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Sohail AH, Cohen K, Ho K, Cimaroli S, Brathwaite CEM, Shin P. Incidental aortocaval fistula in the setting of an unruptured abdominal aortic aneurysm. J Surg Case Rep 2023; 2023:rjad384. [PMID: 37416494 PMCID: PMC10319617 DOI: 10.1093/jscr/rjad384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023] Open
Abstract
An aortocaval fistula, a rare abnormal vascular communication between the aorta and inferior vena cava, is most commonly associated with abdominal aortic aneurysms (AAAs). Other factors leading to aortocaval fistula formation include atherosclerosis, collagen vascular diseases, vasculitis, hematogenous infections, prior spinal surgery, malignancy and radiation exposure. In rare instances, aortocaval fistulas may be discovered incidentally on abdominal imaging. We report an unusual case of an incidental aortocaval fistula in a 93-year-old male patient with an unruptured AAA, presenting with shortness of breath, malaise and lethargy. The patient had no other obvious risk factors for aortocaval fistula formation. Multidetector computed tomography angiography helped identify the fistula, and the patient was eventually transferred to hospice for comfort measures. This case highlights the importance of detailed imaging and preoperative planning in managing aortocaval fistulas and associated AAAs.
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Affiliation(s)
- Amir H Sohail
- Department of Surgery, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Koral Cohen
- Correspondence address. Department of General Surgery, NYU Long Island School of Medicine, Mineola, NY, USA. Tel: 201-414-2434; Fax: 516-663-8707; E-mail:
| | - Kimberly Ho
- Department of Surgery, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Sawyer Cimaroli
- Department of Surgery, NYU Long Island School of Medicine, Mineola, NY, USA
| | | | - Patrick Shin
- Department of Surgery, NYU Long Island School of Medicine, Mineola, NY, USA
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Pratesi C, Esposito D, Apostolou D, Attisani L, Bellosta R, Benedetto F, Blangetti I, Bonardelli S, Casini A, Fargion AT, Favaretto E, Freyrie A, Frola E, Miele V, Niola R, Novali C, Panzera C, Pegorer M, Perini P, Piffaretti G, Pini R, Robaldo A, Sartori M, Stigliano A, Taurino M, Veroux P, Verzini F, Zaninelli E, Orso M. Guidelines on the management of abdominal aortic aneurysms: updates from the Italian Society of Vascular and Endovascular Surgery (SICVE). THE JOURNAL OF CARDIOVASCULAR SURGERY 2022; 63:328-352. [PMID: 35658387 DOI: 10.23736/s0021-9509.22.12330-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The objective of these Guidelines was to revise and update the previous 2016 Italian Guidelines on Abdominal Aortic Aneurysm Disease, in accordance with the National Guidelines System (SNLG), to guide every practitioner toward the most correct management pathway for this pathology. The methodology applied in this update was the GRADE-SIGN version methodology, following the instructions of the AGREE quality of reporting checklist as well. The first methodological step was the formulation of clinical questions structured according to the PICO (Population, Intervention, Comparison, Outcome) model according to which the Recommendations were issued. Then, systematic reviews of the Literature were carried out for each PICO question or for homogeneous groups of questions, followed by the selection of the articles and the assessment of the methodological quality for each of them using qualitative checklists. Finally, a Considered Judgment form was filled in for each clinical question, in which the features of the evidence as a whole are assessed to establish the transition from the level of evidence to the direction and strength of the recommendations. These guidelines outline the correct management of patients with abdominal aortic aneurysm in terms of screening and surveillance. Medical management and indication for surgery are discussed, as well as preoperative assessment regarding patients' background and surgical risk evaluation. Once the indication for surgery has been established, the options for traditional open and endovascular surgery are described and compared, focusing specifically on patients with ruptured abdominal aortic aneurysms as well. Finally, indications for early and late postoperative follow-up are explained. The most recent evidence in the Literature has been able to confirm and possibly modify the previous recommendations updating them, likewise to propose new recommendations on prospectively relevant topics.
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Affiliation(s)
- Carlo Pratesi
- Department of Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Davide Esposito
- Department of Vascular Surgery, Careggi University Hospital, Florence, Italy -
| | | | - Luca Attisani
- Department of Vascular Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Raffaello Bellosta
- Department of Vascular Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Filippo Benedetto
- Department of Vascular Surgery, AOU Policlinico Martino, Messina, Italy
| | | | | | - Andrea Casini
- Department of Intensive Care, Careggi University Hospital, Florence, Italy
| | - Aaron T Fargion
- Department of Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Elisabetta Favaretto
- Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Antonio Freyrie
- Department of Vascular Surgery, Parma University Hospital, Parma, Italy
| | - Edoardo Frola
- Department of Vascular Surgery, AO S. Croce e Carle, Cuneo, Italy
| | - Vittorio Miele
- Department of Diagnostic Imaging, Careggi University Hospital, Florence, Italy
| | - Raffaella Niola
- Department of Vascular and Interventional Radiology, AORN Cardarelli, Naples, Italy
| | - Claudio Novali
- Department of Vascular Surgery, GVM Maria Pia Hospital, Turin, Italy
| | - Chiara Panzera
- Department of Vascular Surgery, AOU Sant'Andrea, Rome, Italy
| | - Matteo Pegorer
- Department of Vascular Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Paolo Perini
- Department of Vascular Surgery, Parma University Hospital, Parma, Italy
| | | | - Rodolfo Pini
- Department of Vascular Surgery, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Alessandro Robaldo
- Department of Vascular Surgery, Ticino Vascular Center - Lugano Regional Hospital, Lugano, Switzerland
| | - Michelangelo Sartori
- Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | | | | | | | - Fabio Verzini
- Department of Vascular Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Erica Zaninelli
- Department of General Medical Practice, ATS Bergamo - ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimiliano Orso
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Perugia, Italy
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miR-424/322 protects against abdominal aortic aneurysm formation by modulating the Smad2/3/runt-related transcription factor 2 axis. MOLECULAR THERAPY. NUCLEIC ACIDS 2022; 27:656-669. [PMID: 35036072 PMCID: PMC8752907 DOI: 10.1016/j.omtn.2021.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022]
Abstract
Rupture of abdominal aortic aneurysms (AAAs) is one of the leading causes of sudden death in the elderly population. The osteogenic transcription factor runt-related gene (RUNX) encodes multifunctional mediators of intracellular signal transduction pathways in vascular remodeling and inflammation. We aimed to evaluate the roles of RUNX2 and its putative downstream target miR-424/322 in the modulation of several AAA progression-related key molecules, such as matrix metalloproteinases and vascular endothelial growth factor. In the GEO database, we found that male patients with AAAs had higher RUNX2 expression than did control patients. Several risk factors for aneurysm induced the overexpression of MMPs through RUNX2 transactivation, and this was dependent on Smad2/3 upregulation in human aortic smooth muscle cells. miR-424 was overexpressed through RUNX2 after angiotensin II (AngII) challenge. The administration of siRUNX2 and miR-424 mimics attenuated the activation of the Smad/RUNX2 axis and the overexpression of several AAA progression-related molecules in vitro. Compared to their littermates, miR-322 KO mice were susceptible to AngII-induced AAA, whereas the silencing of RUNX2 and the administration of exogenous miR-322 mimics ameliorated the AngII-induced AAA in ApoE KO mice. Overall, we established the roles of the Smad/RUNX2/miR-424/322 axis in AAA pathogenesis. We demonstrated the therapeutic potentials of miR-424/322 mimics and RUNX2 inhibitor for AAA progression.
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Kessler V, Klopf J, Eilenberg W, Neumayer C, Brostjan C. AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis. Biomedicines 2022; 10:94. [PMID: 35052774 PMCID: PMC8773452 DOI: 10.3390/biomedicines10010094] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/30/2021] [Indexed: 01/27/2023] Open
Abstract
Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2-3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.
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Affiliation(s)
| | | | | | | | - Christine Brostjan
- Department of General Surgery, Division of Vascular Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (V.K.); (J.K.); (W.E.); (C.N.)
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Antunes BFF, Tachibana A, Mendes CDA, Lembrança L, Silva MJ, Teivelis MP, Wolosker N. Signs of impending rupture in abdominal aortic and iliac artery aneurysms by computed tomography: Outcomes in 41 patients. Clinics (Sao Paulo) 2021; 76:e2455. [PMID: 33681945 PMCID: PMC7920398 DOI: 10.6061/clinics/2021/e2455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic patients with abdominal aortic and iliac artery aneurysms, and to evaluate whether these signs were associated with rupture in asymptomatic patients. METHODS This was a retrospective study of patients with abdominal aortic and iliac artery aneurysms identified on computed tomography (CT) over a 10-year period in a single center. The CT scans were reviewed by two reviewers, and patients with SIR were assigned to one of three groups: (1) early symptomatic (ES), (2) late symptomatic (LS), and (3) always asymptomatic (AA). The four main SIR described in the literature were investigated: 1) crescent sign, 2) focal wall discontinuity of circumferential calcifications, 3) aortic bulges or blebs, and 4) aortic draping. RESULTS From a total of 759 aortic and iliac aneurysm reports on 2226 CT scans, we identified 41 patients with at least one SIR, and a prevalence of 4.14% in asymptomatic patients. Focal wall discontinuity of circumferential calcifications was the most common sign, and it was present in 46.3% of these patients (19/41); among these, 26 were repaired (ES: 9, LS: 2, AA: 15). Eleven asymptomatic patients underwent follow-up CT. The aneurysm increased in size in 6 of the 11 (54.5%) patients, and three ruptured (all with discontinuity of calcifications), one of which had no increase in diameter. CONCLUSIONS The presence of focal wall discontinuity of circumferential calcifications was the most common SIR. There was a prevalence of all signs in less than 5% of asymptomatic patients. In unrepaired patients, the signs could be observed on follow-up CT scans with an increase in aneurysm size, indicating that the presence of SIR alone in the absence of other clinical factors or aneurysm characteristics is an insufficient indication for surgery.
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Affiliation(s)
- Bruno Fabricio Feio Antunes
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Adriano Tachibana
- Departamento de Radiologia, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | | | - Lucas Lembrança
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | - Marcela Juliano Silva
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | | | - Nelson Wolosker
- Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
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Lorandon F, Salomon du Mont L, Puyraveau M, Gharbi M, Behr J, Herail J, Steinmetz E, Rinckenbach S. Scannographic Study of Risk Factors of Abdominal Aortic Aneurysm Rupture. Ann Vasc Surg 2020; 73:27-36. [PMID: 33359695 DOI: 10.1016/j.avsg.2020.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Current decision about when to operate abdominal aortic aneurysms (AAAs) is based only on the maximum aneurysm diameter (MAD). However, small aneurysms still rupture and we can observe very large AAA without any symptom. A simple morphologic analysis could be a tool to assess the risk of rupture. The main objective of this study was to assess the relevance of ratios between MAD and healthy aorta on computed tomography (CT) as a risk factor of AAA rupture. The secondary objective was to evaluate CT signs as risk factors of AAA rupture. METHODS Retrospective observational bicentric study comparing CT scans of a ruptured AAA group and a control group treated electively was conducted. Appariement 1:1 based on MAD was applied. Ratios between healthy aorta diameters at several levels, celiac trunk (CTR), superior mesenteric artery (SMA), highest renal artery (RA), and the MAD were calculated. The presence of blebs, crescent signs, ruptures of calcifications of the aneurysm sack, and draped aorta were notified. RESULTS From 2010 to 2016, 38 ruptured AAA and 38 controls were included. Ratios were superior in the rupture group, respectively: MAD/CTR [2.77 (±0.5) versus 2.58 (±0.4) P < 0.095], MAD/SMA [2.92 (±0.7) versus 2.74 (±0.5) P < 0.194], and MAD/RA [3.02 (±0.70) versus 2.76 (±0.5) P < 0.054] but not significatively. Receiver operating characteristic curve analysis demonstrated optimal threshold to detect rupture at 2.8 for the ratio MAD/CTR (area under the curve (AUC) 0.593, sensitivity 47.4%, specificity 78.9%), at 3.3 for the ratio MAD/SMA (AUC 0.564, sensitivity 31.6%, specificity 92.1%), and at 3.3 for the ratio MAD/RA (AUC 0.591, sensitivity 31.6%, specificity 94.7%). Bivariate analysis for rupture risk factor showed significance for the three ratios (MAD/CTR > 2.8 [OR = 11 (1.42; 85.20) P < 0.0217], MAD/SMA > 3.3 [OR = 10 (1.28; 78.12) P < 0.0281], and MAD/RA >3.3 [OR = 11.00 (1.42; 85.20) P < 0.0217]). One scannographic sign was more present in the rupture group: crescent sign 36.8% versus 5.3%, P = 0.0007, as well in bivariate analysis [OR = 7 (1.59; 30.80) P < 0.0326]. CONCLUSIONS In our experience, specific ratios when they exceed calculated threshold, seem to be more prone to rupture. We could consider that these measures, easy to apply in clinical practice, would be complementary keys for rupture risk individual assessment.
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Affiliation(s)
- Fanny Lorandon
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France
| | - Lucie Salomon du Mont
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France; EA3920, University Hospital of Besançon, Besançon, France
| | - Marc Puyraveau
- uMETh, Centre d'Investigation Clinique, Inserm CIC 1431, University Hospital of Besançon, Besançon, France
| | - Manel Gharbi
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France
| | - Julien Behr
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France
| | - Jordane Herail
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France
| | - Eric Steinmetz
- Department of Vascular Surgery, University Hospital of Dijon, Dijon, France
| | - Simon Rinckenbach
- Department of Vascular and Endovascular Surgery, University Hospital of Besançon, Besançon, France; EA3920, University Hospital of Besançon, Besançon, France.
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Patel TV, Canario DAH, Isaacson AJ, Mauro DM. Vascular Etiologies of the Acute Abdomen. Semin Roentgenol 2020; 55:417-426. [PMID: 33220787 DOI: 10.1053/j.ro.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Tirth V Patel
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | | | - Ari J Isaacson
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - David M Mauro
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC.
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Yang CJ, Tsai SH, Wang JC, Chang WC, Lin CY, Tang ZC, Hsu HH. Association between acute aortic dissection and the distribution of aortic calcification. PLoS One 2019; 14:e0219461. [PMID: 31295298 PMCID: PMC6622544 DOI: 10.1371/journal.pone.0219461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/21/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Aortic calcification (AC) is associated with increased risks of cardiovascular events and mortality. Numerous studies have explored the association between calcification and abdominal artery aneurysm. However, evidence regarding the association between AC and acute aortic dissection (AAD) is limited. We aimed to evaluate the association between AC-related variables and the development of intimal tear (IT) in patients with AAD. Methods We conducted a retrospective observational study involving 64 patients with type A AAD and 32 patients with type B AAD from February, 2011 to January, 2017 at a tertiary referral medical center in Taiwan. We used the default analysis module “calcification score analysis” to calculate all the calcification variables, including AC scores and volume. Results We identified an association between AC and AAD. Patients with AAD had a greater AC volume in the aortic arch and greater AC scores for both the ascending aorta and the aortic arch than did patients without AAD. However, hypertension and coronary artery disease, rather than AC remained to be the independent risk factor for AAD in multivariate analysis. Patients with type A AAD had greater mean and cumulative AC volumes in the aortic arch, greater cumulative AC volumes in the whole aorta and higher cumulative AC scores in the aortic arch than did patients with type B AAD. ACs were superimposed on ITs in nearly half of the patients with AAD. In patients with type A AAD, AC was more commonly located distal to the IT and farther from the IT. Conclusions We identified the associations between AC-related variables and the location of IT in patients with AAD. However, AC was not an independent risk factor for AAD. The distribution of AC was different between patients with type A and type B AAD.
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Affiliation(s)
- Chih-Jen Yang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (SHT); (HHH)
| | - Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Yuan Lin
- Division of Cardiovascular surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Zun-Cheng Tang
- Department of Biological Imaging and Radiological Science, National Yang-Ming University, Taipei, Taiwan
| | - Hsian-He Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (SHT); (HHH)
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Hayim M, Balakrishnan S. Highlights from the scientific and educational abstracts presented at the ASER 2016 annual scientific meeting and postgraduate course. Emerg Radiol 2017; 24:393-400. [PMID: 28551864 DOI: 10.1007/s10140-017-1518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 11/30/2022]
Abstract
The annual meeting of the American Society of Radiology (ASER) took place in San Francisco, California on September 14 through September 17, 2016. Attendees represented the USA as well as international emergency radiology communities, including those from academic, private practice, and teleradiology settings. There were several "members in training" in attendance as well. The meeting again featured the "Trauma Head to Toe" 2-day didactic course, highlighting various important topics on imaging of traumatic injuries. Scattered throughout the 4 days were several poster and case of the day presentations, scientific sessions, and self-assessment modules. The following is a summary of the educational posters and scientific papers.
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Affiliation(s)
- Morris Hayim
- LAC-USC Medical Center, 2051 Marengo Street, Los Angeles, CA, 90033, USA.
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Kumar DS, Bhat V, Gadabanahalli K, Kalyanpur A. Spectrum of Abdominal Aortic Disease in a Tertiary Health Care Setup: MDCT Based Observational Study. J Clin Diagn Res 2017; 10:TC24-TC29. [PMID: 28050476 DOI: 10.7860/jcdr/2016/21373.8928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Abdominal aortic disease is an important cause of clinical disability that requires early detection by imaging methods for prompt and effective management. Understanding regional disease pattern and prevalence has a bearing on healthcare management and resource planning. Non-invasive, conclusive imaging strategy plays an important role in the detection of disease. Multi-Detector Computed Tomography (MDCT) with its technological developments provides affordable, accurate and comprehensive imaging solution. AIM To evaluate regional demography of abdominal aortic disease spectrum detected using MDCT imaging data in a tertiary hospital. MATERIALS AND METHODS A descriptive study was conducted based on MDCT imaging data of patients who were investigated with clinical diagnosis of abdominal aortic disease, from March 2008-2010, over a period of 24 months. Patients were examined with the contrast-enhanced MDCT examination. Morphological diagnosis of the aortic disease was based on changes in relative aortic caliber, luminal irregularity, presence of wall calcification, dissection or thrombus and evidence of major branch occlusion. Patients were categorized into four groups based on imaging findings. MDCT information and associated clinical parameters were examined and correlated to management of patient. Descriptive statistical data, namely mean, standard deviation and frequency of disease were evaluated. RESULTS A total of 90 out of 210 patients (43%) were detected with the abdominal aortic abnormality defined by imaging criteria. Group I, comprising of patients with atherosclerosis -including those with complications, constituted 65.5% of the patients. Group II represented patients with aneurysms (45.5%). Group III, consisting of 32.2% of the patients, contained those with dissections. The rest of the patients, including patients with aorto-arteritis, were classified as group IV. Eight patients with aneurysm and one patient with aorto-arteritis were considered for surgical treatment. Ten patients with dissection underwent endovascular procedure. Rest of the patients was managed conservatively. CONCLUSION Aortic disease was observed in 43% of investigated patients. Atherosclerosis with and without aortic aneurysm constituted the largest group. MDCT provided comprehensive information about the lesion and associated complications. In view of the wider availability and desired imaging qualities, MDCT provided optimal information for diagnosis and management of aortic pathology. Majority of our patients (90%) were treated conservatively.
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Affiliation(s)
- Dg Santosh Kumar
- Consultant Radiologist, Narayana Health, Shaw Mazumdar Medical Center , Bengaluru, Karnataka, India
| | - Venkatraman Bhat
- Director of Imaging Services, Sr. Consultant, Department of Radiology, Narayana Health, Shaw Mazumdar Medical Center , Bengaluru, Karnataka, India
| | - Karthik Gadabanahalli
- Consultant Radiologist, Department of Radiology, Narayana Health, Teleradiology Solutions , Whitefield, Bengaluru, Karnataka, India
| | - Arjun Kalyanpur
- CEO, Teleradiology Solutions, Teleradiology Solutions , Whitefield, Bengaluru, Karnataka, India
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Mechanical characterization of biological tissues: Experimental methods based on mathematical modeling. Biomed Eng Lett 2016. [DOI: 10.1007/s13534-016-0222-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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