The Effect of Fiber Optic RealShape (FORS) Technology on Peri- and Post-Operative Outcomes following Complex Abdominal Aortic Repair.

Introduction: Ongoing innovations in the minimally invasive management of complex abdominal aortic aneurysms (cAAA), including physician-modified endografts (PMEG) and, more recently, Fiber Optic RealShape (FORS) technology, have allowed vascular surgeons to expand surgical indications and complexity of care to this multifaceted patient population. Prior analyses have demonstrated intraoperative advantages of FORS in the management of cAAA for lower total procedural radiation and cannulation tasks, however, few analyses have evaluated the technology's effect on peri- and post-operative outcomes.

Methods: All PMEGs performed at our institution between 2020-2024 were retrospectively reviewed.

Long-Term Outcomes and Late Complications of Thoracic Endovascular Aortic Repair Using the GORE TAG or Conformable GORE TAG.

Purpose: Previous clinical studies have reported on the short- and mid-term prognoses of thoracic endovascular aortic repair (TEVAR) using the GORE thoracic aortic graft (TAG) or conformable GORE TAG. We evaluated the long-term prognoses of patients who underwent TEVAR using the GORE TAG or conformable GORE TAG in a real-world setting.

Materials And Methods: This retrospective observational study analyzed the data of all consecutive patients aged 20 years or older who underwent TEVAR using either the GORE TAG or the conformable GORE TAG at a single center.

ACKR1ECs Promote Aortic Dissection Through Adjusting Macrophage Behavior.

Background: Type A aortic dissection (TAAD) is a life-threatening condition characterized by complex pathophysiology, in which macrophages play a critical but not yet fully understood role. This study focused on the role of endothelial cells with elevated expression of ACKR1 (atypical chemokine receptor 1) and their interaction with proinflammatory macrophages in TAAD development.

Methods And Results: Single-cell transcriptomic analysis of human aortic tissues revealed increased populations of endothelial cells exhibiting high ACKR1 expression and proinflammatory macrophages in TAAD samples.

Endovascular stent graft treatment for stenosis in isolated infrarenal abdominal aortic dissection: A case report.

We report a case of complicated isolated infrarenal abdominal aortic dissection (IAAD) that was treated with stent graft. A 79-year-old man presented with acute bilateral lower limb pain. A contrast-enhanced CT performed 2 h later revealed sever stenosis of infrarenal abdominal aorta due to IAAD.

Staged, hybrid approach by zone 2 arch replacement and completion thoracic endoprosthesis in retrograde acute type A aortic dissection.

We describe a case of retrograde acute type A aortic dissection approached by a hybrid, staged approach consisting of a zone 2 arch replacement and completion thoracic endovascular aortic repair procedure combined with distal balloon-assisted stent graft dilatation to prevent retrograde false lumen flow. This technique may be an alternative and more complete when compared with a frozen elephant trunk procedure at onset. Additionally, favorable remodeling of the entire thoracic aorta is observed.

Comprehensive Genetic Testing for Coexisting Marfan and Loeys-Dietz Syndromes in Hereditary Thoracic Aortic Disease.

Hereditary thoracic aortic disease (HTAD) is a rare heritable condition with several subtypes, including Marfan syndrome (MFS), vascular Ehlers-Danlos syndrome, and Loeys-Dietz syndrome (LDS). Although MFS is the most common type of HTAD caused by mutations in , differentiation from other conditions such as LDS is crucial due to the varying clinical courses. We report the case of a family history of early-onset ascending aortic dissection initially diagnosed as MFS based on a pathogenic variant of .

Successful Investigational Phage Therapy for Pan-Resistant Bacterial Mediastinitis Following Type II Hybrid Aortic Arch Replacement.

A 47-year-old woman presented to our hospital with Stanford type B aortic dissection with retrograde arch extension. The decision was made to undergo hybrid arch repair with thoracic endovascular aortic repair. The patient underwent surgery, but her intraoperative course was complicated by delayed sternal closure and mediastinitis requiring flap reconstruction.

A Case Report of Acute Pericarditis Presenting With Acute Aortic Dissection.

This case report presents a rare occurrence of acute pericarditis coinciding with acute aortic dissection (AAD), emphasizing the significance of recognizing and managing these dual conditions effectively. It highlights the necessity of a multidisciplinary approach and underscores the importance of maintaining a high index of suspicion regardless of symptomatology to ensure prompt patient management and complication prevention. This case describes a 91-year-old male patient, who initially presented with mild chest pain, and was later diagnosed with AAD alongside acute pericarditis.

Evaluation of Aortic Diseases Using Four-Dimensional Flow Magnetic Resonance Imaging.

The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters.

Endovascular salvage of renal and common iliac artery malperfusion following inadvertent hybrid arch dissection stent deployment in the false lumen during repair of type A dissection.

This case report describes the endovascular management of a hybrid arch dissection stent inadvertently deployed in the false lumen during acute type A aortic dissection repair, resulting in renal and lower extremity malperfusion. Prompt identification and intervention are essential to minimize the morbidity and mortality associated with malperfusion. Various endovascular strategies exist to restore perfusion, and this case highlights a unique approach given the obliteration of the true lumen proximally and anatomy of the visceral ostia predominantly originating from the false lumen.

What Is the Efficacy of Bilateral Antegrade Cerebral Perfusion in Cerebral Protection?

Acute type A aortic dissection is among the many types of catastrophic cardiovascular emergencies. The development of serious morbidity, especially neurological complications after the operation, remains a huge threat. We aimed to present comparatively the results of using unilateral or bilateral antegrade cerebral perfusion to minimize these threats and to demonstrate the postoperative effects of antegrade cerebral perfusion choices.

Preoperative and Postoperative Arterial Adaptation in Patients with Acute Aortic Dissection.

Spinal cord ischemia is one of the most serious complications after an aortic repair. To date, there is no evidence for arterial changes during an aortic dissection or for the observation of such arteries after an aortic repair. The aim of this study was to compare spinal-cord-supplying arteries in patients with an acute aortic dissection, preoperatively and postoperatively, with patients without an acute aortic dissection.

A Dual Challenge: Endocarditis in a Patient with Familial Thoracic Aortic Aneurysm-Case Report and Literature Review.

: Thoracic aortic aneurysms (TAAs) are potentially life-threatening medical conditions, and their etiology involves both genetic and multiple risk factors. endocarditis is one of the most frequent causes of blood culture-negative infective endocarditis (BCNIE) in patients with previous cardiac surgery. Our review aims to emphasize the importance of genetic testing in patients with thoracic aortic aneurysms but also the importance of additional testing in patients with suspected endocarditis whose blood cultures remain negative.

Hybrid Aortic Arch Replacement with Frozen Elephant Trunk (FET) Technique: Surgical Considerations, Pearls, and Pitfalls.

The involvement of the aortic arch in thoracic aortic aneurysms (TAA), or acute aortic dissections (AAD), represents a challenging clinical entity, mandating a meticulous surgical plan, tailored to each individual case. The advent of endovascular techniques and the introduction of modern arch protheses have led to the implementation of the frozen elephant trunk (FET) technique. This one-step hybrid operation consists of a total aortic arch replacement combined with an antegrade delivery of a stent-graft for the descending aorta, which acts as a proximal landing zone facilitating a potential distal endovascular reintervention.

Changes in the Epidemiology of Thoracic and Cardiovascular Diseases in Korea During the COVID-19 Pandemic: A Nationwide Analysis.

There is limited evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on the epidemiology of thoracic and cardiovascular diseases. This study aimed to investigate changes in medical visits for these conditions during the COVID-19 pandemic. We analyzed the entire Korean population (~50 million) for monthly medical visits for 15 common thoracic and cardiovascular conditions, including pneumothorax, large bullae, lung cancer, esophageal cancer, thymoma, empyema, mediastinitis, esophageal rupture, multiple rib fractures, hemothorax, rib mass, varicose vein, pectus excavatum, aortic dissection, aortic aneurysm, and valve disease from January 2019 to December 2021.

Enhancing Radiologist Efficiency with AI: A Multi-Reader Multi-Case Study on Aortic Dissection Detection and Prioritization.

Background And Objectives: Acute aortic dissection (AD) is a life-threatening condition in which early detection can significantly improve patient outcomes and survival. This study evaluates the clinical benefits of integrating a deep learning (DL)-based application for the automated detection and prioritization of AD on chest CT angiographies (CTAs) with a focus on the reduction in the scan-to-assessment time (STAT) and interpretation time (IT).

Materials And Methods: This retrospective Multi-Reader Multi-Case (MRMC) study compared AD detection with and without artificial intelligence (AI) assistance.

Conservative Treatment of Retrograde Aortic Dissection after Endovascular or Hybrid repair of descending aorta pathologies.

Background: Retrograde type A dissection (RTAD) represents a rare but possible lethal complication of thoracic endovascular aortic repair. Intervention is often recommended but conservative management has been advocated in selected cases.

Methods: We performed a systematic review of the literature through MedLine and Cochrane databases over the last 24 years to identify reported cases of RTAD managed conservatively.

Trends in Kidney Function and Chronic Kidney Disease After Surgery for Acute Type A Aortic Dissection.

Objectives: We sought to assess the effect of postoperative renal failure (RF) on outcomes and identify predictors of chronic kidney disease (CKD) post-ATAAD.

Methods: This retrospective single-center analysis included all adults with ATAAD from 2011-2023. Patients were stratified into renal failure (RF) and no RF groups.

Impact of direct mesenteric perfusion on malperfusion in acute type a aortic dissection repair.

Objectives: Mesenteric malperfusion in acute aortic dissection remains a life-threatening complication with no standardized treatment strategy. This study aimed to describe and evaluate the outcomes of our integrated approach combining exploratory laparotomy, immediate mesenteric reperfusion, and central aortic repair.

Methods: We retrospectively reviewed patients with acute aortic dissection with a preoperative diagnosis of mesenteric malperfusion who were treated between August 2011 and November 2022.

Underappreciated Relationship: A Case of Type A Aortic Dissection Presented With Atrial Flutter.

Aortic dissection (AD) is a life-threatening emergency involving a tear in the aortic intima, leading to a false lumen. Atrial fibrillation (AF) can complicate AD, increasing management challenges and mortality risks. We report a 67-year-old male with no known past medical history who presented with a 1-day history of abdominal pain.

Preliminary experience of endovascular treatment of acute mesenteric occlusion in stable patients with acute type A aortic dissection.

Background: Patients presenting with Stanford type A aortic dissection complicated by acute occlusion of the superior mesenteric artery (SMA) exhibit an exceedingly high mortality rate, even if emergency surgery for ascending aorta repair is performed. consequently, appropriate management of acute SMA occlusion arising from acute Stanford type A aortic dissection is crucial. This study aimed to evaluate the safety and efficacy of endovascular treatment of acute mesenteric occlusion first in stable patients with acute type A aortic dissection.

Clinical features and survival analysis of non-hypertensive aortic dissection patients post-thoracic endovascular aortic repair: a 10-year retrospective study.

Background: The clinical characteristics and predictors for aortic adverse events (AAEs) after thoracic endovascular aortic repair (TEVAR) of non-hypertensive aortic dissection (AD) patients remain unclear. This study sought to clarify the clinical features of non-hypertensive AD and its incidence of AAEs after TEVAR.

Methods: Clinical data were collected from the electronic medical records, imaging databases and follow-up.