Dissertations / Theses on the topic 'Abdominal aneurysm'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Abdominal aneurysm.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
Rossaak, Jeremy Ian, and n/a. "The genetics of abdominal aortic aneurysms." University of Otago. Dunedin School of Medicine, 2004. http://adt.otago.ac.nz./public/adt-NZDU20070502.143818.
Full textSvensjö, Sverker. "Screening for Abdominal Aortic Aneurysm." Doctoral thesis, Uppsala universitet, Kärlkirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-198677.
Full textChinien, Ganessen. "Molecular genetics of abdominal aortic aneurysm." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/molecular-genetics-of-abdominal-aortic-aneurysm(e269485a-e71a-41a7-9a8e-ae40eb968dd4).html.
Full textMalina, Martin. "Endovascular repair of abdominal aortic aneurysms aspects on a novel technique /." Lund : Dept. of Vascular and Renal Diseases, Lund University, Malmö University Hospital, 1998. http://books.google.com/books?id=hWBsAAAAMAAJ.
Full textLowe, Christopher. "Three-dimensional ultrasound in the management of abdominal aortic aneurysm." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/threedimensional-ultrasound-in-themanagement-of-abdominal-aorticaneurysm(b8950db7-847b-4d11-a6a5-2a06b3bb66d0).html.
Full textDjavani, Gidlund Khatereh. "Intra-abdominal Hypertension and Colonic Hypoperfusion after Abdominal Aortic Aneurysm Repair." Doctoral thesis, Uppsala universitet, Institutionen för kirurgiska vetenskaper, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-149241.
Full textBoyle, Jonathan Robert. "New perspectives in abdominal aortic aneurysm management." Thesis, University of Leicester, 2000. http://hdl.handle.net/2381/29606.
Full textChoke, Tieng Chek. "Molecular mechanisms of abdominal aortic aneurysm rupture." Thesis, St George's, University of London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511897.
Full textWatton, Paul N. "Mathematical modelling of the abdominal aortic aneurysm." Thesis, University of Leeds, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.411948.
Full textHolmström, Ami. "Abdominal Aortic Aneurysm Screening : an Ethical Discussion." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-72994.
Full textAbbas, Abeera. "Multimodality imaging of the abdominal aortic aneurysm." Thesis, King's College London (University of London), 2015. http://kclpure.kcl.ac.uk/portal/en/theses/multimodality-imaging-of-the-nabdominal-aortic-aneurysm(fcdd75c2-eb72-4623-9529-515004d32d8d).html.
Full textBailey, Marc Aaron. "Store operated calcium entry in abdominal aortic aneurysm." Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/13678/.
Full textTambyraja, Andrew Laksman. "Prediction of outcome after abdominal aortic aneurysm rupture." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/29391.
Full textTegler, Gustaf. "Abdominal Aortic Aneurysm : Molecular Imaging Studies of Pathophysiology." Doctoral thesis, Uppsala universitet, Kärlkirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-194663.
Full textOlofsson, Anna. "Capturing circulating microRNAs in abdominal aortic aneurysm disease." Thesis, Uppsala universitet, Institutionen för biologisk grundutbildning, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-296450.
Full textPotseluev, V., and M. Kora. "Anesthesia in endovascular abdominal aortic aneurysm (AAA) repair." Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/58598.
Full textMani, Kevin. "Abdominal aortic aneurysm epidemiological and health economic aspects /." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-110810.
Full textMello, Flávia Moerbeck Casadei de [UNESP]. "Aneurisma da aorta abdominal infra-renal: avaliação ultra-sonográfica em homens acima de 50 anos." Universidade Estadual Paulista (UNESP), 2003. http://hdl.handle.net/11449/87358.
Full textCom o objetivo de avaliar a ocorrência de aneurisma da aorta abdominal infra-renal (AAAIR), estudou-se uma amostra da população masculina do Município de Marília, com idade igual ou acima de 50 anos, no período de 2000 a 2002. Foram avaliados 240 homens por meio da ultrasonografia abdominal (USAb), com média de idade de 65,1 anos (±9,8 anos). A aorta abdominal foi medida no sentido ânteroposterior (AP) e látero-lateral (LL) aproximadamente a 2cm abaixo da artéria mesentérica superior (AMS) e 2cm acima de sua bifurcação. O critério utilizado para considerar aneurisma foi o maior diâmetro encontrado igual ou maior que 3,1cm. Também por questionário, foram avaliados os fatores de risco (tabagismo, sedentarismo, alimentação) e as doenças associadas (HAS, DPOC, IM, DM, AOP ou hiperlipidemia). Nos 240 homens, foram encontrados 11 aneurismas, sendo, portanto, a freqüência de 4,6%. Desses 11 aneurismas, 8 mediam entre 3,1 e 4cm (72,7%) e 3, entre 4,1 e 5cm (27,3%). O maior diâmetro da aorta aneurismática foi de 5 cm (sentido AP a 2cm abaixo da AMS). Foi encontrada uma associação significativa entre aneurisma e AOP e DM, não ocorrendo o mesmo com os demais fatores de risco ou outras doenças associadas. A freqüência de aneurisma encontrada em nossa amostra não foi diferente da referida nos estudos populacionais publicados na literatura, o que mostra a importância da doença em nosso meio, e os indivíduos com AOP e DM têm risco maior de desenvolver a doença.
In order to evaluate the occurrence of Infra-Renal Abdominal Aortic Aneurysm (AAAIR), a sample of the male population in the city of Marília aged 50 years or older was studied from 2000 to 2002. A group of 240 men with mean age of 65,1 years (±9,8 years) was evaluated through abdominal ultra-sonography examination. The abdominal aorta was measured in the anteroposterior (AP) and in the latero-lateral directions (LL) approximately 2cm below the superior mesenteric artery and 2cm above its bifurcation. The largest diameter equal or larger than 3.1cm found was the criterion used for aneurysm. Risk factors such as smoking, eating, and exercise habits and associated diseases (systemic arterial hypertension, chronic obstructive pulmonary disease, myocardial infarction, diabetes mellitus, occlusive peripheral arterial disease, or hyperlipidemia) were also evaluated through questionnaires. Eleven aneurysms were found in the 240 men, which meant a frequency of 4,6%. Out of these 11 aneurysms, 8 measured from 3.1 to 4cm (72,7%) and 3 measured from 4.1 to 5cm (27,3%). The largest diameter of the aneurysmatic aorta was 5cm (AP direction approximately 2cm of the superior mesenteric artery). A significant association between aneurysm and peripheral vascular disease and diabetes mellitus was found. The same did not occur with the other risk factors or other associated diseases. The frequency of aneurysm found in our sample was not different from the frequency mentioned in population studies published in the literature, which shows the importance of the disease in our environment and that patients with peripheral vascular disease and diabetes mellitus have a higher risk to develop the disease.
Tenório, Emanuel Júnio Ramos. "Expressão dos níveis plasmáticos dos miRNA-191 e miRNA-455-3P em pacientes com aneurisma de aorta abdominal e suas relações com a evolução clínica após tratamento endovascular." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-10042018-142246/.
Full textBackground: Abdominal aortic aneurysm (AAA) is an important cause of morbidity and mortality in the elderly population. Endovascular treatment is associated with lower morbidity and mortality than conventional treatment, however, it requires a rigorous follow-up with contrast imaging tests to confirm the aneurysmal sac exclusion. Considering that the formation of an aneurysm is a complex multifactorial process, involving the destructive remodeling of the connective tissue throughout the affected segment of the aortic wall and that this process involves a chronic local inflammation, a decrease in the number of smooth muscle cells of the media tunic, and fragmentation of the extracellular matrix of the aorta and although an aberrant expression profile of miRNAs has been associated with human diseases, including cardiovascular dysfunction, it was proposed to carry out this study involving this whole process. The main objective was to quantify and evaluate miRNA expression response to endovascular correction of abdominal aortic aneurysm based on serum dosages at the six-month follow-up. Population and Method: We recruited 30 consecutive patients with AAA without other associated inflammatory diseases from the Ambulatory of Vascular and Endovascular Surgery of the HCFMRPUSP with indication of endovascular treatment. The miRNA-191 and miRNA-455-3p were selected for study and serum dosages. The differential expression of the miRNAs was performed by the real-time PCR method, after extraction of RNA from the whole blood samples at two moments, preoperatively and after 6 months of follow-up. In addition, bioinformatics tools were used to determine pathophysiological pathways related to AAA. Demographic profile, clinical follow-up and imaging examinations with angiotomography performed in the preoperative period and after 6 months were collected. Results: Hyperexpression of miR-191 and miR-455-3p in whole blood of AAA patients was observed. The endovascular treatment of patients with AAA resulted in a significant decrease in the expression of the miRNAS studied, indicating that the exclusion of the aneurysmal sac altered their expression. In addition, the expression of miR-191 and miR-455-3p showed no correlation with the diameter of the aneurysm and analysis of the influence of the various types of devices used for the endovascular treatment of AAA did not show significant differences in the expression of miR-191 And miR-455-3p. Conclusions: The hyperexpression of miR- 191 and miR-455-3p with its significant reduction after endovascular treatment may suggest the use of these molecules as potential biomarkers in the follow-up of these patients. New studies with a greater number of cases should be performed with the objective of validating the data obtained including patients with possible endoleaks.
Gopalakrishnan, Shyam Sunder. "Dynamics and Stability of Flow through Abdominal Aortic Aneurysms." Doctoral thesis, Université de Lyon 1, Ecole Centrale de Lyon, Lyon, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/245358.
Full textBrekken, Reidar. "Ultrasound-based Estimation of Strain in Abdominal Aortic Aneurysm." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sirkulasjon og bildediagnostikk, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-19999.
Full textChamberlain, Ciara M. "Granzyme B in abdominal aortic aneurysm and aortic dissection." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/5584.
Full textGrytsan, Andrii. "Abdominal aortic aneurysm inception and evolution - A computational model." Doctoral thesis, KTH, Biomekanik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-197289.
Full textBukaortaaneurysm (AAA) kännetecknas av en utbuktning hos aortaväggen i buken. Tillväxt av en AAA är oftast asymtomatisk, men en sådan utbuktning kan plö̈tsligt brista, vilket har hög dödlighet. Tyvärr finns det inga mediciner som kan förhindra AAA från att expandera eller brista. Patienter med upptä̈ckt AAA hålls därför under uppsikt tills operationskrav är uppnådda, såsom maximal AAA-diameter på 55 mm eller expansionstakt på 1 cm/år. Modeller för AAA-tillväxt kan bidra till att öka förståelsen för sjukdomsförloppet och till att förbättra beslutsunderlaget på en patientspecifik basis. AAA modeller för tillväxt och strukturförändring (G&R) är ganska komplicerade och innan man tar sig an denna utmaning krävs de god klinisk validering. I Artikel A har en befintlig tjockväggig modell för tillväxt av ett skikt av en AAA-skiva utö̈kats till en två-skiktsmodell. Denna modell återspeglar bättre den skiktade strukturen hos kärlväggen. Genom en parameterstudie undersö̈ktes påverkan av mekaniska egenskaper och G&R-parametrar hos en sådan modell för AAA-tillväxt. I Artikel B utvidgades modellen från Artikel A till en organnivå-modell för AAA-tillväxt. Vidare inkorporerades modellen i ett “Fluid–Solid–Growth” (FSG) ramverk. En patientspecifik geometri hos bukaortan användes för att illustrera möjligheterna med modellen. I Artikel C undersöktes utvecklingen av patientspecifika biomekaniska egenskaper hos AAA. Fyra patienter som skannats fem till åtta gånger med “Computed Tomography-Angiography” (CT-A) vid olika tillfällen analyserades. Flera icke triviala statistiska samband konstaterades mellan de analyserade parametrarna. I Artikel D undersöktes effekten av olika tillväxt-kinematik för AAA tillväxt. En modell med transversellt-isotrop-i-tjockleken-tillväxt var den bäst lämpade för AAA tillväxt, medans antagandet om fullt-isotrop-tillväxt och transversellt-isotrop-i-planet-tillväxt producerade orimliga resultat. Dessutom gav modellering av vävnadsvolymsförändring ett förbättrat väggtjockleks resultat men en fortsatt överskattning av väggförtunningen under AAA-expansionen.
QC 20161201
Milne, Alan Anderson. "Coagulopathy and haemostasis in surgery for abdominal aortic aneurysm." Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/21422.
Full textGrytsan, Andrii. "Computational model of abdominal aortic aneurysm inception and evolution." Licentiate thesis, KTH, Biomekanik, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-142649.
Full textQC 20140311
Mello, Flávia Moerbeck Casadei de. "Aneurisma da aorta abdominal infra-renal : avaliação ultra-sonográfica em homens acima de 50 anos /." Botucatu : [s.n.], 2003. http://hdl.handle.net/11449/87358.
Full textResumo: Com o objetivo de avaliar a ocorrência de aneurisma da aorta abdominal infra-renal (AAAIR), estudou-se uma amostra da população masculina do Município de Marília, com idade igual ou acima de 50 anos, no período de 2000 a 2002. Foram avaliados 240 homens por meio da ultrasonografia abdominal (USAb), com média de idade de 65,1 anos (±9,8 anos). A aorta abdominal foi medida no sentido ânteroposterior (AP) e látero-lateral (LL) aproximadamente a 2cm abaixo da artéria mesentérica superior (AMS) e 2cm acima de sua bifurcação. O critério utilizado para considerar aneurisma foi o maior diâmetro encontrado igual ou maior que 3,1cm. Também por questionário, foram avaliados os fatores de risco (tabagismo, sedentarismo, alimentação) e as doenças associadas (HAS, DPOC, IM, DM, AOP ou hiperlipidemia). Nos 240 homens, foram encontrados 11 aneurismas, sendo, portanto, a freqüência de 4,6%. Desses 11 aneurismas, 8 mediam entre 3,1 e 4cm (72,7%) e 3, entre 4,1 e 5cm (27,3%). O maior diâmetro da aorta aneurismática foi de 5 cm (sentido AP a 2cm abaixo da AMS). Foi encontrada uma associação significativa entre aneurisma e AOP e DM, não ocorrendo o mesmo com os demais fatores de risco ou outras doenças associadas. A freqüência de aneurisma encontrada em nossa amostra não foi diferente da referida nos estudos populacionais publicados na literatura, o que mostra a importância da doença em nosso meio, e os indivíduos com AOP e DM têm risco maior de desenvolver a doença.
Abstract: In order to evaluate the occurrence of Infra-Renal Abdominal Aortic Aneurysm (AAAIR), a sample of the male population in the city of Marília aged 50 years or older was studied from 2000 to 2002. A group of 240 men with mean age of 65,1 years (±9,8 years) was evaluated through abdominal ultra-sonography examination. The abdominal aorta was measured in the anteroposterior (AP) and in the latero-lateral directions (LL) approximately 2cm below the superior mesenteric artery and 2cm above its bifurcation. The largest diameter equal or larger than 3.1cm found was the criterion used for aneurysm. Risk factors such as smoking, eating, and exercise habits and associated diseases (systemic arterial hypertension, chronic obstructive pulmonary disease, myocardial infarction, diabetes mellitus, occlusive peripheral arterial disease, or hyperlipidemia) were also evaluated through questionnaires. Eleven aneurysms were found in the 240 men, which meant a frequency of 4,6%. Out of these 11 aneurysms, 8 measured from 3.1 to 4cm (72,7%) and 3 measured from 4.1 to 5cm (27,3%). The largest diameter of the aneurysmatic aorta was 5cm (AP direction approximately 2cm of the superior mesenteric artery). A significant association between aneurysm and peripheral vascular disease and diabetes mellitus was found. The same did not occur with the other risk factors or other associated diseases. The frequency of aneurysm found in our sample was not different from the frequency mentioned in population studies published in the literature, which shows the importance of the disease in our environment and that patients with peripheral vascular disease and diabetes mellitus have a higher risk to develop the disease.
Mestre
Hua, Fang. "Role of angiotensin II and inflammatory cells in the development of human abdominal aortic aneurysm /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18409.pdf.
Full textKrenzien, Felix, Ivan Matia, Georg Wiltberger, Hans-Michael Hau, Moritz Schmelzle, Sven Jonas, Udo X. Kaisers, and Peter T. Fellmer. "Early prediction of survival after open surgical repair of ruptured abdominal aortic aneurysms." Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-156960.
Full textMaiellaro, Kathryn Adele. "The role of oxidative stress in abdominal aortic aneurysm development: molecular and mechanical effects in the origins of aneurysmal disease." Diss., Atlanta, Ga. : Georgia Institute of Technology, 2008. http://hdl.handle.net/1853/24708.
Full textCommittee Chair: W. Robert Taylor; Committee Member: John Oshinski; Committee Member: Kathy Griendling; Committee Member: Raymond P. Vito; Committee Member: Rudolph L. Gleason.
Haug, Erik Skaaheim. "Infrarenal abdominal aortic aneurysm : comorbidity and results following open surgery." Doctoral thesis, Norwegian University of Science and Technology, Department of Circulation and Medical Imaging, 2005. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-1772.
Full textHadjianastassiou, Vassilis Georgiou. "Risk stratification modelling in post-operative abdominal aortic aneurysm patients." Thesis, University of Oxford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491903.
Full textQu, Zao, and 瞿早. "Expression of sphingosine-1-phosphate receptor in abdominal aortic aneurysm." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47050834.
Full textAng, Lisa Shouning. "The extracellular role of granzyme B in abdominal aortic aneurysm." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/45649.
Full textLiu, Jing. "THE ROLE OF APOB-CONTAINING LIPOPROTEINS IN ABDOMINAL AORTIC ANEURYSM." UKnowledge, 2015. http://uknowledge.uky.edu/pharmacol_etds/12.
Full textO'Connell, Mary Kathleen. "Understanding abdominal aortic aneurysm progression through three-dimensional microstructure imaging /." May be available electronically:, 2007. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
Full textTroxler, M., Khalid M. Naseem, and Shervanthi Homer-Vanniasinkam. "Increased nitrotyrosine production in patients undergoing abdominal aortic aneurysm repair." Wiley, 2004. http://hdl.handle.net/10454/4094.
Full textVascular inflammation is implicated in the pathogenesis of atherosclerosis and abdominal aortic aneurysm (AAA), and is thought to involve reactive species such as the nitric oxide-derived oxidant peroxynitrite. In the present study nitrotyrosine was measured as a stable marker of peroxynitrite production in vivo. Perioperative blood samples were obtained from patients undergoing elective open or endovascular repair of an AAA and from patients with intermittent claudication, smoking aged-matched controls, non-smoking aged-matched controls and non-smoking young healthy controls. Plasma nitrotyrosine was measured by an enzyme-linked immunosorbent assay. The median plasma nitrotyrosine concentration in patients with an AAA (0·46 nmol nitrated bovine serum albumin equivalents per mg protein) was significantly higher than that in patients with intermittent claudication (0·35 nmol; P = 0·002), smoking controls (0·36 nmol; P = 0·001), non-smoking controls (0·35 nmol; P = 0·002) and young healthy controls (0·27 nmol; P < 0·001). Nitrotyrosine concentrations increased during early reperfusion in open AAA repair, but not during endovascular repair. AAA exclusion from the circulation reduced levels to control values (P = 0·001). Patients with an AAA had raised levels of circulating nitrated proteins compared with patients with claudication and controls, suggesting a greater degree of ongoing inflammation that was not related to smoking. Copyright
Sidloff, David Adam. "The epidemiology of abdominal aortic aneurysm and natural history of type II endoleak after endovascular aneurysm repair." Thesis, University of Leicester, 2015. http://hdl.handle.net/2381/33067.
Full textSolanich, Valldaura Teresa. "Síndrome compartimental abdominal en aneurismas de aorta abdominal rotos." Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/665385.
Full textIntroduction: Ruptured abdominal aortic aneurysms (RAAA) carry a high mortality. Patients who survive surgery have mortality rates of 32 to 80%1-4). Multi-organ failure during the immediate postoperative period is a very common cause of death. Abdominal compartment syndrome (ACS) is present in 30-53% of cases and represents a frequent cause of multi-organ failure with both endovascular and open inter-ventions, which accounts for 70% of deaths (3). ACS is an independent predictor of mortality in RAAA and its prevention, detection and treatment with decompressive laparotomy can increase survival. The aim of the present study was to analyse 30-day survival of patients undergoing RAAA repair, the presence of risk factors for ACS and RAAA and the results obtained with delayed abdominal closure. Material and methods: A retrospective observational study was designed, with the inclusion of patients undergoing RAAA repair between 2002 and 2016 in the Angiology and Vascular Surgery service, at the Hospital Uni-versitari Parc Taulí. RAAA was defined as the extravasation of blood or haematoma outside the wall of the abdominal aortic aneurysm (AAA) in computed tomography (CT) angiography and/or evidence of haematoma outside the AAA during the surgery. The presence of ACS was established according to the parameters established by the WSACS or when primary abdominal closure could not be performed at the discretion of the vascular surgeon. Demographic variables, type of surgery, delayed abdominal closure, pre-, intra- and postoperative ACS risk factors and 30-day survival were collected. Results: A total of 61 patients were included out 85 eligible: 39 open and 22 endovascular surgeries.Patient not submitted to repair were excluded. Overall intra- and postoperative mortality was 54% (66.7% with open surgery and 31.8% with endovascular surgery (p=0.009)). The postoperative results of 43 patients who survived surgery were analysed: 21 (48.8%) with open surgery and 22 (51.2%) with endovascular surgery. Overall 30-day postoperative survival was 67.4% (61.9% with open surgery and 72.7 with endovascular surgery). The most frequent risk factors for abdominal compartment syndrome were: perfusion >5 litres, coag-ulopathy, transfusion > 6 units of packed red blood cells and metabolic acidosis. In the open surgery group: 12 presented ACS, 4 of which died, and 4 of the 9 patients who did not present ACS died (p=0.604). In the endovascular surgery group, 6 patients presented ACS, 4 of which died, and 3 of the 6 patients who did not present ACS died (p=0.032). Of the patients who underwent OS, the abdomen was left open in 9 cases (42.86%), and primary abdominal closure was performed in 12. Delayed abdominal closure increased survival (88.9% vs. 41.7%). Six patients in the endovascular group had decompressive laparotomy during the same sur-gical procedure. Decompressive laparotomy did not increase survival in the endovascular surgery group (42.9% vs. 87.5%). Conclusions: Abdominal compartment syndrome did not increase mortality in the open surgery group. Abdominal compartment syndrome increased mortality in the endovascular surgery group. Intraoperative mortality of RAAA was higher in the open surgery group. We did not detect differences in postoperative mortality of RAAA according to the type of surgery. The risk factors for abdominal compartment syndrome were: perfusion >5 litres, coagulopathy, trans-fusion >6 units of packed red blood cells and metabolic acidosis. Primary decompressive laparotomy increased survival in the open surgery group, but not in the endovascular surgery group.
Thompson, Andrew. "The aetiology behind AAA disease formation and progression." Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/17595/.
Full textSun, Zhonghua. "CT virtual intravascular endoscopy in aortic stent grafting." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248607.
Full textMaroney, Roy Thomas. "Missed opportunities for the detection of abdominal aortic aneurysms : a retrospective study of eighteen patients presenting with a ruptured or acute symptomatic abdominal aortic aneurysm." Master's thesis, University of Cape Town, 1997. http://hdl.handle.net/11427/25566.
Full textAlves, Lais Missae Murakami Domingues Estraiotto. "Estudo da expressão sérica do microRNA-1281, proteína C reativa e avaliação da função renal em indivíduos com aneurisma de aorta abdominal antes e após tratamento endovascular." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-28052018-160605/.
Full textIntroduction: Abdominal aortic aneurysm (AAA) is a prevalent and silent disease. Currently, the endovascular approach has been widely used and is the main technique due to the innumerable advantages. However, it has a higher rate of reintervention and requires periodic follow-up with tomography over the years, which increases its costs and has implications such as altered renal function besides the accumulation of radiation. Such conditions justify the search for possible biomarkers that may perhaps replace CT. Objectives: In this study, we sought to correlate the microRNA-1281, Creactive protein (CRP) and the renal function evaluation of individuals with AAA with their evolution after endovascular treatment. Patients and methods: We selected 30 consecutive patients from the Ambulatory of Vascular and Endovascular Surgery of the HCFMRP-USP, in the period from January of 2104 until November of 2015, with abdominal aortic aneurysm and with indication for endovascular treatment. Serum dosages were made preoperatively and 6 months after the intervention Results: There was a hyperexpression of the micro-RNA -1281 in patients with aneurysm and a significant reduction of their serum levels after endovascular correction. Expression of miRNA-1281 showed a positive correlation with creatinine clearence. There was also a positive correlation of CRP with the presence of the aneurysm, and with its diameter, and there was no significant alteration of renal function measured through serum urea, creatinine and indirect clearance calculations. Conclusion: The study showed that 1281 miRNAs may prove to be a potential biomarker for eventual follow-up of patients undergoing AAA endovascular repair. New studies are needed to validate and complement these findings.
Adam, Donald John. "Coagulation, fibrinolysis and endothelial cell activation in abdominal aortic aneurysm repair." Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/25152.
Full textGalle, Cécile. "Inflammatory and helper T lymphocyte responses in human abdominal aortic aneurysm." Doctoral thesis, Universite Libre de Bruxelles, 2006. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210815.
Full textAbdominal aortic aneurysm (AAA) is a chronic degenerative disease that usually affects men over 65 years with an estimated prevalence of 5%. Aneurysm rupture represents a catastrophic event which carries a mortality rate of almost 90%. Current therapeutic options for AAAs measuring 5.5 cm in diameter or larger are based on prophylactic surgery, including conventional open reconstruction and endovascular stent-graft insertion. For patients with small asymptomatic AAAs (4.0 up to 5.5 cm in diameter), evidence from two recent large randomized controlled trials indicates no long-term survival benefit from immediate elective surgical repair as compared to imaging surveillance until aneurysm expands to 5.5 cm. This highlights the need for development of novel medical management strategies, including selective pharmacologic approaches, directed at preventing aneurysm expansion. In this regard, it is expected that a detailed knowledge of the pathobiology of human AAA lesion and a better understanding of pathophysiological mechanisms underlying initiation and progression of aneurysmal degeneration, particularly the specific involvement of T lymphocytes, will have special relevance to this challenging issue.
Inflammatory and helper T-cell responses in abdominal aortic aneurysm :controversial issues
Innate and inflammatory responses to endovascular versus open AAA repair. The occurrence of early acute systemic inflammatory responses after conventional open AAA repair is widely recognized and is thought to lead to the development of organ dysfunction and multiple organ failure, responsible for a large proportion of morbidity and mortality associated with aortic surgery. New therapeutic strategies designed to avoid ischemia-reperfusion injury related to aortic cross-clamping and to minimize the degree of tissue damage have thus been developed recently. Specifically, the advent of endovascular techniques has radically extended management options for patients with AAA. Although the method is believed to offer a clear short-term benefit over open repair, notably as regards restricted perioperative haemodynamic parameter fluctuations, reduced blood loss, briefer duration of surgery, shorter hospital stay, and lower 30-day mortality and complication rates, conflicting data are available regarding the exact nature and extent of the inflammatory events arising after such endoluminal procedures ;while several authors have indeed reported that endovascular AAA repair can determine a less intense and extensive inflammatory response, others have unexpectedly observed that the method may elicit a strong inflammatory response, the so-called « postimplantation syndrome ».
Adaptive cellular immune responses in human aneurysmal aortic lesion.
The inflammatory nature of AAA disease has long been suggested by the presence of a great number of CD4+ T lymphocytes in the outer media and adventitia of human AAA lesion. Interestingly, such infiltrating T-cell populations may have significant implications in the process of aneurysm dilation, since cytokines produced by T cells, notably IFN-gamma, have previously been shown to modulate production of matrix-degrading enzymes by resident macrophages and to induce apoptosis of medial SMCs. Through these key pathological mechanisms, T cells could potentially contribute to orchestrate aortic wall connective tissue disordered remodeling and degradation, and promote extensive disruption of elastic media, ultimately leading to aneurysmal degeneration. Nevertheless, despite their relative abundance in human AAA wall tissues, there is limited and controversial information as regards the functional profile of lesional lymphocytes, the exact nature of aortic wall adaptive cellular responses, and the etiologic role of T cells and their cytokines in initiation and progression of the aneurysmal process. Indeed, both Th1-type and Th2-type responses have been identified in human studies and experimental animal models of AAA.
Aims of the work
The main objectives of our work were to explore the innate and adaptive cellular immune responses in human AAA. In the first part of our work, we aimed to examine prospectively innate and inflammatory responses arising in a non-randomised cohort of patients undergoing endovascular versus open AAA repair. In the second part of our work, we focused our efforts on characterizing the nature of adaptive cellular immune responses and the phenotypic and functional repertoire of T cells in human AAA wall tissues obtained from a consecutive series of patients undergoing open AAA repair. Specifically, we sought to determine whether type 1 or type 2 responses occur predominantly in advanced AAA lesion.
Main experimental findings
Limited inflammatory response after endovascular AAA repair. Serial peripheral venous blood samples were collected preoperatively, immediately after declamping or insertion of endograft, and after 1, 3, 6, 12, 24, 48, and 72 hours. We first examined the acute phase reaction and liberation of complement cascade products using turbidimetric method and nephelometry. We found that endovascular repair produced lower postoperative CRP, leucocytosis, neutrophilia, and C3d/C3 ratio as compared to open surgery. We next analyzed surface expression of activation markers on peripheral CD3+ T cells using flow cytometry. We observed a strong upregulation of CD38 after open but not endovascular repair. Analysis of CD69 and CD25 molecules revealed no perioperative fluctuations in any group. We then investigated release of various circulating soluble cell adhesion molecules, proinflammatory cytokines, and chemokines using enzyme-linked immunosorbent assays. We demonstrated that both procedures are characterized by similar increases in ICAM-1 and IL-6 levels. Finally, tendency towards high levels of TNF-alpha and IL-8 was detected in endovascular repair, but data failed to reach statistical significance.
Predominance of type 1 CD4+ T cells in human aneurysmal aortic lesion. We have developed a tissue enzymatic digestion and cell extraction procedure to isolate intact mononuclear cells from aortic wall segments. This original cell isolation protocol enabled us to examine ex vivo the presence, phenotype, and cytokine secretion profile of infiltrating T lymphocytes freshly isolated from human AAA tissues for comparison with their circulating counterparts using flow cytometry. We found that both populations of infiltrating CD4+ and CD8+ T cells display a unique activated memory phenotype, as assessed by an increased expression of CD69 and HLA-DR activation antigens, downregulation of CD62L molecule, and predominant expression of the CD45RO isoform characteristics of memory cells. In addition, we identified the presence in human aneurysmal aortic wall lesion of CD4+ T cells producing high levels of IFN-gamma but not IL-4, reflecting their type 1 nature. In an additional series of experiments, cytokine gene expression was determined in whole aneurysmal and non-diseased aortic samples using LightCycler-based quantitative real-time reverse transcription-polymerase chain reaction. The molecular basis of type 1 or type 2 dominant responses was further specified by analyzing mRNA levels of transcription factors specifically involved in Th1 or Th2 differentiation such as T-bet and GATA-3. We demonstrated that aneurysmal aortic specimens exhibit high transcript levels of IFN-gamma but not IL-4, and consistently overexpressed the IFN-g-promoting cytokine IL-12 and the type 1-restricted transcription factor T-bet, further establishing the prominent type 1 nature of aortic wall responses. Moreover, such selective tissue expression of IL-12 and T-bet in the vessel microenvironment points to a potential role for these signals in directing aortic wall responses towards a type 1 phenotype.
Conclusions
Our findings indicate that endovascular AAA repair is associated with a lesser degree of acute phase reaction, peripheral T-cell activation, and release of complement proteins as compared to conventional open surgery, suggesting that the innate and inflammatory responses to AAA repair are significantly attenuated by the endovascular approach as compared to the traditional open reconstruction. These results support the view that the endoluminal procedure represents an attractive alternative to open surgery for the treatment of large aneurysms. On the other hand, we have demonstrated that Th1 cell infiltrates predominate in human end-stage AAA lesion. These observations are relevant for helping clarify the pathobiology of human AAA tissues and defining prospects for the prevention of aneurysm expansion. Indeed, identification of such infiltrating populations of IFN-gamma-producing CD4+ T cells not only provide new insights into the pathogenesis of the disorder, but could also serve as a basis for the development of novel medical management strategies directed at preventing aneurysm formation and progression, including therapeutic approaches based on the modulation of aortic wall responses and designed to selectively target T-cell activation and cytokine production. In this respect, the present work provides experimental evidence in support of the emerging concept that, although multifactorial, aneurysm disease may be regarded as a Th1-driven immunopathological condition, and suggests that strategies targeting IFN-gamma could be a particularly exciting and fruitful avenue for further investigation. Ongoing clinical and basic research in these areas can be expected to yield design of promising pharmacologic approaches to control AAA expansion. From a clinical perspective, such efforts have the potential to dramatically influence both the outcome and management of this common and life threatening condition.
Doctorat en sciences médicales
info:eu-repo/semantics/nonPublished
Wilson, W. Richard W. "Molecular and clinical observations in abdominal aortic aneurysm pathogenesis and treatment." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/29521.
Full textAnderson, Michael A. B. "Organ injury following ruptured abdominal aortic aneurysm is mediated by oxidants." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0028/MQ50434.pdf.
Full textMonsur, Kazi. "Cellular and molecular mechanisms in abdominal aortic aneurysm growth and rupture /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-558-5/.
Full textWanhainen, Anders. "Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459.
Full textFoulds, Sharmila. "Neutrophil activation in organ failure after thoraco-abdominal aortic aneurysm repair." Thesis, Imperial College London, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396009.
Full textDesai, Grishma Mahesh. "Automated extraction of abdominal aortic aneurysm geometries from CT scan data." Thesis, University of Hull, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.441672.
Full text