Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrafast breath-hold contrast material-enhanced magnetic resonance (MR) angiography can be performed with a flexible imaging sequence. With the current generation of high-speed imaging gradients, it is possible to achieve sequence repetition times of 4 msec or less. These repetition times make it possible to obtain high-resolution (512 x 512 x 64) images in under 30 seconds. Applications of this versatile technique include imaging of aortic dissection, thoracic and abdominal aortic aneurysm, pulmonary embolus, carotid stenosis, and peripheral vascular disease. The administration of contrast material must be tailored to the vascular anatomy under examination to avoid venous enhancement. The rapid data acquisition times can be used to image multiple temporal phases or multiple locations. With this technique and administration of a T1-shortening contrast agent, high-quality MR angiography can be routinely performed in a variety of vascular regions (eg, thoracic and abdominal aorta, pulmonary arteries, carotid arteries, lower extremities).
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PMID:Ultrafast contrast-enhanced three-dimensional MR angiography: state of the art. 953 77

We present our experience of 15 patients operated on by lumbar sympathectomies between 1987-1993, to confirm the effective and permanent efficacy of sympathectomy in peripheral vascular disease of the lower limbs. The patients, 9 men and 6 women (age 58-86) presented with rest pain (12), and minimal toe lesions (3). After an eco color-Doppler and angiography of the lower limbs, a radical operative sympathectomy (L2-L5) was performed in all patients. Associated diseases were: ischemic cardiopathy (61.7%), renal failure (25%), diabetic disease (61.7%), carotid stenosis (25%), abdominal aortic aneurysm (12%). In four patients, was performed during the same surgical time, 2 abdominal aortic aneurysm repairs, and 2 aorto-bifemoral bypasses. No patients died, operative morbidity was 12.5% (2 cases). The clinical and instrumental follow-up performed on 6 patients (38.3%) after 3 years, demonstrated in all cases the regression of the rest pain (12 patients) and the healing of the toe lesions (3 diabetic patients). Our results confirm the efficacy of sympathectomy especially when performed in young patients. The small number of diabetic patients in our study made statistical evaluation difficult, but it is generally considered that the results are worse in diabetic patients, because the microvascular lesions in these patients reduce peripheral vasodilatation.
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PMID:[Long-term results of radical lumbar ganglionectomy. Our experience]. 961 14

A woman with peripheral vascular disease developed cytomegalovirus colitis following repair of abdominal aortic aneurysm. Cytomegalovirus colitis developing in an immunocompetent individual may be caused by a breach in the integrity of the mucosal lining of the colon from various causes and should alert the clinician to explore these causes in order to provide effective care.
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PMID:Cytomegalovirus colitis in immunocompetent individual. 977 50

The current nonsurgical therapeutic options for patients with peripheral vascular disease are rapidly expanding. No longer is conservative management the only alternative for patients with significantly symptomatic but noncritical limb ischemia. Certainly for vascular disease above the inguinal ligament interventional procedures especially with adjunctive stent placement have excellent success and long term patency. Femoropopliteal vascular disease of relatively limited nature also is well-treated with interventional procedures. Infrapopliteal vascular disease treated with a surgical venous bypass appears to have superior results than intervention. However, for poor surgical risk patients or in patients without the necessary venous conduit, limb salvage is still good with a percutaneous approach. Renal artery stenosis appears now to be well treated with interventional techniques. Early data with up to one year follow-up shows that even ostial stenoses respond well when vascular stents are utilized. Extending the life of failing hemodialysis grafts is another area where interventional techniques are of benefit. In the future, more extensive vascular disease and other vascular disease entities such as cerebrovascular disease and abdominal aortic aneurysm may be successfully treated by a percutaneous approach.
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PMID:Current status of percutaneous vascular procedures. 1015 68

Bare-metal Wallstent endoprostheses were used to treat a 60-year-old man who had an inflammatory abdominal aortic aneurysm, as confirmed by clinical and computed tomographic findings. The patient had concomitant coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, and severe iliofemoral disease. Because of high surgical risk due to coexisting disease (including severe peripheral vascular disease), the patient was not a candidate for current endovascular methods or surgical repair. Therefore, we used the novel endovascular approach described. Serial, spiral, computed tomographic scans during a 2-year follow-up period revealed a reduction in the maximal diameter of the abdominal aortic aneurysm from 44 mm to 36 mm. Stabilization of thrombus and regression of the periaortitis were also noted. To our knowledge, this is the 1st reported case of endoluminal therapy with an uncovered stent for an inflammatory abdominal aortic aneurysm. Bare-metal Wallstent exclusion of inflammatory abdominal aortic aneurysms presents a treatment option for patients who are at high risk for surgery and cannot be treated with covered stent-grafts due to severe disease of the iliofemoral vessels.
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PMID:Regression of inflammatory abdominal aortic aneurysm after endoluminal treatment with bare-metal Wallstent endoprostheses. 1092 2

EPIX is developing MS-325 (AngioMARK), an intravascular magnetic resonance contrast agent for use in the imaging of blood vessels and blood flow in patients with cardiovascular disease, including peripheral vascular disease (PVD). In June 1999, EPIX and Mallinckrodt began phase III trials of MS-325 for the detection of aortoiliac occlusive disease in patients with PVD or abdominal aortic aneurysm [328640]. NDAs for the peripheral and cardiac applications were expected in 1999 and 2000, respectively [275240], [325717]. MS-325 has also shown promise in demonstrating the presence of microscopic muscular dystrophy, as well as monitoring the effects of gene therapy in a mouse model of the disease [360974]. MS-325 is a stable complex of gadolinium and an organic chelating agent. It resembles approved agents in terms of stability, safety and elimination profile, but possesses novel chemical groups which allow it to bind reversibly to albumin. This retains the agent in the blood and, via a patented biophysical phenomenon, enhances the magnetic properties of the gadolinium ion approximately ten-fold.
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PMID:MS-325 EPIX. 1124 2

The third Adult Treatment Panel guidelines from the National Cholesterol Education Program, released in May 2001, depart from previous guidelines in several ways. As in previous guidelines, treatment and treatment goals are based not only on lipid levels but also on the patient's risk status. The method for calculating risk, however, has been refined considerably. Patients are classified in the highest-risk group if they have any of these disorders: known coronary artery disease, diabetes mellitus, peripheral vascular disease, abdominal aortic aneurysm, carotid artery disease, or a 10-year risk of a coronary event of more than 20% (as determined by use of a scoring method).
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PMID:Using the new cholesterol guidelines in everyday practice. 1145 73

Newer, minimally invasive catheter-based endovascular technology utilizing stent grafts are currently being evaluated for abdominal aortic aneurysm (AAA) repair. A retrospective review of all (3 years) consecutive, non-ruptured elective AAA repairs was undertaken to document the results of AAA surgical repair in a modern cohort of patients to allow a contemporary comparison with the evolving endoluminal data. One hundred twenty-one AAAs were identified in a male veteran population. Mean age was 68.5 +/-7.7 years. Medical history review showed hypertension in 55%, heart disease in 73.5%, peripheral vascular disease in 21%, stroke and transient ischemic attacks in 22%, diabetes mellitus in 7%, renal insufficiency in 10%, and smoking history in 80%. The AAA size was documented with ultrasound (5.2 +/-1.3 cm, n=40) and computed tomography (5.6 +/-1.3 cm, n=100). Fifty-nine percent had angiography. Intraoperative end points included an operative time of 165 +/-6.3 minutes from incision to dressing placement. A Dacron tube graft was used in 78%, the remaining were Dacron bifurcated grafts. A suprarenal clamp was used in 8% for proximal aortic control with juxtarenal aneurysms. A pulmonary-artery catheter was placed in 69%. A transverse incision was used in 69% of patients and a midline incision was used in the rest. Estimated blood loss was 1505 +/-103 mL; cell saver blood returned 754 +/-53 mL; crystalloid/Hespan 4771 +/-176 mL; banked packed red blood cells 0.75 +/-0.11 U. Time to extubation was, in the operating room (78.5%), on the day of the operation (5.0%), postoperative day (POD) 1 (12.4%), POD2 (1.7%), POD3 (0.8%), and one case was performed with epidural anesthesia only. Postoperative end points included a 30-day mortality rate of 1.6% (two patients). Postoperative morbidity included wound dehiscence 0.8%; sepsis, urinary tract infection, wound infection, leg ischemia, ischemic colitis, and stroke each had an incidence of 1.6%; myocardial infarction, congestive heart failure, pneumonia, re-operation for suspected bleeding, and ileus or bowel obstruction occurred with an incidence of 3.3%. No significant increase in serum creatinine levels was noted. Time to enteral fluids/nutrition was 3.5 +/-0.08 days. Patients were out of bed to a chair or walking by 1.3 +/-0.06 days postoperatively. The length of stay in the intensive care unit (ICU) was 2.0 +/-0.12 days and postoperative hospital stay was 6.6 +/- 0.33 days. Transfusion requirement for the hospital stay was 1.6 +/-0.2 U per patient. This review highlights a cohort of male veteran patients with significant cardiac co-morbidity who have undergone repair with a conventional open technique and low mortality and morbidity rates. This group had rapid extubation, time to oral intake, and ambulation. In addition, ICU and hospital stays were relatively short.
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PMID:Abdominal aortic aneurysm repair. 1156 37

There is growing evidence that inflammatory processes may be involved in the development of atherosclerosis and its complications. Viral and bacterial pathogens have been implicated as possible causative factors in the pathogenesis of coronary artery disease (CAD) and restenosis after angioplasty. Antibiotic trials are now in progress to examine whether treatment of infection can prevent the complications of CAD. Atherosclerosis, the primary pathologic process in coronary artery disease (CAD), carotid artery disease, abdominal aortic aneurysm, and peripheral vascular disease, is no longer considered to be an obscure, slowly progressive, degenerative disease. Indeed, recent molecular studies on the atherosclerotic plaque have shown that the initiation, progression, and acute sequelae of atherosclerosis can be explained in part by a low-grade inflammatory process. Studies show that mediators of inflammation can be found at all stages of the life cycle of the atherosclerotic plaque. These include activated macrophages and lymphocytes, cytokines, growth factors, matrix degenerating proteinases, and tissue factor. It is hypothesized that risk factors such as hypertension, smoking, or elevated levels of low-density lipoprotein (LDL) cholesterol result in injury to the endothelial cell of the artery, and this injury initiates the inflammatory process. However, many patients with vascular disease do not have these established risk factors, and this observation has galvanized efforts to find new risk factors. Because inflammation is now considered to be an operative paradigm for atherosclerosis, it is not a major leap to the hypothesis that infectious agents, such as viral or bacterial, may play a role. Certainly this is not a new concept, and with the recent discovery that peptic ulcer disease, heretofore considered a disease of excess acid and reduced mucosal resistance, is caused by the ubiquitous bacterium Helicobacter pylori, interest in finding an infectious etiology for atherosclerosis has increased. Accordingly, the purpose of this discussion is to review in a historical manner the evidence that infectious agents-including herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), Enterovirus (adenovirus, Coxsackie virus), Chlamydia pneumoniae, and H. pylori-may play a role in atherosclerosis and its manifestations, especially as they relate to CAD.
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PMID:The role of infection in atherosclerosis and coronary artery disease: a new therapeutic target. 1172 77

The objective of this report was to analyze the current surgical results of operative treatment in patients suffering ruptured AAA (abdominal aortic aneurysms) and to define those independent predictive factors for mortality. During a period of 2 years, from January 1996 to December 1997, 144 patients operated on for ruptured AAA in 10 hospitals were included in a multicenter retrospective study. Among the collected variables concerning each patient, those with potential relation to surgical mortality were studied: gender, age, diabetes, hypertension, cardiopathy, pulmonary obstructive disease, preoperative renal dysfunction, symptomatic cerebrovascular disease, peripheral vascular disease, hematocrit on admission, preoperative hypotension < 80 mmHg, loss of consciousness, cardiac arrest, aortic aneurysm location (infrarenal versus non-infrarenal), iliac involvement, aneurysm size, type of rupture, left renal vein ligature, ligature of a patent inferior mesenteric artery, place of aortic cross-clamping, type of grafting, exclusion of both hypogastric arteries, venous technical complications, associated surgery, use of cell saver, intraoperative blood loss, and postoperative complications (renal failure, sepsis, coagulopathy, cardiac complications, pulmonary complications, colon ischemia, prosthetic graft complications, and need for reoperation). Those variables with statistical significance in the univariate analysis were introduced into a multivariate logistic regression model to determine the independent predictors of death. From our results we concluded that surgery for ruptured abdominal aortic aneurysms continues to have an excessively high mortality rate. Even though some preoperative variables could be identified as predictors of mortality, an absolute mortality risk has not yet been determined and the decision to negate surgery should be individualized rather than taken on that basis only. Early diagnosis and treatment of symptomatic aneurysms would improve mortality figures and selective screening should be contemplated.
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PMID:Factors increasing the mortality rate for patients with ruptured abdominal aortic aneurysms. 1176 39


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