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PubMed1995

Fish oil supplementation attenuates myointimal proliferation of the abdominal aorta after balloon injury in diet-induced hypercholesterolemic rabbits.

The effects of supplementing with fish oil on the myointimal proliferation of the abdominal aorta after balloon injury were studied in control and in rabbits fed a 1% cholesterol-enriched diet, with and without 10% fish oil supplementation. Twenty-one animals in each group underwent a balloon injury of the abdominal aorta and left common iliac artery after 2 weeks of feeding. The animals remained on their respective diets thereafter. In 7 balloon-injured and 7 sham-operated animals of each group, the abdominal aorta was harvested 3 days later for the analysis of prostanoids, malondialdehyde, superoxide dismutase activity, [3H]thymidine uptake, and cholesterol levels. In the other 7 balloon-injured rabbits of each group, the tissue was harvested 3 weeks later for morphometric study. The fish oil-treated rabbits had the lowest aortic production of thromboxane B2 levels and the highest 6-keto-PGF1 alpha/thromboxane B2 ratios among the three groups after balloon injury. The aortic malondialdehyde levels of the cholesterol-fed rabbits were significantly higher than the other two groups (each P < 0.001) independent of balloon injury. The myointimal proliferation of the abdominal aorta and left common iliac artery in the fish oil-treated rabbits was less severe than in the cholesterol-fed animals (both P < 0.001) and was comparable with the controls. These results suggest that a fish oil supplement changes prostanoid metabolism to a favorable pattern and reduces lipid peroxidation on the abdominal aortic wall, thus attenuating myointimal proliferation after balloon injury in diet-induced hypercholesterolemic rabbits.

6-Ketoprostaglandin F1 alpha↗
PubMed2005

[An inflammatory aneurysm of the abdominal aorta].

Inflammatory aneurysm of the abdominal aorta is a rare disorder, affecting approximately 3-10% of the population with a diagnosis of the abdominal aortic aneurysm. The principal etiological agents of the disorder include bacterial microorganisms, primarily Salmonella, Staphylococcus aureus, and Escherichia coli. However, in many cases the etiology od the disorder remains unclear and, likely, autoimmune and genetic dispositions may play a certain role, as well. The principal diagnostic procedures include ultrasound, CT and MRI examinations. The principal therapeutic procedures include open resection of the inflammatory aneurysm with complete removal of the infectious tissue and its replacement by a prosthesis or a vascular allograft "in situ" or through an extraantomical reconstructive procedure. New procedures also include endovascular therapy which is technically much simpler, less demanding for a patient, however, it may leave a potential infectious focus in the organism with a risk of further septic complications to follow. Therefore, the authors recommend a strictly individual treatment strategy in each patient with this serious disorder. In case of positive cultivation bacteriological findings, extended (a minimum of 6 weeks) antibiotic therapy and regular, long-term patient follow-up with regular visits, are essential.

Aged↗
PubMed1977

Tandem coarctations of thoracic and abdominal aorta with intervening hypoplastic thoracic aorta: treatment with unilateral axillofemoral graft.

Tandem coarctations of the thoracic and abdominal aorta with an intervening segment of hypoplastic thoracic aorta were discovered unexpectedly in a 14-year-old boy brought to the emergency room for a displaced fracture of the radius. After the fracture healed, the boy's potentially dangerous anomalies were treated successfully with a unilateral axillofemoral prosthetic graft. This has remained patent for 42 months, and the boy has done well.

Adolescent↗
PubMed1993

Carotid intima-media wall thickness in elderly women with and without atherosclerosis of the abdominal aorta.

In the present study the association was evaluated between non-invasively assessed atherosclerosis of the abdominal aorta and ultrasonographically measured intima-media wall thickness of the common carotid arteries in a population-based study of 41 elderly women. Atherosclerosis of the abdominal aorta was assessed in 1985 using a lateral X-ray of the lumbar spine, on which the presence of calcified deposits was determined. The carotid arteries were ultrasonographically evaluated in 1990 for presence of atherosclerotic plaques and intima-media wall thickness of the distal common carotid was measured off line using dedicated software. The age-adjusted mean intima-media wall thickness of the right common carotid artery was significantly higher in subjects with calcified deposits in the aorta (n = 16) compared with those without deposits (n = 25) with a mean difference of 0.15 mm (95% confidence interval (CI) 0.03, 0.26). For the left side similar results were observed. Mean common carotid intima-media wall thickness, ((left+right)/2), differed significantly across groups with a mean difference of 0.11 mm (95% CI 0.01, 021). Additional adjustment for differences across groups in body mass index, serum cholesterol, hypertension and smoking did not change the magnitude of the observed association: mean difference of 0.12 mm (95% CI -0.01, 0.25). The findings of the present study provide evidence that among subjects with atherosclerotic plaques in the abdominal aorta, the intima-media wall thickness of the distal common carotid arteries is increased.

Aged↗
PubMed1993

Time-dependent increase in Ca2+ influx in rabbit abdominal aorta: role of Na-Ca exchange.

Exposure of the rabbit abdominal aorta to the combination of high K+ and norepinephrine resulted in a time-dependent increase in the rate of 45Ca influx and 45Ca and 22Na content over that observed after stimulation with either K+ or norepinephrine alone. The increase in 45Ca influx, but not the increase in 22Na content, was extracellular Ca2+ (Cao2+) dependent. This time-dependent increase in 45Ca influx was prevented by incubating the tissue in Na(+)-free medium. Nifedipine inhibited both the initial depolarization-induced 45Ca influx and time-dependent increase in 45Ca influx and 22Na content. The effect of nifedipine on time-dependent fluxes was prevented by ouabain. Phorbol dibutyrate mimicked the effects of norepinephrine on 22Na retention and 45Ca fluxes. The effects of phorbol dibutyrate and norepinephrine were not additive. It is concluded that, in rabbit abdominal aorta, norepinephrine plus K+ causes 22Na retention (possibly through inhibition of the sodium pump) and a Cao(2+)- and intracellular Na+ (Nai+)-dependent increase in 45Ca influx. This latter effect is possibly the result of increased Nai(+)-Cao2+ exchange.

Animals↗
PubMed1993

Risberg retroperitoneal approach to the abdominal aorta.

In a study of the best approach to the infrarenal abdominal aorta, 47 patients were compared retrospectively: 15 underwent a standard transperitoneal incision, 15 a retroperitoneal left flank incision and 17 a new modified lateral pararectus incision, the Risberg approach. Operating time, length of postoperative intubation and hospital stay, mortality rate, morbidity rate and cost were assessed. There was a significant reduction (P < 0.05) in mean(s.d.) operating time (141(21) versus 198(41) min), intraoperative cross-clamping time (74(13) versus 104(46) min) and postoperative intubation time (6.5(8.0) versus 13.3(7.3) h) associated with the Risberg retroperitoneal incision compared with the left flank retroperitoneal route. There was also a significant decrease (P < 0.02) in mean(s.d.) postoperative intubation time (6.5(8.0) versus 17.5(12.0) h), time after operation to discharge (11.0(2.4) versus 17.3(7.6) days) and hospital cost (4885(670) pounds versus 7732(580)) pounds associated with the Risberg incision compared with the transperitoneal approach. The Risberg incision gives better access to the infrarenal abdominal aorta while maintaining the advantages of other retroperitoneal approaches. This technique is recommended as the incision of choice for the retroperitoneal approach to the aorta.

Aged↗
PubMed1999

Effect of exercise on hemodynamic conditions in the abdominal aorta.

PURPOSE: The beneficial effect of exercise in the retardation of the progression of cardiovascular disease is hypothesized to be caused, at least in part, by the elimination of adverse hemodynamic conditions, including flow recirculation and low wall shear stress. In vitro and in vivo investigations have provided qualitative and limited quantitative information on flow patterns in the abdominal aorta and on the effect of exercise on the elimination of adverse hemodynamic conditions. We used computational fluid mechanics methods to examine the effects of simulated exercise on hemodynamic conditions in an idealized model of the human abdominal aorta. METHODS: A three-dimensional computer model of a healthy human abdominal aorta was created to simulate pulsatile aortic blood flow under conditions of rest and graded exercise. Flow velocity patterns and wall shear stress were computed in the lesion-prone infrarenal aorta, and the effects of exercise were determined. RESULTS: A recirculation zone was observed to form along the posterior wall of the aorta immediately distal to the renal vessels under resting conditions. Low time-averaged wall shear stress was present in this location, along the posterior wall opposite the superior mesenteric artery and along the anterior wall between the superior and inferior mesenteric arteries. Shear stress temporal oscillations, as measured with an oscillatory shear index, were elevated in these regions. Under simulated light exercise conditions, a region of low wall shear stress and high oscillatory shear index remained along the posterior wall immediately distal to the renal arteries. Under simulated moderate exercise conditions, all the regions of low wall shear stress and high oscillatory shear index were eliminated. CONCLUSION: This numeric investigation provided detailed quantitative data on the effect of exercise on hemodynamic conditions in the abdominal aorta. Our results indicated that moderate levels of lower limb exercise are necessary to eliminate the flow reversal and regions of low wall shear stress in the abdominal aorta that exist under resting conditions. The lack of flow reversal and increased wall shear stress during exercise suggest a mechanism by which exercise may promote arterial health, namely with the elimination of adverse hemodynamic conditions.

Aorta, Abdominal↗
PubMedDate not supplied

Review of Ehlers-Danlos syndrome. Successful repair of rupture and dissection of abdominal aorta.

Successful surgical treatment of spontaneous rupture and dissection of the abdominal aorta in Ehlers-Danlos syndrome has not been previously reported. A 16-year-old male sustained spontaneous rupture and dissection of the abdominal aorta. Successful surgical treatment included placement of an abdominal aortic bifurcation graft. Genetical, biochemical and clinical differences of seven types of the syndrome are outlined. A brief guideline for treatment and prevention of vascular complications is discussed.

Adolescent↗
PubMed1989

[Ectopic calcification of the abdominal aorta and bone mineral content of vertebrae].

The relationship between the ectopic calcification of abdominal aorta and the de-calcification of bone in 137 elderly patients was investigated by quantitative computed tomography. We calculated the index (CAI) of the calcification volume to the aorta volume in the lower abdominal aorta, and simultaneously estimated the bone mineral content (BMC) of the vertebral body using a calibration phantom. The CAI increased and the BMC decreased progressively in proportion to aging. There was a significant negative correlation between the CAI and the MBC in females in the eighth and ninth decades (eighth decade: n = 37, r = -0.400; p less than 0.01, ninth decade: n = 37, r = -0.334; p less than 0.05). These results suggested that in elderly females, abdominal aortic calcification is closely related to de-calcification from the vertebral body.

Aged↗
PubMed1992

[Choice of the approach in the performance of reconstructive surgery of the abdominal aorta].

The experience with surgical treatment of 630 patients with the use of extraperitoneal and transabdominal approaches to the abdominal aorta is summarized. Their advantages and disadvantages are noted. The expediency to use a new extraperitoneal approach to suprarenal and infrarenal portions of the abdominal aorta has been proved. The results of a topographic-anatomic study are presented. The technique for performance of a new approach to the abdominal aorta at this region, its advantages over the existing approaches are described.

Aorta, Abdominal↗
PubMed1992

[Inflammatory aneurysm of the abdominal aorta: anatomo-clinical study on 16 cases and pathogenetic hypothesis].

BACKGROUND: Inflammatory aneurysms of the abdominal aorta constitute an anatomoclinical entity characterised by prominent thickening and fibrosis of the aneurysmal wall, extending to the adjoining structures. Etiology, pathogenesis and relation with atherosclerosis still remain controversial. METHODS: Sixteen consecutive patients undergoing surgery for inflammatory aneurysm of the abdominal aorta between March 1987 and December 1990 were studied (Group I); as a control, a series of 16 consecutive patients operated on in the same period for atherosclerotic aneurysm of the abdominal aorta was selected (Group II). As far as clinical history and symptoms are concerned, the comparison between the two groups revealed significant differences only for hydronephrosis (exclusively present in Group I, p < 0.05) and abdominal pain (more frequent in Group I, p < 0.01). The microscopic study of the aneurysmal wall was performed by scoring its histological features (atherosclerotic lesions, medial and adventitial fibrosis, inflammatory infiltrates and lymphatic stasis) from 1+ to 3+. RESULTS: As regards the microscopical features, atherosclerotic lesions were present in all the examined cases, whereas periadventitial fibrosis appeared in all the aneurysms of Group I and in none of Group II; the comparison between the two groups revealed further significant differences for extensive intimal calcification (exclusively present in Group II, p < 0.05), fibrous replacement of the tunica media (more thorough in Group I, p < 0.02), and the extent of inflammatory infiltrates (more prominent in Group I, p < 0.05). CONCLUSIONS: From the scarcity of pathognomonic features in both case-history and clinical presentation, the constant coexistence of prominent atherosclerotic lesions, and the progressive trend of the pathologic features, inflammatory aneurysms may be inferred to be a variant of atherosclerotic ones, characterised by a particular prominence of inflammation and fibrosis. The frequent occurrence of dilation of both periaortic lymphatic vessels and lymph node sinuses, even in "incipient" aneurysms, supports the hypothesis that it may be the lymphatic stasis which determines periaortic fibrosis. Finally, atherosclerotic components passing into periaortic fibrosis and eliciting granulomatous reaction were observed in two Group I cases featuring prominent "inflammatory" symptoms; such a finding favours the hypothesis that an immune reaction against some components of the atherosclerotic plaque may lead to the pronounced inflammatory response that is peculiar of inflammatory aneurysms.

Aged↗
PubMedDate not supplied

Transluminal catheter angioplasty of abdominal aorta in Takayasu's arteritis.

Nine patients with Takayasu's arteritis and a long stenotic segment of the abdominal aorta were treated by percutaneous transluminal angioplasty (PTA). Intermittent claudication disappeared in six of seven cases, the femoral pulse reappeared in all five; ankle/arm indices increased in seven cases; elevated blood pressure normalized in seven of eight cases. Seven patients were followed for 3 to 28 months. They were all free of symptoms from the lower extremities. In three patients with or without renal artery stenosis and with hypertension, the blood pressure decreased after PTA of the abdominal aorta only. PTA may be a valuable treatment in Takayasu's arteritis and stenosis of the abdominal aorta.

Adolescent↗
PubMed1994

Optimal exposure of the proximal abdominal aorta: a critical appraisal of transabdominal medial visceral rotation.

PURPOSE: Adequate exposure of the upper abdominal aorta and its branches is a necessary prelude to safe and durable reconstruction of this aortic segment. Although a variety of approaches to this exposure have been described, few outcome data are available to assess the benefits and limitations of the different exposure options. In this series we report the results of the transabdominal medial visceral rotation (MVR) approach to exposure of the paramesenteric and pararenal aorta. METHODS: One hundred eight operations were performed in 104 patients, representing 19.5% of all aortic reconstructions during a 5.5 year interval. Most patients had hypertension (n = 77, 71.3%) or a history of smoking (n = 83, 76.9%). Heart disease was present in one third of patients (n = 33) and a similar proportion had abnormal renal function (elevated creatinine level) before operation (n = 40, 37.0%). One third of patients (n = 34) had undergone previous aortic or aortic branch reconstruction. Eighty percent of procedures were elective (n = 87). Seventy-one patients (65.7%) required renal revascularization, usually for hypertension or elevated creatinine levels, whereas 37 patients (34.3%) underwent visceral reconstruction, most often for symptoms of chronic mesenteric ischemia. Only 22 patients required isolated infrarenal aortic repair. Most of the aortic lesions were aneurysmal (n = 42). Eighty percent of procedures (n = 88) required suprarenal or more proximal aortic clamping. The most frequently used reconstruction techniques were bypass (n = 39, 36.1%), endarterectomy (n = 18, 16.7%), or both (n = 23, 21.3%). RESULTS: There were four intraoperative deaths (3.7%) and 15 postoperative deaths (13.9%). All intraoperative deaths and four postoperative deaths were related to hemorrhage and its complications. Visceral infarction was the most frequent cause of postoperative death. The intraoperative complications that were determined to be related to the medial visceral rotation approach included splenic injury (n = 23, 21.3%), one aortic injury, and one adrenal injury. The aortic injury was associated with substantial intraoperative bleeding and subsequent death. The postoperative complications resulting from MVR included pancreatitis (n = 5), which contributed to death in two patients, and possibly some of the cases of visceral infarction not associated with visceral reconstruction. The other common postoperative complications, cardiac (n = 25, 24.0%), pulmonary (n = 32, 30.8%), renal (n = 20, 19.2%), and infectious (n = 17, 16.3%), were attributed to the procedures performed. CONCLUSIONS: Transabdominal MVR exposure of the upper abdominal aorta provides unrestricted access to the visceral branch-bearing segment of the aorta and places no limitations on the choice of arterial reconstruction technique. The associated morbidity and mortality rates are typical of patients undergoing these complex vascular repairs, but the frequency of splenic injury and postoperative pancreatitis is increased.

Abdomen↗
PubMed1990

[A case report of combined composite valve graft replacement of the aortic root and graft replacement of the abdominal aorta].

A 55-year-old man who had both aortic root aneurysm with severe aortic regurgitation and enlarging abdominal aortic aneurysm was admitted to our hospital. We employed the combined composite valve graft replacement of the aortic root and Y-graft replacement of the infrarenal abdominal aorta at one stage operation. At the operation, median sternotomy was made and the composite graft replacement of the aortic root was performed under cardiopulmonary bypass prior to the abdominal procedure. After cardiopulmonary bypass was removed, abdominal incision was made. Although ventricular arrhythmias and mild hypotension transiently occurred when the abdominal aorta was clamped, the Y-graft replacement was also completed uneventfully, and no complication occurred postoperatively. We conclude that the combined operation of the aortic root and the abdominal aorta is clinically feasible in certain situation.

Aorta↗
PubMed2001

[Surgical treatment of aneurysms of unpaired visceral branches of the abdominal aorta].

Aneurysms of unpaired visceral branches of the abdominal aorta are rare diseases but they are dangerous for life. Russian Research Center of Surgery RAMS has an experience of diagnosis and surgical treatment of 23 patients with aneurysms of the celiac trunk (2), superior mesenteric artery (4), inferior mesenteric artery (1), hepatic artery (4), splenic artery (7), gastroduodenal artery (2), inferior pancreatoduodenal artery (1), multiple aneurysms of celiac trunk and superior mesenteric artery (2). 21 of 23 patients were operated. 20 patients were discharged with complete recovery. 1 (4.8%) patient died due to gastroduodenal bleeding 4 months after surgery. The results show that patients with aneurysms of unpaired visceral branches of abdominal aorta require surgical treatment.

Adolescent↗