contraction induced by noradrenaline and KCl. The results obtained with control drugs show that ketanserin has clear selectivity for 5-HT receptors, whereas prazosin and phentolamine have high selectivity for the α1-adrenoceptor and nifedipine seems to have a more potent ef…