P5190Endovascular repair for blunt thoracic aortic injury: subsequent heart structure and vascular function
Paola VallerioIlenia D’AlessioAlessandro MalobertiM. CaraccioloBenedetta De ChiaraFrancesco PanseraEnea SpadaMarco CarbonaroAlessio PerettiS. MaggioniValentina CantuMaría Cristina FerraraBruno PalmieriAlfredo ListaCristina Giannattasio
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Vascular diseases -1 1079 as primary patency, freedom from stent occlusion and major adverse limb events (MALE) using Kaplan-Meier method.Stent patency was assessed by either duplex ultrasound or angiography.Results: Mean follow-up period was 1232±650 days.Primary patency of BMS and DES were 81% vs 85% at a year and 71% and 63% at 3 years.(p=0.52)Freedom from stent occlusion were 92% vs 91% at a year and 88% vs 79% at 3 years.(p=0.22)Freedom from MALE at 3 years was 95% vs 90%.(p=0.22)Kaplan-Meier estimation curve showed that incidence of stent occlusion over a year was significantly higher in DES group.(p<0.05)Conclusion: Though 3 year clinical outcomes after EVT with BMS and DES were not significantly different, DES causes higher incidence of stent occlusion in chronic phase.Keywords:
Aortic repair
Thoracic aorta
Thoracic aorta
Dorsal aorta
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Regional heterogeneity exists in reactivity of different vascular beds to vasoactive substances. Experiments were designed to determine if there are differences between thoracic and abdominal aorta response to acetylcholine-induced relaxation. Ten male Sprague-Dawley rats with a weighing between 200g-250g were used. The aorta was isolated and 3mm aortic rings were cut and suspended in organ baths containing physiological salt saline (PSS). Contractile and relaxation responses to noradrenaline (NA) and ACh, in the presence or absence of L-NNA and high K+ concentration were studied. Contractile response to NA was similar along the aorta. At the higher doses, ACh elicited a greater (p < 0.05) relaxation in the abdominal aorta when compared with the thoracic aorta. However, inhibition of eNOS was more effective (p<0.05) in preventing ACh-induced relaxation in the thoracic aorta when compared with the abdominal aorta. Conversely, inhibition of endothelial hyperpolarizing factor (EDHF) by high K+ concentration blocked ACh-induced relaxation to a greater extent in the abdominal aorta (p<0.05) when compared with the thoracic aorta. ACh-induced relaxation differs in the thoracic and abdominal aorta. Differences in the EDHF activity along the aorta underlie the differential response of the thoracic and abdominal aorta to ACh-induced relaxation.
Abdominal aorta
Thoracic aorta
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Objective:To explore the value of preoperative spiral CT examination in the diagnosis of invaded thoracic aorta by esophageal carcinoma. Methods: All the 100 patients with diagnosed esophageal carcinoma by pathological examination took spiral CT and were analyzed preoperatively. Exist of fat space between e-sophagus and thoracic aorta, the thickness of esophagus wall and the angle of esophagus touched thoracic aorta were the criteria of diagnosis. All the results of spiral CT examination were compared with the results of their postoperative histopathological status. Results:(1) Among 18 cases with fat space between e-sophagus and thoracic aorta disappeared, 14 cases thoracic aorta invaded(77. 78%), 4 cases thoracic aorta noninvaded(12. 22%) ;(2) Among 12 cases with the thickness of esophagus wall less than 1cm, 3 cases thoracic aorta invaded(25. 00%), 9 cases thoracic aorta noninvaded(75. 00%). Among 23 cases with the thickness more than 2cm, 19 cases thoracic aorta invaded(82. 61%), 4 cases thoracic aorta noninvaded(17. 39%). Among 65 cases with the thickness between 1cm and 2cm, 8 cases thoracic aorta invaded(12. 31%), 57 cases thoracic aorta noninvaded(87. 69%). sensitivity, specificity, accuracy were 82. 35%(14/ 17), 95. 18%(79/83), 93. 00%(93/100) respectively; (3) Among 43 cases with the angle of esophagus touched thoracic aorta less than 45 degree, 4 cases thoracic aorta invaded(9. 30%), 39 cases thoracic aorta noninvaded(90. 70%). Among 17 cases with the angle more than 90 degree, 12 cases thoracic aorta inva-ded(70. 59%), 5 cases thoracic aorta noninvaded(29. 41%). Among 40 cases with the angle between 45 and 90 degree, 17 cases thoracic aorta invaded(42. 50%), 23 cases thoracic aorta noninvaded(57. 50%). Accuracy was 85. 00%. Conclusion; Preoperative spiral CT examination has a greater value in the diagnosis of the invaded thoracic aota by esophageal carcinoma.
Thoracic aorta
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Objective:To compare and analyze the imaging features of pulmonary sequestration(PS)supplied by thoracic aorta and supplied by abdominal aorta.Methods:A retrospective analysis was performed in 23 patients with PS confirmed by pathology after operation and the CT images were comparatively analyzed according to the source of blood supply.Results:Of the 23 patients with PS,16 cases were supplied by thoracic aorta and 7of them had two supplying arteries,7cases were supplied by abdominal aorta.The lesions appeared as mass with soft tissue density in 21 cases.One case supplied by thoracic aorta showed cystic heterogeneous density.In one case supplied by thoracic aorta,focal thick vessel was shown.The average diameter and length of the supplying arteries from thoracic aorta were(4.8±2.2)mm and(37±12)mm respectively,while these from abdominal aorta were(3.3±0.5)mm and(104±42)mm respectively.The length of supplying arteries and volume of sequestrated lung tissues supplied by thoracic aorta were smaller than those supplied by abdominal aorta(P0.001).Conclusion:PS supplied by thoracic and abdominal aorta share similar imaging features.The length of supplying arteries and the volume of sequestrated lung tissues supplied by thoracic aorta are different from those supplied by abdominal aorta.
Abdominal aorta
Thoracic aorta
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The contents of ATP, ADP, AMP and calcium in the thoracic aorta were determined in rats with moderate uraemia, and in rats with the same degree of uraemia following treatment with 1,25-dihydroxycholecalciferol (1,25-DHCC). The contents of ATP, ADP and total nucleotides were decreased in the thoracic aorta in the uraemic rats but not in uraemic rats following 1,25-DHCC treatment. The content of calcium in the aorta increased substantially in uraemic rats given 1,25-DHCC. The results indicate that the development of arterial calcifications in uraemic rats following vitamin D treatment is dissociated from an impaired energy metabolism, since vitamin D may simultaneously restore impaired energy metabolism and accumulate calcium in the aortic wall.
Thoracic aorta
Energy charge
Adenine nucleotide
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Atherosclerosis was produced in dogs by feeding them thiouracil and cholesterol. The increments in cholesterol concentration at sites along the length of the aortas of these dogs Avere determined by subtracting from the value for each site the corresponding value obtained from normal dogs. After about 1 month on the experimental regimen the cholesterol increments along the length of the aorta formed a gradient. The increment was greatest in the proximal aorta and progressively less down the length of the aorta. After about 5 months on the regimen, the gradient no longer existed. Instead, the cholesterol increment in the abdominal aorta exceeded that in the thoracic aorta. Albumin is known to enter aortic wall with a gradient of rates that is similar to the gradient of cholesterol increments early in the course of experimental atherosclerosis. The foregoing facts are consistent with the following theory: In the development of atherosclerosis, intact low-density lipoproteins containing cholesterol enter the aortic wall with a gradient of rates. They enter fastest in the proximal aorta and progressively less rapidly down the length of the aorta. However, cholesterol is removed from the abdominal aorta much more slowly than from the thoracic aorta. Thus, the increment in cholesterol concentration in the abdominal aorta eventually exceeds that in the thoracic aorta.
Abdominal aorta
Thoracic aorta
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Irisin, a polypeptide hormone that is released from skeletal muscle in response to exercise, has been found to improve endothelial functions, protect against endothelial injuries and change blood pressure, which also affected blood vessels. The aim of this study was to assess the histological changes of the rat thoracic aorta in response to irisin injection.Twenty-four rats were used. They were divided into two groups: the control group without irisin injection and the irisin-injected group subdivided into three subgroups treated with different irisin concentrations (20, 40 and 160 nM, respectively) twice a week for 4 weeks. The control group and irisin-treated subgroups consisted of 6 rats each. After 4 weeks all rats were sacrificed, and the descending thoracic aorta was treated for histological evaluation. Sections were stained with haematoxylin and eosin and orcein stains. Morphometric measurement included: intima-media thickness, number of elastic lamellae and number of smooth muscle cells' nuclei.Histological study showed that intraperitoneal injection of different concentrations of irisin (20, 40 and 160 nM) in rats increased intima-media thickness, the number of smooth muscle cell's nuclei and the number of elastic lamellae in media layer of the thoracic aorta in a dose-dependent manner.Irisin significantly affected the morphology of the wall of the rat thoracic aorta indicating a role of irisin in influencing the growth factors of the thoracic aorta walls and activating smooth muscle cells in the thoracic aorta layers.
Thoracic aorta
Intraperitoneal injection
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Aortic repair
Cardiothoracic surgery
Aortic surgery
Thoracic aorta
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Senescence
Thoracic aorta
Lipid peroxide
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Blunt thoracic aortic injury (BTAI) has a high mortality rate, and the occurrence of clinical complications is high. Several studies have reported the efficacy of thoracic endovascular aortic repair (TEVAR) for BTAI. This study aimed to clarify the use of TEVAR for BTAI.We analyzed 10 cases of TEVAR for BTAI from July 2011 to December 2020 at our hospital. Five of 10 cases of BTAI were caused by road traffic accidents, while five were caused by falls from a height.The mean patient age was 59.3 years. When arriving at our hospital, seven of 10 patients were in shock. Nine of 10 cases of BTAI were at the aortic isthmus. With respect to BTAI severity, five of 10 patients were categorized as grade IV. Ps of non-survivors were extremely low. All patients underwent TEVAR. The mean surgical duration and volume of intraoperative blood loss were 77.5 minutes and 234 ml, respectively.The results of TEVAR for BTAI at our institution support previous reports, which show excellent clinical results. To further improve the outcomes, we must clarify the adaptation of nonoperative management (delayed repair), the optimal timing of invasive treatment, and the importance of long-term follow-up.
Aortic repair
Cardiothoracic surgery
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