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At least 523 records · Page 29Linked to original sources
PubMed2002

Gadobenate dimeglumine-enhanced MR angiography of the abdominal aorta and renal arteries.

OBJECTIVE: This study was conducted to determine the efficacy and safety of four different doses of gadobenate dimeglumine for contrast-enhanced three-dimensional MR angiography of the abdominal aorta and renal arteries. SUBJECTS AND METHODS: Ninety-four patients with suspected abnormality of the abdominal aorta or renal arteries underwent unenhanced three-dimensional gradient-recalled echo time-of-flight MR angiography and contrast-enhanced MR angiography after the IV injection of one of four doses of gadobenate dimeglumine (0.025, 0.05, 0.1, and 0.2 mmol/kg of body weight). Efficacy was assessed on-site and by two blinded off-site reviewers in terms of change in total diagnostic quality score and diagnostic quality score per vessel segment from baseline unenhanced time-of-flight MR angiography to contrast-enhanced MR angiography. Secondary efficacy end points included lesion count and level of confidence in lesion characterization. Safety assessments comprised adverse event monitoring, physical evaluation, vital signs, ECG, and laboratory investigations. RESULTS: A significant change in the total diagnostic quality score from unenhanced to contrast-enhanced MR angiography was observed at all doses. The change increased with increased dose, plateauing at the 0.1 mmol/kg dose level. More patients with lesions detected and increased reviewer confidence for lesion characterization were noted on contrast-enhanced MR angiography compared with unenhanced MR angiography, although no dose-related trends were observed. All doses were well tolerated, and no significant changes in safety parameters were observed. CONCLUSION: Gadobenate dimeglumine is an effective and safe agent for contrast-enhanced MR angiography of the abdominal aorta and renal arteries. A dose of 0.1 mmol/kg of body weight appears to be the most suitable.

Adult↗
PubMed1996

[Colorectal ischemic necrosis following reconstructive surgery of the abdominal aorta. Report of 2 clinical cases].

The authors report two cases of colorectal ischemic necrosis following surgical reconstruction of abdominal aorta. An intestinal resection according to Hartmann was performed in both cases. The value of prevention based on a careful anamnesis, on a precise angiography study of the abdominal aorta and of splanchnic circle in addition to inferior mesenteric artery reimplantation, when advisable, is underlined as the most effective therapeutic instrument against colorectal ischemic necrosis following surgical reconstruction of the abdominal aorta.

Aged↗
PubMed2004

[The expression and significance of hypoxia-inducible factor-1 alpha and related genes in abdominal aorta aneurysm].

OBJECTIVE: To study the expression of hypoxia-inducible factor (HIF)-1alpha and related genes in abdominal aorta aneurysm (AAA) and explore the underlying pathogenesis. METHODS: Twenty-two AAA specimens were collected and 5 normal abdominal aorta tissue were used as control. Northern blot, western blot and immunohistochemistry were used to evaluated the expression of HIF-1alpha mRNA and protein product. Western blot and immunohistochemistry method were also used to determine the expression of vascular endothelial growth factor (VEGF) and caspase-3. Microvessel density (MVD) was studied by immunohistochemistry stain of CD34. RESULTS: The expression of HIF-1alpha mRNA and protein product were significantly higher in AAA than that in normal abdominal aorta (P < 0.01). The expression of VEGF and caspase-3 were also higher in AAA and both had a significantly positive relationship with HIF-1alpha expression (P < 0.01). Most of the positive cells located in VSMC and adventitia of AAA. The MVD counts were higher in AAA. CONCLUSION: HIF-1alpha may have an important role the development of AAA, which maybe obtained by regulating the expression of VEGF or caspase-3.

Aged↗
PubMed1999

Digital subtraction angiography of the abdominal aorta and lower extremities: carbon dioxide versus iodinated contrast material.

PURPOSE: To compare the diagnostic value of carbon dioxide to that of iodinated contrast material for digital subtraction angiography of the abdominal aorta and lower extremities. MATERIALS AND METHODS: Thirty-five patients underwent comparative CO2 and iodinated contrast material arteriography of the abdominal aorta and lower extremities. For each contrast study, three independent observers evaluated the degree of opacification and percentage of stenosis of each vessel, the degree of certainty of their observations, and the overall quality of the study. Data of CO2 and iodinated studies were compared using analysis of variance for repeated measures. Interobserver and intertechnique agreements were estimated with Cohen's kappa and intraclass correlation coefficient. RESULTS: Iodine-based vascular opacification was superior to that with CO2 in the central and distal arteries (P = .02). The degree of certainty and overall quality score were higher for iodine than for CO2-based contrast studies (P = .00001). The interobserver agreement for categorizing stenoses was higher for iodine as compared to CO2-based angiography. No significant difference was observed between the mean stenosis values obtained with CO2 and iodine-based angiography in any segment. Intraclass correlation coefficient demonstrated a high degree of convergence of the two techniques for assessing the percentage of stenosis. CONCLUSION: CO2 can be used as an alternative to iodinated contrast material for obtaining arteriograms of the abdominal aorta and lower extremities for investigating atherosclerotic disease.

Aged↗
PubMed2004

[Abdominal aorta lesion during surgical treatment of a foraminal disk hernia].

We report a case of an abdominal aorta lesion on a 54-year-old woman, who underwent surgery for the treatment of a foraminal disk hernia. At the end of the hernia repair, a sudden hypovolaemic collapse occurred. A computed tomography revealed an abdominal aorta disruption and a retroperitoneal haematoma. An endovascular treatment was preferred to a surgical reintervention and an endoluminal stent-graft was inserted; the postoperative course was uneventful. This case report describes an example of vascular complications of disk hernia surgery which are rare but potentially serious. It emphasizes the increasing development of endovascular procedures and their utility in the treatment of acute contained aortic disruption.

Aorta, Abdominal↗
PubMed2003

Endovascular treatment of isolated atherosclerotic stenosis of the infrarenal abdominal aorta: long-term outcome.

The purpose of this multicenter study was to assess the long-term outcome of endovascular treatment of isolated atherosclerotic stenosis of the infrarenal abdominal aorta on the basis of clinical and ultrasound examination. Clinical, ultrasound, and angiographic findings from 36 women and 50 men (mean age, 53.2 years) treated for atherosclerotic stenosis of the infrarenal abdominal aorta were reviewed. Patients had claudication in 74 cases and rest pain in 4. Seven patients presented trophic manifestations and one had blue toe syndrome. Mean preoperative systolic index was 0.71. Mean diameter reduction was 77%. Circumferential calcification was partial in 36 cases (41%) and complete in 30 cases (35%). Percutaneous transluminal angioplasty was performed using the single-balloon technique in 60 cases and double-balloon technique in 26 cases. A stent was placed in 76 cases (88%) by necessity in 34% of cases (22 residual stenoses, 4 dissections). Completion angiographic findings were considered good in 82 cases (95%). The remaining four patients had residual stenosis with a diameter reduction >30%. One patient died during the immediate postoperative period from septicemia unrelated to treatment (early mortality, 1.2%). Aortic angioplasty was complicated by stent detachment from the angioplasty balloon in two patients, retroperitoneal hematoma in one, peripheral embolism in two, puncture-site hematoma in three, myocardial infarction in one, and thrombophlebitis of deep femoral artery in one patient (early morbidity, 9.3%). All patients underwent follow-up with clinical and hemodynamic evaluation (mean follow-up, 31 months). Actuarial survival at 3 years was 91%. Primary actuarial patency was 94% at 1 year, 89% at 3 years, and 77% at 5 years. Aortic restenosis occurred in seven patients and was treated by angioplasty in two, aortobifemoral bypass in four, and surveillance in one. Mean systolic index was 0.89. Statistical analysis of patency demonstrated no factor predictive of long-term complication. From the long-term follow-up findings in this study, we conclude that aortic angioplasty is a reliable minimally invasive technique for treatment of isolated atherosclerotic stenosis of the infrarenal abdominal aorta.

Actuarial Analysis↗
PubMed1980

Atrophic coarctation of the abdominal aorta.

Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication.

Adolescent↗
PubMed2003

[Feasibility and accuracy of a rapid evaluation of the abdominal aorta during routine transthoracic echocardiography].

BACKGROUND: Mass screening for occult abdominal aortic aneurysm is not realistic for the low prevalence of this condition in the general population. Screening in a high-risk population, especially during standard echocardiographic examination, could be more cost-effective than a separate screening program. The aim of this study was to evaluate the feasibility and accuracy of a rapid evaluation (examination arbitrary time-limit of 2 min) of the abdominal aorta at the end of a routine transthoracic echocardiographic examination. METHODS: One hundred and eighty-one male patients (average age 61 years, range 45-79 years) were studied. A subgroup of 83 patients was also blindly examined by a radiologist for diagnostic accuracy evaluation. RESULTS: Abdominal aortic aneurysm was defined as an aortic diameter enlargement > or = 3.0 cm. Sixteen patients were excluded due to suboptimal aortic wall imaging or to examination lasting > 2 min (feasibility 91%). An occult aneurysm was found in 7 patients (3.8%). As regards the presence/absence of aneurysms in the subgroup of patients undergoing double examination, sensitivity and specificity were 80 and 100% respectively. CONCLUSIONS: Rapid evaluation of the abdominal aorta for aortic screening during routine echocardiography is highly feasible and accurate without any significant prolongation of the examination time and should therefore be routinely performed during standard examination.

Aged↗
PubMed1997

Repair of Salmonella mycotic aneurysm of the paravisceral abdominal aorta using in situ prosthetic graft.

Salmonella infection of the abdominal aorta is associated with a high mortality and morbidity, especially when the paravisceral segment is involved. The presentation may be vague and a high index of suspicion is required in order to make the diagnosis early so that prompt treatment can be instituted. Imaging techniques such as computed tomography and angiogram are useful in arriving at a diagnosis as well as planning of operation. The management of a patient with Salmonella mycotic aortic aneurysm includes potent antibiotics, adequate debridement and revascularization. The method of revascularization, in situ bypass or extra-anatomic bypass, has been the subject of controversy. In situ bypass involves placing a graft in an infected field with potentially fatal graft infection, while extra-anatomic bypass has the problem of inferior patency and the necessity of a future reconstruction. We report here a patient with Salmonella mycotic aneurysm of the paravisceral abdominal aorta successfully treated with in situ prosthetic bypass graft.

Aged↗
PubMed1987

Salmonella infections of the abdominal aorta cured with prolonged antibiotic treatment.

Three cases of endovascular infection of atherosclerotic aneurysm of the abdominal aorta due to Salmonella spp. are described. 'Breakthrough' or relapsing bacteraemia were major clues for diagnosis in each case. They were treated with a prolonged course of bactericidal antibiotics before surgery. Resection with an interposed graft was performed in all cases and antibiotic treatment continued. Two of our patients have survived for more than two years and the other for 18 months without evidence of relapse. Thus, it would appear possible at times to treat successfully mycotic aneurysm of the abdominal aorta with antimicrobial agents plus resection of the aneurysm followed by in situ bypass grafting. Extra-anatomical grafts should be kept for infections due to antimicrobial-resistant organisms or when periaortic infection is widespread.

Aged↗
PubMed2000

Coarctation of the abdominal aorta and renal artery stenosis related to an umbilical artery catheter placement in a neonate.

Umbilical artery catheters have been associated with thrombotic complications, such as partial or complete occlusion in the aorta, the renal arteries, and other blood vessels. There have been few reports of the long-term consequences of either symptomatic or asymptomatic thrombi. We report a patient, now 22 years of age, born with a normal aorta, who developed hypertension at the age of 2 months after use of an umbilical artery catheter. An intravenous pylegram and nuclear renal scan were compatible with occlusion of left renal artery and of the distal aorta. At 6 months of age, the patient presented with reduced femoral pulses. Angiography demonstrated an acquired coarctation of the abdominal aorta and renal artery stenosis. An abdominal ultrasound performed at 22 years of age revealed partial obstruction of the lower abdominal aorta and marked atrophy of the left kidney. This case underlines the importance of long-term follow-up studies of infants who have undergone umbilical artery catheterizations.

Aorta, Abdominal↗
PubMed1993

Complete recanalization of total occlusion in abdominal aorta by intra-aortic infusion of a thrombolytic agent--a case report.

Complete recanalization was achieved by intra-aortic infusion of urokinase in a case of complete occlusion of the abdominal aorta. The patient was a fifty-nine-year-old man with atrial fibrillation, hypertension, and diabetes mellitus who was admitted because of intermittent claudication and pain in both lower extremities at rest. Angiography demonstrated complete obstruction of the abdominal aorta, but the bilateral iliac arteries were visualized via collaterals. Urokinase was administered intra-aortically in a total dose of 1,200,000 U during the first day and a total dose of 960,000 U during the second day. The aorta and the iliac arteries recanalized after this treatment, and complete recanalization associated with disappearance of subjective symptoms was observed after one month of treatment with warfarin. The present case suggests the usefulness of intra-arterial infusion of urokinase for the treatment of complete occlusion of the abdominal aorta.

Aorta, Abdominal↗