Objective: Induced hypothermia improves outcome in aortic arch surgery, neonatal neurointensive care, and transplant surgery for example. In contrast, spontaneous hypothermia has been associated with worse outcomes in patients suffering from hemorrhagic shock, mostly explained by its adverse effects on the coagulation system. We investigated if induced hypothermia would impair short-term survival in experimental aortic rupture with retroperitoneal bleeding.
Methods: Anesthetized pigs were randomized into 2 groups: hypothermia by peritoneal lavage of ice-cold Ringer's acetate and external cooling ( = 10) and normothermia ( = 10). Aortic rupture with retroperitoneal bleeding was induced by endovascular means creating a 6 mm hole in the retroperitoneal portion of abdominal aorta. Survival (primary outcome), hemodynamics, and arterial blood gases including lactate were collected and analyzed up to 180 min after aortic rupture.
Results: The body temperature (mean ± standard deviation) in the hypothermic group was 31.5 ± 1.0 °C and 38.7 ± 0.4 °C in the normothermic group at the time for aortic rupture. Survival up to 180 min after the retroperitoneal bleeding was significantly higher in the hypothermic compared with the normothermic group ( = 0.023).
Conclusions: Induced hypothermia did not impair survival in this experimental retroperitoneal aortic bleeding model in anesthetized pigs. This finding may indicate a minor role for the coagulation system in this type of bleeding.
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http://dx.doi.org/10.1177/15569845241253234 | DOI Listing |
Physiol Meas
January 2025
Electronics, Universidad Favaloro, Solis 453, Buenos Aires, Buenos Aires, 1078, ARGENTINA.
Aortic dilatation is a severe pathology that increases the risk of rupture and its hemodynamics could be accurately assessed by using the 4D flow cardiovascular magnetic resonance (CMR) technique but flow assessment under complex flow patterns require validation. The aim of this work was to develop an in vitro system compatible with CMR to assess the accuracy of volume flow measurements in dilated aortas. Approach.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Department of Surgery, University of Rochester School of Medicine, Rochester, NY.
Type B aortic dissection (TBAD) represents a serious medical emergency with up to a 50% associated 5-year mortality caused by thoracic aorta, dissection-associated aneurysmal (DAA) degeneration, and rupture. Unfortunately, conventional size-related diagnostic methods cannot distinguish high-risk DAAs that benefit from surgical intervention from stable DAAs. Our goal is to use DAA stiffness measured with magnetic resonance elastography (MRE) as a biomarker to distinguish high-risk DAAs from stable DAAs.
View Article and Find Full Text PDFRes Pract Thromb Haemost
January 2025
Division of Vascular Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Background: Abdominal aortic aneurysm (AAA) is characterized by the proteolytic breakdown of the extracellular matrix, leading to dilatation of the aorta and increased risk of rupture. Biomarkers that can predict major adverse aortic events (MAAEs) are needed to risk stratify patients for more rigorous medical treatment and potential earlier surgical intervention.
Objectives: The primary objective was to identify the association between baseline levels of these biomarkers and MAAEs over a period of 5 years.
J Endovasc Ther
January 2025
Aortic Center, Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint Joseph, Université Paris-Saclay, INSERM UMR_S 999, Le Plessis Robinson, France.
Introduction: Management of patients with large aortic arch aneurysms who are considered high risk for frozen elephant trunk technique have been challenging, especially when they have a dilated ascending aorta (AA) that precludes total endovascular branched repair (arch BEVAR). A viable option in our armamentarium is wrapping of the AA (AW), and zone 0 Ishimaru TEVAR.
Methods: Retrospective analysis of our aortic database from 2013 to 2024 to select high-risk patients with aortic arch aneurysm that had an AW and TEVAR.
Most thoracic aortic aneurysms (TAAs) are asymptomatic and often diagnosed at the time of rupture. TAAs involving the proximal arch require adequate coverage with thoracic endovascular aortic repair, which is timely and challenging in emergent ruptures. In situ laser fenestration is a novel method of arch revascularization.
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