Detection of Atherosclerosis by Small RNA-Sequencing Analysis of Extracellular Vesicle Enriched Serum Samples.

Atherosclerosis can occur throughout the arterial vascular system and lead to various diseases. Early diagnosis of atherosclerotic processes and of individual disease patterns would be more likely to be successful if targeted therapies were available. For this, it is important to find reliable biomarkers that are easily accessible and with little inconvenience for patients.

Effect of endoleaks on changes in aortoiliac volume after endovascular repair for abdominal aortic aneurysm.

Purpose: To evaluate changes in aortoiliac volume after endovascular repair (EVAR) for abdominal aortic aneurysm (AAA) in patients with and without endoleaks.

Materials And Methods: We retrospectively analyzed 137 patients who underwent EVAR for AAA. We manually measured the aortoiliac volume on pre-procedural baseline CT angiograms (CTAs) and post-procedural follow-up CTAs.

Type A aortic dissection model to improve endovascular research and technologies.

Objective: Type A aortic dissection is a life-threatening disease requiring immediate surgical treatment. With emerging catheter-based technologies, endovascular stent-graft implantation to treat aneurysms and dissections has become a standardized procedure. However, endovascular treatment of the ascending aorta remains challenging.

A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after endovascular aneurysm repair.

Background: This study compared contrast-enhanced ultrasound (CEUS) imaging and multislice computed tomography (MS-CT) angiography in detecting and classifying endoleaks in the follow-up of patients after endovascular aneurysm repair (EVAR).

Methods: This retrospective study consisted of 171 patients with CEUS imaging and MS-CT angiography follow-up examinations after EVAR. During follow-up, 489 CEUS and 421 MS-CT examinations were assessed.

Prolonged overall survival after pulmonary metastasectomy in patients with breast cancer.

Background: We investigated whether overall survival (OS) in patients with primary breast cancer (BC) is prolonged by pulmonary metastasectomy and which prognostic criteria may facilitate the decision in favor of thoracic surgical intervention.

Methods: We assessed the median OS of 81 women after resection of pulmonary primary BC metastases by means of Kaplan-Meier estimators. Statistical interferences regarding prognostic factors were based on univariate log-rank tests and multivariate Cox proportional hazards regression.

Combined resection of colorectal hepatic-pulmonary metastases shows improved outcome over chemotherapy alone.

Background: The objective of this retrospective study was to assess the survival of patients after resection of hepatic and pulmonary colorectal metastases to identify predictors of long-term survival.

Methods: Patients receiving chemotherapy alone were compared to patients receiving surgery and chemotherapy in a matched-pair analysis with the following criteria: UICC stage, grading, and date of initial primary tumor occurrence.

Results: A total of 30 patients with liver and lung metastases of colorectal carcinoma underwent resection.

CT fluoroscopy guided percutaneous gastrostomy or jejunostomy without (CT-PG/PJ) or with simultaneous endoscopy (CT-PEG/PEJ) in otherwise untreatable patients.

Purpose: Percutaneous endoscopic gastrostomy (PEG) or percutaneous endoscopic jejunostomy (PEJ) are substantial for patients with swallowing disorders to maintain enteral nutrition or to decompress palliatively intractable small bowel obstruction. Endoscopic placement can be impossible due to previous (gastric) operation, obesity, hepato-splenomegaly, peritoneal carcinosis, inadequate transillumination, or obstructed passage. Computed tomography (CT)-fluoroscopic guidance with or without endoscopy can enable placement of CT-PG/CT-PJ or CT-PEG/CT-PEJ if endoscopically guided placement fails.

Time-resolved CT angiography for the detection and classification of endoleaks.

Purpose: To assess the feasibility and diagnostic performance of time-resolved computed tomographic (CT) angiography in the detection and classification of endoleaks after endovascular aortic aneurysm repair (EVAR) in high-risk patients.

Materials And Methods: The study was approved by our ethics committee. Written informed consent was obtained from all participating patients.

Management of thoracic aortic lesions--the future is endovascular.

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the "state-of-the-art" treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates.

Diagnostic accuracy of dynamic computed tomographic angiographic of the lower leg in patients with critical limb ischemia.

Objective: The purpose of this study was to assess the diagnostic accuracy of dynamic computed tomographic angiography (dyn-CTA) in patients with critical lower leg ischemia.

Materials And Methods: A population of 29 patients with known peripheral arterial occlusive disease (Fontaine stage III or IV) was examined with a combined CTA protocol consisting of a standard CTA (s-CTA) of the lower leg runoff from the diaphragm to the toes and dyn-CTA of the calves (scan range, 48 cm; 8 phases; 3.5 seconds per phase, 100 kV; 120 mAs; contrast volume, 50 mL; flow rate, 5.

Time-resolved CT angiography in aortic dissection.

Objectives: We performed this study to assess feasibility and additional diagnostic value of time-resolved CT angiography of the entire aorta in patients with aortic dissection.

Materials And Methods: 14 consecutive patients with known or suspected aortic dissection (aged 60±9 years) referred for aortic CT angiography were scanned on a dual-source CT scanner (Somatom Definition Flash; Siemens, Forchheim, Germany) using a shuttle mode for multiphasic image acquisition (range 48 cm, time resolution 6s, 6 phases, 100 kV, 110 mAs/rot). Effective radiation doses were calculated from recorded dose length products.

Endovascular versus open treatment of degenerative aneurysms of the descending thoracic aorta: a single center experience.

Multiple reports could show a reduced risk for thoracic endovascular aortic repair (TEVAR) compared with open treatment. The aim of this study was to evaluate our twelve-year TEVAR experience for thoracic aortic aneurysms and compare these results with open repair. All patients who had received either open or endovascular surgery for a degenerative aortic aneurysm of the descending thoracic aorta in our center were evaluated retrospectively.

Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy.

Background: Anastomotic leakage after esophagectomy is an important determinant of early and late morbidity and mortality. Control of the septic focus is essential when treating patients with anastomotic leakages. Surgical and endoscopic treatment options are limited.

Diagnostic value of time-resolved CT angiography for the lower leg.

Objective: The aim of this study was to test the feasibility of time-resolved computed tomography angiography (TR-CTA) for use in the lower leg.

Methods: Fifty-nine patients with suspected peripheral arterial occlusive disease were examined with a standard CTA (S-CTA) of the lower run-off and with an additional TR-CTA of the calves (12 phases; 2.5 s/phase, 80 kV, 120 mAs, volume of contrast medium 50 mL, flow rate 5.

First experience using intraoperative contrast-enhanced ultrasound during endovascular aneurysm repair for infrarenal aortic aneurysms.

Background: Endovascular aortic repair (EVAR) has become an additional treatment option for patients with infrarenal aortic aneurysms and suitable aortic morphology. However, endoleaks are commonly encountered and represent a relevant risk for secondary treatment failure. In addition, impaired renal function or allergic reactions to intravascular iodine application might represent exclusion criteria for conventional infrarenal endovascular aortic repair using intraoperative angiography with iodine contrast media.

Strategies for prevention and operative treatment of aortic lesions related to spinal interventions.

Study Design: A retrospective analysis of a case series was performed.

Objective: To give recommendations for the prevention and operative treatment of thoracic and thoracoabdominal aortic lesions in association with spinal interventions.

Summary Of Background Data: Aortic lesions after spinal interventions for traumatic vertebral fractures, segmental spondylodiscitis, or vertebral metastasis are fortunately rare, but associated with a high perioperative mortality rate and absolute numbers are unknown.

Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method.

Background: Conservative treatment of anastomotic leakage after anterior resection of the rectum seems to be possible in patients who have no occurrence of generalized peritonitis. This report describes a new method of endoscopic management of large anastomotic leakage in these patients.

Method: The main feature of this new method is the endoscopically assisted placement of an open-cell sponge connected to a vacuum device into the abscess cavity via an introducer device.

Surgical and endovascular treatment of symptomatic aberrant right subclavian artery (arteria lusoria).

Right aberrant subclavian artery, also called arteria lusoria, is one of the most common intrathoracic arterial anomalies. Although mostly asymptomatic, the retroesophageal and retrotracheal course of the lusorian artery might result in unspecific thoracic pain, dysphagia, dyspnea, arterioesophageal or arteriotracheal fistulae with hematemesis or hemoptysis, and aneurysmal formation with relevant risk of rupture. The purpose was to present our experience with six patients with a symptomatic aberrant right subclavian artery, two patients with dysphagia or dyspnea caused by a nonaneurysmal lusorian artery, and four patients with arteria lusoria aneurysms.

Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

Stent versus open surgery for acute and chronic traumatic injury of the thoracic aorta: a single-center experience.

Background: Traumatic injuries of the thoracic aorta have a high morbidity and mortality. Treatment options include either open surgery or endovascular stent graft implantation.

Methods: We have reviewed retrospectively all our patients treated for acute and chronic traumatic injury of the thoracic aorta and compared the outcome of the endovascular versus open therapy.