China
Africa
Explore chapters and articles related to this topic
Descending Thoracic Aortic Aneurysm
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
The patient has his CT angiogram. Can you please interpret these images?“There is what looks like a very large descending thoracic aortic aneurysm. It occupies a large portion of the left chest. It starts a few centimetres beyond the left subclavian artery, and ends around 2 cm above the level of the diaphragm. The aneurysm, because of its size, is quite tortuous. There are no signs of inflammation/fat stranding/rupture. The chest otherwise looks clear.”
Specific Arterial Disease
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
The vast database of the Yale University Center for Thoracic Aortic Disease—which includes information on 3000 patients with thoracic aortic aneurysm or dissection—has, over the last decade, permitted multiple glimpses into this virulent disease (Elefteriades, 2008). Understanding the behavioral features of thoracic aortic aneurysm and dissection permits more effective combat of this disease. Descending thoracic aortic aneurysm, while lethal, is indolent. Mortality usually does not occur until after years of growth. Sixty percent of thoracic aortic aneurysms involve the ascending aorta and grows slowly. The Yale group estimates this to be about 1 mm per year (the descending aorta “grows” somewhat faster) which is much less than that reported earlier (see below). Prior estimates had failed to account for negative observed growth (measurements of any object will vary about a mean) and other statistical complexities, leading to overestimates of actual growth. This group developed exponential equations specifically for the purpose of accurately estimating growth rates (Rizzo et al., 1998). In fact, reports of rapid “growth” of the thoracic aorta are usually reflective of measurement error—specifically, measuring across an oblique portion of the aorta, especially the aortic arch. Over a patient’s lifetime, “hinge points” at which the likelihood of rupture or dissection skyrockets are seen at 5.5 cm for the ascending and 6.5 cm for the descending aorta. Intervening at 5.5 cm for the thoracic aorta (ascending or descending) prevents most adverse events (Figure 20.5).
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
A patient with a widened mediastinum on chest X-ray needs to have the diagnosis of a thoracic aortic aneurysm excluded. The gold standard investigation to detect this abnormality is an angiogram. However, a CT scan is easier, time-efficient, and non-invasive. Both investigations will demonstrate whether the aneurysm is secondary to an aortic dissection. As this patient is cardiovascularly stable, there is time to undergo formal investigations.
Numerical investigation of different viscosity models on pulsatile blood flow of thoracic aortic aneurysm (TAA) in a patient-specific model
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Amir Faraji, Mahdi Sahebi, Sadjad SalavatiDezfouli
Cardiovascular diseases are one of the most causes of death in the world. Estimations show it will be the cause of 23.6 million death in 2030 (Zhang et al. 2013). Aneurysm is one of the prevalent cardiovascular diseases (He et al. 2013). The aneurysm is a permanent and local expansion in the vein that leads to the complete irreversibility of the structure of the vessel's wall. One of the most common aneurysm types is an aortic aneurysm which usually occurs in abdominal and thoracic areas known as abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA) (Martufi et al. 2014). TAAs are usually asymptomatic. So, their diagnosis is so challenging, and most of the time, it remains unknown until the occurrence of some problems like dissection or rupture of the aortic wall (Elefteriades and Farkas 2010). From the mechanical viewpoint, rupture and dissection can be considered the mechanical fracture of the aortic wall. Indeed, this occurs when the mechanical stress of blood flow goes beyond the wall's local fracture strength. Numerous studies show that the progression of vascular diseases and their therapeutic successes are closely dependent on blood hemodynamics factors because the role of biomechanical factors like WSS has been proven in the occurrence and development of vascular diseases (Feliciani et al. 2015).
LncRNA AK131850 is downregulated in thoracic aortic aneurysm and negatively affects the levels of TGF-β1 in aortic smooth muscle cells
Published in Archives of Physiology and Biochemistry, 2022
Xiulei Cai, Yongqi Li, Shengjie Fu, Han Wang, Bing Liu, Yu Tian, Lei Li
The weakness of blood vessel wall may cause ballooning or widening of a region of the artery, which is called aneurysm (International Study of Unruptured Intracranial Aneurysms Investigators 2018). Thoracic aortic aneurysm (TAA) is a subtype of aneurysm that mainly affects aorta, which is the largest artery passes through the chest (Kuzmik et al. 2012). TAA causes a series of clinical symptoms, such as reduced blood pressure, trouble breathing, trouble swallowing, chest or back pain and even loss of consciousness (Elefteriades and Farkas 2010). In severe cases, TAA may burst and leads deaths (Jonker et al. 2011). The main causes of TAA include severe infections, hardening of the arteries and chest injury (Ruddy et al. 2013). However, molecular pathogenesis of this clinical disorder remains elusive (Cao et al. 2010), leading to difficulties in clinical treatment.
Incidence and predictors of thoracic aortic damage in biopsy-proven giant cell arteritis
Published in Scandinavian Journal of Rheumatology, 2021
MJ Koster, CS Crowson, C Labarca, KJ Warrington
American thoracic guidelines suggest that all patients with a diagnosis of GCA undergo baseline advanced arterial imaging [i.e. computed tomography angiography (CTA) or magnetic resonance angiography (MRA)] to assess them for large vessel involvement (9). Guidelines by the European League Against Rheumatism (EULAR) suggest that early arterial imaging can complement clinical criteria and investigate mural inflammation and luminal changes of extracranial arteries to support the diagnosis of GCA (10). While close monitoring for aortic aneurysm for patients at risk is suggested (10), guidance on the frequency and imaging modality used for long-term monitoring of AoSD is lacking. Factors associated with the increased risk of AoSD vary between evaluated populations and consistent predictors have not been identified (2, 4–8). The aim of this study was to evaluate the incidence and predictors of thoracic aortic aneurysm in a large, single-institution cohort of biopsy-proven GCA patients to provide further understanding of aortic complications in this subgroup.