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PubMed1995

Differential effect of the retropleural and retroperitoneal environments on healing of the inner wall of porous fabric prostheses in the thoracic and abdominal aorta of the same dog.

Healing of the inner wall of the same preclotted knitted Dacron arterial prostheses was compared in the descending thoracic aorta (DTA) and the abdominal aorta (AA) of the same dog. Each of 16 dogs received this dual implantation with study periods of 4 weeks for five dogs, 8 weeks for five dogs, and 16 weeks for six dogs. Healing was studied with light microscopy, scanning electron microscopy, transmission electron microscopy, and immunocytochemistry identification. The outer capsule was firmly adherent to the Dacron framework of all grafts implanted in the DTA; advanced healing of the inner wall of all thoracic grafts was present by 4 weeks, nearly complete healing by 8 weeks, and complete healing by 16 weeks. In contrast, the outer capsule was either not attached or only loosely adherent to the Dacron framework in eight AA grafts (50%), and in these implants no healing of the inner wall occurred beyond the limited perianastomotic pannus zone. In the other eight implants in which the outer capsule was firmly adherent to the Dacron framework, healing was roughly comparable to that in the grafts implanted in the DTA. This study demonstrated that (1) DTA grafts heal faster and more completely than AA grafts, (2) healing and endothelialization are related to the tightness of the outer capsule, (3) there is a high incidence of loose tissue attachment in the AA, and (4) healing of aortic grafts is site specific.

Animals↗
PubMed2001

Atherosclerotic enlargement of the human abdominal aorta.

Aortic aneurysms usually develop in the atherosclerosis prone infrarenal abdominal aorta. To assess the role of atherosclerosis in aortic enlargement, we studied the relation between plaque formation and aortic size in 30 pressure-fixed male cadaver aortas (age 40-95 years, mean age 67 years). Morphometric analysis of transverse sections of the mid-thoracic and the mid-abdominal aortas included measurement of intimal plaque area, lumen area, plaque and media thicknesses. The area encompassed by the internal elastic lamina area (IEL area) was taken to be an index of aortic size. IEL area increased with age at both the thoracic (r=0.77, P<0.01) and abdominal (r=0.54, P<0.01) aortic levels. The aorta also enlarged with increasing plaque area at the thoracic (r=0.73, P<0.01) and abdominal (r=0.79, P<0.01) levels. Regression analysis of IEL area on age, body weight, height and plaque area revealed that the primary predictor of thoracic aortic size was age, whereas the primary predictor of abdominal aortic size was plaque area. Plaque thickness in the abdominal aorta was greater than in the thoracic aorta (P<0.01). Increased plaque area was associated with a significant decrease in media thickness in the abdominal aorta (r=-0.75, P<0.01) but not in the thoracic aorta. Aortas with relatively enlarged abdominal segments, i.e. those with a thoracic to abdominal ratio of <1.2 (n=13), were compared to those with a normal ratio (> or =1.2, n=17). Relatively large abdominal aortas had twofold greater plaque area (P<0.001), reduced medial thickness (P<0.05), fewer medial elastic lamellae (P<0.01) and greater mural tensile stress (P<0.05) than relatively normal abdominal aortas. We conclude that plaque formation in the infrarenal abdominal aorta in humans is associated with aortic enlargement and decreased media thickness. These changes may be predisposing factors for the preferential development of subsequent aneurysmal dilation in the abdominal aorta.

Adult↗
PubMed2000

Feasibility of gadodiamide compared with dilute iodinated contrast material for imaging of the abdominal aorta and renal arteries.

PURPOSE: To determine the quality of digital abdominal angiograms obtained with use of full-strength, intra-arterial gadodiamide compared with similar volumes of half-strength iodinated contrast material for evaluating the abdominal aorta and renal vessels. MATERIALS AND METHODS: Twenty-five consecutive patients underwent digital subtraction arteriography of the abdominal aorta performed with equal volumes (32 mL) of either half-strength (300 mg/mL iodine) iodinated contrast material or full strength gadodiamide (0.11-0.25 mmol/kg) to evaluate the abdominal aorta and renal arteries. The contrast agent used was not known to the image readers. The abdominal aorta, left and right renal main renal artery, and first and second order segmental branches were graded separately as diagnostic or nondiagnostic by four angiographers. RESULTS: Images of the abdominal aorta were diagnostic 100% of the time for iodine and gadodiamide, 76% and 80% diagnostic for iodine and gadodiamide in the left main renal artery, respectively; and 100% and 80% diagnostic for iodine and gadodiamide in the right main renal artery, respectively. The first order segmental branches of the right and left renal arteries were graded diagnostic 72% and 56% of the time, respectively, for dilute iodinated contrast material, and 40% and 28% of the time, respectively, for gadodiamide. The second order segmental branches of the right and left kidney were graded diagnostic 24% of the time for iodinated contrast and 8% and 4% of the time, respectively, for gadodiamide. CONCLUSION: Full-strength, intra-arterial gadodiamide at doses smaller than 0.3 mmol/kg can produce diagnostic images of the abdominal aorta and main renal arteries. However, images of the intrarenal branches are usually not diagnostic.

Adult↗
PubMed1992

Pathogenesis of acquired aneurysms of the abdominal aorta.

The incidence of abdominal aortic aneurysm has recently increased. There is still no accurate definition of abdominal aortic aneurysm. The diameter of abdominal aortic aneurysms is the only factor permitting evaluation of the risk of rupture of aneurysms whose growth remains unpredictable. Abdominal aortic aneurysm is a multi-factorial disease associated with aortic aging and atheroma. It differs from stenotic disease by the intensity of degenerative or destructive phenomena in the media. Particular hemodynamic conditions in the infrarenal abdominal aorta seem to enhance the development of aneurysm at this level. While certain constitutional anomalies of the extracellular matrix of proteins seem to enhance the development of abdominal aortic aneurysm, protease activity of as yet undetermined origin also seems to play a prominent role. Family cases of abdominal aortic aneurysms have been reported but the mechanisms responsible remain to be determined. Several genetic markers have been suggested. The most reliable marker of aortic aneurysm is arteriomegaly.

Aorta, Abdominal↗
PubMed1991

Bethanechol and phenylephrine responses in canine inferior vena cava and abdominal aorta.

Both canine inferior vena cava and abdominal aorta showed a concentration dependent increase of contraction in response to phenylephrine; however, inferior vena cava contracted in response to bethanechol but abdominal aorta did not respond to bethanechol. When the inferior vena cava was preconstricted with 1 x 10(-3)M bethanechol, low concentrations of phenylephrine (1 x 10(-7)M to 1 x 10(-6)M) induced relaxation, but relaxation by phenylephrine of abdominal aorta pretreated with 1 x 10(-3)M bethanechol did not occur.

Animals↗
PubMed2005

Diameter of the infrarenal abdominal aorta in children with cerebral palsy.

The diameters of the infrarenal abdominal aorta by ultrasonography have not yet been reported in children with cerebral palsy (CP). Because the demand for the surgical applications of the abdominal aorta probably increases in the CP population owing to their prolonged life-span, we planned a study to assess the diameter of the infrarenal abdominal aorta by ultrasonography in children with CP and to compare them with those of healthy subjects. The study comprised 60 children with CP and 95 age- and sex-matched healthy children. The diameter of the infrarenal abdominal aorta was measured by B-mode ultrasonography. The correlation between the aortic diameter, weight, height, body surface area (BSA), and body mass index was studied. The diameter of the infrarenal abdominal aorta was found to be smaller in children with CP than in healthy children (p < 0.05). There was a significant correlation between the aortic diameter, weight, height, and BSA in both groups (p < 0.05). When a vascular surgical treatment is needed in children with CP, the probability of a small-diameter infrarenal abdominal aorta should be considered.

Aorta, Abdominal↗
PubMedDate not supplied

A simplified technique for the surgical treatment of aneurysms of the thoraco-abdominal and the upper abdominal aorta.

Aneurysms of the thoraco-abdominal and upper abdominal aorta require widespread and complex surgical treatment because of their extension and involvement of the viscera. This surgery is accompanied by significant morbidity and operative mortality rates. A description is made of a simplified surgical technique, easier to carry out than other techniques and with less risk to the patient, and minimal cardiac, cerebral and renal repercussions. In this technique, an aorto-iliac shunt is created, followed by intrasaccular revascularization of the splanchnic vessels by means of grafts placed between the shunt and the ostia of the digestive and renal arteries. Two cases in which this was successfully carried out are presented and discussed.

Aorta, Abdominal↗
PubMed1999

Imaging of the abdominal aorta during examination of patients referred for transthoracic echocardiography.

BACKGROUND: Screening for aneurysm of abdominal aorta (AAA) in the general population is costly and unrealistic, but examination of the abdominal aorta appears reasonable in a high risk cardiological population. METHOD: As the abdominal aorta is easily accessible to standard transthoracic echocardiographic equipment, we tested this hypothesis in 301 consecutively referred patients (182 men, 119 women, mean age 58.6 +/- 16.5 years) by imaging the abdominal aorta at the end of the cardiac examination. RESULTS: After exclusion of three patients operated on for AAA before, the native infrarenal segment most often involved in AAA was visualised in 297 out of 298 patients (99.7%), and the aortic bifurcation was seen satisfactorily in 285 of them (95.6%). The abdominal aorta was dilated (> or = 2 cm) in 44 patients (15%), all but one of whom were > 50 years old; 17 of these (5.7%) had AAA defined as segmental dilation with a maximum diameter of > or = 3 cm (15 men, 2 women, age 67.4 +/- surgical repair and one endovascular repair within one year after completion of the data collection. Their mean age was 70.1 +/- 7.9 years, ranging from 58 to 80 years. No significant surgical morbidity and no mortality was observed. CONCLUSIONS: Prevalence of dilative alterations of the abdominal aorta is high in cardiological patients. Visualisation during transthoracic echocardiography of the most important infrarenal segment is nearly always feasible (99.7%), including its bifurcation (95.6%). Since detection of life-threatening but asymptomatic AAA may save lives by offering safe elective surgical treatment or stenting, opportunistic examination of the abdominal aorta during routine transthoracic echocardiography, which involves little time and no additional cost, would appear to be highly effective and should be included in routine examinations, at least in patients over 50 years of age.

Adult↗
PubMed1996

Feasibility of transgastric ultrasonography of the abdominal aorta.

PURPOSE: Transesophageal echocardiography provides detailed images of the thoracic aorta, but imaging of the abdominal aorta and its branches does not occur routinely when the transesophageal echocardiography transducer is advanced into the stomach. Transgastric aortic ultrasonography (TAUS) was investigated as an intraoperative procedure to determine whether transgastric imaging of the abdominal aortic, mesenteric, and renal arteries could be obtained and whether pathologic lesions of these arteries could be identified. METHODS: Twelve patients with diagnoses of aortic aneurysmal or occlusive disease, chronic mesenteric ischemia, or renal artery stenosis that required operative treatment were examined. Preoperative transabdominal duplex imaging was performed in all 12 patients. Transgastric B-mode and color-flow ultrasonography of the abdominal aorta and branches was performed as an intraoperative procedure with the patients under general anesthesia. After the abdomen was opened but before the vascular reconstruction was performed, the transesophageal transducer was advanced into the stomach and directed by the surgeon's hand to obtain an image of the underlying aorta and branches. TAUS images were compared with those obtained by standard transabdominal duplex imaging. RESULTS: TAUS provided high-resolution images of both aneurysmal and occlusive aortic disease. In all 12 cases the images of the aortic lumen, plaque, and thrombus obtained with TAUS had greater detail and better resolution than those obtained with transabdominal duplex imaging. The origins of the renal arteries were seen with TAUS in 23 of 24 cases, whereas transabdominal ultrasonography obtained images of the origins in only 6 of 24 cases (p < 0.01). In the five renal arteries and the one mesenteric artery with hemodynamically significant stenoses in which transabdominal ultrasonography identified the stenoses based on velocity criteria alone, TAUS visualized the occlusive plaque at the origin of the renal and mesenteric arteries. CONCLUSION: Intraoperative TAUS is feasible and may be useful for evaluating atherosclerotic disease of the abdominal aorta and renal arteries.

Adult↗
PubMed1980

Infected aneurysms of the abdominal aorta.

Infected aneurysms of the abdominal aorta are relatively uncommon, but potentially lethal if improperly managed. Two case reports emphasize the importance of the preoperative aortogram for accurate diagnosis. We stress the principles of total excision of infected tissue and revascularization in uninfected tissue planes. A useful vascular reconstructive technique consisting of unilateral axillofemoral bypass and an ilioiliac anastomosis was used in both patients.

Aged↗
PubMed1992

Metabolic activity in inflammatory and non-inflammatory aneurysms of the abdominal aorta.

Inflammatory aneurysms of the abdominal aorta (IAA) comprise 10-15% of all aortic aneurysms (AA) but their aetiology and pathogenesis are obscure. Destruction of mural elastin is a prominent feature of IAA, and both increased elastolysis and decreased inhibition of elastolysis have been implicated. In order to study these factors, we have examined the peripheral blood of three groups of patients; 15 with inflammatory aortic aneurysms (IAA), 61 with simple aortic aneurysms (SAA) and 35 with aorto-iliac occlusive disease (OD). In all cases, alpha-1-anti-trypsin (A-1-AT), alpha-2-macroglobulin (A-2-MG), elastase inhibitory activity (E.I.A.), elastase-anti-trypsin complex, C-reactive protein (CRP), caeruloplasmin (CP) and plasma viscosity were measured. Patients with IAA had a significantly higher plasma viscosity (Mann-Whitney, p less than 0.05), E.I.A. (Mann-Whitney, p less than 0.01) and levels of A-1-AT, CRP, CP and elastase/anti-trypsin complex (Mann-Whitney, all p less than 0.05) than patients in the other two groups. There was no difference in the levels of A-2-MG between any of the groups. This study refutes the theory that reduced inhibition of elastase activity predisposes to the formation of SAA. In patients with IAA, raised marker levels indicate ongoing destruction of elastin, and suggest a difference in pathogenesis between IAA and SAA. The study also suggests that IAA are highly active metabolically, as opposed to the more degenerative SAA.

Acute-Phase Proteins↗
PubMed1980

Inflammatory aneurysm of the abdominal aorta.

Inflammatory aneurysms of the abdominal aorta are an uncommon variant of the arteriosclerotic variety. They are characterized by a perivascular peel of inflamed fibrous tissue. The radiographic appearance of such a case is presented.

Aortic Dissection↗
PubMed1983

Transluminal angioplasty of the abdominal aorta.

Transluminal angioplasty of the abdominal aorta was performed in 6 women between 49 and 69 years of age with histories of cigarette smoking. Five had a relatively small aorta. This procedure is effective in treating focal aortic stenoses.

Aged↗
PubMedDate not supplied

[Acute obstruction of the abdominal aorta].

The acute occlusion of abdominal aorta is a rare event that may have severe clinical results. Personal experience in three cases of acute thrombosis treated in emergency surgery are presented. Aorto-iliac thromboendarterectomy, aorto-bifemoral bypass and thrombectomy with Fogarty catheter were performed. In the first case, after the operation, a renal ischemia occurred. The second and the third patient died after seven days and twenty-four hours respectively.

Acute Disease↗
PubMed1996

[Effects of m-Nif and Nif on left ventricle hypertrophy in rats induced by partial ligation of abdominal aorta].

Partial ligation of the abdominal aorta of rats was adopted to induce left ventricle hypertrophy (LVH). The effects of m-nifedipine (m-Nif) and nifedipine (Nif) on prevention of hypertrophy and the possible mechanism were investigated. The wet weights of the left ventricle (WWLV) of the LVH group were increased compared with those of the sham operated group. After treatment with m-Nif and Nif for 4 wks, the WWLV decreased by 25% +/- 9% and 16% +/- 9%, respectively. The pressure-volume (P-V) curve of the hypertrophied group was markedly elevated, which means that the myocardial compliance was decreased, and the stiffness coefficient of the hypertrophied group was significantly elevated than that of the sham operated group, but the groups treated with m-Nif or Nif were significantly improved. The characteristics of the left ventricular myocardial DHP binding sites were studied. The results showed that the Kd and the Bmax were similar in the m-Nif, Nif and hypertrophied groups, but the total number of the DHP receptors (TNR) of the LVH group was markly increased than that of the sham operated group, but the TNR of the m-Nif and Nif groups were the same as that of the sham operated group. These results suggest that the effects of m-Nif and Nif on preventing cardiac hypertrophy and improving myocardial compliance may be related to their depressing the TNR of DHP.

Animals↗
PubMed1995

Giant aneurysm of the abdominal aorta.

A giant aneurysm of the abdominal aorta presented with a 2-3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the abdominal aorta with a maximum transverse diameter of 13.5 cm. The patient underwent successful emergency surgery, at which time a right-sided posterolateral rupture of the aneurysm was present. The patient remains alive and well 4 years later.

Aged↗