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Ortega J, Wyneken J, Garner MM. Aneurysm Associated with Vascular Wall Degeneration in Bearded Dragons ( Pogona vitticeps). Vet Pathol 2024; 61:468-475. [PMID: 38006226 DOI: 10.1177/03009858231214025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
This study describes the clinical, gross, and histologic findings in 17 cases of aneurysms in bearded dragons (Pogona vitticeps). The clinical presentation ranged from incidental to sudden and unexpected death. The affected vasculature was predominantly arterial; however, based on the topographical locations of the lesions, gross structure, and drainage, some veins were likely involved. Magnetic resonance imaging and computerized tomography scans of 1 animal showed a large aneurysm of the internal carotid artery extending from near its aortic origin into the caudal head. Aneurysms were organized in 5 groups based on their anatomical locations: cephalic, cranial coelom (for all near the heart), caudal coelom (for the mesenteric vessels and descending aorta), limbs, and tail. The cranial coelomic region was the most prevalent location. Gross findings were large hematomas or red serosanguineous fluid filling the adjacent area, as most of the aneurysms (94%) were ruptured at the time of the study. The main histological findings were degenerative changes of the vessel walls characterized by moderate to severe disruption of the collagen and elastic fibers of the tunica media and adventitia (100%), followed by thickening of the intima with thrombi formation (54%) and dissecting hematoma of the vessel wall (47%). Vasculitis (29%), mineralization (6%), and lipid deposits (6%) in the vessel wall were observed occasionally. Based on these findings, the vascular dilations and ruptures observed in bearded dragons likely are associated with weakness of the vessel walls caused by degenerative changes in the intimal and medial tunics.
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Affiliation(s)
- Joaquín Ortega
- Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
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Amani A, Farajollahi AH. Drug Delivery Angle for Various Atherosclerosis and Aneurysm Percentages of the Carotid Artery. Mol Pharm 2024; 21:1777-1793. [PMID: 38478900 DOI: 10.1021/acs.molpharmaceut.3c01109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Stroke is the second cause of mortality among adult males and the first cause of death in adult females all around the world. It is also recognized as one of the most important causes of morbidity and dementia in adults. Stenosis or rupture of the only channels of the blood supply from the heart to the brain (carotid arteries) is among the main causes of stroke. In this regard, treatment of the lesions of carotid arteries, including atherosclerosis and aneurysm, could be a huge step in preventing stroke and improving brain performance. Targeted drug delivery by drug-carrying nanoparticles is the latest method for optimal delivery of drug to the damaged parts of the artery. In this study, a wide range of carotid artery lesions, including different percentages of atherosclerosis and aneurysm, were considered. After analyzing the dynamics of the fluid flow in different damaged regions and selecting the magnetic framework with proper ligand (Fe3O4@MOF) as the drug carrier, the size of the particles and their number per cycle were analyzed. Based on the results, the particle size of 100 nm and the use of 300 particles per injection at each cardiac cycle can result in maximum drug delivery to the target site. Then, the effect of the hospital bed angle on drug delivery was investigated. The results showed a unique optimal drug delivery angle for each extent of atherosclerosis or aneurysm. For example, in a 50% aneurysm, drug delivery at an angle of 30° is about 387% higher than that at an angle of 15°. Finally, simulation of real geometry indicated the effectiveness of simple geometry instead of real geometry for the simulation of carotid arteries, which can remarkably decrease the computational time and costs.
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Affiliation(s)
- Ali Amani
- School of Mechanical Engineering, Sharif University of Technology, Tehran 11155-9466, Iran
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Yang L, Hao X, Gao B, Ren C, Du H, Su X, Zhang D, Bao T, Qiao Z, Cao Q. Endothelialization of PTFE-covered stents for aneurysms and arteriovenous fistulas created in canine carotid arteries. Sci Rep 2024; 14:4803. [PMID: 38413764 PMCID: PMC10899654 DOI: 10.1038/s41598-024-55532-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/24/2024] [Indexed: 02/29/2024] Open
Abstract
To investigate the endothelialization of covered and bare stents deployed in the canine carotid arteries and subclavian arteries for treating experimental aneurysms and arteriovenous fistulas, twenty aneurysms were created in 10 dogs, and 20 fistulas in another 10 dogs. The Willis balloon-expandable covered stent and a self-expandable covered stent were used to treat these lesions, and a self-expandable bare stent was deployed in the subclavian artery for comparison. Followed up for up to 12 months, the gross observation, pathological staining, and scanning electronic microscopic data were analyzed. Two weeks after creation of animal model, thirty self-expandable covered stents and ten balloon-expandable covered stents were deployed. Fifteen bare stents were deployed within the left subclavian arteries. Twenty days after stenting, the aneurysm significantly shrank. At 6 months, the thrombi within the aneurysm cavity were organized. Three to 12 months later, most covered and bare stents were covered by a thin transparent or white layer of endothelial intima. Layers of intima or pseudomembrane were formed on the stent 20-40 days after stent deployment. Over three months, the pseudomembrane became organized, thinner, and merged into the vascular wall. Under scanning electronic microscopy, the surface of covered and bare stents had only deposition of collagen fibers and rare endothelial cells 20-40 days after stenting. From three to ten months, the endothelial cells on the internal surface of stent became mature, with spindle, stripe-like or quasi round morphology along the blood flow direction. Over time, the endothelial cells became mature. In conclusion, three months after deployment in canines' arteries, the self-expandable bare and covered stents have mostly been covered by endothelial cells which become maturer over time, whereas the balloon-expandable covered stents do not have complete coverage of endothelial cells at three months, especially for protruding stent struts and areas. Over time, the endothelialization will become mature.
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Affiliation(s)
- Lei Yang
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China.
| | - Xiaohong Hao
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Bulang Gao
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Chunfeng Ren
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Hong Du
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - XianHui Su
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Dongliang Zhang
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Tong Bao
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Zongrong Qiao
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China
| | - Qinying Cao
- Shijiazhuang People's Hospital, Shijiazhuang, 050011, Hebei Province, People's Republic of China.
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Brahim O, Mahjoub Y, Boussaid M, Limem H, Aissaoui A. Fibromuscular dysplasia of the coronary arteries: An unusual case of sudden death and review of the literature. J Forensic Leg Med 2024; 102:102633. [PMID: 38241822 DOI: 10.1016/j.jflm.2023.102633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/21/2024]
Abstract
Fibromuscular dysplasia of the coronary is an uncommon coronary defect with a range of pathological alterations and unpredictable clinical description that can cause sudden death. We present an autopsy case of sudden cardiac death due to a rupture of a coronary artery aneurysm in a 59-year-old woman. Postmortem autopsy revealed two huge saccular aneurysms located at the right coronary artery, one of which was ruptured leading to a fatal hemopericardium. Histopathological examination revealed coronary artery fibromuscular dysplasia with fibromyxoid dissociation of the media causing saccular aneurysms. The involvement of coronary arteries in fibromuscular dysplasia with aneurysmal features has been rarely reported in the literature and is most likely an underdiagnosed finding. Due to the little number of published studies, the etiology is not fully understood and data on pathogenesis, risk factors, manifestation, disease course, and mortality are still unclear, which is a gap that needs to be filled in order to avoid under-diagnosis of the disease. Our case report aimed to discuss the mechanisms of sudden death attributed to coronary fibromuscular dysplasia.
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Affiliation(s)
- Oumeima Brahim
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Yosra Mahjoub
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Marwa Boussaid
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Hiba Limem
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
| | - Abir Aissaoui
- Department of Legal Medicine, Taher Sfar Teaching Hospital, 5100, Mahdia, Tunisia; Faculty of Medicine of Monastir, University of Monastir, Tunisia; Laboratory of Technology and Medical Imaging " LR12ES06, Tunisia.
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Pedroza AJ, Dalal AR, Shad R, Yokoyama N, Nakamura K, Mitchel O, Gilles C, Hiesinger W, Fischbein MP. Smooth Muscle Cell Klf4 Expression Is Not Required for Phenotype Modulation or Aneurysm Formation in Marfan Syndrome Mice-Brief Report. Arterioscler Thromb Vasc Biol 2023; 43:971-978. [PMID: 37128911 PMCID: PMC10434826 DOI: 10.1161/atvbaha.122.318509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Smooth muscle cell (SMC) phenotypic reprogramming toward a mixed synthetic-proteolytic state is a central feature of aortic root aneurysm in Marfan syndrome (MFS). Previous work identified Klf4 as a potential mediator of SMC plasticity in MFS. METHODS MFS (Fbn1C1041G/+) mouse strains with an inducible vascular SMC fluorescent reporter (MFSSMC) with or without SMC-specific deletion of Klf4 exons 2 to 3 (MFSSMC-Klf4Δ) were generated. Simultaneous SMC tracing and Klf4 loss-of-function (Klf4Δ mice) was induced at 6 weeks of age. Aneurysm growth was assessed via serial echocardiography (4-24 weeks). Twenty-four-week-old mice were assessed via histology, RNA in situ hybridization, and aortic single-cell RNA sequencing. RESULTS MFS mice demonstrated progressive aortic root dilatation compared with control (WTSMC) mice regardless of Klf4 genotype (P<0.001), but there was no difference in aneurysm growth in MFSSMC-Klf4Δ versus MFSSMC (P=0.884). Efficient SMC Klf4 deletion was confirmed via lineage-stratified genotyping, RNA in situ hybridization, and immunohistochemistry. Single-cell RNA sequencing of traced SMCs revealed a highly similar pattern of phenotype modulation marked by loss of contractile markers (eg, Myh11, Cnn1) and heightened expression of matrix genes (eg, Col1a1, Fn1) between Klf4 genotypes. Pseudotemporal quantitation of SMC dedifferentiation confirmed that Klf4 deletion did not alter the global extent of phenotype modulation, but reduced expression of 23 genes during this phenotype transition in MFSSMC-Klf4Δmice, including multiple chondrogenic genes expressed by only the most severely dedifferentiated SMCs (eg, Cytl1, Tnfrsf11b). CONCLUSIONS Klf4 is not required to initiate SMC phenotype modulation in MFS aneurysm but may exert regulatory control over chondrogenic genes expressed in highly dedifferentiated SMCs.
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Affiliation(s)
- Albert J. Pedroza
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Alex R. Dalal
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Rohan Shad
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Nobu Yokoyama
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Ken Nakamura
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Olivia Mitchel
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Casey Gilles
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - William Hiesinger
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
| | - Michael P. Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine. Stanford CA, USA
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Manole S, Rancea R, Vulturar R, Simon SP, Molnar A, Damian L. Frail Silk: Is the Hughes-Stovin Syndrome a Behçet Syndrome Subtype with Aneurysm-Involved Gene Variants? Int J Mol Sci 2023; 24:ijms24043160. [PMID: 36834577 PMCID: PMC9968083 DOI: 10.3390/ijms24043160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/21/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Hughes-Stovin syndrome is a rare disease characterized by thrombophlebitis and multiple pulmonary and/or bronchial aneurysms. The etiology and pathogenesis of HSS are incompletely known. The current consensus is that vasculitis underlies the pathogenic process, and pulmonary thrombosis follows arterial wall inflammation. As such, Hughes-Stovin syndrome may belong to the vascular cluster with lung involvement of Behçet syndrome, although oral aphtae, arthritis, and uveitis are rarely found. Behçet syndrome is a multifactorial polygenic disease with genetic, epigenetic, environmental, and mostly immunological contributors. The different Behçet syndrome phenotypes are presumably based upon different genetic determinants involving more than one pathogenic pathway. Hughes-Stovin syndrome may have common pathways with fibromuscular dysplasias and other diseases evolving with vascular aneurysms. We describe a Hughes-Stovin syndrome case fulfilling the Behçet syndrome criteria. A MYLK variant of unknown significance was detected, along with other heterozygous mutations in genes that may impact angiogenesis pathways. We discuss the possible involvement of these genetic findings, as well as other potential common determinants of Behçet/Hughes-Stovin syndrome and aneurysms in vascular Behçet syndrome. Recent advances in diagnostic techniques, including genetic testing, could help diagnose a specific Behçet syndrome subtype and other associated conditions to personalize the disease management.
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Affiliation(s)
- Simona Manole
- Department of Radiology, “Niculae Stăncioiu” Heart Institute, 19-21 Calea Moților Street, 400001 Cluj-Napoca, Romania
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Raluca Rancea
- Cardiology Department, Heart Institute “Niculae Stăncioiu”, 19-21 Calea Moților Street, 400001 Cluj-Napoca, Romania
| | - Romana Vulturar
- Department of Molecular Sciences, “Iuliu Hatieganu” University of Medicine and Pharmacy 6, Pasteur, 400349 Cluj-Napoca, Romania
- Cognitive Neuroscience Laboratory, University Babes-Bolyai, 30, Fântânele Street, 400294 Cluj-Napoca, Romania
- Correspondence:
| | - Siao-Pin Simon
- Department of Rheumatology, Emergency Clinical County Hospital Cluj, Centre for Rare Autoimmune and Autoinflammatory Diseases (ERN-ReCONNET), 2-4 Clinicilor Street, 400347 Cluj-Napoca, Romania
- Discipline of Rheumatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Adrian Molnar
- Department of Cardiovascular Surgery, Heart Institute “Niculae Stăncioiu”, 19-21 Calea Moților Street, 400001 Cluj-Napoca, Romania
- Department of Cardiovascular and Thoracic Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Laura Damian
- Department of Rheumatology, Emergency Clinical County Hospital Cluj, Centre for Rare Autoimmune and Autoinflammatory Diseases (ERN-ReCONNET), 2-4 Clinicilor Street, 400347 Cluj-Napoca, Romania
- CMI Reumatologie Dr. Damian, 6-8 Petru Maior Street, 400002 Cluj-Napoca, Romania
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Meng PP, Lin CJ, Hsia NY, Lai CT, Bair H, Lin JM, Chen WL, Tsai YY. Use of Ultra-Widefield Fluorescein Angiography to Guide the Treatment to Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis-Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58101467. [PMID: 36295627 PMCID: PMC9611749 DOI: 10.3390/medicina58101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To review the clinical features, diagnosis, and treatment of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) and to report a case with the use of ultra-widefield fluorescein angiography (UWFA) for confirming the precise staging of IRVAN and aid in early treatment. The patient improved after being treated with intravitreal aflibercept injection. RESULTS A 26-year-old female complained of progressive blurred vision OD for one week. Her BCVA was 0.6 OD and 1.0 OS. Fundus examination showed vitritis, retinal hemorrhage, and vasculitis over bilateral eyes. Fluorescein angiography (FA) with a 55 degree of view revealed aneurysmal dilations of the peripapillary arteriole, peripapillary focal leakage, venous leakage, and capillary nonperfusion area. Stage 2 IRVAN was impressed OU. Oral prednisolone was administered. After four months, she experienced decreased visual acuity OS. Optical coherence tomography (OCT) revealed subretinal and intraretinal fluid with hyperreflective material. One posterior subtenon triamcinolone and one intravitreal aflibercept injection were performed OS, and macular edema subsided. A 105-degree ultra-widefield fluorescein angiography (UWFA) showed multiple peripheral background hypofluorescence areas corresponding to capillary nonperfusion. Retinal neovascularization (NV) was found OS, which had not been revealed by the previous 55-degree FA. Stage 3 IRVAN was made OS and panretinal laser photocoagulation (PRP) was performed. Oral prednisone and cyclosporine were prescribed. Her vision improved to 1.0 OU. CONCLUSION UWFA provides visualization of peripheral retinal pathology and for precise staging. It also had direct implications in the follow-up and treatment strategy.
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Affiliation(s)
- Ping-Ping Meng
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan
- Department of Optometry, Asia University, Taichung City 404, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
| | - Henry Bair
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA 94303, USA
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City 404, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan
- Department of Optometry, Asia University, Taichung City 404, Taiwan
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Liu Q, Jiang P, Jiang Y, Ge H, Li S, Jin H, Liu P, Li Y. Development and validation of an institutional nomogram for aiding aneurysm rupture risk stratification. Sci Rep 2021; 11:13826. [PMID: 34226632 PMCID: PMC8257713 DOI: 10.1038/s41598-021-93286-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/10/2021] [Indexed: 11/26/2022] Open
Abstract
Rupture risk stratification is critical for incidentally detected intracranial aneurysms. Here we developed and validated an institutional nomogram to solve this issue. We reviewed the imaging and clinical databases for aneurysms from January 2015 to September 2018. Aneurysms were reconstructed and morphological features were extracted by the Pyradiomics in python. Multiple logistic regression was performed to develop the nomogram. The consistency of the nomogram predicted rupture risks and PHASES scores was assessed. The performance of the nomogram was evaluated by the discrimination, calibration, and decision curve analysis (DCA). 719 aneurysms were enrolled in this study. For each aneurysm, twelve morphological and nine clinical features were obtained. After logistic regression, seven features were enrolled in the nomogram, which were SurfaceVolumeRatio, Flatness, Age, Hyperlipemia, Smoker, Multiple aneurysms, and Location of the aneurysm. The nomogram had a positive and close correlation with PHASES score in predicting aneurysm rupture risks. AUCs of the nomogram in discriminating aneurysm rupture status was 0.837 in a separate testing set. The calibration curves fitted well and DCA demonstrated positive net benefits of the nomogram in guiding clinical decisions. In conclusion, Pyradiomics derived morphological features based institutional nomogram was useful for aneurysm rupture risk stratification.
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Affiliation(s)
- QingLin Liu
- Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China
| | - Peng Jiang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
| | - YuHua Jiang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China
| | - HuiJian Ge
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China
| | - ShaoLin Li
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
| | - HengWei Jin
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China
| | - Peng Liu
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China
| | - YouXiang Li
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China.
- Beijing Neurointerventional Engineering Center, Beijing, 100050, China.
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9
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Suganuma E, Sato S, Honda S, Nakazawa A. All trans retinoic acid alleviates coronary stenosis by regulating smooth muscle cell function in a mouse model of Kawasaki disease. Sci Rep 2021; 11:13856. [PMID: 34226641 PMCID: PMC8257698 DOI: 10.1038/s41598-021-93459-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
Coronary artery (CA) stenosis is a detrimental and often life-threatening sequela in Kawasaki disease (KD) patients with coronary artery aneurysm (CAA). Therapeutic strategies for these patients have not yet been established. All-trans-retinoic acid (atRA) is a modulator of smooth muscle cell functions. The purpose of this study was to investigate the effect of atRA on CA stenosis in a mouse model of KD. Lactobacillus casei cell wall extract (LCWE) was intraperitoneally injected into 5-week-old male C57BL/6 J mice to induce CA stenosis. Two weeks later, the mice were orally administered atRA (30 mg/kg) 5 days per week for 14 weeks (LCWE + atRA group, n = 7). Mice in the untreated group (LCWE group, n = 6) received corn oil alone. Control mice were injected with phosphate-buffered saline (PBS, n = 5). Treatment with atRA significantly suppressed CA inflammation (19.3 ± 2.8 vs 4.4 ± 2.8, p < 0.0001) and reduced the incidence of CA stenosis (100% vs 18.5%, p < 0.05). In addition, atRA suppressed the migration of human coronary artery smooth muscle cells (HCASMCs) induced by platelet-derived growth factor subunit B homodimer (PDGF-BB). In conclusion, atRA dramatically alleviated CA stenosis by suppressing SMC migration. Therefore, it is expected to have clinical applications preventing CA stenosis in KD patients with CAA.
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Affiliation(s)
- Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children's Medical Center, 1-2 Shintoshin Chuou-ku Saitama-shi, Saitama, 330-8777, Japan.
| | - Satoshi Sato
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children's Medical Center, 1-2 Shintoshin Chuou-ku Saitama-shi, Saitama, 330-8777, Japan
| | - Satoko Honda
- Division of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Atsuko Nakazawa
- Division of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
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Affiliation(s)
- Albert A Kota
- Department of Surgery, Christian Medical College, Vellore, India
| | - Keisin Wang
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - Katherine Leckie
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - Justin King
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - John Maijub
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind
| | - Raghu L Motaganahalli
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind.
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Heo SH, Park YJ, Kim YW. An internal carotid artery aneurysm in a 15-year-old girl. J Vasc Surg 2020; 72:714-715. [PMID: 32711911 DOI: 10.1016/j.jvs.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/03/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Seon-Hee Heo
- Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yang-Jin Park
- Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Wook Kim
- Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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12
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13
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Abstract
RATIONALE The incidence of pure arterial malformations is relatively low, and few cases have been reported. Only 2 cases with pure arterial malformation have been reported to receive surgery or endovascular treatment. PATIENT CONCERNS We report 3 cases and review the relevant literatures. The head examinations of the patients suggested the presence of high-density shadows in front of the pons and midbrain, the dilation of the supraclinoid segment of the right internal carotid artery, and moyamoya in the left brain with an aneurysm-like expansion located on the left posterior communicating artery respectively. After admission, head digital subtraction angiography (DSA) was performed. DIAGNOSES Digital subtraction angiography (DSA) for these 3 patients showed that the left posterior communicating artery, the supraclinoid segment of the right internal carotid artery, and the left posterior communicating artery appeared dilated, tortuous, and spirally elongated. In addition, the lesions in the latter 2 patients were accompanied with local aneurysmal changes. INTERVENTIONS Two patients were given conservative treatment, and another patient was given endovascular treatment. A head DSA was reviewed 6 months after therapy. OUTCOMES The prognosis status of the 3 patients was good. Two patients in the conservative treatment group showed no changes in the lesions on head DSA examination. The DSA examination of the third patient indicated that the vascular remodeling of the diseased vessels was good, the blood vessels were unobstructed, and the aneurysms had disappeared. LESSONS Pure arterial malformations mostly occur in young women and may involve any blood vessels in the brain. It can be accompanied with local aneurysms and calcification. The patients are often given conservative treatment but need to be reviewed regularly. However, it is beneficial to give endovascular treatment to the patients with local aneurysms.
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14
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Cione E, Piegari E, Gallelli G, Caroleo MC, Lamirata E, Curcio F, Colosimo F, Cannataro R, Ielapi N, Colosimo M, de Franciscis S, Gallelli L. Expression of MMP-2, MMP-9, and NGAL in Tissue and Serum of Patients with Vascular Aneurysms and Their Modulation by Statin Treatment: A Pilot Study. Biomolecules 2020; 10:biom10030359. [PMID: 32111073 PMCID: PMC7175213 DOI: 10.3390/biom10030359] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are involved in vascular wall degradation, and drugs able to modulate MMP activity can be used to prevent or treat aneurysmal disease. In this study, we evaluated the effects of statins on MMP-2, MMP-9, and neutrophil gelatinase-associated lipocalin (NGAL) in both plasma and tissue in patients with aneurysmal disease. METHODS We performed a prospective, single-blind, multicenter, control group clinical drug trial on 184 patients of both sexes >18 years old with a diagnosis of arterial aneurysmal disease. Enrolled patients were divided into two groups: Group I under statin treatment and Group II not taking statins. In addition, 122 patients without aneurysmal disease and under statin treatment were enrolled as a control group (Group III). The expression of MMPs and NGAL in plasma was evaluated using ELISA, while their expression in endothelial tissues was evaluated using Western blot. RESULTS The ELISA test revealed greater plasma levels (p < 0.01) of MMPs and NGAL in Groups I and II vs. Group III. Western blot analysis showed higher expression (p < 0.01) of MMPs and NGAL in Group II vs. Group I, and this increase was significantly higher (p < 0.01) in patients treated with low potency statins compared to high potency ones. CONCLUSIONS MMPs and NGAL seem to play a major role in the development of aneurysms, and their modulation by statins suggests that these drugs could be used to prevent arterial aneurysmal disease.
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Affiliation(s)
- Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Elena Piegari
- Department of Experimental Medicine, Section of Pharmacology, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy;
| | - Giuseppe Gallelli
- Unit of Vascular Surgery, Department of Surgery, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Maria Cristina Caroleo
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Elena Lamirata
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Francesca Curcio
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Federica Colosimo
- National Institution of Social Insurance, Department of Medical Law, 88100 Catanzaro, Italy;
| | - Roberto Cannataro
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, 87036 Rende, Italy; (E.C.); (M.C.C.); (R.C.)
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome 5, 00185 Roma, Italy;
| | - Manuela Colosimo
- Unit of Microbiology and Virology, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Stefano de Franciscis
- Department of Experimental Medicine, University of Catanzaro, and Vascular Surgery Unit, 88100 Mater Domini Hospital, 88100 Catanzaro, Italy; (E.L.); (F.C.); (S.d.F.)
| | - Luca Gallelli
- Department of Health Sciences, University of Catanzaro, and Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-030961712322
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15
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Sellier J, Karam C, Beauchet A, Dallongeville A, Binsse S, Blivet S, Bourgault-Villada I, Charron P, Chinet T, Eyries M, Fagnou C, Lesniak J, Lesur G, Lucas J, Nicod-Tran A, Ozanne A, Palmyre A, Soubrier F, El Hajjam M, Lacombe P. Higher prevalence of splenic artery aneurysms in hereditary hemorrhagic telangiectasia: Vascular implications and risk factors. PLoS One 2020; 15:e0226681. [PMID: 31971937 PMCID: PMC6977744 DOI: 10.1371/journal.pone.0226681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 12/02/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Splenic artery aneurysm (SAA) is a rare but potentially fatal condition. Rupture results in 25% mortality up to 75% in pregnant women with 95% fetal mortality. Brief reports suggest an increased risk of developing SAA in patients with HHT. METHODS We analyzed enhanced multidetector CT data in 186 HHT patients matched (gender and ± 5 year old) with 186 controls. We screened for SAA and recorded diameter of splenic and hepatic arteries and hepatic, pancreatic and splenic parenchymal involvements. We determined by univariate and multivariate analysis, the relationship with age, sex, genetic status, cardiovascular risk factors (CVRF) and visceral involvement. RESULTS SAA concerned 24.7% of HHT patients and 5.4% of controls, p<0.001. Factors associated with increased risk of SAA in HHT were female gender (p = 0.04, OR = 2.12, IC 95% = 1.03-4.50), age (p = 0.0003, OR = 1.04, 95% CI = 1.02-1.06) and pancreatic parenchymal involvement (p = 0.04, OR = 2.13, 95% CI = 1.01-4.49), but not type of mutation, hepatic or splenic parenchymal involvements, splenic size or splenic artery diameter or CVRF. CONCLUSIONS We found a 4.57 higher rate of SAA in HHT patients without evidence of splenic high output related disease or increased CVRF. These results suggest the presence of a vascular intrinsic involvement. It should lead to screening all HHT patients for SAA. The vasculopathy hypothesis could require a change in management as screening of all systemic arteries and even the aorta and to further research in the field.
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Affiliation(s)
- Jacques Sellier
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Carma Karam
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
- * E-mail:
| | - Alain Beauchet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Axel Dallongeville
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Stephen Binsse
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Sandra Blivet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Isabelle Bourgault-Villada
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Philippe Charron
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Thierry Chinet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Mélanie Eyries
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Carole Fagnou
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Jérome Lesniak
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Gilles Lesur
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Jérome Lucas
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Agnès Nicod-Tran
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Augustin Ozanne
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Aurélien Palmyre
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Florent Soubrier
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Mostafa El Hajjam
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Pascal Lacombe
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
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16
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Affiliation(s)
- Gang Fang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Bin Chen
- Institute of Vascular Surgery, Fudan University, Shanghai 200032, China
| | - Da-Qiao Guo
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xin Xu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jun-Hao Jiang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhen-Yu Shi
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhi-Hui Dong
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Wei-Guo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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17
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Simon D, Cailleux-Talbot N, Armengol G, Benhamou Y, Lévesque H, Monnot A, Miranda S. [A neck mass]. Rev Med Interne 2019; 41:348-349. [PMID: 31662231 DOI: 10.1016/j.revmed.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/18/2022]
Affiliation(s)
- D Simon
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France.
| | - N Cailleux-Talbot
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France
| | - G Armengol
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France
| | - Y Benhamou
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
| | - H Lévesque
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
| | - A Monnot
- UNIROUEN, service de chirurgie vasculaire, Normandie université, 76000 Rouen, France
| | - S Miranda
- UNIROUEN, service de médecine interne, Normandie université, 76000 Rouen, France; UNIROUEN, U1096, service de médecine interne, Normandie université, 76000 Rouen, France
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18
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Affiliation(s)
- Megan A. Slack
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Scott M. Gordon
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
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19
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Khodarahmi I, Alizai H, Adler R. Partially thrombosed aneurysm of the medial marginal vein. J Clin Ultrasound 2019; 47:436-438. [PMID: 30896046 DOI: 10.1002/jcu.22723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/23/2019] [Accepted: 03/03/2019] [Indexed: 06/09/2023]
Abstract
Lower extremity superficial venous aneurysms are occasionally encountered by clinicians and are almost always located above the knee. Very few cases of aneurysm of the medial marginal vein in the most distal part, near the origin of the great saphenous vein, have been reported. We present a case of partially thrombosed aneurysm of the medial marginal vein, and briefly review the imaging characteristics and treatment options of this entity. Being aware of the existence of superficial venous aneurysms may help clinicians in their differential diagnosis of foot masses and choice of appropriate treatment.
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Affiliation(s)
- Iman Khodarahmi
- Department of Radiology, Section of Musculoskeletal Radiology, New York University School of Medicine, New York, New York
| | - Hamza Alizai
- Department of Radiology, Section of Musculoskeletal Radiology, New York University School of Medicine, New York, New York
| | - Ronald Adler
- Department of Radiology, Section of Musculoskeletal Radiology, New York University School of Medicine, New York, New York
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20
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G B, Vedula K, Aggarwal P. Young Female With Palpitations. Ann Emerg Med 2019; 74:303-304. [PMID: 31331497 DOI: 10.1016/j.annemergmed.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Bharath G
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kartik Vedula
- Department of Infectious Disease, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Aggarwal
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
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21
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Karmegaraj B, Rajeshkannan R, Kappanayil M, Vaidyanathan B. Fetal descending aortic tortuosity with ductal aneurysm. Ultrasound Obstet Gynecol 2019; 54:142-144. [PMID: 31021025 DOI: 10.1002/uog.20303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Affiliation(s)
- B Karmegaraj
- Division of Fetal Cardiology, Department of Pediatric Cardiology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - R Rajeshkannan
- Department of Radiodiagnosis, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - M Kappanayil
- Division of Fetal Cardiology, Department of Pediatric Cardiology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - B Vaidyanathan
- Division of Fetal Cardiology, Department of Pediatric Cardiology, Amrita School of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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22
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Igari K, Kelly MJ, Yamanouchi D. Cigarette Smoke Extract Activates Tartrate-Resistant Acid Phosphatase-Positive Macrophage. J Vasc Res 2019; 56:139-151. [PMID: 31064000 PMCID: PMC6764454 DOI: 10.1159/000498893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/13/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND It has been reported that smoking is one of the strongest positive risk factors for abdominal aortic aneurysms (AAAs). Although many studies have been directed to decipher the effect of smoking on AAA, its effect on macrophage activation has not yet been explored. OBJECTIVES We have reported the importance of osteoclastogenesis (OCG) in aneurysm formation. Therefore, we examined the effect of cigarette smoking on OCG and arterial aneurysmal formation by using cigarette smoke extract (CSE) in this study. METHODS Macrophage cell lines were stimulated with CSE, and their activation and differentiation were examined in vitro. Since macrophages activated through the OCG pathway are identified by tartrate-resistant acid phosphatase (TRAP) expression, these cells are referred to as TRAP-positive macrophages (TPMs) in this study. We also applied CSE-contained PBS in the calcium chloride-induced mouse carotid aneurysm model in vivo. RESULTS Macrophages stimulated with CSE expressed significantly higher levels of nuclear factor of activated T-cells cytoplasmic 1 (NFATc1), TRAP, cathepsin K, matrix metalloproteinase-9 and membrane-type metalloproteinase (MT1-MMP). CSE-treated mouse aneurysms showed increased aneurysm size with increased TPM infiltration and protease expression compared to non-CSE-treated mouse aneurysms. CONCLUSIONS These results suggest that CSE intensifies OCG in macrophages and promotes arterial aneurysmal progression.
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Affiliation(s)
- Kimihiro Igari
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Matthew J Kelly
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Dai Yamanouchi
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA,
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23
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Karasozen Y, Osbun JW, Parada CA, Busald T, Tatman P, Gonzalez-Cuyar LF, Hale CJ, Alcantara D, O'Driscoll M, Dobyns WB, Murray M, Kim LJ, Byers P, Dorschner MO, Ferreira M. Somatic PDGFRB Activating Variants in Fusiform Cerebral Aneurysms. Am J Hum Genet 2019; 104:968-976. [PMID: 31031011 PMCID: PMC6506794 DOI: 10.1016/j.ajhg.2019.03.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/15/2019] [Indexed: 12/20/2022] Open
Abstract
The role of somatic genetic variants in the pathogenesis of intracranial-aneurysm formation is unknown. We identified a 23-year-old man with progressive, right-sided intracranial aneurysms, ipsilateral to an impressive cutaneous phenotype. The index individual underwent a series of genetic evaluations for known connective-tissue disorders, but the evaluations were unrevealing. Paired-sample exome sequencing between blood and fibroblasts derived from the diseased areas detected a single novel variant predicted to cause a p.Tyr562Cys (g.149505130T>C [GRCh37/hg19]; c.1685A>G) change within the platelet-derived growth factor receptor β gene (PDGFRB), a juxtamembrane-coding region. Variant-allele fractions ranged from 18.75% to 53.33% within histologically abnormal tissue, suggesting post-zygotic or somatic mosaicism. In an independent cohort of aneurysm specimens, we detected somatic-activating PDGFRB variants in the juxtamembrane domain or the kinase activation loop in 4/6 fusiform aneurysms (and 0/38 saccular aneurysms; Fisher's exact test, p < 0.001). PDGFRB-variant, but not wild-type, patient cells were found to have overactive auto-phosphorylation with downstream activation of ERK, SRC, and AKT. The expression of discovered variants demonstrated non-ligand-dependent auto-phosphorylation, responsive to the kinase inhibitor sunitinib. Somatic gain-of-function variants in PDGFRB are a novel mechanism in the pathophysiology of fusiform cerebral aneurysms and suggest a potential role for targeted therapy with kinase inhibitors.
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Affiliation(s)
- Yigit Karasozen
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Joshua W Osbun
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Carolina Angelica Parada
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Tina Busald
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Philip Tatman
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Luis F Gonzalez-Cuyar
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Christopher J Hale
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Diana Alcantara
- Genome Damage and Stability Centre, University of Sussex, Falmer, Brighton BN1 9RH, UK
| | - Mark O'Driscoll
- Genome Damage and Stability Centre, University of Sussex, Falmer, Brighton BN1 9RH, UK
| | - William B Dobyns
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98195, USA; Department of Neurology, University of Washington School of Medicine, Seattle, Washington 98195, USA; Center for Integrative Brain Research, Seattle Children's Hospital, Seattle, Washington 98105, USA
| | - Mitzi Murray
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195, USA; Department of Medicine, Division of Genetics, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Louis J Kim
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Peter Byers
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195, USA; Department of Genome Sciences, University of Washington School of Medicine, Seattle, Washington 98195, USA; Department of Medicine, Division of Genetics, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Michael O Dorschner
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195, USA; Department of Genome Sciences, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | - Manuel Ferreira
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington 98195, USA.
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24
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Sapalidis K, Tsopouridou K, Florou M, Hytiroglou P, Munteanu AC, Şurlin V, Pavlidis E, Kesisoglou I, Popescu C. Spermatic vein aneurysm: a report of a unique case and review of the literature. Rom J Morphol Embryol 2019; 60:1039-1041. [PMID: 31912121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A spermatic vessel aneurysm is a rare entity, described only a few times in the literature. In most cases, it is caused by trauma or inflammation and appears as a painful mass in the scrotum or the inguinal area. We present a case of a 22-year-old man who came to our Surgical Department with a painful, palpable mass in the right inguinal area. A spermatic vein aneurysm was diagnosed with the use of ultrasonography and it was surgically excised. The findings were confirmed by pathological examination. The patient is well, four months after surgery. A spermatic vessel aneurysm, though rare, should always be included in the differential diagnosis of a scrotal or inguinal mass. The lesion can be cured by surgical resection.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece;
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25
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Shen Y, Zhang R, Chen G, Li F, Chu H, Hu B, Zhao W. [One case of hepatosplenic artery aneurysm with hepato-splenomesenteric trunk and literature review]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2018; 47:601-605. [PMID: 30900837 PMCID: PMC10393651 DOI: 10.3785/j.issn.1008-9292.2018.12.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An asymptomatic 71-year-old woman was admitted to the hospital due to aneurysm of visceral artery. CT angiography revealed that she possessed a hepatosplenic artery aneurysm with hepatosplenomesenteric trunk anomaly. The aneurysm was big with diameter about 28 mm, and is very adjacent to the superior mensenteric artery. The neck of the aneurysm is wide (the diameter of the neck was 5.5-6.0 mm) and short (length of the proximal landing zone was about 2.0 mm). The patient received endovascular reconstruction of the hepatosplenic artery and coil embolization of the aneurysm, and got satisfactory result.
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Affiliation(s)
- Yang Shen
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Ruili Zhang
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Guang Chen
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Fei Li
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Haiwei Chu
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Bin Hu
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Wenjun Zhao
- Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
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Liu P, Liu Y, Li P, Zhou Y, Song Y, Shi Y, Feng W, Mo X, Gao H, An Q, Zhu W. Rosuvastatin- and Heparin-Loaded Poly(l-lactide- co-caprolactone) Nanofiber Aneurysm Stent Promotes Endothelialization via Vascular Endothelial Growth Factor Type A Modulation. ACS Appl Mater Interfaces 2018; 10:41012-41018. [PMID: 30403126 DOI: 10.1021/acsami.8b11714] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study explored a new rosuvastatin calcium- and heparin-loaded poly(l-lactide- co-caprolactone) (PLCL) scaffold for covered stents for treating aneurysms. The mechanism of rosuvastatin-induced endothelialization via vascular endothelial growth factor (VEGF)-A elevation was further explored. Rosu50, Rosu75, Rosu100, and phosphate-buffered saline (PBS) nanofibrous scaffolds were fabricated by coaxial electrospinning and observed by electron microscopy. Anticoagulation and pro-endothelialization properties were tested. Sixteen rabbits were selected for an in vivo assay and underwent microsurgery to establish a carotid aneurysm model. The animals were treated with covered stents and followed for 4 months using digital subtraction angiography (DSA), electron microscopy, and histology. Rosuvastatin-treated human umbilical vein endothelial cell (HUVEC) viability, function, and VEGF-A modulation were further studied to elucidate the pro-endothelialization mechanism of rosuvastatin. Our study demonstrates that rosuvastatin and heparin can be incorporated into PLCL nanofibers via electrospinning. Rosu100 nanofiber scaffolds exhibited significant anticoagulation properties. The viability of HUVECs transferred to Rosu100 nanofiber scaffolds was increased significantly. In vivo, DSA revealed that the Rosu100 group had better outcomes than the PBS group. In addition, the Rosu100 stents induced more integrated endothelialization. Further study demonstrated that rosuvastatin promoted HUVEC viability and function in vitro. The effects of rosuvastatin may be attributed to an elevation in VEGF-A. We demonstrated that rosuvastatin- and heparin-loaded PLCL-covered stents show favorable anticoagulation and pro-endothelialization properties in vitro and in vivo in a rabbit aneurysm model. VEGF-A elevation played a crucial role in rosuvastatin-promoted endothelialization. This work provides an additional option for treating cerebral aneurysms with covered stents.
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Affiliation(s)
| | | | | | | | - Yaying Song
- Department of Neurology , Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China
| | | | - Wenhao Feng
- Key Laboratory of Science & Technology of Eco-Textile, Ministry of Education, College of Chemistry, Chemical Engineering and Biotechnology , Donghua University , Shanghai 201620 , China
| | - Xiumei Mo
- Key Laboratory of Science & Technology of Eco-Textile, Ministry of Education, College of Chemistry, Chemical Engineering and Biotechnology , Donghua University , Shanghai 201620 , China
| | - Hongyang Gao
- Electron Microscopy Core Laboratory, School of Basic Medical Sciences , Fudan University , Shanghai 200433 , China
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Dong SZ, Zhu M. MR imaging of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein in the fetus. Sci Rep 2018; 8:14781. [PMID: 30283087 PMCID: PMC6170443 DOI: 10.1038/s41598-018-33033-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022] Open
Abstract
The purpose of this study was to report fetal cases of subaortic and retroesophageal anomalous courses of the left brachiocephalic vein (LBCV) evaluated by fetal cardiac magnetic resonance imaging (MRI). A retrospective review of 7282 fetal cardiac MRI from June 2006 to March 2017, nine cases of anomalous courses of the LBCV were correctly diagnosed by fetal cardiac MRI, one case of abnormal subaortic left brachiocephalic vein (ASLBV) missed by fetal MRI was identified postnatally during further imaging of the TOF. The diagnosis was confirmed postnatally by cardiac CT/MRI. An ASLBV was found in 8 cases, a retroesophageal LBCV was found in 2 additional cases with right aortic arch and aberrant left subclavian artery. 3 of 8 ASLBV cases were with a right aortic arch, 4 ASLBV cases had additional cardiovascular anomalies with one case isolated. 7 of 8 ASLBV and 2 retroesophageal LBCV were correctly diagnosed by fetal cardiac MRI; however fetal cardiac MRI missed 2 cases of associated pulmonary atresia (PA). Prenatal echocardiography (echo) correctly diagnosed five ASLBV and one retroesophageal LBCV as well as associated intracardiac anomalies. Fetal cardiac MRI can be a useful adjunct in the identification of subaortic and retroesophageal anomalous courses of the LBCV prenatally.
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Affiliation(s)
- Su-Zhen Dong
- Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China
| | - Ming Zhu
- Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.
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Abstract
This research aims to model cardiac pulse wave reflections due to the presence of arterial irregularities such as bifurcations, stiff arteries, stenoses or aneurysms. When an arterial pressure wave encounters an irregularity, a backward reflected wave travels upstream in the artery and a forward wave is transmitted downstream. The same process occurs at each subsequent irregularity, leading to the generation of multiple waves. An iterative algorithm is developed and applied to pathological scenarios to predict the pressure waveform of the reflected wave due to the presence of successive arterial irregularities. For an isolated stenosis, analysing the reflected pressure waveform gives information on its severity. The presence of a bifurcation after a stenosis tends do diminish the amplitude of the reflected wave, as bifurcations' reflection coefficients are relatively small compared to the ones of stenoses or aneurysms. In the case of two stenoses in series, local extrema are observed in the reflected pressure waveform which appears to be a characteristic of stenoses in series along an individual artery. Finally, we model a progressive change in stiffness in the vessel's wall and observe that the less the gradient stiffness is important, the weaker is the reflected wave.
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Affiliation(s)
- Alexandre Cornet
- Imperial College London, South Kensington Campus, London SW72AZ, United Kingdom
- Ecole normale supérieure Paris-Saclay, 61 Avenue du Président Wilson, Cachan 94230, France
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Chaubard S, Lacroix P, Kennel C, Jaccard A. [Aneurysm of the portal venous system: A rare and unknown pathology]. Rev Med Interne 2018; 39:946-949. [PMID: 30146175 DOI: 10.1016/j.revmed.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/02/2018] [Accepted: 07/08/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Portal vein aneurysms are rare, representing 3% of venous aneurysms, with about 200 cases described in the literature, probably underestimated. CASE REPORT A 66-year-old man, suspect of splenomegaly, underwent an abdominal ultrasound and a thoraco-abdomino-pelvic CT scan showing a 40mm portal vein aneurysm. Final diagnosis was T-cell hemopathy. Five and six months later, abdominal imaging was stable, suggesting congenital origin due to lack of obliteration of the vitelline vein. CONCLUSION Portal vein aneurysms are often asymptomatic and an incidental finding. Monitoring is recommended because of their potential complications (thrombosis, rupture of aneurysm, portal hypertension, adjacent organs compression), annually if asymptomatic or more frequently with sometimes a surgical management in case of clinical manifestations.
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Affiliation(s)
- S Chaubard
- Service d'hématologie clinique et de thérapie cellulaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France.
| | - P Lacroix
- Service de chirurgie vasculaire et thoracique-médecine vasculaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France
| | - C Kennel
- Service d'hématologie clinique et de thérapie cellulaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France
| | - A Jaccard
- Service d'hématologie clinique et de thérapie cellulaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France
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Farber HW, McDermott S, Witkin AS, Kelly NP, Miloslavsky EM, Stone JR. Case 11-2018: A 48-Year-Old Woman with Recurrent Venous Thromboembolism and Pulmonary Artery Aneurysm. N Engl J Med 2018; 378:1430-1438. [PMID: 29641962 DOI: 10.1056/nejmcpc1800323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Harrison W Farber
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Shaunagh McDermott
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Alison S Witkin
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Noreen P Kelly
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - Eli M Miloslavsky
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
| | - James R Stone
- From the Department of Medicine, Boston Medical Center (H.W.F.), the Department of Medicine, Boston University School of Medicine (H.W.F.), the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Massachusetts General Hospital, and the Departments of Radiology (S.M.), Medicine (A.S.W., N.P.K., E.M.M.), and Pathology (J.R.S.), Harvard Medical School - all in Boston
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Kaneyuki D, Ueda H, Matsumiya G. Right Subclavian Artery Aneurysms with Fibromuscular Dysplasia. Ann Vasc Surg 2018; 48:253.e7-253.e9. [PMID: 29421412 DOI: 10.1016/j.avsg.2017.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/22/2017] [Accepted: 10/30/2017] [Indexed: 11/18/2022]
Abstract
Subclavian artery aneurysms (SAAs) are rare and even more uncommon in patients with fibromuscular dysplasia (FMD). A 20-year-old man with a past medical history of moyamoya disease presented with an abnormal mass shadow in the apex of the right lung on chest X-ray. Based on computed tomography imaging, a diagnosis of right SAA was established, and an excision of the aneurysm was performed. Because the left vertebral artery is dominant, the proximal and distal right subclavian artery and right vertebral artery were clamped. Then, the aneurysm was excised, and resection anastomosis was performed. Histological findings revealed FMD. The postsurgical course has been uneventful after 2 years. Among treatment modalities, open surgery would be the first choice for SAAs with FMD, despite the current era of endovascular surgeries.
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Affiliation(s)
- Daisuke Kaneyuki
- Department of Cardiovascular Surgery, Chiba University Hospital, Chuo-ku, Chiba-shi, Chiba, Japan.
| | - Hideki Ueda
- Department of Cardiovascular Surgery, Chiba University Hospital, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Hospital, Chuo-ku, Chiba-shi, Chiba, Japan
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Brizzi V, Déglise S, Dubuisson V, Midy D, Ducasse E, Berard X. Laparoscopic Resection of a Middle Colic Artery Aneurysm. Ann Vasc Surg 2018; 48:253.e1-253.e3. [PMID: 29421421 DOI: 10.1016/j.avsg.2017.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/15/2017] [Accepted: 10/24/2017] [Indexed: 12/30/2022]
Abstract
We report herein the successful laparoscopic resection of an asymptomatic 3-cm middle colic artery aneurysm in a young woman. Endovascular treatment represents nowadays the first-line option facing visceral artery aneurysm, but in this case, embolization was excluded because of hostile anatomy. Advantages of laparoscopic approach were the safe resection of the aneurysm with immediate evaluation of the bowel tolerance and the possibility of a histological examination of the arterial wall, without the disadvantages of laparotomy.
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Affiliation(s)
- Vincenzo Brizzi
- Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France.
| | - Sebastien Déglise
- Vascular Surgery Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Vincent Dubuisson
- Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France
| | - Dominique Midy
- Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France
| | - Eric Ducasse
- Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France
| | - Xavier Berard
- Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Faculty of Medicine, University of Bordeaux, Bordeaux, France
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Pourier VEC, van Laarhoven CJHCM, Vergouwen MDI, Rinkel GJE, de Borst GJ. Prevalence of extracranial carotid artery aneurysms in patients with an intracranial aneurysm. PLoS One 2017; 12:e0187479. [PMID: 29131823 PMCID: PMC5683613 DOI: 10.1371/journal.pone.0187479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/22/2017] [Indexed: 11/30/2022] Open
Abstract
Background and purpose Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA). Methods We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH). The medical files of patients included in both databases were screened for availability of radiological reports, imaging of the brain and of the cervical carotid arteries. All available radiological images were then reviewed primarily for the presence of an ECAA and secondarily for an extradural/cavernous carotid or vertebral artery aneurysm. An ECAA was defined as a fusiform dilation ≥150% of the normal internal or common carotid artery or a saccular distention of any size. Results We screened 4465 patient records (SAH database n = 3416, UIA database n = 1049), of which 2931 had radiological images of the carotid arteries available. An ECAA was identified in 12/638 patients (1.9%; 95% CI 1.1–3.3) with completely imaged carotid arteries and in 15/2293 patients (0.7%; 95% CI 0.4–1.1) with partially depicted carotid arteries. Seven out of 27 patients had an additional extradural (cavernous or vertebral artery) aneurysm. Conclusions This comprehensive study suggests a prevalence for ECAA of approximately 2% of patients with an IA. The rarity of the disease makes screening unnecessary so far. Future registry studies should study the factors associated with IA and ECAA to estimate the prevalence of ECAA in these young patients more accurately.
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Affiliation(s)
- V. E. C. Pourier
- Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan Utrecht, The Netherlands
| | | | - M. D. I. Vergouwen
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan Utrecht, the Netherlands
| | - G. J. E. Rinkel
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan Utrecht, the Netherlands
| | - Gert J. de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan Utrecht, The Netherlands
- * E-mail:
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Guerra A, De Gaetano AM, Infante A, Mele C, Marini MG, Rinninella E, Inchingolo R, Bonomo L. Imaging assessment of portal venous system: pictorial essay of normal anatomy, anatomic variants and congenital anomalies. Eur Rev Med Pharmacol Sci 2017; 21:4477-4486. [PMID: 29131270 DOI: pmid/29131270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The purpose of this pictorial essay is to describe anatomic variants and congenital anomalies of portal venous system and related liver parenchymal alterations. The imaging findings of some of these entities have been previously described in other articles, however this work encompasses all congenital anomalies of portal venous system with attention to their features on various imaging modalities; in particular we illustrated with detailed pictures all the main portal vein variants, congenital extra- and intra-hepatic porto-systemic venous shunts and portal vein aneurysm. Variants of portal branches and intrahepatic portosystemic shunts are quite uncommon, however, when present, they should be recognized before performing surgery or interventional procedures. Congenital absence of the portal vein is an important finding as the complete loss of portal perfusion predisposes the liver to focal or diffuse hyperplastic or dysplastic changes. Portal vein aneurysm is a rare clinical entity that can affect intra- and extra-hepatic portal branches; although usually asymptomatic, thrombosis can occur. Awareness of congenital variants of portal venous system among radiologists should allow a more confident diagnosis and permit an accurate planning of surgical procedures and percutaneous interventions; identification of portal system anomalies also suggest an accurate evaluation of associated hepatic parenchymal anomalies such as nodular regenerative hyperplasia, focal nodular hyperplasia (FNH), and adenomas with high risk of malignant transformation.
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Affiliation(s)
- A Guerra
- Area Diagnostica per Immagini, UOC Radiologia, University Hospital Foundation "A. Gemelli", Catholic University of the Sacred Hearth, Rome, Italy.
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Zhu K, Li S, Chen H, Wang Y, Yu M, Wang H, Zhao W, Cao Y. Late onset MELAS with m.3243A > G mutation and its association with aneurysm formation. Metab Brain Dis 2017; 32:1069-1072. [PMID: 28321601 DOI: 10.1007/s11011-017-9989-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/03/2017] [Indexed: 10/19/2022]
Abstract
We reported a 53-year-old with late-onset mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) accompanied by aneurysm and large vessel dilations. Most studies have focused on microangiopathy causing stroke-like episodes. We report a case to describe large vessel involvement in clinical considerations, and possible mechanisms of aneurysm formation. We recommended regular angiographic examination for patients with MELAS.
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Affiliation(s)
- Kun Zhu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China
- The 96th Class, 7-Year Program, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Shuang Li
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China
| | - Huan Chen
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China
| | - Yao Wang
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China
| | - Miao Yu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China
- The 97th Class, 7-Year Program, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Hongyan Wang
- Department of Cadre, The Central Hospital of Jiamusi City, No. 256 Zhongshan Road, Xiangyang District, Jiamusi, Heilongjiang, 154002, China
| | - Weijie Zhao
- Department of Neurology, Capital Medical University Affiliated Beijing Friendship Hospital, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China
| | - Yunpeng Cao
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
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Li Z, Zhao R, Fang X, Huang Q, Liu J. Recombinant human SDF-1α administration accelerates aneurysm neck reendothelialization in rabbit saccular aneurysm after flow diverter treatment. Acta Biochim Biophys Sin (Shanghai) 2017; 49:246-253. [PMID: 28159982 DOI: 10.1093/abbs/gmx001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Indexed: 12/21/2022] Open
Abstract
Reendothelialization in the aneurysm neck is pivotal to vascular repair for intracranial aneurysm after flow diverter (FD) implantation. Recombinant human stromal cell-derived factor 1α (rhSDF-1α) is a vital chemoattractant to stem cells and potentially facilitates reendothelialization. Here, we sought to investigate the therapeutic effects of intravenous administration of rhSDF-1α and uncover its potential mechanism for promoting aneurysm neck reendothelialization. Recombinant pET32a-186 plasmid was transformed into Escherichia coli to produce the rhSDF-1α protein with biological activity. FD was implanted into the elastase-induced saccular aneurysm in New Zealand white rabbits. rhSDF-1α (50 μg/kg/day) was intravenously administrated for consecutive 7 days after FD implantation. After these procedures, aneurysms were harvested after 2 or 4 weeks. Scanning electron microscopy was used to measure the neointima thickness and count the endothelial-like cells at aneurysm neck. Four weeks later, the mRNA levels of endothelial markers in the neointima at aneurysm neck were examined. Migration assay showed that rhSDF-1α could induce migration of endothelial progenitor cells in a dose-dependent manner. Two weeks after stent implantation, follow-up angiography showed partial aneurysm occlusion in one of each group and total aneurysm occlusion in 17 saccular aneurysm rabbits (9 of the rhSDF-1α group and 8 of the control group). No significant change of neointima thickness at aneurysm neck was observed. Intriguingly, more endothelial-like cells were observed at aneurysm neck in the rhSDF-1α group at 2 weeks (55 vs 13 cells per high-power field) and 4 weeks (104 vs 60 cells per high-power field). The mRNA levels of Tie-2, VE-cadherin, KDR and E-selectin were significantly enhanced compared with those of the control group. These results showed that intravenous administration of rhSDF-1α can accelerate reendothelialization in the aneurysm neck after FD implantation. Our study reveals an important role of rhSDF-1α in inducing aneurysm occlusion and suggests that it achieves its function through modulating the reendothelialization.
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Affiliation(s)
- Zifu Li
- Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Rui Zhao
- Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Xinggen Fang
- Neurosurgery Department, Yijishan Hospital, Wuhu 241001, China
| | - Qinghai Huang
- Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Jianmin Liu
- Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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Yoshioka T, Araki M, Ariyoshi Y, Wada K, Tanaka N, Nasu Y. Successful microscopic renal autotransplantation for left renal aneurysm associated with segmental arterial mediolysis. J Vasc Surg 2016; 66:261-264. [PMID: 27988157 DOI: 10.1016/j.jvs.2016.09.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/14/2016] [Indexed: 11/19/2022]
Abstract
Segmental arterial mediolysis (SAM) is an uncommon, nonarteriosclerotic vascular disease. SAM is characterized by lysis of arterial media and can lead to aneurysm formation. The renal arteries are the third most common arteries associated with SAM. We report the case of a 32-year-old man with left renal artery aneurysm associated with SAM. We successfully performed left renal autotransplantation using microscopic vascular reconstruction. SAM is characterized by vascular fragility; therefore, microscopic surgery is favorable for treating aneurysms associated with SAM.
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Affiliation(s)
- Takashi Yoshioka
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Yuichi Ariyoshi
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriyuki Tanaka
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Yasutomo Nasu
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Vele E, Kurtcehajic A, Zerem E, Maskovic J, Alibegovic E, Hujdurovic A. Plasma D-dimer as a predictor of the progression of abdominal aortic aneurysm. J Thromb Haemost 2016; 14:2298-2303. [PMID: 27567003 DOI: 10.1111/jth.13487] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/08/2016] [Indexed: 08/31/2023]
Abstract
Essentials D-dimer could provide important information about abdominal aortic aneurysm (AAA) progression. The greatest diameter of the infrarenal aorta and the value of plasma D-dimer were determined. AAA progression is correlated with increasing plasma D-dimer levels. The increasing value of plasma D-dimer could be a predictor of aneurysm progression. SUMMARY Background The natural course of abdominal aortic aneurysm (AAA) is mostly asymptomatic and unpredictable. D-dimer could provide potentially important information about subsequent AAA progression. Objectives The aims of this study were to establish the relationship between the progression of an abdominal aortic aneurysm (AAA) and plasma D-dimer concentration over a 12-month period and determine the value of plasma D-dimer in patients with sub-aneurysmal aortic dilatation. Patients/Methods This was a prospective observational study that involved 33 patients with an AAA, 30 patients with sub-aneurysmal aortic dilatation and 30 control subjects. The greatest diameter of the infrarenal aorta, which was assessed by ultrasound, and the value of plasma D-dimer were determined for all subjects at baseline assessment, as well as after 12 months for those with an AAA. Results A positive correlation was found between the diameter of an AAA and plasma D-dimer concentration at the baseline and the control measurement stages. There was a strong positive correlation between AAA progression and increasing plasma D-dimer concentration over a 12-month period. Among patients with sub-aneurysmal aortic dilatation (n = 30), the value of plasma D-dimer was higher compared with matched controls (n = 30). Conclusions There is a strongly positive correlation between AAA progression and increasing plasma D-dimer concentration. The value of plasma D-dimer is higher in patients with sub-aneurysmal aortic dilatation than in control subjects.
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Affiliation(s)
- E Vele
- Department of Surgery, Cantonal Hospital 'Dr. Safet Mujic', Mostar, Bosnia and Herzegovina
| | - A Kurtcehajic
- Department of Internal Medicine, Medical Center 'Plava Poliklinika', Tuzla, Bosnia and Herzegovina
| | - E Zerem
- Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
- Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - J Maskovic
- Department of Radiology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - E Alibegovic
- Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - A Hujdurovic
- Department of Internal Medicine, Medical Center 'Plava Poliklinika', Tuzla, Bosnia and Herzegovina
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Ali Shah SA, Laude A, Faye I, Tang TB. Automated microaneurysm detection in diabetic retinopathy using curvelet transform. J Biomed Opt 2016; 21:101404. [PMID: 26868326 DOI: 10.1117/1.jbo.21.10.101404] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/18/2016] [Indexed: 06/05/2023]
Abstract
Microaneurysms (MAs) are known to be the early signs of diabetic retinopathy (DR). An automated MA detection system based on curvelet transform is proposed for color fundus image analysis. Candidates of MA were extracted in two parallel steps. In step one, blood vessels were removed from preprocessed green band image and preliminary MA candidates were selected by local thresholding technique. In step two, based on statistical features, the image background was estimated. The results from the two steps allowed us to identify preliminary MA candidates which were also present in the image foreground. A collection set of features was fed to a rule-based classifier to divide the candidates into MAs and non-MAs. The proposed system was tested with Retinopathy Online Challenge database. The automated system detected 162 MAs out of 336, thus achieved a sensitivity of 48.21% with 65 false positives per image. Counting MA is a means to measure the progression of DR. Hence, the proposed system may be deployed to monitor the progression of DR at early stage in population studies.
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Affiliation(s)
- Syed Ayaz Ali Shah
- Universiti Teknologi PETRONAS, Department of Electrical and Electronic Engineering, Centre for Intelligent Signal and Imaging Research, Bandar Seri Iskandar, Perak 32610, Malaysia
| | - Augustinus Laude
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Ibrahima Faye
- Universiti Teknologi PETRONAS, Department of Fundamental and Applied Sciences, Centre for Intelligent Signal and Imaging Research, Bandar Seri Iskandar, Perak 32610, Malaysia
| | - Tong Boon Tang
- Universiti Teknologi PETRONAS, Department of Electrical and Electronic Engineering, Centre for Intelligent Signal and Imaging Research, Bandar Seri Iskandar, Perak 32610, Malaysia
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Abstract
Aneurysms of the proximal subclavian artery are extremely rare. A 39-year-old female with an incidental finding of a small proximal left subclavian artery aneurysm at its origin from the aortic arch is described. This was an incidental finding during workup for chest pain. No other vascular abnormalities were found and no obvious etiology was identified. The workup, plan for conservative treatment, and close follow-up are described. Although larger aneurysms and those in the middle and distal subclavian arteries, symptomatic or asymptomatic, are generally considered for surgical treatment, very little is known about the natural history of small proximal subclavian aneurysms.
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Affiliation(s)
- A Halldorsson
- Department of General Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Abstract
Venous aneurysms are lesions that can be difficult to diagnose and may be a source of significant morbidity. Venous aneurysms have been reported to occur in most major veins, neck, central thoracic veins, and extremities. The authors report 4 cases of venous aneurysms: 1 of the upper and 3 of the lower extremity. All patients underwent aneurysmectomy with end-toend anastomosis and no complications after surgery were reported. These cases are presented along with a review of literature and their origin, diagnosis, and treatment.
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Affiliation(s)
- Y Yuan
- Department of Vascular Surgery, Wuxi People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - H J Lu
- Department of Vascular Surgery, Wuxi People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
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Shuster TA, Almeida J, Coats R, Kalra A, Silver D. Gastrointestinal Bleeding as the Initial Manifestation of a Polyarteritis Nodosa-Associated Hepatic Artery Aneurysm-Duodenal Fistula. Vasc Endovascular Surg 2016; 38:563-8. [PMID: 15592638 DOI: 10.1177/153857440403800611] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors report an unusual case of upper gastrointestinal bleeding from a hepatic artery aneurysm-duodenal fistula in a 21-year-old male. Arteriography revealed multiple visceral artery aneurysms. Biopsy of the hepatic artery aneurysm (HAA) revealed focal areas of necrosis, medial degeneration, fibrosis, and giant cells. The necrotizing vasculitis plus the multiple visceral aneurysms were highly suggestive of polyarteritis nodosa (PAN). This report reviews the pathophysiology and management of PAN and the diagnosis and management of HAA.
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Affiliation(s)
- Thomas A Shuster
- Division of Vascular Surgery, Department of Surgery, University of Missouri-Columbia, Columbia, MO 65212, USA
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Abstract
Symptomatic visceral aneurysms usually present with abdominal pain and shock, gastrointestinal bleeding, or hemobilia when the aneurysm ruptures. Less frequently, visceral aneurysms are found incidentally during abdominal computed tomography or angiography. Thrombosis is a frequent complication of popliteal and femoral aneurysms but is rarely seen with a visceral aneurysm. The author believes this is the first report of complete thrombosis of a gastroepiploic artery aneurysm. The patient, who was seen for abdominal pain, had a previously unrecognized aneurysm.
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Affiliation(s)
- James H McClenathan
- Department of Surgery, Kaiser Permanente Medical Center, Santa Clara, CA 95051, USA.
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Wichajarn K, Munkong W. Iliac Artery Aneurysms in Menkes Disease: A Case Report. J Med Assoc Thai 2016; 99 Suppl 5:S177-S181. [PMID: 29906074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Menkes disease is a disorder of copper transportation that results in multi-systems involvement including neurological deterioration, seizure, dysmorphic facies and kinky hair. The authors report a case of Menkes disease that was complicated with bilateral iliac artery aneurysms. CASE REPORT A 6-month-old Thai male infant presented with seizure, global delayed development, hypotonia and sparse, short, lightly pigmented and kinky hair. Light microscopic hair analysis showed pili torti. His serum copper and ceruloplasmin levels were low and were compatible with Menkes disease. Radiological finding from magnetic resonance angiography (MRA) revealed irregular tortuosity of abdominal aorta, a large right internal iliac artery aneurysm and a small left common iliac artery aneurysm. Genetic counseling and supportive treatment were provided for this patient. CONCLUSION Iliac aneurysms are a serious complication of patients with Menkes disease. Careful investigation with computed tomographic angiography (CTA) or MRA is helpful in those patients.
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Yamazaki K. Systemic lupus erythematosus with hepatic aneurysm, Valsalva sinus aneurysm and associated polyangiitis: aneurysmal wall remodeling with dense fibrosis and calcification mediated by residual smooth muscle cells. Lupus 2016; 13:54-9. [PMID: 14870918 DOI: 10.1191/0961203304lu462cr] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Isolated case reports have demonstrated the combination of hepatic aneurysm and systemic lupus erythematosus (SLE). The author experienced a rare autopsy case of a 36-year old Japanese male with SLE, a hepatic aneurysm, a Valsalva sinus aneurysm and associated polyangiitis. In the histopathological and ultrastructural examinations of the postmortem organs, most of the angiitis lesions were in the scar phase associated with the histopathological features of collagenous fibrosis with the diminution of the smooth muscle cells and elastic fibre layers. Massive calcification was seen on the wall and obliterative changes in the lumen with calcified thrombi. In the dense collagenous stroma of the aneurysmal wall, residual atrophic smooth muscle cells with immunohistochemical (HHF35, alpha-smooth-muscle actin, vimentin and desmin almost-) and ultrastructural features (spindle-shapedcells with a few rER and rich intracytoplasmicfilaments with peripheraldense patches)were assumed to be involvedin the histogenesisof the aneurysmalwall. Massivecalcification and degenerationor dynamic remodelingof the extracellularmatrices in the aneurysmalwall might be mediated by the residual smooth muscle cells. It was suspected that the generalized polyangiitis as a complication of SLE might have involved the intrahepatic arteries and Valsalva sinus wall and subsequently generated the aneurysm.
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Affiliation(s)
- K Yamazaki
- Department of Pathology, Saiseikai Central Hospital, Tokyo, Japan.
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Wang S, Tang HL, Al Turk LI, Hu Y, Sanei S, Saleh GM, Peto T. Localizing Microaneurysms in Fundus Images Through Singular Spectrum Analysis. IEEE Trans Biomed Eng 2016; 64:990-1002. [PMID: 27362756 DOI: 10.1109/tbme.2016.2585344] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
GOAL Reliable recognition of microaneurysms (MAs) is an essential task when developing an automated analysis system for diabetic retinopathy (DR) detection. In this study, we propose an integrated approach for automated MA detection with high accuracy. METHODS Candidate objects are first located by applying a dark object filtering process. Their cross-section profiles along multiple directions are processed through singular spectrum analysis. The correlation coefficient between each processed profile and a typical MA profile is measured and used as a scale factor to adjust the shape of the candidate profile. This is to increase the difference in their profiles between true MAs and other non-MA candidates. A set of statistical features of those profiles is then extracted for a K-nearest neighbor classifier. RESULTS Experiments show that by applying this process, MAs can be separated well from the retinal background, the most common interfering objects and artifacts. CONCLUSION The results have demonstrated the robustness of the approach when testing on large scale datasets with clinically acceptable sensitivity and specificity. SIGNIFICANCE The approach proposed in the evaluated system has great potential when used in an automated DR screening tool or for large scale eye epidemiology studies.
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Alberti N, Petitpierre F, Crombe A, Bernard S, Sironneau S. [Azygos vein aneurysm: An unusual and rare diagnostic]. Rev Pneumol Clin 2016; 72:217-219. [PMID: 27133177 DOI: 10.1016/j.pneumo.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Affiliation(s)
- N Alberti
- Service de radiologie, centre hospitalier Alpes-Leman, 558, route de Findrol, 74130 Contamine-sur-Arve, France.
| | - F Petitpierre
- Service d'imagerie diagnostique et interventionnelle, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - A Crombe
- Service de neuroimagerie, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - S Bernard
- Service d'imagerie, Maison de santé protestante, 201, rue Robespierre, 33400 Talence, France
| | - S Sironneau
- Service d'imagerie, Maison de santé protestante, 201, rue Robespierre, 33400 Talence, France
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Abstract
Background The aim of this study was to elucidate aspects of diabetes mellitus–induced suppression of aneurysm. We hypothesized that high glucose suppresses aneurysm by inhibiting macrophage activation via activation of Nr1h2 (also known as liver X receptor β), recently characterized as a glucose‐sensing nuclear receptor. Methods and Results Calcium phosphate (CaPO4)–induced aneurysm formation was significantly suppressed in the arterial wall in type 1 and 2 diabetic mice. A murine macrophage cell line, RAW264.7, was treated with tumor necrosis factor α (TNF‐α) plus CaPO4 and showed a significant increase in matrix metalloproteinase 9 (Mmp9) mRNA and secreted protein expression compared with TNF‐α alone. Elevated Mmp9 expression was significantly suppressed by hyperglycemic conditions (15.5 mmol/L glucose) compared with normoglycemic conditions (5.5 mmol/L glucose) or normoglycemic conditions with high osmotic pressure (5.5 mmol/L glucose +10.0 mmol/L mannitol). Nr1h2 mRNA and protein expression were suppressed by treatment with TNF‐α plus CaPO4 but were restored by hyperglycemic conditions. Activation of Nr1h2 by the antagonist GW3965 during stimulation with TNF‐α plus CaPO4 mimicked hyperglycemic conditions and inhibited Mmp9 upregulation, whereas the deactivation of Nr1h2 by small interfering RNA (siRNA) under hyperglycemic conditions canceled the suppressive effect and restored Mmp9 expression induced by TNF‐α plus CaPO4. Moreover, Nr1h2 activation with GW3965 significantly suppressed CaPO4‐induced aneurysm in mice compared with vehicle‐injected control mice. Conclusions Our results show that hyperglycemia suppresses macrophage activation and aneurysmal degeneration through the activation of Nr1h2. Although further validation of the underlying pathway is necessary, targeting Nr1h2 is a potential therapeutic approach to treating aneurysm.
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Affiliation(s)
- Teruyoshi Tanaka
- Division of Vascular Surgery, Department of Surgery, Wisconsin Institute for Medical Research, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Yuichiro Takei
- Division of Vascular Surgery, Department of Surgery, Wisconsin Institute for Medical Research, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Dai Yamanouchi
- Division of Vascular Surgery, Department of Surgery, Wisconsin Institute for Medical Research, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Fræhr L, Madsen MS. [Popliteal venous aneurysm]. Ugeskr Laeger 2016; 178:V08150647. [PMID: 26815721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Popliteal venous aneurysm is a rare disease. The diameter of the vein is at least twice as big as the normal proximal vein. The aneurysm is usually asymptomatic but it can suddenly cause pulmonary embolism even in young persons. Due to an unpredictable risk of thromboembolism even under anticoagulation treatment operation is often advisable if the diameter of the aneurysm is more than 20 mm. The operation can usually be done as tangential aneurysmectomy and lateral venorrhaphy which has a low complication rate and a good patency.
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