Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thoracic aorta shows with advancing age various changes and a progressive deterioration in structure and function. As a result, vascular remodeling (VR) and medial degeneration (MD) occur as pathological entities responsible principally for the sporadic TAA onset. Little is known about their genetic, molecular, and cellular mechanisms. Recent evidence is proposing the strong role of a chronic immune/inflammatory process in their evocation and progression. Thus, we evaluated the potential role of Toll like receptor- (TLR-) 4-mediated signaling pathway and its polymorphisms in sporadic TAA. Genetic, immunohistochemical, and biochemical analyses were assessed. Interestingly, the rs4986790 TLR4 polymorphism confers a higher susceptibility for sporadic TAA (OR = 14.4, P = 0.0008) and it represents, together with rs1799752 ACE, rs3918242 MMP-9, and rs2285053 MMP-2 SNPs, an independent sporadic TAA risk factor. In consistency with these data, a significant association was observed between their combined risk genotype and sporadic TAA. Cases bearing this risk genotype showed higher systemic inflammatory mediator levels, significant inflammatory/immune infiltrate, a typical MD phenotype, lower telomere length, and positive correlations with histopatological abnormalities, hypertension, smoking, and ageing. Thus, TLR4 pathway should seem to have a key role in sporadic TAA. It might represent a potential useful tool for preventing and monitoring sporadic TAA and developing personalized treatments.
...
PMID:Can the TLR-4-mediated signaling pathway be "a key inflammatory promoter for sporadic TAA"? 2512 Feb 86

BACKGROUND Hemetemesis is rarely caused by an aorta-esophageal fistula with thoracic aorta aneurysm in patients. This uncommon etiology, AEF/TAA, can potentially rupture and cause death if left untreated. Thoracic endovascular aorta repair places a stent-graft to seal the aneurysm and cover the fistulous track. Open surgical repair is associated with high risk of morbidity and mortality; therefore, TEVAR is a much safer alternative to it. However, recurrent or persistent infection remains a major concern with TEVAR for AEF. CASE REPORT We present a rare case of an 80-year-old woman who presented with complaints of hemetemesis and epigastric pain. The patient underwent a computerized tomography scan, highlighting a TAA and AEF. A stent was placed in the descending thoracic aorta via endovascular approach and a subsequent EGD was negative for any residual bleeding. Methicillin-resistant Staphylococcus aureus was isolated from the patient's sputum cultures and she was treated with a prolonged course of antibiotics. She presented to the hospital a few weeks later with new-onset hematemesis. Workup identified an AEF. The patient was high risk for open surgical repair due to her comorbid conditions; therefore, an esophageal stent was placed. She was diagnosed with AEF secondary to an infected endovascular thoracic aorta stent. CONCLUSIONS Patients who are high risk for open surgical repair from immediate rupture of TAA with AEF can benefit from use of the TEVAR approach. The stent itself is a foreign body; therefore, the risk of infection persists. AEF is a rare but potentially fatal complication of the infected thoracic aortic stent itself.
 ...
PMID:Aortoesophageal Fistula: A Fatal Complication of Thoracic Endovascular Aortic Stent-Graft Placement. 3034 37

Introduction: Thoracic endovascular aortic repair has been increasingly used to treat type B aortic dissection (TBAD) when it is indicated, offering better outcome in terms of mortality and morbidity compared to open repair. Accepted goals for endovascular treatment of aortic dissections are the closure of the primary intimal entry tear, depressurization, and thrombosis of the false lumen. Areas covered: This is a descriptive review on the Zenith Dissection Endovascular System (Cook Medical Inc., Bloomington, IN) which is a modular system specifically designed to treat TBAD, consisting of a proximal component, the Zenith TX2 TAA Endovascular Graft, and a distal component, the Zenith Dissection Endovascular Stent. The distal stents are uncovered to avoid blockage of dominant spinal cord intercostal arteries and allow for the deployment of the stents across branch vessel origins as needed to treat the dissection. Expert opinion: The Zenith Dissection Endovascular System has already been used for the treatment of TBAD for the last decade mostly in experienced centers. Current evidence suggests that this is a feasible and safe technique with relative low early mortality and morbidity rates. It is important to highlight the potential benefit of Zenith Dissection Endovascular System on the remodeling the dissected aorta during the follow-up period.
 ...
PMID:Device profile of the Zenith Dissection Endovascular System for aortic dissection. 3115 76