Journal articles on the topic 'Aortic aneurysms'
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1
von Kodolitsch, Aydin, Bernhardt, Habermann, Treede, Reichenspurner, Meinertz, and Dodge-Khatami. "Aortic aneurysms after correction of aortic coarctation: A systematic review." Vasa 39, no. 1 (February 1, 2010): 3–16. http://dx.doi.org/10.1024/0301-1526/a000001.
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Despite advanced techniques for surgical or percutaneous therapy coarctation of the aorta continues to carry a high risk of aneurysmal formation. Mortality of these aneurysms ranges between <1 and >90%, reflecting remarkable differences in surgical strategies and the follow-up management of coarctation. We review the frequency, anatomical types, risk factors and mechanisms of aortic aneurysm forming late after surgical or percutaneous therapy of aortic coarctation. We emphasize that aneurysms do not form exclusively at the site of previous intervention, but also at remote locations such as the ascending aorta. Moreover, aneurysm formation may only in part be attributed to a specific technique of coarctation therapy, and we emphasize the role of a bicuspid aortic valve and inherent weakness of the aortic wall as significant risk factors for aneurysm after aortic coarctation. We report the presenting symptoms, follow-up protocols, and imaging criteria for local and proximal aneurysms. Finally, we discuss criteria for prophylactic intervention at the site of such aneurysms, and present therapeutic options for different types of aneurysms. With this systematic review, we wish to provide data for establishing more uniform strategies for preventing, diagnosing and treating aneurysms associated with aortic coarctation.
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Federspiel, Jan M., Philipp A. Schnabel, Thomas Tschernig, Brittany Balint, Tanja Schwab, Matthias W. Laschke, and Hans-Joachim Schäfers. "Aortic aneurysms with tricuspid aortic valve have more degeneration than unicuspid aortic valve aneurysms." European Journal of Cardio-Thoracic Surgery 60, no. 2 (March 1, 2021): 333–40. http://dx.doi.org/10.1093/ejcts/ezab101.
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Abstract OBJECTIVES The unicuspid aortic valve (UAV) is a rare cardiac malformation and is associated with the formation of ascending aortic aneurysms. To characterize its associated aortic wall changes, normal and aneurysmatic ascending aortic wall specimens were analysed, focusing on the potential mechanisms of aneurysm formation. Patients with tricuspid aortic valve (TAV) served as controls. METHODS In a retrospective observational study, 74 specimens (dilated and non-dilated aortas; individuals with UAV and TAV) obtained intraoperatively were studied. Standard stains and immunohistochemical labelling of cleaved caspase-3, cluster of differentiation 31 and endothelial nitric oxide synthase (eNOS) were performed to assess the degree of apoptosis, distribution of eNOS within the aortic wall, smooth muscle cell (SMC) nuclei loss and mucoid extracellular matrix accumulation (MEMA). RESULTS Deeper ingrowth of vasa vasorum was found in dilated aortas. Interestingly, eNOS was expressed mostly in vasa vasorum. More apoptosis was seen in UAV aortas compared to TAV aortas (P < 0.001). Both UAV and TAV aortas were comparable regarding SMC nuclei loss (P = 0.419). In dilated compared to non-dilated aortas regardless valve morphology SMC nuclei loss was increased (P = 0.005) and more pronounced translamellar MEMA was present (P = 0.011). The highest grade of distribution (P = 0.043) and the highest severity (P = 0.005) regarding MEMA were seen in TAV dilated specimens compared to UAV dilated specimens. CONCLUSIONS Aneurysms with UAV show increased apoptosis, the role of which is unclear. Strikingly, more severe MEMA was found in TAV aneurysms compared to UAV aneurysms. Thus, UAV-associated aortic wall changes and resulting aneurysm may be less aggressive than aneurysms with TAV.
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Kisis, Kaspars, Dainis Krievins, Marcis Gedins, Janis Savlovskis, Natalija Ezite, and Patricija Ivanova. "Patient with Syphilitic Thoracic and Abdominal Aortic Aneurysms." Acta Chirurgica Latviensis 10, no. 2 (January 1, 2010): 131–33. http://dx.doi.org/10.2478/v10163-011-0028-7.
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Patient with Syphilitic Thoracic and Abdominal Aortic AneurysmsWe are presenting a rare case of patient with two syphilitic aneurysms localized in thoracic and abdominal aorta. Routine lung computer tomography (CT) for the patient with complains about irritating and unclear ethiology cough revealed 10 cm diameter aneurysm of descending thoracic aorta (TAA) and additionally 4.8 cm aneurysm of abdominal aorta (AAA) just below the aortic hiatus. As there was no evidence of previous trauma, Marfan syndrome or connective tissue disease patient was screened for syphilis. Diagnosis of tertiary syphilis was confirmed and specific treatment started. As complains of irritating cough intensified - patients TAA was successfully treated endovascularly with thoracic stent graft (Valiant®Captivia, Medtronic Ltd.) on emergency basis. On control CT angiography 3 month after treatment there was no evidence of graft migration, endoleaks and aneurysmal sac was thrombosed. AAA has not increased in size, and open repair is planned.
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Joshi, Nikhil V., Maysoon Elkhawad, Rachael O. Forsythe, Olivia M. B. McBride, Nikil K. Rajani, Jason M. Tarkin, Mohammed M. Chowdhury, et al. "Greater aortic inflammation and calcification in abdominal aortic aneurysmal disease than atherosclerosis: a prospective matched cohort study." Open Heart 7, no. 1 (March 2020): e001141. http://dx.doi.org/10.1136/openhrt-2019-001141.
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ObjectiveUsing combined positron emission tomography and CT (PET-CT), we measured aortic inflammation and calcification in patients with abdominal aortic aneurysms (AAA), and compared them with matched controls with atherosclerosis.MethodsWe prospectively recruited 63 patients (mean age 76.1±6.8 years) with asymptomatic aneurysm disease (mean size 4.33±0.73 cm) and 19 age-and-sex-matched patients with confirmed atherosclerosis but no aneurysm. Inflammation and calcification were assessed using combined 18F-FDG PET-CT and quantified using tissue-to-background ratios (TBRs) and Agatston scores.ResultsIn patients with AAA, 18F-FDG uptake was higher within the aneurysm than in other regions of the aorta (mean TBRmax2.23±0.46 vs 2.12±0.46, p=0.02). Compared with atherosclerotic control subjects, both aneurysmal and non-aneurysmal aortae showed higher 18F-FDG accumulation (total aorta mean TBRmax2.16±0.51 vs 1.70±0.22, p=0.001; AAA mean TBRmax2.23±0.45 vs 1.68±0.21, p<0.0001). Aneurysms containing intraluminal thrombus demonstrated lower 18F-FDG uptake within their walls than those without (mean TBRmax2.14±0.43 vs 2.43±0.45, p=0.018), with thrombus itself showing low tracer uptake (mean TBRmax thrombus 1.30±0.48 vs aneurysm wall 2.23±0.46, p<0.0001). Calcification in the aneurysmal segment was higher than both non-aneurysmal segments in patients with aneurysm (Agatston 4918 (2901–8008) vs 1017 (139–2226), p<0.0001) and equivalent regions in control patients (442 (304-920) vs 166 (80-374) Agatston units per cm, p=0.0042).ConclusionsThe entire aorta is more inflamed in patients with aneurysm than in those with atherosclerosis, perhaps suggesting a generalised inflammatory aortopathy in patients with aneurysm. Calcification was prominent within the aneurysmal sac, with the remainder of the aorta being relatively spared. The presence of intraluminal thrombus, itself metabolically relatively inert, was associated with lower levels of inflammation in the adjacent aneurysmal wall.
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Kim, Ha Won, and Brian K. Stansfield. "Genetic and Epigenetic Regulation of Aortic Aneurysms." BioMed Research International 2017 (2017): 1–12. http://dx.doi.org/10.1155/2017/7268521.
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Aneurysms are characterized by structural deterioration of the vascular wall leading to progressive dilatation and, potentially, rupture of the aorta. While aortic aneurysms often remain clinically silent, the morbidity and mortality associated with aneurysm expansion and rupture are considerable. Over 13,000 deaths annually in the United States are attributable to aortic aneurysm rupture with less than 1 in 3 persons with aortic aneurysm rupture surviving to surgical intervention. Environmental and epidemiologic risk factors including smoking, male gender, hypertension, older age, dyslipidemia, atherosclerosis, and family history are highly associated with abdominal aortic aneurysms, while heritable genetic mutations are commonly associated with aneurysms of the thoracic aorta. Similar to other forms of cardiovascular disease, family history, genetic variation, and heritable mutations modify the risk of aortic aneurysm formation and provide mechanistic insight into the pathogenesis of human aortic aneurysms. This review will examine the relationship between heritable genetic and epigenetic influences on thoracic and abdominal aortic aneurysm formation and rupture.
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Onalan, Mehmet Akif, Omer Ali Sayin, and Emin Tireli. "Surgical Resection Of Thoracic Aortic Aneurysms In Wiskott–Aldrich Syndrome." Heart Surgery Forum 21, no. 4 (July 2, 2018): E305—E306. http://dx.doi.org/10.1532/hsf.1972.
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Aortic aneurysms are a rare condition in children. Wiskott-Aldrich syndrome is a primary immunodeficiency characterized by infections, thrombocytopenia, and eczema. Aortitis and aneurysm formation seem to be progressive in patients with Wiskott–Aldrich syndrome. The risk of death from aneurysmal rupture in patients with Wiskott–Aldrich syndrome is high and surgery is required for resection of aneurysms. We report a case where a successful resection of a descending thoracic aneurysm. We present a-12 year-old child with this syndrome who underwent a one-stage descending aortic aneurysm repair under continuous visceral perfusion.Histologic examination showed the presence of an aortitis withgranulomatous inflammatory response and multinucleated cells.
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Samura, Makoto, Nobuya Zempo, Yoshitaka Ikeda, Masaaki Hidaka, Yoshikazu Kaneda, Kazuhiro Suzuki, Hidetoshi Tsuboi, and Kimikazu Hamano. "Single-stage thoracic and abdominal endovascular aneurysm repair for multilevel aortic disease." Vascular 22, no. 1 (May 13, 2013): 55–60. http://dx.doi.org/10.1177/1708538112473965.
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This investigation evaluated the results of single-stage thoracic endovascular aneurysm repair (TEVAR) and endovascular aneurysm repair (EVAR) for multilevel aortic disease in a series of nine patients. The lesions repaired included thoracic and abdominal aortic aneurysms ( n = 7) and subacute type B dissections with abdominal aortic aneurysms ( n = 2). All procedures were successfully performed, and none of the patients experienced postoperative stroke or spinal cord ischemia. The median follow-up period for these patients was 18.9 months (range 1.7–31.4 months) and none of the patients exhibited any signs of type I endoleaks or aneurysmal diameter enlargements more than 5 mm. In conclusion, single-stage TEVAR and EVAR procedures for multilevel aortic disease were found to be safe and feasible modalities for high-risk patients.
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Dolmaci, Onur B., Sulayman El Mathari, Antoine H. G. Driessen, Robert J. M. Klautz, Robert E. Poelmann, Jan H. N. Lindeman, and Nimrat Grewal. "Are Thoracic Aortic Aneurysm Patients at Increased Risk for Cardiovascular Diseases?" Journal of Clinical Medicine 12, no. 1 (December 29, 2022): 272. http://dx.doi.org/10.3390/jcm12010272.
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Objectives: Abdominal aortic aneurysms are associated with a sharply increased cardiovascular risk. Cardiovascular risk management is therefore recommended in prevailing guidelines for abdominal aneurysm patients. It has been hypothesized that associated risk relates to loss of aortic compliance. If this hypothesis is correct, observations for abdominal aneurysms would also apply to thoracic aortic aneurysms. The objective of this study is to test whether thoracic aneurysms are also associated with an increased cardiovascular risk burden. Methods: Patients who underwent aortic valve or root surgery were included in the study (n = 239). Cardiovascular risk factors were studied and atherosclerosis was scored based on the preoperative coronary angiographies. Multivariate analyses were performed, controlling for cardiovascular risk factors and aortic valve morphology. Comparisons were made with the age- and gender-matched general population and non-aneurysm patients as control groups. A thoracic aortic aneurysm was defined as an aortic aneurysm of ≥45 mm. Results: Thoracic aortic aneurysm was not associated with an increased coronary atherosclerotic burden (p = 0.548). Comparison with the general population revealed a significantly higher prevalence of hypertension (61.4% vs. 32.2%, p < 0.001) and a lower prevalence of diabetes (1.4% vs. 13.1%, p = 0.001) in the thoracic aneurysm group. Conclusions: The extreme cardiovascular risk associated with abdominal aortic aneurysms is location-specific and not explained by loss of aortic compliance. Thoracic aortic aneurysm, in contrast to abdominal, is not part of the atherosclerotic disease spectrum and, therefore, cardiovascular risk management does not need to be implemented in treatment guidelines of isolated thoracic aneurysms. Hypertension should be treated.
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Cury, Marcelo, Fernanda Zeidan, and Armando C. Lobato. "Aortic Disease in the Young: Genetic Aneurysm Syndromes, Connective Tissue Disorders, and Familial Aortic Aneurysms and Dissections." International Journal of Vascular Medicine 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/267215.
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There are many genetic syndromes associated with the aortic aneurysmal disease which include Marfan syndrome (MFS), Ehlers-Danlos syndrome (EDS), Loeys-Dietz syndrome (LDS), familial thoracic aortic aneurysms and dissections (TAAD), bicuspid aortic valve disease (BAV), and autosomal dominant polycystic kidney disease (ADPKD). In the absence of familial history and other clinical findings, the proportion of thoracic and abdominal aortic aneurysms and dissections resulting from a genetic predisposition is still unknown. In this study, we propose the review of the current genetic knowledge in the aortic disease, observing, in the results that the causative genes and molecular pathways involved in the pathophysiology of aortic aneurysm disease remain undiscovered and continue to be an area of intensive research.
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Faries, Peter L., Luis A. Sanchez, Michael L. Marin, Richard E. Parsons, Ross T. Lyon, Steve Oliveri, and Frank J. Veith. "An Experimental Model for the Acute and Chronic Evaluation of Intra-Aneurysmal Pressure." Journal of Endovascular Therapy 4, no. 3 (August 1997): 290–97. http://dx.doi.org/10.1177/152660289700400310.
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Purpose: To develop an animal model for the acute and chronic monitoring of pressure within abdominal aortic aneurysms (AAAs) to be treated with endovascular grafts. Methods: A strain-gauge pressure transducer was placed within an AAA created from a prosthetic vascular graft. Prosthetic aneurysms were implanted into 17 canine infrarenal aortas. The intra-aneurysmal pressure was monitored and correlated with noninvasive forelimb sphygmomanometry for 2 weeks. After this time, an intravascular manometer catheter was passed into the aneurysm. Simultaneous pressure measurements were obtained using the implanted strain-gauge pressure transducer, the manometer catheter, and the forelimb sphygmomanometer. Angiography was performed to assess intraluminal morphology, aneurysm anastomoses, and adjoining aortic vessels. In addition, two control animals underwent intra-aneurysmal pressure monitoring after standard surgical aneurysm repair. Results: There was excellent correlation (r = 0.97) between the pressure measurements obtained with the implanted strain-gauge pressure transducer and the intravascular manometer. Close correlation was also observed between the implanted strain-gauge transducer and the forelimb sphygmomanometer (r = 0.88) during postprocedural monitoring. Intra-aneurysmal pressure was lowered dramatically by surgical exclusion (aneurysm: 15/5 ± 7/4 mmHg; systemic: 124/66 ± 34/17 mmHg; p < 0.001). The prosthetic aneurysms were successfully imaged with angiography. Conclusions: This animal model provides an accurate and reproducible means for measuring intra-aneurysmal pressure on an acute and chronic basis. It may be possible to use this model in the assessment of endovascular devices to determine their efficacy in reducing intra-aneurysmal pressure. Evaluation of complications associated with their use, such as patent aneurysm side branches, perigraft channels, and perianastomotic reflux, may also be possible.
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Weiss, Norbert, Roman N. Rodionov, and Adrian Mahlmann. "Medical management of abdominal aortic aneurysms." Vasa 43, no. 6 (November 1, 2014): 415–21. http://dx.doi.org/10.1024/0301-1526/a000388.
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Abdominal aortic aneurysms (AAA) are the most common arterial aneurysms. Endovascular or open surgical aneurysm repair is indicated in patients with large AAA ≥ 5.5 cm in diameter as this prevents aneurysm rupture. The presence even of small AAAs not in need of immediate repair is associated with a very high cardiovascular risk including myocardial infarction, stroke or cardiovascular death. This risk by far exceeds the risk of aneurysm rupture. These patients therefore should be considered as high-risk patients and receive optimal medical treatment and life-style modificiation of their cardiovascular risk factors to improve their prognosis. In addition, these patients should be followed-up for aneurysm growth and receive medical treatment to decrease aneurym progression and rupture rate. Treatment with statins has been shown to reduce cardiovascular mortality in these patients, and also slows the rate of AAA growth. Use of beta-blockers, ACE inhibitors and AT1-receptor antagonists does not affect AAA growth but may be indicated for comorbidities. Antibiotic therapy with roxithromycin has a small effect on AAA growth, but this effect must be critically weighed against the potential risk of wide-spread use of antibiotics.
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Oller, Jorge, Enrique Gabandé-Rodríguez, María Jesús Ruiz-Rodríguez, Gabriela Desdín-Micó, Juan Francisco Aranda, Raquel Rodrigues-Diez, Constanza Ballesteros-Martínez, et al. "Extracellular Tuning of Mitochondrial Respiration Leads to Aortic Aneurysm." Circulation 143, no. 21 (May 25, 2021): 2091–109. http://dx.doi.org/10.1161/circulationaha.120.051171.
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Background: Marfan syndrome (MFS) is an autosomal dominant disorder of the connective tissue caused by mutations in the FBN1 (fibrillin-1) gene encoding a large glycoprotein in the extracellular matrix called fibrillin-1. The major complication of this connective disorder is the risk to develop thoracic aortic aneurysm. To date, no effective pharmacologic therapies have been identified for the management of thoracic aortic disease and the only options capable of preventing aneurysm rupture are endovascular repair or open surgery. Here, we have studied the role of mitochondrial dysfunction in the progression of thoracic aortic aneurysm and mitochondrial boosting strategies as a potential treatment to managing aortic aneurysms. Methods: Combining transcriptomics and metabolic analysis of aortas from an MFS mouse model ( Fbn1 c1039g/+ ) and MFS patients, we have identified mitochondrial dysfunction alongside with mtDNA depletion as a new hallmark of aortic aneurysm disease in MFS. To demonstrate the importance of mitochondrial decline in the development of aneurysms, we generated a conditional mouse model with mitochondrial dysfunction specifically in vascular smooth muscle cells (VSMC) by conditional depleting Tfam (mitochondrial transcription factor A; Myh11-Cre ERT2 Tfam flox/flox mice). We used a mouse model of MFS to test for drugs that can revert aortic disease by enhancing Tfam levels and mitochondrial respiration. Results: The main canonical pathways highlighted in the transcriptomic analysis in aortas from Fbn1 c1039g/+ mice were those related to metabolic function, such as mitochondrial dysfunction. Mitochondrial complexes, whose transcription depends on Tfam and mitochondrial DNA content, were reduced in aortas from young Fbn1 c1039g/+ mice. In vitro experiments in Fbn1 -silenced VSMCs presented increased lactate production and decreased oxygen consumption. Similar results were found in MFS patients. VSMCs seeded in matrices produced by Fbn1-deficient VSMCs undergo mitochondrial dysfunction. Conditional Tfam-deficient VSMC mice lose their contractile capacity, showed aortic aneurysms, and died prematurely. Restoring mitochondrial metabolism with the NAD precursor nicotinamide riboside rapidly reverses aortic aneurysm in Fbn1 c1039g/+ mice. Conclusions: Mitochondrial function of VSMCs is controlled by the extracellular matrix and drives the development of aortic aneurysm in Marfan syndrome. Targeting vascular metabolism is a new available therapeutic strategy for managing aortic aneurysms associated with genetic disorders.
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Lu, Hong, Debra L. Rateri, Dennis Bruemmer, Lisa A. Cassis, and Alan Daugherty. "Involvement of the renin–angiotensin system in abdominal and thoracic aortic aneurysms." Clinical Science 123, no. 9 (July 13, 2012): 531–43. http://dx.doi.org/10.1042/cs20120097.
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Aortic aneurysms are relatively common maladies that may lead to the devastating consequence of aortic rupture. AAAs (abdominal aortic aneurysms) and TAAs (thoracic aortic aneurysms) are two common forms of aneurysmal diseases in humans that appear to have distinct pathologies and mechanisms. Despite this divergence, there are numerous and consistent demonstrations that overactivation of the RAS (renin–angiotensin system) promotes both AAAs and TAAs in animal models. For example, in mice, both AAAs and TAAs are formed during infusion of AngII (angiotensin II), the major bioactive peptide in the RAS. There are many proposed mechanisms by which the RAS initiates and perpetuates aortic aneurysms, including effects of AngII on a diverse array of cell types and mediators. These experimental findings are complemented in humans by genetic association studies and retrospective analyses of clinical data that generally support a role of the RAS in both AAAs and TAAs. Given the lack of a validated pharmacological therapy for any form of aortic aneurysm, there is a pressing need to determine whether the consistent findings on the role of the RAS in animal models are translatable to humans afflicted with these diseases. The present review compiles the recent literature that has shown the RAS as a critical component in the pathogenesis of aortic aneurysms.
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Rajab, T., Miriam Beyene, Farhang Yazdchi, and Matthew Menard. "Aortic Aneurysm Eroding into the Spine." AORTA 06, no. 02 (April 2018): 068–69. http://dx.doi.org/10.1055/s-0038-1669416.
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AbstractAortic aneurysms are usually asymptomatic until catastrophic rupture occurs. Ruptured abdominal aortic aneurysms classically present with acute back pain, shock, and a pulsatile abdominal mass. The natural history of some aortic aneurysms also includes a stage of contained rupture. This occurs when extravasation of blood from the ruptured aneurysm is contained by surrounding tissues. Here, the authors report the case of a chronic contained abdominal aortic aneurysm rupture that resulted in erosion of the spine.
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Tomasi, Jacques, Reda Belhaj Soulami, Marion Rolland, and Jean-Philippe Verhoye. "Endovascular Repair of a Dacron Pseudoaneurysm in an Ascending-to-Descending Aortic Bypass." AORTA 08, no. 04 (August 2020): 104–6. http://dx.doi.org/10.1055/s-0040-1715087.
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AbstractIn the setting of postcoarctation aortic repair, Dacron graft dilatation and late aneurysms are not uncommon. Reintervention usually involves redo open surgery and replacement of the aneurysmal graft or the pseudoaneurysmal suture line. The present case describes the endovascular repair of a Dacron anastomotic false aneurysm in an extra-anatomic ascending-to-descending aortic bypass, 19 years after surgical correction of aortic recoarctation.
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Kadyraliev, B. K., V. B. Arutyunyan, S. V. Kucherenko, V. N. Pavlova, E. S. Spekhova, and S. T. Enginoev. "Successful case of Benthal de Bono surgery in Cabrol modification with one-step aortic arch prosthesis and repeat coronary artery bypass surgery in a patient with de Bakey type 1 acute aortic dissection." Perm Medical Journal 38, no. 3 (July 16, 2021): 153–58. http://dx.doi.org/10.17816/pmj383153-158.
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The ascending aortic aneurysm occurs in 45 % of cases from the total number of aortic aneurysms of various localization. The incidence rate of combination of the aortic disease with aneurysm per 100 000 of the population is 5.9. The problem of prosthetics of the aortic root and aortic valve due to aneurysm and the changed AV is rather actual. The main principle of aneurysm surgery is the prevention of the risk of dissection and rupture with reconstruction of normal dimensions of the ascending aorta. Currently, there are different techniques for the treatment of root aneurysms and ascending aorta. The standard techniques are aortic root replacement, aortic valve reconstruction with replacement of aortic root or ascending aorta and partial or full replacement of aortic arch depending on the situation.
The Bentall De Bono operation at present remains a golden standard of surgical treatment of the aneurysms of the root and ascending aorta with changed aortic valve. This surgery can have the following complications: thrombotic, thromboembolic followed by conduit dysfunction, formation of false anastomosis aneurysms, hemorrhage, compression of coronary artery orifices due to tension in the zone of coronary anastomoses.
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Torra, R., C. Nicolau, C. Badenas, C. Brú, L. Pérez, X. Estivill, and A. Darnell. "Abdominal aortic aneurysms and autosomal dominant polycystic kidney disease." Journal of the American Society of Nephrology 7, no. 11 (November 1996): 2483–86. http://dx.doi.org/10.1681/asn.v7112483.
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Although cases of autosomal dominant polycystic kidney disease (ADPKD) associated with abdominal aortic aneurysm have been repeatedly reported in the literature, no systematic studies of the aortas of these patients have been performed. In the study presented here, a sonographic study of the abdominal aorta in 139 ADPKD patients and in 149 healthy family members was carried out. For both groups, an increase in aortic diameter related to age and sex, (being wider in men than women) was found. In ADPKD patients, neither a wider aortic diameter nor a higher prevalence of abdominal aortic aneurysms could be found in any age group. It was concluded that, although these patients are prone to develop aortic aneurysms because of hypertension and associated connective tissue disorders, the presence of abdominal aortic aneurysms should be questioned as a frequent feature of ADPKD.
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Pereira, Thiago Scremin Boscolo, Vanessa Belentani Marques, Elizandra Moura dos Santos, Ana Letícia Daher Aprígio da Silva, Eduardo Martini Romano, and Carla Patricia Carlos. "Association Between Abdominal Aortic and Common Iliac Artery Aneurysms: Case Report." Journal of Biology and Life Science 10, no. 2 (June 30, 2019): 71. http://dx.doi.org/10.5296/jbls.v10i2.14714.
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The infrarenal abdominal aortic aneurysm is the most common among arterial aneurysms; it happens when there is an abnormal and irreversible enlargement of the blood vessel. This disease usually compromises other arterial segments and is linked to high mortality rates, mainly due to its rupture. Given its importance, we present a case study of an abdominal aortic aneurysm associated with a common iliac artery aneurysm. During a dissection practice in the Morphofunctional Laboratory at FACERES Medical School, we observed the presence of a mild stenosis in the abdominal aorta below the renal arteries, as well as the formation of an infrarenal abdominal aortic aneurysm. In addition, we noticed that the infrarenal abdominal aortic aneurysm was associated with a bilateral common iliac artery aneurysm. Morphological analyses carried out in the blood vessels showed a large quantity of atheromatous plaques, which are the probable cause of the pathology. The information herein may broaden the knowledge on the infrarenal abdominal aortic aneurysmal disease, thus reducing its complications and mortality rates.
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Frech, Andreas, Juergen Falkensammer, Gustav Fraedrich, and Michael Schirmer. "Abdominal Aortic Aneurysms." Journal of Primary Care & Community Health 3, no. 2 (November 22, 2011): 142–47. http://dx.doi.org/10.1177/2150131911421506.
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Abdominal aortic aneurysms represent both an individual risk of mortality and a socioeconomic burden for health care systems worldwide, but screening is not performed in all countries. Here, the authors summarize the pros and cons of screening to reduce abdominal aortic aneurysm–related mortality.
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Bararu Bojan (Bararu), Iris, Carmen Elena Pleșoianu, Oana Viola Badulescu, Maria Cristina Vladeanu, Minerva Codruta Badescu, Dan Iliescu, Andrei Bojan, and Manuela Ciocoiu. "Molecular and Cellular Mechanisms Involved in Aortic Wall Aneurysm Development." Diagnostics 13, no. 2 (January 10, 2023): 253. http://dx.doi.org/10.3390/diagnostics13020253.
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Aortic aneurysms represent a very common pathology that can affect any segment of the aorta. These types of aneurysms can be localized on the thoracic segment or on the abdominal portion, with the latter being more frequent. Though there are similarities between thoracic and abdominal aortic aneurysms, these pathologies are distinct entities. In this article, we undertook a review regarding the different mechanisms that can lead to the development of aortic aneurysm, and we tried to identify the different manners of treatment. For a long time, aortic wall aneurysms may evolve in an asymptomatic manner, but this progressive dilatation of the aneurysm can lead to a potentially fatal complication consisting in aortic rupture. Because there are limited therapies that may delay or prevent the development of acute aortic syndromes, surgical management remains the most common manner of treatment. Even though, surgical management has improved much in the last years, thus becoming less invasive and sophisticated, the morbi-mortality linked to these therapies remains increased. The identification of the cellular and molecular networks triggering the formation of aneurysm would permit the discovery of modern therapeutic targets. Molecular and cellular mechanisms are gaining a bigger importance in the complex pathogenesis of aortic aneurysms. Future studies must be developed to compare the findings seen in human tissue and animal models of aortic aneurysm, so that clinically relevant conclusions about the aortic aneurysm formation and the pharmacological possibility of pathogenic pathways blockage can be drawn.
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Batinic, Nikola, Tijana Kokovic, Dragan Nikolic, Vladimir Manojlovic, Viktor Till, and Slavko Budinski. "The impact of abdominal aortic aneurysm diameter on the outcome of endovascular aortic repair." Medical review 74, no. 11-12 (2021): 347–53. http://dx.doi.org/10.2298/mpns2112347b.
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Introduction. Abdominal aortic aneurysm diameter is one of the most important parameters in the diagnostic and therapeutic algorithm for aneurysm follow-up. Currently, two therapeutic modalities are used: open surgery and endovascular aortic repair. The aim of this study is to analyze the impact of the maximum transverse diameter of the abdominal aortic aneurysm on the incidence of general and specific complications. Material and Methods. The retrospective study included 75 patients with infrarenal abdominal aortic aneurysm who underwent endovascular aortic repair in the period from July 2008 to January 2020. The patients were divided into two groups: group A with an abdominal aortic aneurysm size ? 5.9 cm, and group B with an abdominal aortic aneurysm size ? 6.0 cm. Results. A total of 41.3% of patients presented with a maximum transverse aneurysm diameter of ? 5.9 cm, and 58.7% of patients had ? 6.0 cm. Of comorbid diseases, chronic obstructive pulmonary disease was more prevalent in patients with a large abdominal aortic aneurysm (group A 25.8%; group B 59.1%). None of the other comorbidities showed a statistically significant difference between the two groups of patients. Early complications were present in a total of 14.7% of patients, of which 12.9% of patients with a small and 15.9% with a large abdominal aortic aneurysm. Late complications occurred in a total of 18.7% of patients, in 9.7% of patients with a small and 25% of patients with a large abdominal aortic aneurysm. Conclusion. Patients with abdominal aortic aneurysms with a maximum transverse diameter of 6 cm and larger, present with a higher rate of late postoperative complications, increase in aneurysmal sac on control multislice computed tomography angiography, and have a worse prognosis compared to patients with smaller abdominal aortic aneurysms.
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Kostic, Dusan, Lazar Davidovic, Drago Milutinovic, Radomir Sindjelic, Marko Dragas, and Momcilo Colic. "Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm." Srpski arhiv za celokupno lekarstvo 132, no. 7-8 (2004): 250–53. http://dx.doi.org/10.2298/sarh0408250k.
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INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l). Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of shorter arteries was implanted into the long artery, and another one into PTFE graft. After 30 minutes of explanation, autotransplantation of the kidney into the right iliac fossa was performed. The right renal vein was implanted into the inferior vein cava, and PTFE graft into the right limb of Dacron graft. Immediately following the completion of both anastomoses, large volume of urine was evident. Finally, ureteneocystostomy was performed with previous insertion of double "J" catheter. In the immediate postoperative period, renal function was restored to normal, while postoperative angiography revealed all patent grafts. DISCUSSION The most common causes of renal artery aneurysms are arteriosclerosis, as in our case, and fibro-muscular dysplasia. Very often, renal artery aneurysms are asymptomatic and discovered only during angiography in patients with aneurysmal and occlusive aortic disease. Other cases include: arterial hypertension, groin pain and acute or chronic renal failure. Due to relatively small number of evaluated cases, the risk of aneurysmal rupture is not known. According to some authors, the overall rupture rate of renal artery aneurysm is 5%, however, the rupture risk becomes higher in young pregnant woman. Several standard surgical procedures are available for the repair of renal artery aneurysms. These include saphenous vein angioplasty, bypass grafting, as well as ex vivo reconstruction with reimplantation or autotransplantation. Furthermore, interventional embolization therapy, as well as endovascular treatment with ePTFE covered stent, or autologous vein-coverage stent graft, have been also reported to be successful. CONCLUSION The major indications for surgical treatment of renal artery aneurysms are to eliminate the source of thromboembolism which leads to fixed renal hypertension and kidney failure, as well as prevention of aneurysmal rupture.
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Khashram, Manar, Julie S. Jenkins, Jason Jenkins, Allan J. Kruger, Nicholas S. Boyne, Wallace J. Foster, and Philip J. Walker. "Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: A 24-year experience." Vascular 24, no. 2 (May 12, 2015): 115–25. http://dx.doi.org/10.1177/1708538115586682.
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Background Abdominal aortic aneurysms can be either treated by an open abdominal aortic aneurysm repair or an endovascular repair. Comparing clinical predictors of outcomes and those which influence survival rates in the long term is important in determining the choice of treatment offered and the decision-making process with patients. Aims To determine the influence of pre-existing clinical predictors and perioperative determinants on late survival of elective open abdominal aortic aneurysm repair and endovascular repair at a tertiary hospital. Methods Consecutive patients undergoing elective abdominal aortic aneurysm repair from 1990 to 2013 were included. Data were collected from a prospectively acquired database and death data were gathered from the Queensland state death registry. Pre-existing risks and perioperative factors were assessed independently. Kaplan–Meier and Cox regression modeling were performed. Results During the study period, 1340 abdominal aortic aneurysms were repaired electively, of which 982 were open abdominal aortic aneurysm repair. The average age was 72.4 years old and 81.7% were males. The cumulative percentage survival rates for open abdominal aortic aneurysms repair at 5, 10, 15 and 20 years were 79, 49, 31 and 22, respectively. The corresponding 5-, 10- and 15-year survival rates for endovascular repair were not significantly different at 75, 49 and 33%, respectively (P = 0.75). Predictors of reduced survival were advanced age, American Society of Anaesthesiology scores, chronic obstructive pulmonary disease, renal impairment, bifurcated grafts, peripheral vascular disease and congestive heart failure. Conclusions Open repair offers a good long-term treatment option for patients with an abdominal aortic aneurysm and in our experience there is no significant difference in late survival between open abdominal aortic aneurysms repair and endovascular repair. Consideration of the factors identified in this study that predict reduced long-term survival for open abdominal aortic aneurysms repair and endovascular repair should be considered when deciding repair of abdominal aortic aneurysm.
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Wilmink, A. B. M., M. Forshaw, C. R. G. Quick, C. S. Hubbard, and N. E. Day. "Accuracy of serial screening for abdominal aortic aneurysms by ultrasound." Journal of Medical Screening 9, no. 3 (September 1, 2002): 125–27. http://dx.doi.org/10.1136/jms.9.3.125.
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OBJECTIVES: To assess the accuracy of screening for abdominal aortic aneurysms (AAAs) by ultrasound (US). SETTING: An aneurysm screening programme in Huntingdon. METHODS: False negative tests were identified by tracing all patients with a ruptured aneurysm who were screened and then finding the number classified as normal on US. False positive tests were identified by calculating the number of aneurysmal aortas on US that were classified as normal on CT. Measurement variability of the infrarenal aortic diameter between US and CT was estimated. RESULTS: 14 out of 93 patients with a ruptured AAA since 1991 had been screened. No ruptured aneurysm had been classified as normal on US. All 64 patients with an AAA larger than 4.5 cm on US had their aneurysm confirmed on CT. The mean difference between CT and US measurements was 4 mm. The limit of variability between CT and US was 12 mm. CONCLUSION: No false negative scans were found using a cut off point of 3 cm as abnormal. No false positives were found if subjects with an AAA exceeding 4.5 cm were referred for further procedures. A serial US screening policy has excellent screening performance, justifying its use as a screening tool.
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Kontopodis, Nikolaos, Eleni Metaxa, Yannis Papaharilaou, Emmanouil Tavlas, Dimitrios Tsetis, and Christos Ioannou. "Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture." Vascular 23, no. 1 (April 22, 2014): 65–77. http://dx.doi.org/10.1177/1708538114532084.
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Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it. The peak wall stress, the role of the unique geometry of every individual abdominal aortic aneurysm as well as the mechanical properties and the local strength of the degenerated aneurysmal wall, all confer to rupture risk. In this review article, the assessment of these variables through mechanical testing, advanced imaging and computational modeling is reviewed and the clinical perspective is discussed.
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Genyk, Stepan. "Aneurysmal Disease of the Main Arteries." Archive of Clinical Medicine 22, no. 2 (December 8, 2016): 201627. http://dx.doi.org/10.21802/acm.2016.2.7.
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The high incidence of aneurysms of different arterial systems in case of abdominal aortic aneurysm causes the need for the examination of all patients with aortic aneurysm in order to detect aneurysmal process in all main arteries. The use of the mentioned predictors of aneurism wall failure in daily clinical practice provides an opportunity to improve the results of surgical treatment. Active surgical approach in relation to aortic aneurysm and main arteries is indicated in the presence of aneurismal disease. The choice of treatment depends on the severity of the patient’s condition, clinical manifestations, localization of the aneurysm and its morphology, with the preference for endovascular approach.
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Karaarslan Cengiz, O., and G. Nergizoglu. "Prevalenceof abdominal aortic aneurysm among stage 3-4 chronic kidney disease patients aged 55 years and older." Ukrainian Journal of Nephrology and Dialysis, no. 2(66) (March 24, 2020): 9–16. http://dx.doi.org/10.31450/ukrjnd.2(66).2020.02.
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The risk of cardiovascular disease begins to increase from the early stages of chronic kidney disease (CKD). Abdominal aortic aneurysms are the most common arterial aneurysms of peripheral arterial diseases. The frequency of abdominal aortic aneurysm varies according to the population studied. This study aimed to determine the prevalence of abdominal aortic aneurysm in patients with stage 3-4 CKD and investigate CKD is a risk factor for abdominal aortic aneurysm formation.
Methods. Patients aged 55 years and older who were followed up in the internal medicine outpatient clinics were enrolled. Two hundred CKD patients with glomerular filtration rates between 15-59 mL/min per 1.73 m2 were included in the study group, and 110 patients with glomerular filtration rates of 60 mL/min per 1.73 m2 or above were assigned to the control group. An ultrasonography device with a 3.5 MHz probe was used for screening. Abdominal aortic diameters of 3 cm and above were accepted as abdominal aortic aneurysms.
Results. Eighteen patients in the study group (9%) and four in the control group (3.6%) had an abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysms was higher in the CKD group. However, the difference was not statistically significant (p=0.078). Moreover, the median aortic diameter was 21.8 mm (14-44 mm) in the study group, compared to 21.0 mm (14-46 mm) in the control group. The prevalence of the abdominal aortic aneurysm was 14.9% in stage 4 CKD patients and 6% in stage 3 CKD patients (p=0.038).
Conclusion. An abdominal aortic aneurysm is more common in patients with CKD although it does not reach statistical significance. The median aortic diameter was significantly wider in CKD patients compared to the control group . The prevalence of abdominal aortic aneurysm increased with an increase in the CKD stage .
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Müller, Verena, Milena Miszczuk, Christian E. Althoff, Andrea Stroux, Andreas Greiner, Helena Kuivaniemi, and Irene Hinterseher. "Comorbidities Associated with Large Abdominal Aortic Aneurysms." AORTA 07, no. 04 (June 2019): 108–14. http://dx.doi.org/10.1055/s-0039-1692456.
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Background Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm. Methods We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis. Results The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significantly higher American Society of Anesthesiology score (2.84 vs. 2.63; p = 0.015) and were more likely to have coronary artery disease (p < 0.001), congestive heart failure (p < 0.001), or chronic obstructive pulmonary disease (p < 0.001). Aneurysm patients were more likely to be former (p = 0.034) or current (p = 0.006) smokers and had a significantly higher number of pack years (p < 0.001). Aneurysm patients also had a significantly poorer lung function. In multivariate analysis, the following factors were associated with aneurysms: chronic obstructive pulmonary disease (odds ratio, OR = 12.24; p = 0.002), current smoking (OR = 4.14; p = 0.002), and coronary artery disease (OR = 2.60; p = 0.020). Conclusions Our comprehensive analysis identified several comorbidities associated with abdominal aortic aneurysms. These results could help to recognize aneurysms earlier by targeting individuals with these comorbidities for screening.
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Hossack, Martin, Robert Fisher, Francesco Torella, Jillian Madine, Mark Field, and Riaz Akhtar. "Micromechanical and Ultrastructural Properties of Abdominal Aortic Aneurysms." Artery Research 28, no. 1 (March 2022): 15–30. http://dx.doi.org/10.1007/s44200-022-00011-3.
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AbstractAbdominal aortic aneurysms are a common condition of uncertain pathogenesis that can rupture if left untreated. Current recommended thresholds for planned repair are empirical and based entirely on diameter. It has been observed that some aneurysms rupture before reaching the threshold for repair whilst other larger aneurysms do not rupture. It is likely that geometry is not the only factor influencing rupture risk. Biomechanical indices aiming to improve and personalise rupture risk prediction require, amongst other things, knowledge of the material properties of the tissue and realistic constitutive models. These depend on the composition and organisation of the vessel wall which has been shown to undergo drastic changes with aneurysmal degeneration, with loss of elastin, smooth muscle cells, and an accumulation of isotropically arranged collagen. Most aneurysms are lined with intraluminal thrombus, which has an uncertain effect on the underlying vessel wall, with some authors demonstrating a reduction in wall stress and others a reduction in wall strength. The majority of studies investigating biomechanical properties of ex vivo abdominal aortic aneurysm tissues have used low-resolution techniques, such as tensile testing, able to measure the global material properties at the macroscale. High-resolution engineering techniques such as nanoindentation and atomic force microscopy have been modified for use in soft biological tissues and applied to vascular tissues with promising results. These techniques have the potential to advance the understanding and improve the management of abdominal aortic aneurysmal disease.
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Bonamigo, Telmo Pedro, and Iara Siqueira. "Screening for abdominal aortic aneurysms." Revista do Hospital das Clínicas 58, no. 2 (2003): 63–68. http://dx.doi.org/10.1590/s0041-87812003000200002.
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OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.
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Wilson, J. S., S. Baek, and J. D. Humphrey. "Importance of initial aortic properties on the evolving regional anisotropy, stiffness and wall thickness of human abdominal aortic aneurysms." Journal of The Royal Society Interface 9, no. 74 (April 4, 2012): 2047–58. http://dx.doi.org/10.1098/rsif.2012.0097.
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Complementary advances in medical imaging, vascular biology and biomechanics promise to enable computational modelling of abdominal aortic aneurysms to play increasingly important roles in clinical decision processes. Using a finite-element-based growth and remodelling model of evolving aneurysm geometry and material properties, we show that regional variations in material anisotropy, stiffness and wall thickness should be expected to arise naturally and thus should be included in analyses of aneurysmal enlargement or wall stress. In addition, by initiating the model from best-fit material parameters estimated for non-aneurysmal aortas from different subjects, we show that the initial state of the aorta may influence strongly the subsequent rate of enlargement, wall thickness, mechanical behaviour and thus stress in the lesion. We submit, therefore, that clinically reliable modelling of the enlargement and overall rupture-potential of aneurysms may require both a better understanding of the mechanobiological processes that govern the evolution of these lesions and new methods of determining the patient-specific state of the pre-aneurysmal aorta (or correlation to currently unaffected portions thereof) through knowledge of demographics, comorbidities, lifestyle, genetics and future non-invasive or minimally invasive tests.
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Puech-Leão, Pedro, Lazlo Josef Molnar, Ilka Regina de Oliveira, and Giovanni Guido Cerri. "Prevalence of abdominal aortic aneurysms: a screening program in São Paulo, Brazil." Sao Paulo Medical Journal 122, no. 4 (2004): 158–60. http://dx.doi.org/10.1590/s1516-31802004000400005.
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CONTEXT: Abdominal aortic aneurysm is an asymptomatic but potentially fatal condition. Elective surgery can prevent death from rupture, and is indicated for aneurysms larger than 45 mm. Because aneurysms tend to grow with time, detection of small ones (> 29 mm) may lead to a closer follow-up of patients at risk. OBJECTIVE: To determine the prevalence of abdominal aortic aneurysms in São Paulo, Brazil. DESIGN: Prospective, descriptive. SETTING: University Hospital. PARTICIPANTS: Persons aged 50 years or more were offered, through the press, the opportunity to be screened for abdominal aortic aneurysm. The total number screened was 2,756. PROCEDURE: All were submitted to abdominal palpation and ultrasound examination. PARAMETER STUDIED: A maximum diameter of 30 mm or more was considered to be an aneurysm. RESULTS: Sixty-four aneurysms were detected, nine of which measuring more than 49 mm. Palpation detected 60 aneurysms, but only 20 of these were confirmed by the ultrasound. Conversely, 41 of the ultrasound-detected aneurysms were not palpable. The percentages of abdominal aortic aneurysms found in the subgroups via ultrasound examination (with 95% confidence interval) were as follows: total group, 2.3 (1.8-3); men, 4.6 (3.5-5.9); women, 0.6 (0.3-1.1); men aged 60 or more, 6 (4.3-8); women aged 60 or more, 0.9 (0.4-1.8). CONCLUSION: In São Paulo, Brazil, 1.8 to 3 % of persons aged 50 years or more are expected to have abdominal aortic aneurysms. In the subgroup of men aged 60 or more, the expected prevalence is between 4.3 and 8%.
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David, Michel, Raúl A. Borracci, Luis M. Ferreira, Patricio Giménez Ruiz, José M. Álvarez Galesio, and Ricardo La Mura. "Técnica del debranching híbrido tipo I del arco aórtico sin circulación extracorpórea." Revista Argentina de Cirugía 111, no. 4 (December 1, 2019): 274–83. http://dx.doi.org/10.25132/raac.v111.n4.1411.es.
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Aortic arch aneurysms represent a major challenge as the involvement of the supra-aortic vessels demands a complex surgical technique. Since the advent of endovascular aortic repair, hybrid treatment of aortic arch disease has emerged in recent years. The procedure consists of surgical bypass of the supra-aortic vessels followed by exclusion of the aneurysm with an endograft. This hybrid method is known as debranching and, briefly, consists in performing bypasses between the ascending aorta and the brachiocephalic artery, the left carotid artery and possibly the left subclavian artery without cardiopulmonary bypass, in order to advance an endograft to cover the entire lumen of the aneurysm. The aim of this paper is to describe the surgical technique of type I hybrid debranching without cardiopulmonary bypass and antegrade endograft delivery to treat aortic arch aneurysms.
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Synowiec, Checinski, Micker, Samolewski, Glyda, and Ast. "Unusual abdominal aneurysms in a patient after kidney transplantation treated by endovascular technique." Vasa 41, no. 1 (January 1, 2012): 63–66. http://dx.doi.org/10.1024/0301-1526/a000165.
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While abdominal aortic aneurysms are quite common, visceral aneurysms are a seldomly diagnosed vascular pathology. Aneurysms of renal arteries, abdominal aorta and iliac arteries seem to be very rare. We present a patient after renal transplantation with aneurysms of both stumps of the renal arteries, abdominal aortic aneurysm and aneurysms of common iliac arteries. Because of the symptomatic course, the patient required urgent treatment. A successful endovascular procedure was performed. Follow-up imaging did not reveal any complications.
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Yamashiro, Yoshito, Bui Quoc Thang, Seung Jae Shin, Caroline Antunes Lino, Tomoyuki Nakamura, Jungsil Kim, Kaori Sugiyama, et al. "Role of Thrombospondin-1 in Mechanotransduction and Development of Thoracic Aortic Aneurysm in Mouse and Humans." Circulation Research 123, no. 6 (August 31, 2018): 660–72. http://dx.doi.org/10.1161/circresaha.118.313105.
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Rationale: Abnormal mechanosensing of smooth muscle cells (SMCs) resulting from the defective elastin-contractile units has been suggested to drive the formation of thoracic aortic aneurysms; however, the precise molecular mechanism has not been elucidated. Objective: The aim of this study was to identify the crucial mediator(s) involved in abnormal mechanosensing and propagation of biochemical signals during the aneurysm formation and to establish a basis for a novel therapeutic strategy. Methods and Results: We used a mouse model of postnatal ascending aortic aneurysms ( Fbln4 SMKO ; termed SMKO [SMC-specific knockout]), in which deletion of Fbln4 (fibulin-4) leads to disruption of the elastin-contractile units caused by a loss of elastic lamina-SMC connections. In this mouse, upregulation of Egr1 (early growth response 1) and angiotensin-converting enzyme leads to activation of Ang II (angiotensin II) signaling. Here, we showed that the matricellular protein, Thbs1 (thrombospondin-1), was highly upregulated in SMKO ascending aortas and in human thoracic aortic aneurysms. Thbs1 was induced by mechanical stretch and Ang II in SMCs, for which Egr1 was required, and reduction of Fbln4 sensitized the cells to these stimuli and led to higher expression of Egr1 and Thbs1. Deletion of Thbs1 in SMKO mice prevented the aneurysm formation in ≈80% of DKO (SMKO;Thbs1 knockout) animals and suppressed Ssh1 (slingshot-1) and cofilin dephosphorylation, leading to the formation of normal actin filaments. Furthermore, elastic lamina-SMC connections were restored in DKO aortas, and mechanical testing showed that structural and material properties of DKO aortas were markedly improved. Conclusions: Thbs1 is a critical component of mechanotransduction, as well as a modulator of elastic fiber organization. Maladaptive upregulation of Thbs1 results in disruption of elastin-contractile units and dysregulation of actin cytoskeletal remodeling, contributing to the development of ascending aortic aneurysms in vivo. Thbs1 may serve as a potential therapeutic target for treating thoracic aortic aneurysms.
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Mercado, Rodrigo, Susana López, Carlos Cantú, Angel Sanchez, Rogelio Revuelta, Sergio Gómez-Llata, J. Antonio Bouffard, and Carlos Pineda. "Intracranial aneurysms associated with unsuspected aortic coarctation." Journal of Neurosurgery 97, no. 5 (November 2002): 1221–25. http://dx.doi.org/10.3171/jns.2002.97.5.1221.
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✓ Intracranial aneurysms (IAs) are found more often in patients with aortic coarctation (AC) than in the general population and aneurysm rupture occurs much earlier in the lives of these patients when there is coexistent AC. The diagnosis of AC is frequently made only after a serious cerebrovascular complication has developed. The aim of this paper is to call attention to AC in patients presenting with aneurysmal subarachnoid hemorrhage. The literature is reviewed, the key clinical features are highlighted, and the proposed pathogenesis of this association is discussed. The authors present clinical information and imaging data obtained in three young patients with ruptured IAs that were associated with initially unnoticed AC. Abnormal results of cardiovascular examinations led the authors to consider an underlying AC, which was later confirmed by aortography. These aneurysms were successfully treated prior to correction of the ACs. The diagnosis of AC should be considered in adolescent and young adult patients presenting with IAs.
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Tireli, Emin, A. Kubilay Korkut, Eylül Kafali, and Murat Basaran. "Successful Repair of Ascending Aortic Aneurysm Due to Takayasu's Arteritis." Asian Cardiovascular and Thoracic Annals 10, no. 2 (June 2002): 184–85. http://dx.doi.org/10.1177/021849230201000225.
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A 2-year-old girl with Takayasu's arteritis and an ascending aortic aneurysm underwent successful graft replacement. Although aneurysms of the great vessels are rarely encountered, this disease should be considered in the differential diagnosis of ascending aortic aneurysms in children.
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Hiromatsu, Shinichi, Yukio Hosokawa, Noriko Egawa, Hiroko Yokokura, Keiichi Akaiwa, and Shigeaki Aoyagi. "Strategy for Isolated Iliac Artery Aneurysms." Asian Cardiovascular and Thoracic Annals 15, no. 4 (August 2007): 280–84. http://dx.doi.org/10.1177/021849230701500403.
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We retrospectively reviewed 41 patients with isolated iliac artery aneurysms presenting over a 21-year period. The mean age was 72 years. Mean aneurysmal diameter was 6.0 cm (range, 3.2–13 cm). The aneurysms were located in the common iliac artery in 31 patients, internal iliac artery in 7, and both arteries in 3. Rupture occurred in 20 patients (49%). The frequency of rupture of isolated iliac artery aneurysms was significantly higher than that of abdominal aortic aneurysms (8%) during the same period. The 30-day mortality was 9.8%; death in all 4 patients was due to rupture of the aneurysm. The surgical procedure was aneurysmectomy and replacement with a bifurcated prosthetic graft in 24 patients (59%), closure of the common iliac artery with a femorofemoral crossover in 7, minilaparotomy in 3, thromboexclusion in 6, and endoluminal stent-graft repair in one. In contrast to abdominal aortic aneurysms, isolated iliac artery aneurysms can be treated by various methods other than replacement with a bifurcated prosthetic graft. When selecting a strategy for such aneurysms, it is important to choose an approach appropriate to the location and risk, because of the frequency of rupture.
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Liu, Zhao, Min Zhou, Chen Liu, Tong Qiao, Dian Huang, Ming Zhang, Feng Ran, Wei Wang, and Changjian Liu. "Hybrid procedures for thoracoabdominal aortic pathologies." Vascular 21, no. 4 (May 13, 2013): 205–14. http://dx.doi.org/10.1177/1708538113478772.
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We report our three-year experience with the visceral hybrid procedure for patients with thoracoabdominal aortic aneurysms, dissections and Takayasu's arteritis. We also evaluate and discuss the outcomes of hybrid procedures. Hybrid procedures include debranching of the visceral or renal arteries followed by endovascular repair of the disease. The surgical strategy was designed individually to reduce trauma and minimize stent coverage area. A series of 11 patients (9 men, mean age 52 years) were treated between June 2008 and September 2011. The pathologies were aneurysmal disease (thoracoabdominal aortic aneurysms) (5, 45.5%), aortic dissection (thoracoabdominal aortic dissection) (4, 36.4%) or true/false aneurysm formation after Takayasu's arteritis (2, 18.2%). Simultaneous approach (9, 81.8%) and staged approach (2, 18.2%) were performed. The mean follow-up was 13.5 months (range 1–36). The technical success was 100%. Stent grafts were implanted in the entire or part of the thoracoabdominal aorta. The overall mortality rate was 9.1% (1/11) with no aneurysm-related death. The permanent paraplegia and bypass graft occlusion rate was 0%. The overall morbidity was 36.4% with two endoleaks (2/11, 18.2%). In conclusion, hybrid procedures can minimize surgical invasiveness in treatments of thoracoabdominal aortic pathologies, and it is a safe method with acceptable morbidity and mortality.
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Gopalakrishnan, Shyam Sunder, Benoît Pier, and Arie Biesheuvel. "Dynamics of pulsatile flow through model abdominal aortic aneurysms." Journal of Fluid Mechanics 758 (October 7, 2014): 150–79. http://dx.doi.org/10.1017/jfm.2014.535.
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AbstractTo contribute to the understanding of flow phenomena in abdominal aortic aneurysms, numerical computations of pulsatile flows through aneurysm models and a stability analysis of these flows were carried out. The volume flow rate waveforms into the aneurysms were based on measurements of these waveforms, under rest and exercise conditions, of patients suffering abdominal aortic aneurysms. The Reynolds number and Womersley number, the dimensionless quantities that characterize the flow, were varied within the physiologically relevant range, and the two geometric quantities that characterize the model aneurysm were varied to assess the influence of the length and maximal diameter of an aneurysm on the details of the flow. The computed flow phenomena and the induced wall shear stress distributions agree well with what was found in PIV measurements by Salsac et al. (J. Fluid Mech., vol. 560, 2006, pp. 19–51). The results suggest that long aneurysms are less pathological than short ones, and that patients with an abdominal aortic aneurysm are better to avoid physical exercise. The pulsatile flows were found to be unstable to three-dimensional disturbances if the aneurysm was sufficiently localized or had a sufficiently large maximal diameter, even for flow conditions during rest. The abdominal aortic aneurysm can be viewed as acting like a ‘wavemaker’ that induces disturbed flow conditions in healthy segments of the arterial system far downstream of the aneurysm; this may be related to the fact that one-fifth of the larger abdominal aortic aneurysms are found to extend into the common iliac arteries. Finally, we report a remarkable sensitivity of the wall shear stress distribution and the growth rate of three-dimensional disturbances to small details of the aneurysm geometry near the proximal end. These findings suggest that a sensitivity analysis is appropriate when a patient-specific computational study is carried out to obtain a quantitative description of the wall shear stress distribution.
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Yetman, Anji T., James Hammel, Jennifer N. Sanmann, and Lois J. Starr. "Valve-Sparing Root and Total Arch Replacement for Cutis Laxa Aortopathy." World Journal for Pediatric and Congenital Heart Surgery 10, no. 3 (July 4, 2017): 376–79. http://dx.doi.org/10.1177/2150135117698458.
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Aortic aneurysms requiring surgery in early childhood are rare. Herein we describe the case of a three-year-old with massive aneurysmal aortic dilation secondary to the rare and often lethal genetic disorder, cutis laxa. Initial thoracic aortic aneurysm gene panel was negative. Parents of the child were not known to be consanguineous, but high-density SNP array revealed several regions of homozygosity. This prompted targeted sequence analysis that identified a novel homozygous missense mutation in the gene for cutis laxa, EFEMP2. The patient underwent aortic valve–sparing aortic root and ascending aorta replacement and total aortic arch replacement, with continuous, moderately hypothermic cardiopulmonary bypass, using a dual cannulation technique. He was discharged well on the third postoperative day and remains free of aneurysmal disease at two-year follow-up.
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Ohki, Masafumi. "Thoracic Saccular Aortic Aneurysm Presenting with Recurrent Laryngeal Nerve Palsy prior to Aneurysm Rupture: A Prodrome of Thoracic Aneurysm Rupture?" Case Reports in Otolaryngology 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/367873.
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Left recurrent laryngeal nerve palsy rarely results from cardiac disease. We present 2 cases of left recurrent laryngeal nerve palsy caused by thoracic saccular aortic aneurysms. One patient suffered an aortic aneurysm rupture one month after the advent of hoarseness, necessitating emergency surgery with aortic arch replacement. The other patient underwent elective aortic arch replacement surgery. Both saccular aortic aneurysms protruded downward in the aortopulmonary window to compress the recurrent laryngeal nerves. This is only the 5th case report of the rare occurrence of acute recurrent laryngeal nerve palsy subsequent to saccular aneurysm rupture in the English literature. Recurrent laryngeal nerve palsy does not always indicate imminent aneurysm rupture, but should trigger awareness of a potential rupture in the near future. Left recurrent laryngeal nerve palsy might be a prodrome of aneurysm rupture.
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White, Rodney A., Carlos Donayre, Irwin Walot, James Lee, and George E. Kopchok. "Regression of a Descending Thoracoabdominal Aortic Dissection following Staged Deployment of Thoracic and Abdominal Aortic Endografts." Journal of Endovascular Therapy 9, no. 2_suppl (June 2002): II—92—II—97. http://dx.doi.org/10.1177/15266028020090s215.
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Purpose: To describe the successful endovascular repair and regression of an extensive descending thoracoabdominal aortic dissection associated with thoracic and abdominal aortic aneurysms. Case Report: An 83-year-old man presented with acute chest pain and shortness of breath. A descending thoracoabdominal aortic dissection that extended from near the left subclavian artery (LSA) to the right common iliac artery was found on computed tomography. Separate aneurysms in the thoracic and abdominal aorta were also identified. Staged endovascular procedures were undertaken to (1) close the single entry site and exclude the aneurysm in the thoracic aorta with an AneuRx thoracic stent-graft, (2) exclude the abdominal aneurysm and distal re-entry site with a bifurcated AneuRx endograft, and (3) treat a newly dilated thoracic segment between the LSA and first thoracic stent-graft. At 1 year, the false lumen had completely disappeared, the thoracic aneurysm had collapsed onto the endograft, and the abdominal aneurysm had shrunk by 30%. Conclusions: The potential to treat extensive aortic dissections with the hope that they might regress is promising, but repair of highly complex lesions involving one or more aneurysms in addition to the dissection requires meticulous imaging studies both preoperatively and intraprocedurally.
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Chung, Christine, Rajesh Malik, Michael Marin, Peter Faries, and Sharif Ellozy. "Staged hybrid open and endovascular exclusion of a symptomatic thoracoabdominal aortic aneurysm in a high-risk patient." Vascular 22, no. 4 (June 6, 2013): 280–85. http://dx.doi.org/10.1177/1708538113492515.
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Thoracoabdominal aortic aneurysms have a higher prevalence in the elderly, who are often poor surgical candidates. These extensive aneurysms may be lethal if left untreated. Conventional open repair has proven to be a major task, involving cardiopulmonary bypass, aortic cross-clamping and expeditious repair of an inaccessible structure involving two body cavities. Endovascular repair has become a viable option to treat isolated descending thoracic aneurysms and infrarenal abdominal aortic aneurysms. However, endovascular techniques alone have been less applicable for treating complex aortic aneurysms, including those involving visceral vessels. Therefore, a hybrid open and endovascular approach with visceral debranching has become an increasingly favorable alternative for patients with these complex conditions. We report a case in which a staged hybrid approach was used for successful exclusion of an extensive thoracoabdominal aortic aneurysm in a symptomatic, high-risk patient who would not have been an appropriate candidate for open surgical repair.
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Sparks, Andrea, Scott Oplinger, Elizabeth Maynes, Keiko Meshida, Maria Ximena Leighton, Gary Wind, and Guinevere Granite. "Chronic Atherothrombosis in a Sub-Massive Infrarenal Abdominal Aortic Aneurysm in a 91-Year-Old White Male Donor." Diagnostics 12, no. 10 (September 20, 2022): 2270. http://dx.doi.org/10.3390/diagnostics12102270.
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Screening for abdominal aortic aneurysms became the standard of care in 2005, yet screening procedures continue to be underutilized. While improvements in mortality rates have been noted over the past 15 years, continued patient mortality from ruptured abdominal aortic aneurysms suggests a need for further research, regarding the effectiveness of the current screening process. Abdominal aortic aneurysms can progress silently, and the risk of rupture increases significantly with increase in diameter. We report a large, untreated infrarenal abdominal aortic aneurysm of 17 cm in length and 8 cm in diameter, showing the chronic atherothrombosis discovered in a 91 year-old white male cadaveric donor. A literature review was conducted to elucidate current understanding of the pathology, risk factors, screening recommendations, and treatment options available for abdominal aortic aneurysms.
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Rahme, Rudy J., Joseph G. Adel, Bernard R. Bendok, John F. Bebawy, Dhanesh K. Gupta, and H. Hunt Batjer. "Association of Intracranial Aneurysm and Loeys-Dietz Syndrome: Case Illustration, Management, and Literature Review." Neurosurgery 69, no. 2 (March 30, 2011): E488—E493. http://dx.doi.org/10.1227/neu.0b013e318218cf55.
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Abstract BACKGROUND AND IMPORTANCE: Loeys-Dietz syndrome (LDS) is a newly described connective tissue disease associated with aortic aneurysms. A strong association between LDS and intracranial aneurysms has not yet been documented in the literature. We present the first detailed report of an intracranial aneurysm finding in an LDS patient. CLINICAL PRESENTATION: The patient is a 20-year-old female recently diagnosed with LDS and found to harbor 2 incidental intracranial aneurysms on a screening magnetic resonance angiography: a 3-mm right carotid ophthalmic aneurysm and an 8-mm partially fusiform paraclinoid carotid artery aneurysm. A standard left pterional craniotomy was performed. Intraoperative adenosine was used instead of temporary clipping because her vessels were extremely friable. After reconstruction, an intraoperative indocyanine green angiogram was obtained, confirming complete aneurysmal obliteration and internal carotid artery patency. CONCLUSION: This is the first detailed report of a clear association between intracranial aneurysms and LDS. An association between LDS and intracranial aneurysms, if substantiated in a larger study, has implications for aneurysm screening in this population. Such an association may shed light on mechanisms of aneurysm formation, growth, and rupture.
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Li, Haiyang, Wenjian Jiang, Weihong Ren, Dong Guo, Jialong Guo, Xiaolong Wang, Yuyong Liu, Feng Lan, Jie Du, and Hongjia Zhang. "Downregulation of the Yes-Associated Protein Is Associated with Extracellular Matrix Disorders in Ascending Aortic Aneurysms." Stem Cells International 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/6786184.
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Previous studies indicate that extracellular matrix (ECM) disorders lead to the apoptosis of Vascular Smooth Muscle Cells (VSMCs), which impairs the aortic wall by reducing the generation of elastic fibers, and ultimately result in ascending aortic aneurysm. The critical role of the Yes-associated protein (YAP) has been elucidated in cardiac/SMC proliferation during cardiovascular development. However, the association of YAP expression and extracellular matrix disorders in ascending aortic aneurysms is not clear. Here, we present for the first time that the downregulation of YAP in VSMCs is associated with ECM disorders of the media in ascending aortic aneurysms. We found that aortic ECM deteriorated with increased apoptotic VSMCs. Moreover, expression of YAP was dramatically reduced in the aortic walls of patients with ascending aortic aneurysms, while the normal aortic samples exhibited abundant YAP in the VSMCs. These results suggest that downregulation of YAP leads to apoptosis of VSMCs, which are essential for the homeostasis of the aortic wall. The resultant ECM disorders affect aortic structure and function and contribute to the development of ascending aortic aneurysms. In summary, through assessment of clinical samples, we revealed the association between downregulation of YAP in VSMCs and the development of ascending aortic aneurysms, providing new insight into the pathogenesis of this disease.
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Vänni, V., T. Hakala, J. Mustonen, J. Turtiainen, T. T. Rissanen, O. Kajander, E. Ilveskoski, J. Koivumäki, M. Eskola, and J. Hernesniemi. "Ultrasound Screening of Men with Coronary Artery Disease for Abdominal Aortic Aneurysms: A Prospective Dual Center Study." Scandinavian Journal of Surgery 105, no. 4 (June 22, 2016): 235–40. http://dx.doi.org/10.1177/1457496915626839.
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Background and Aims: According to the heterogeneous results of previous studies, the prevalence of abdominal aortic aneurysm seems high among men with coronary artery disease. The associating risk factors for abdominal aortic aneurysm in this population require clarification. Our objective was to assess the prevalence of non-diagnosed abdominal aortic aneurysms in men with angiographically verified coronary artery disease and to document the associated co-morbidities and risk factors. Material and Methods: Altogether, 407 men with coronary artery disease were screened after invasive coronary angiography in two series at independent centers. Risk factor data were recorded and analyzed. Results and Conclusion: The mean age of the study cohort was 70.0 years (standard deviation: 11.0). The prevalence of previously undiagnosed abdominal aortic aneurysms in the whole screened population of 407 men was 6.1% (n = 25/407). In a multivariate analysis of the whole study population, the only significant risk factors for abdominal aortic aneurysm were age (odds ratio: 1.04, 95% confidence interval: 1.00–1.09) and history of smoking (odds ratio: 3.13, 95% confidence interval: 1.26–7.80). Non-smokers with abdominal aortic aneurysm were significantly older than smokers (mean age: 80.7 (standard deviation: 8.0) vs 68.0 (standard deviation: 11.1), p = 0.003), and age was a significant risk factor only among non-smokers (p = 0.011; p = 0.018 for interaction). Among smokers, the prevalence of abdominal aortic aneurysm was 8.8%, and 72% (n = 18/25) of all diagnosed abdominal aortic aneurysm patients were smokers. Prevalence of undiagnosed abdominal aortic aneurysms among patients with coronary artery disease is high, and history of smoking is the most significant risk factor for abdominal aortic aneurysm. Effectiveness of selective screening of abdominal aortic aneurysm in male patients with coronary artery disease warrants further studies.
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Ferraz de Freitas, Marcelo, Marcelo Valladão de Carvalho, and Marcelo Derbli Schafranski. "Association of aortic and main left coronary aneurysms with severe aortic insufficiency in Takayasu’s arteritis." Clinics and Practice 1, no. 2 (April 22, 2011): 26. http://dx.doi.org/10.4081/cp.2011.e26.
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Takayasu’s arteritis is a granulomatous vasculitis of unknown etiology that affects mainly the aorta and its branches. As a result of intimal fibroproliferation, segmental stenosis, occlusion, dilatation, and aneurysmal formation of the involved vessels may develop. It is an uncommon disease and usually affects young Asian female patients during the second and third decades of life. Coronary arteries are exceptionally affected and coronary aneurysm formation is a very rare finding. We describe a case of a previously healthy 26-year-old Caucasian female whose Takayasu’s arteritis presented as a previously undescribed association of aortic and main left coronary aneurysms with severe aortic insufficiency.
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Martínez-León, J. I., J. C. Bohórquez-Sierra, A. R. Sánchez-Guzmán, F. N. Arribas-Aguilar, F. Ceijas-Lloreda, M. Rodríguez-Piñero, and C. Bohórquez-Sierra. "Inferior Vena Cava Compression Caused by Ruptured Abdominal Aortic Aneurysms: Report of Two Cases." Phlebology: The Journal of Venous Disease 12, no. 3 (September 1997): 112–14. http://dx.doi.org/10.1177/026835559701200308.
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Objective: To report two cases of inferior vena cava (IVC) and iliac vein thrombosis secondary to expansive and ruptured abdominal aortic aneurysms. Design: Case report. Setting: Angiology and Vascular Surgery Unit, Hospital Universitario Puerta del Mar, Cádiz, Spain. Patients: Patients with clinical and radiological evidence of IVC and iliac vein thrombosis secondary to a sealed rupture from expanding aortic aneurysms. Interventions: Surgical repair in one case and conservative management in the second case. Conclusions: Venous compression was relieved, avoiding the risk associated with anticoagulant therapy in the presence of an aortic aneurysm. Ultrasound scanning is useful in assessing deep venous thrombosis and detecting compressive masses such as aortic and iliac aneurysms. Inappropriate management of patients with venous obstruction from undiagnosed arterial aneurysms may cause serious complications.