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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spin-echo MR is an established method to evaluate thoracic aortic dissections, but is not well suited to study the abdominal aorta. In this study we evaluated whether MR angiography could provide a complete examination of the abdominal aorta. In 28 patients (40 MR studies) with suspected (n = 6) or known (n = 34) aortic dissection, MR studies were performed. Thoracic aorta was evaluated with spin-echo and gradient-recalled-echo MR imaging. Axial two-dimensional time-of-flight MR angiography with thin overlapping slices was used to study the abdominal aorta. Intermediate and high signal intensity on MR angiography was interpreted as patent flow, and low signal was interpreted as thrombus. The presence of an intima flap and the re-entry site could be depicted in all MR studies. Thrombus in the false channel was seen in 8 studies. The origin of the abdominal visceral branches and their relation to the false-true channel could be depicted, except in 4 of 80 renal arteries studied. Extension of the dissection into the coeliac trunk was seen in 2 and in the superior mesenteric artery in 10 studies. Dilatation of the suprarenal abdominal aorta was seen in 20 studies, and of the infrarenal aorta in 9 studies. MR angiography provides valuable information about the abdominal aorta and its branches in patients with aortic dissection. This makes MR imaging appealing as the preferred imaging modality for the diagnosis and follow-up of aortic dissection.
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PMID:Follow-up of aortic dissection: contribution of MR angiography for evaluation of the abdominal aorta and its branches. 916 68

The main goal of primary percutaneous coronary intervention (PPCI) is to achieve not only restoration of flow in the epicardial coronary artery, but also reperfusion at the level of myocardial tissue. Distal embolization is a possible complication of PPCI; in these patients, a microvascular injury occurs, which finally leads to a lack of myocardial reperfusion. Thrombus aspiration during PPCI has been proposed to prevent embolization. Several different thrombectomy devices have been demonstrated to be well tolerated and effective in improving surrogate markers of myocardial reperfusion; furthermore, in a few studies, the use of thrombectomy was associated with an improvement of clinical outcome. Because study results appeared largely inconsistent, especially about clinical outcome data, several meta-analyses have been carried out, showing that thrombectomy is able to improve markers of myocardial reperfusion and that manual thrombectomy is associated with better results in terms of myocardial reperfusion and clinical outcome, compared with embolic protection or mechanical thrombectomy devices, probably due to its easy and time-sparing use with low rate of complication. Literature data, based mainly on the Thrombus Aspiration During Primary Percutaneous Coronary Intervention (TAPAS) trial, indicate a favourable effect on outcome of routine manual thrombectomy strategy and the recent European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) guidelines on myocardial revascularization recommend thrombus aspiration during PPCI. However, data on long-term clinical outcome are still inconsistent and no trials have been, at the present time, designed to assess hard endpoint. In this review, we have carefully analysed literature data on thrombectomy during PPCI, taking into account the most recent studies and the last meta-analyses; study results have been compared to verify if either a routine or a selective use of thrombectomy should be adopted and to assess whether the use of thrombectomy may finally improve clinical outcome.
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PMID:Thrombus aspiration during primary percutaneous coronary intervention. 2198 89

Objective Thrombotic disease of the thoracic and abdominal aorta co-existing with aorto-iliac disease is a rare clinical association, which poses a great therapeutic challenge and adds to the complexity of the open surgical repair. Method We describe a case of 53-year-old woman with symptomatic thrombus in the thoracic and abdominal aorta down to the aortic bifurcation, which was successfully treated by Thoracic EndoVascular Aortic Repair via the left subclavian artery, open thrombectomy and aorto-iliac bypass. Result Completion angiogram performed through the axillary cannula showed good flow in the aorta, visceral vessels and iliac arteries. Conclusion This hybrid technical approach was a safe and effective strategy to tackle diffuse aortic thrombus with minimal morbidity and visceral embolization. Simultaneous aorto bi iliac bypass with thoracic endovascular aortic repair is a viable approach that can be undertaken with lesser morbidity and mortality risk as compared to complex and highly stressful total open surgical repair.
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PMID:Hybrid technique for the management of thoracoabdominal aortic thrombosis and symptomatic Trans-Atlantic Inter-Society Consensus "C" aorto-iliac disease. 2902 56