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Domagała D, Data K, Szyller H, Farzaneh M, Mozdziak P, Woźniak S, Zabel M, Dzięgiel P, Kempisty B. Cellular, Molecular and Clinical Aspects of Aortic Aneurysm-Vascular Physiology and Pathophysiology. Cells 2024; 13:274. [PMID: 38334666 PMCID: PMC10854611 DOI: 10.3390/cells13030274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
A disturbance of the structure of the aortic wall results in the formation of aortic aneurysm, which is characterized by a significant bulge on the vessel surface that may have consequences, such as distention and finally rupture. Abdominal aortic aneurysm (AAA) is a major pathological condition because it affects approximately 8% of elderly men and 1.5% of elderly women. The pathogenesis of AAA involves multiple interlocking mechanisms, including inflammation, immune cell activation, protein degradation and cellular malalignments. The expression of inflammatory factors, such as cytokines and chemokines, induce the infiltration of inflammatory cells into the wall of the aorta, including macrophages, natural killer cells (NK cells) and T and B lymphocytes. Protein degradation occurs with a high expression not only of matrix metalloproteinases (MMPs) but also of neutrophil gelatinase-associated lipocalin (NGAL), interferon gamma (IFN-γ) and chymases. The loss of extracellular matrix (ECM) due to cell apoptosis and phenotype switching reduces tissue density and may contribute to AAA. It is important to consider the key mechanisms of initiating and promoting AAA to achieve better preventative and therapeutic outcomes.
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Affiliation(s)
- Dominika Domagała
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (D.D.); (K.D.); (H.S.); (S.W.)
| | - Krzysztof Data
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (D.D.); (K.D.); (H.S.); (S.W.)
| | - Hubert Szyller
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (D.D.); (K.D.); (H.S.); (S.W.)
| | - Maryam Farzaneh
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;
| | - Paul Mozdziak
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27607, USA;
- Physiology Graduate Faculty, North Carolina State University, Raleigh, NC 27613, USA
| | - Sławomir Woźniak
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (D.D.); (K.D.); (H.S.); (S.W.)
| | - Maciej Zabel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.Z.); (P.D.)
- Division of Anatomy and Histology, University of Zielona Góra, 65-046 Zielona Góra, Poland
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.Z.); (P.D.)
- Department of Physiotherapy, University School of Physical Education, 51-612 Wroclaw, Poland
| | - Bartosz Kempisty
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (D.D.); (K.D.); (H.S.); (S.W.)
- Physiology Graduate Faculty, North Carolina State University, Raleigh, NC 27613, USA
- Institute of Veterinary Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland
- Department of Obstetrics and Gynecology, University Hospital and Masaryk University, 602 00 Brno, Czech Republic
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Borzsák S, Süvegh A, Szentiványi A, Fontanini DM, Vecsey-Nagy M, Banga P, Sótonyi P, Szeberin Z, Csobay-Novák C. Midterm Results of Iliac Branch Devices in a Newly Established Aortic Center. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081154. [PMID: 36013332 PMCID: PMC9409818 DOI: 10.3390/life12081154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
The first-line treatment of common iliac artery aneurysms is endovascular repair. International guidelines recommend the preservation of the internal iliac artery, which is best achieved by the implantation of an iliac bifurcation device (IBD). Our aim was to evaluate the initial midterm results of IBDs in the leading vascular center of Hungary. In this single-center retrospective study, relevant clinical data and the results of the imaging examinations were collected and analyzed in all patients who underwent IBD implantation between December 2010 and July 2021. Thirty-five patients (31 males, mean age: 67.9 ± 8.5 years) underwent endovascular treatment with 37 IBD implantations. Technical success was achieved in 88.2% of the patients, with no perioperative mortality or open surgical conversion. One patient was lost during follow-up. Internal iliac artery occlusion was detected in three (8.8%) patients, and reintervention was performed in five (14.7%) patients. Primary patency of the internal iliac branch was 97.1% at 1 month, 93% at 2 months, and 89.0% at 5 years. The average follow-up time was 20.1 ± 26.2 months, during which two (5.9%) deaths occurred. Our initial experience with iliac branch devices was associated with a low complication rate and a favorable outcome, which confirms the midterm success of this intervention.
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Affiliation(s)
- Sarolta Borzsák
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
| | - András Süvegh
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
| | - András Szentiványi
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
| | - Daniele Mariastefano Fontanini
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
| | - Milán Vecsey-Nagy
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
| | - Péter Banga
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
- Department of Vascular and Endovascular Surgery, Semmelweis University, 1122 Budapest, Hungary
| | - Péter Sótonyi
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
- Department of Vascular and Endovascular Surgery, Semmelweis University, 1122 Budapest, Hungary
| | - Zoltán Szeberin
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
- Department of Vascular and Endovascular Surgery, Semmelweis University, 1122 Budapest, Hungary
| | - Csaba Csobay-Novák
- Department of Interventional Radiology, Semmelweis University, 1122 Budapest, Hungary; (S.B.); (A.S.); (A.S.); (D.M.F.); (M.V.-N.)
- Semmelweis Aortic Center, Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary; (P.B.); (P.S.); (Z.S.)
- Correspondence: ; Tel.: +36-1-458-6870
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