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PubMed1976

Gunshot wounds of the suprarenal abdominal aorta.

Four cases of gunshot wounds to the suprarenal abdominal aorta are described. All required prosthetic graft replacement including one or more visceral arterial branches. Two patients survived. Factors important in survival were rapid transportation permitting early resuscitation and retroperitoneal tamponade which delayed exsanguination and permitted stabilization with systematic management. The major problem in management of gunshot wounds of the suprarenal abdominal aorta is limitation of visceral ischemia, particularly hepatic and renal. Special adjuncts such as local renal hypothermia, as used in these cases, or bypass techniques are necessary and should be available before exploration of a periaortic hematoma due to gunshot wound in this area.

Abdominal Injuries↗
PubMedDate not supplied

[The effect of heparin in vasorenal hypertension on the rheological properties of the erythrocytes and on the electrolyte balance of the blood and of the wall of the abdominal aorta].

In hypertension there was shown an increase of the erythrocyte suspension viscosity coefficient, a decrease of the transmural difference of the abdominal aorta potentials and the erythrocyte charge at a lowering of the level of the studied electrolytes in plasma, the abdominal aorta wall and an increase of sodium content in erythrocytes. Heparin corrected the changes in the coefficient of viscosity and charge of erythrocytes, the transmural difference of potentials, potassium and magnesium levels in erythrocytes, sodium level in the abdominal aorta wall induced by hypertension. On the whole there was observed no levelling by heparin of electrolyte imbalance in the erythrocyte-plasma-abdominal aorta wall system.

Animals↗
PubMed2005

Different patterns of atherosclerotic remodeling in the thoracic and abdominal aorta.

PURPOSE: To investigate the relationship between the vascular diameter and the extent and histologic characteristics of atherosclerosis in the thoracic and abdominal aortas of patients who died of atherosclerotic disease. METHOD: We measured the vascular diameter and evaluated the percentage atrophy of the medial layer of the thoracic and abdominal aortas of 19 patients who died due to atherosclerotic disease. The extent of plaques, calcification, ulceration, thrombosis, and the amount of fat in the plaques were evaluated semiquantitatively. RESULTS: Atherosclerosis was more severe in the abdominal than the thoracic aorta as indicated by the higher sum of the macroscopic scores (P = .02) and the higher percentage atrophy of the medial layer (P < .001). The diameter of the thoracic, but not of the abdominal aorta, correlated with age (r = 0.56; P = .01), plaque score (r = 0.59; P = .008), calcification score (r = 0.749; P < .001), and fat score (r = 0.48; P = .04). Multiple linear regression showed that age (P = .06) and calcification score (P = .001) were the parameters with the strongest association to thoracic aorta diameter. CONCLUSION: There are some differences regarding atherosclerosis in the thoracic compared to the abdominal aorta. Progressive thoracic aorta atherosclerosis is associated with fat deposition in the plaques, inducing arterial dilation. In the abdominal aorta, atherosclerosis can either have a similar evolution or be associated with less fat deposition in the arterial wall, which would result in more rigidity, hindering compensatory arterial enlargement.

Aged↗
PubMed1979

Obstruction of the abdominal aorta by a primary retroperitoneal tumor.

An angiographically demonstrated case of total occlusion of the abdominal aorta by a malignant retroperitoneal tumor is presented. Surgical exploration revealed a diffuse tumor of the retroperitoneum involving the wall and lumen of the abdominal aorta and vena cava, respectively. Histologic and ultrastructural evaluation of the tumor established a diagnosis of malignant fibrous histiocytoma. Total occlusion of the abdominal aorta thus represents another angiographic finding in retroperitoneal tumors.

Aorta, Abdominal↗
PubMed1976

[Syndrome of chronic obstruction of the abdominal aorta and its surgical treatment].

The surgical management of 53 patients with high chronic occlusion of the abdominal aorta is reported. The authors unite this pathology under the term "chronic abdominal aorta obstruction syndrome". In 10 patients eversion endarterectomy was performed, in 22--aortofemoral bypass, in 21--prosthetic replacement of the aorta and of the iliac arteries with synthetic grafts. An original techinque of "milking" the thrombus down from the proximal aorta is described; it simplifies the operative procedure and prevents grave complications during surgery in patients with high occlusions of the abdominal aorta. Good results in the immediate postoperative period were achieved in 85% of the cases. Postoperative mortality comprised 12%. Late results were followed-up in 35 patients during 1 to 5 years. In 28 patients the results of surgery proved good.

Adult↗
PubMed1999

Traumatic pseudoaneurysm of the abdominal aorta.

A traumatic pseudoaneurysm of the abdominal aorta is a rare entity, occurring as the result of a missed aortic lesion at the time of the initial injury. Therefore, clinical suspicion and careful abdominal exploration at first laparotomy is mandatory to prevent aortic pseudoaneurysm formation and its risk of delayed rupture. We present a case of successful surgical treatment of a suprarenal aortic false aneurysm, presenting 4 weeks after a life-threatening gunshot wound in a 13-year-old child.

Abdominal Injuries↗
PubMed1987

Intraoperative irradiation of the canine abdominal aorta and vena cava.

The canine abdominal aorta and vena cava were examined 6 months after single doses of intraoperatively delivered electrons (IORT), fractionated external beam X rays, or a combination. The predominant pathologic change in aortas given fractionated doses was a segmental thickening of the subendothelial region of the tunica intima which was due to fibroelastic proliferation. In severe cases, the intimal proliferation caused significant narrowing of the aortic lumen. The greatest proliferation and lumen narrowing resulted from 80 Gy given in 30 fractions, whereas 60 Gy produced little response. In contrast, IORT alone or combined with fractionated doses resulted in mild subendothelial intimal proliferation at all doses. In some aortas there was focal aortic wall thinning after IORT alone or combined with fractionated doses. This response may be explained by increased intimal cell death and lost or delayed proliferative capability caused by large single doses. These studies suggest that large single doses produce structural alterations in the walls of large blood vessels that are clinically undetectable at early post-irradiation times. If these changes progress in severity they could lead to late effects such as rupture, fissure, or aneurysm that are clinically more significant than the marked intimal proliferation and lumen narrowing changes seen after fractionated doses. The aortic cell responsible for intimal fibroelastic proliferation appears to be a pluripotential stem cell capable of producing fibrous, elastic, and possibly smooth muscle tissue. There were no significant alterations in any of the irradiated vena cavas.

Abdominal Neoplasms↗
PubMed1975

Complete occlusion of the infrarenal abdominal aorta: management and results in 64 patients.

Sixty-four patients with complete occlusion of the infrarenal abdominal aorta were reviewed. The clinical findings, diagnostic procedures, and surgical management are described. Sixty-one patients underwent thromboendarterectomy and bypass grafts from the infrarenal abdominal aorta to the iliac or common femoral arteries. Because purulent material was found in the retroperitoneum of two patients, the proximal anastomosis was performed to the descending thoracic aorta in one patient and to the upper abdominal aorta in the other. One patient underwent thromboendarterectomy and patch graft angioplasty. The hospital mortality rate was 4.6 percent. Sixty-one patients discharged from the hospital were followed (average length of follow-up was 37 months). There were three late deaths (4.9 percent). Two patients have had occlusion of one limb of their bypass grafts and, along with four others, have developed recurrent symptoms of vascular insufficiency of the lower extremities. These symptoms were due to progressive atherosclerotic occlusive disease of the distal arterial tree for which additional distal procedures were required.

Adult↗
PubMed2005

The anterior visceral branches of the abdominal aorta and their relationship to the renal arteries.

Variations in the anatomy of the abdominal aorta and its branches are of interest as vessel geometry not only determines flow dynamics, but is also crucial in the pathogenesis of vascular disease. The relationship between the anterior visceral and renal arteries is important when undertaking diagnostic arteriography and endovascular interventions. To examine these relationships, the length of the abdominal aorta was determined and measurements taken of the position of origin of the celiac artery, superior mesenteric artery (SMA), inferior mesenteric artery (IMA) and renal arteries, as well as the three-dimensional projection of each vessel from the aorta. The mean level of bifurcation of the aorta was at the lower third of the body of L4, with the celiac artery, SMA, renal arteries and IMA arising at the level of the T12/L1 intervertebral disc, upper third of the body of L1, lower third of the body of L1 and lower third of the body of L3, respectively. The horizontal projection of the celiac artery, SMA and IMA was to the left of the midline; in the sagittal plane, the celiac artery and SMA projected anteriorly and the IMA posteriorly; in the coronal plane all vessels projected inferiorly, with the SMA to the right and the IMA to the left. The celiac artery, SMA and both renal arteries all arise from the proximal half of the abdominal aorta within 45 mm of each other, with the origins of the renal arteries being remarkably consistent. It is concluded that the celiac artery and SMA are both useful landmarks for determining the position of the renal arteries.

Abdomen↗
PubMed1999

Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo.

OBJECTIVES: to study the relationship between wall shear stresses measured in vivo and early atherosclerotic lesions in the abdominal aorta. MATERIALS: eight young volunteers for in vivo wall shear-stress measurements. Abdominal aortas from 10 young adults without signs or history of atherosclerotic disease were obtained by autopsy for histomorphometric measurements. METHODS: wall shear stresses were measured in the abdominal aorta above and below the renal arteries using a magnetic resonance technique with high resolution for imaging and blood velocity mapping. At identical abdominal aortic locations, intimal thickness was measured blindly using histomorphometric techniques and correlated to wall shear-stress variables using linear-regression analysis. RESULTS: intimal thickness showed a linear decrease with mean wall shear stress (r=-0.90, p<0.01) and with maximum wall shear stress (r=-0.86, p<0.01). CONCLUSIONS: intimal thickness in the normal abdominal aorta is associated with mean, maximum and oscillating wall shear stresses. These in vivo data corroborate previous in vitro studies suggesting that low and oscillating wall shear stresses are localising factors for intimal thickening and hence the early development of atherosclerosis.

Adolescent↗
PubMed2003

[Atherosclerosis of abdominal aorta and carotid arteries and its correlation with blood serum lipid levels in cholelithiasis].

AIM: To elucidate relationship between cholelithiasis and presence and severity of atherosclerosis in abdominal aorta and carotid arteries. MATERIAL AND METHODS: Ultrasound investigation of vessels and abdominal organs, determination of blood serum total, high density lipoprotein cholesterol and triglycerides were carried out in 147 patients with and 167 without (controls) cholelithiasis (mean age 44.2+/-3.1 and 45+/-2.8 years, respectively). RESULTS: Among patients with cholelithiasis 73.2 and 67.6% had atherosclerosis of abdominal aorta and carotid arteries, respectively. This was significantly more than in controls. Compared with controls atherosclerosis of these vessels in all age groups was significantly more pronounced in patients with cholelithiasis. Moreover severity of atherosclerosis was directly related to duration and activity of cholelithiasis. Atherosclerosis of abdominal aorta and carotids was most pronounced in patients with cholelithiasis and concomitant hypertension, ischemic heart disease and obesity. Significant direct correlations were found between blood serum levels of total cholesterol, triglycerides and low density lipoprotein cholesterol and thickness of abdominal aortic wall and carotid artery intima media complex. CONCLUSION: The results evidence for the existence of association between cholelithiasis and presence and severity of atherosclerosis of abdominal aorta and carotid arteries.

Adult↗
PubMed1981

Developmental occlusive disease of the abdominal aorta and the splanchnic and renal arteries.

Developmental occlusive disease of the abdominal aorta and the renal and splanchnic arteries represent an unusual vascular condition. When unrecognized or untreated this disease is associated with premature death, usually from severe secondary hypertension as a consequence of renovascular stenotic lesions. Strong circumstantial evidence indicates that developmental abnormalities occurring during the fetal union of the two dorsal aortae account for most of the occlusive lesions affecting the abdominal aorta and its visceral branches in these patients. Complete arteriographic studies are necessary to confirm and accurately delineate the disease process. Surgical treatment, which often encompasses complex vascular reconstructive efforts, affords excellent results when carefully planned and executed.

Adolescent↗
PubMed1995

[A case of the three branches of the celiac trunk arising directly from the abdominal aorta].

The present report describes the dissection of an 81 year-old Japanese female cadaver in the Kanazawa Medical University in which the celiac trunk was not present, that is, the left gastric, the splenic and the common hepatic arteries arose independently from the abdominal aorta in that order. In this case, the left gastric artery arose from the front wall of the abdominal aorta at a level between the 11th intercostal posterior and subcostal arteries. The splenic artery arose from the left front wall of the abdominal aorta about 5.0 mm below the origin of the left gastric artery. The common hepatic artery arose from the right front wall of the abdominal aorta about 4.0 mm below the origin of the splenic artery. The superior mesenteric artery dividing from the front wall of the abdominal aorta about 9.0 mm below the origin of the common hepatic artery, ran about 17.0 mm to give off the right accessory hepatic artery upwards to the right. This case belongs to type V of Morita's classification (1935), but was not described in Adachi's classification (1928). There seems to be only six such cases reported so far in Japan.

Aged↗
PubMed2005

Protective effects of trapidil in lung after abdominal aorta induced ischemia-reperfusion injury: an experimental study.

UNLABELLED: We aimed to investigate the protective effects of trapidil after the occlusion of abdominal aorta and the reperfusion injury in lung. Eighteen New Zealand albino rabbits were used in the study. In six animals [group 1, ischemia-reperfusion (IR) group], the abdominal aorta was exposed and a microvascular clamp was placed in the infrarenal abdominal aorta for 60 min. After the ischemic period, the microvascular clamp was removed and reperfusion was provided for 2 h. After the reperfusion period, the lungs were removed carefully and specimens were prepared for histopathological and biochemical studies in appropriate conditions. In group 2 (study group), trapidil (Rocarnal, Rentschler-UCB GmbH, Kerpen, Germany) was administered intraperitoneally as a single dose 1 h prior to trial, the IR procedure was performed and lung specimens were prepared similar to group 1. In group 3 (sham group), the infrarenal abdominal aorta was exposed and lung specimens were prepared for histopathological and biochemical studies at the end of the study. Histopathological changes, malondialdehyde (MDA), nitric oxide (NO) and total sulfhydryl group (T-SH) levels were evaluated. There was a statistical difference between the IR group and study group regarding NO and MDA levels (P < 0.05 and P < 0.01, respectively), but this was not detected between the IR group and the sham group (P > 0.05). There was no statistical difference among the three groups regarding T-SH levels (P > 0.05). While a statistical difference was found between the sham group and study group in the NO level (P < 0.05), no statistical difference was found in the MDA level (P > 0.05). There was a statistical difference in interstitial edema, PMN infiltration and hemorrhage scores among the groups (P < 0.05). There was a statistical difference between the IR group and study group in PMN infiltration (P < 0.05), but this was not detected between the groups in interstitial edema and hemorrhage scores (P > 0.05). There was a statistical difference between IR group and sham group in interstitial edema, PMN infiltration and hemorrhage scores (P < 0.05). Statistical difference was found between the sham group and study group in interstitial edema and hemorrhage scores (P < 0.05), but not in PMN infiltration (P > 0.05). CONCLUSIONS: Infrarenal abdominal aortic occlusion and reperfusion causes lung injury. We conclude that trapidil has preventive effects in the lung tissue after IR injury.

Animals↗
PubMedDate not supplied

[Surgical strategy in the association: aneurysm of the abdominal aorta and colonic lesion].

An association of an aneurysm of the abdominal aorta and a lesion of the colon raises an important question as to the correct sequence to follow. A simultaneous operation raises the major risk of infection and most authors prefer a sequential approach, treating either the aneurysm or the lesion of the colon first depending on the initial clinical situation or complications. In our first patient, both pathologies were known before surgery and simultaneous procedures were deliberately programmed. In the second case, both lesions were complicated and required simultaneous cure. In the third case, both were recognized before surgery and a sequential approach was followed--colon then abdominal aorta. In the fourth case, the colon disease was complicated and responded to medical treatment; three months later surgery was performed on the aneurysm followed by a colectomy two months later. A review of the literature and an analysis of our four cases offer a means of developing a management strategy for patients with an aneurysm of the abdominal aorta associated with a lesion of the colon.

Aged↗
PubMed1991

[Inflammatory aneurysms of the abdominal aorta].

The so-called "inflammatory" aneurysm of the aorta of the abdominal wall is a special form of the arteriosclerotic aneurysm of the aorta observed in 5-15% of the abdominal aorta aneurysms. It is characterized by more or less marked periaortal fibrotization. The pathological correlate is represented by lymphocytous and plasmacellular infiltrates that are mainly seen and identified in the region of the adventitia. The etiology has not yet been clarified. Since surgery of the inflammatory aneurysm of the abdominal wall aorta is rendered difficult due to neighbouring organs (e.g. ureters) becoming callous and adhesive, safe preoperative diagnosis is desirable. Suspicion of an aneurysm of the abdominal wall can be fairly safely confirmed by sonography. In case of a partially thrombotic aneurysm a characteristic fourfold stratification can be seen: free lumen/thrombus/calcified wall of aorta/law-echo outer layer. This last-named layer--the "inflammatory" portion--is tapelike, semicircular and more or less strongly developed. The inflammatory aneurysm of the abdominal wall is often symptomatic. Hence, the most important differential diagnosis concerns the covered perforation and the dissecting aortic aneurysm, as well as Ormond's disease, periaortal lymphomas and other retroperitoneal tumours.

Aorta, Abdominal↗
PubMedDate not supplied

Thoracic aorta-to-femoral artery by-pass. For the treatment of complete obstruction of the abdominal aorta at the level of the renal arteries.

Complete obstruction of the abdominal aorta at the renal artery level is often a difficult surgical problem in case of long standing thrombosis, short suprarenal aortic space, and extensive periarterial inflammatory reaction. Six patients in whom revascularization of the lower extremities was performed through a prosthetic by-pass from the thoracic aorta to the femoral arteries, were reported here. One patient underwent also a left nephrectomy for renal hypertension, chronic renal artery obstruction, shrunken kidney. Both the short and long term results have been satisfactory in all cases.

Adult↗