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At least 109 records · Page 6Linked to original sources
PubMed1983

Spatial dispersion of foam cells in the human thoracic aorta.

The lateral walls of the thoracic aorta in the human have a valuable property that permits useful studies of atherogenesis. Each of the points in the sample is similar to all other points, and, therefore, a collection of such points can be treated as a random sample from a defined population. Lateral walls of 215 aortas from subjects of ages 15 to 69 years were sectioned in paraffin and stained with hematoxylin and eosin. These were evaluated at 40 anatomically defined sites, 20 on the left and 20 on the right. Presence or absence of atheronecrosis was noted. In the absence of necrosis, each 100-microns thick layer of intima was assessed for presence or absence of foam cell infiltration. In the presence of necrosis, the fibrous cap was assessed. The prevalence of foam cell infiltrates was strongly associated with intimal thickness, with depth within the intima, and with the presence of atheronecrosis. The association was alike in all 10-year age groups from 30 to 69 years, indicating the existence of a steady state in which intimal thickness determines the prevalence of foam cells without regard to age. Infiltrates were greatest at intimal thicknesses of 400 to 600 microns and were scarce at distances greater than 300 microns from the endothelium. In the absence of atheronecrosis, foam cells were found abundantly in the surface layers of the more thickened regions of intima. The deeper layers acquired that characteristic after the onset of atheronecrosis. An explanation for these findings is not immediately apparent. The focal character of atheronecrosis and of foam cell infiltrates demands that evaluation of a specimen for these features must use a large sample of tissue. Combining left and right thoracic aorta into strips of tissue of 22 to 30 cm total length yields estimates of foam cell involvement which have disappointingly large confidence intervals. Thus, the observed condition of a specimen evaluated at autopsy may be strongly influenced by random sampling variation.

Adolescent↗
PubMed2002

Stent grafts for the thoracic aorta: a new paradigm?

The treatment of thoracic aortic pathology is complicated by the morbidity of the surgical procedure, and the comorbidities encountered in an elderly population. Stent grafts have now been used for approximately 10 years for the treatment of thoracic aneurysmal disease, management of aortic dissections, intramural hematoma, and giant penetrating ulcers, and for traumatic aortic tears, with impressive early results. However, these efforts have been significantly limited by the lack of a commercially available stent graft specifically designed for the thoracic aorta, the lack of real long-term follow-up, and the failure of experience in the abdominal aorta to translate to the thoracic aorta. Nevertheless, significant and even unique therapies have been enabled by stent graft technology for the treatment of the above-mentioned diseases. It is likely that, with more sophisticated technology and improved understanding of thoracic aortic pathology, stent graft use will expand, and its utility will be further clarified.

Aortic Dissection↗
PubMed1992

[Traumatic rupture of the aortic isthmus revealed by acute obstruction of the descending thoracic aorta].

A traumatic transection of the upper descending thoracic aorta, undiagnosed, was complicated on the tenth day by an acute obstruction of the descending thoracic aorta. The upper body hypertension resulted in generalised convulsions and cardiac failure with pulmonary oedema. The lower body ischemia resulted in paraplegia, acute ischemia of the lower limbs, liver failure and anuria. An emergency revascularisation of the lower body was achieved by axillary-bifemoral bypass. The improvement of the clinical status allowed complete repair of the aortic transection two days after the extra-anatomic revascularisation. This case emphasizes the severity of the cases with impaired blood flow to the lower body and the benefit of the extra-anatomic bypass in pathology of the upper descending thoracic aorta when complete repair of the aortic transection is associated with an extremely high risk.

Acute Disease↗
PubMed1985

Adequacy of ascending aorta-descending aorta shunt during cross-clamping of the thoracic aorta for prevention of spinal cord injury.

The effectiveness of various sized shunts placed between the ascending and the descending aorta to prevent paraplegia in dogs with the thoracic aorta cross-clamped for 1 hour was tested. Three tapered shunts sizes were used with tip dimensions of 3.8, 5.2, and 6.3 mm inner diameter, with cross-sectional areas of 11.34, 21.23, and 33.18 mm2, respectively, and with an equal midportion diameter of 10 mm (3/8 inch). These shunts carried 40%, 60%, and 72% respectively, of baseline descending aortic flow during the cross-clamping period. Flow distribution was measured with radioactive microspheres in the spinal cord (gray and white matter) and kidneys. All dogs without shunts (Group I) developed paraplegia, severe proximal circulatory embarrassment, and severe ischemia of the spinal cord (mainly gray matter) that was followed by marked hyperemia persisting up to 24 hours following the experiment. Mortality was 33%. Only animals treated with large shunts (Groups III and IV) avoided paraplegia and postischemic injury. An effective shunt was characterized as carrying 60% or more of baseline descending aortic flow, having a cross-sectional area at its tip equal to or larger than 29% of the descending aorta, and equaling at least 54% of its diameter. Porportionately, the size of the tridodecylmethylamonium-heparin shunts being used in human beings (even the largest 9 mm inner diameter) is significantly inadequate to maintain distal flows and pressures for the prevention of spinal cord injury. Four clinical options are discussed.

Adrenal Glands↗
PubMed2003

[Treatment of strategy for traumatic disruption of the thoracic aorta accompanied by multiple trauma].

Disruption of the thoracic aorta due to blunt chest trauma is often fatal and should generally be treated surgically as soon as possible. However, cases of disruption of the thoracic aorta due to blunt chest trauma are often complicated by damage to vital organs, making treatment difficult. Our policy is to treat other organs before treating the thoracic aorta in 1) cases in which fracture of the pelvic bone or bleeding from abdominal cavity organs is causing shock and 2) cases of severe cerebral contusion or intracranial hemorrhage that require emergency surgical treatment. The use of a stent for treatment of acute-stage cases should be considered prudently.

Accidents, Traffic↗