Predominance of type 1 CD4+ T cells in human abdominal aortic aneurysm.

The functional repertoire of T cells in abdominal aortic aneurysm (AAA) and the exact nature of aortic wall adaptive cellular immune responses still remains a matter of debate. In this study, we sought to determine whether type 1 or type 2 responses occur predominantly in human aneurysmal aortic lesions. We first examined the phenotype and cytokine secretion profile of T lymphocytes freshly isolated from aneurysmal aortic wall for comparison with their circulating counterparts using flow cytometry.

Congenital right subclavian artery aneurysm: a case report.

Aneurysms of the subclavian artery are unusual. The most common causes are atherosclerosis and trauma. We report one case of an elongated and tortuous right subclavian artery with an aneurysm involving the origin of the right vertebral artery.

[Mycotic aneurysm of the extracranial internal carotid artery].

Extracranial internal carotid artery aneurysm is rare. They usually appear as an enlarging pulsatile neck mass with associated tenderness and fever. The diagnosis is difficult and can lead to significant medical morbidity.

[The medico-surgical department of vascular disease].

The Department of Vascular Diseases can be defined as a multidisciplinary integrated clinical entity involving internists and surgeons interested in patient care, education and research in the field of arterial, venous and lymphatic diseases. Because of the increasing medical complexity with the proliferation of treatment options available, the combined expertise of specialists from different training background is required to provide the optimal patient management. The truly integrated entity with interactions on daily basis between internists and surgeons also provides opportunities for improvement in the training of fellows in vascular medicine.

Lumbar paraspinal rhabdomyolysis and compartment syndrome after abdominal aortic aneurysm repair.

Lumbar paraspinal compartment syndrome is an extremely uncommon condition that is known to occur after strainful exercise or trauma. We report on the original case of a 55-year-old man in whom lumbar paraspinal rhabdomyolysis and compartment syndrome developed after open abdominal aortic aneurysm repair, documented with technetium Tc(99m) bone scan and computed tomographic imaging, and in whom successful complete recovery was achieved with conservative management. Clinical features, pathophysiology, and diagnostic and therapeutic strategies of this unusual adverse event are discussed.

Embolization of large aneurysms with long wire coils.

The authors report the experience of using long coils of 2 m length in the management of large aneurysms. Knowledge of the characteristics of these coils is of value for correct placement. These coils are safe and cost-effective for excluding large aneurysms.

Early inflammatory response after elective abdominal aortic aneurysm repair: a comparison between endovascular procedure and conventional surgery.

Objective: To determine the nature of and to compare the inflammatory responses induced by (1) endovascular and (2) conventional abdominal aortic aneurysm (AAA) repair.

Material And Methods: Twelve consecutive patients undergoing elective infrarenal AAA repair were prospectively studied. Seven patients were selected for endovascular procedures (the EAAA group); five patients underwent open surgery (the OAAA group).

Abdominal aortic coarctation with splanchnic arterial occlusion.

Abdominal aortic coarctation is found in only 2% of aortic coarctation and is usually manifested by renovascular hypertension. Splanchnic arterial occlusive lesions occur in 22% of these patients and are exceptionally symptomatic. We present a case report of a young patient with abdominal aortic coarctation causing hypertension and visceral angina.

Adventitial cystic disease of the popliteal artery communicating with the knee joint. A case report.

We describe the case of a patient with adventitial cystic disease of the popliteal artery in which a direct anatomic communication between the cysts and the nearby knee joint was demonstrated by magnetic resonance imaging and confirmed by surgery. This unusual observation could shed some light on the much debated question of the cause, the pathogenesis, and the management of the affection. Moreover, it emphasizes the importance and the role of magnetic resonance imaging in the diagnosis of adventitial cystic disease of the popliteal artery.

Occluding aortic endoluminal stent graft combined with extra-anatomic axillofemoral bypass as alternative management of abdominal aortic aneurysms for patients at high risk with complex anatomic features: a preliminary report.

Purpose: To describe an exclusion endoluminal technique for management of abdominal aortic aneurysms among high-risk patients with complex anatomic features.

Methods: From January 1995 to December 1996, among 143 patients with infrarenal abdominal aortic aneurysm treated by means of endograft placement, 9 (6.3%) had complex aortic or aortoiliac morphologic features.

[The role of season in the incidence of deep venous thrombosis].

Introduction: The question of the role of season as a predisposing factor for development of venous thromboembolic disease still remains a matter of debate. Actually, most reports described a higher incidence of thrombotic disorders in winter, while a recent study showed no seasonal variation in the incidence of deep vein thrombosis (DVT). These data led us to study the seasonal distribution of all outpatients with DVT admitted to our Department over a period of 14 years.

Intravenous nicardipine in the treatment of postoperative arterial hypertension.

Background: Calcium entry blockers are commonly used in the management of postoperative hypertension. The hemodynamic and blood gas effects of nicardipine, a dihydropyridine derivative available intravenously, were studied in patients after abdominal aortic surgery.

Methods: Sixteen patients (66 +/- 8 years) who developed arterial hypertension (mean arterial pressure, > 90 mmHg) after abdominal aortic aneurysm reconstruction were studied.

Endovascular aortic stent-grafts: transcatheter embolization of persistent perigraft leaks.

Purpose: To assess efficacy of transcatheter embolization of peri prosthetic leaks from aortic stent-grafts

Materials And Methods: Eight patients with a long-standing (3-13 months) perigraft leak after stent-graft implantation underwent transcatheter embolization. Leakage was demonstrated at helical computed tomography (CT). Angiography was performed for evaluation of outflow vessels and transcatheter embolization.

A self-expanding bifurcated endovascular graft for abdominal aortic aneurysm repair. An initial study in a canine model.

Approximately 50,000 abdominal aortic aneurysms (AAAs) are surgically repaired annually in the United States. Endovascular grafts (EVGs) combine a stent and a vascular graft offering great potential for reduced morbidity, mortality, and hospital stay because of minimally invasive endoluminal placement through catheters. Because most AAAs extend into one or both iliac arteries, a bifurcated EVG (bEVG) was developed, consisting of a proximal aortic trunk divided into two distinct lumens or sockets to receive two smaller diameter leg (iliac) components.

[Treatment of abdominal aortic aneurysm by application of a Corvita endoprosthesis. Medium-term results of a feasibility study].

Despite improvements in surgical techniques, progress in anesthesia and hemodynamic control, the risk of fatal outcome in the standard surgical technique for aneurysms of the abdominal aorta remains at about 5 to 6% due to associated coronary and pulmonary lesions. Surgical access to the aneurysm may also be hindered in patients with a past history of multiple abdominal operations. In collaboration with the Corvita company, we developed a modular endoprosthesis for endoluminal treatment of AAA and report the results of a feasibility study.

[Livedo vasculitis: report of a case].

Livedo vasculitis is an occlusive thrombotic hyalinizing vessel disease characterized by parietal hyalinization, endothelial proliferation, fibrin deposits and formation of thrombi within the superficial and deep dermal vessels. Diagnosis, essentially clinical, emphasizes the clinical and histopathological features of livedo vasculitis. We conducted an etiological investigation in our case, as required to diagnose idiopathic livedo vasculitis.

[Long occlusion of the superficial femoral artery: revascularization by compliant prosthesis].

We believe that the use of prosthetic grafts is justified in the treatment of long occlusions of the superficial femoral artery. However the surgery should only be done in cases where patients are suffering from severe claudication and in cases of critical ischemia of the lower limbs. We report herein the mid-term results of an European multicentric prospective study of a new prosthesis which is compliant, ultraporous and made of polycarbonate.

Femoropopliteal bypass with a compliant, composite polyurethane/Dacron graft: short-term results of a multicentre trial.

A new, compliant, highly porous, non-woven, polyurethane vascular prosthesis has been developed in an effort to improve on the performance of currently available prosthetic grafts for infrainguinal reconstruction. From April 1990 to August 1991, 57 femoropopliteal bypass grafts were implanted in 47 patients by surgeons at five university centres. In all instances, the saphenous vein was unavailable, unusable or reserved for use elsewhere.

Vascular graft infection caused by Aspergillus species: case report and review of the literature.

We report an unusual case of vascular graft infection caused by Aspergillus fumigatus that began with a false aneurysm, major arterial emboli, and septic arthritis. Successful treatment included resection of the infected graft, restoration of circulation by extraanatomic bypass, and administration of amphotericin B and itraconazole, a new antifungal agent. Graft infection in the case reported herein most likely occurred during surgery and took place during an insidious outbreak of postoperative infection.

Role of the captopril test in renovascular hypertension: a case report.

This article reports the case of a rapidly severe stenosis of the right renal artery, causing uncontrolled hypertension. After failure of a percutaneous transluminal renal angioplasty, which provoked the thrombosis of the vessel, a surgical revascularization was performed after +/- eighteen hours of renal ischemia. Blood pressure, blood urea nitrogen and serum creatinine returned to normal values.