28,100 results match your criteria Aneurysm Thoracic

Marfan syndrome and aortic involvement: a narrative review.

Eur Rev Med Pharmacol Sci 2023 Sep;27(17):8218-8224

Department of Internal Medicine, University of Genoa, Genoa, Italy.

Marfan syndrome (MFS) is a systemic connective tissue disease that commonly and most severely affects the ocular, skeletal, and cardiovascular systems. The aim of the manuscript is to review the aortic involvement and complications in MFS, including aortal dissection, thoracic aortic aneurysm, abdominal aortic aneurysm, and acute aortic syndrome. Dissecting thoracic aortic aneurysm and progressing aortic root enlargement are the major causes of MFS morbidity and mortality. Read More

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September 2023

Outcomes of Percutaneous Access to the First Versus Third Segment of Axillary Artery During Aortic Procedures.

J Endovasc Ther 2023 Sep 26:15266028231202456. Epub 2023 Sep 26.

Department of Vascular Surgery, University Hospital Leipzig, and Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum Munich at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany.

Purpose: This article aims at investigating the outcomes of percutaneous access via the first versus third axillary artery (AXA) segments with closure devices during aortic procedures.

Materials And Methods: All patients receiving percutaneous AXA access closed with Perclose ProGlide device (Abbott, Santa Clara, California) from 2008 to 2021 were included in a retrospective multicenter registry (NCT: 04589962). Efficacy endpoint was the technically successful percutaneous procedure (no open conversion). Read More

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September 2023

Marfan Syndrome, Giant Ascending Aortic Aneurysm, and Left Ventricular Noncompaction: The Heart in Jeopardy!

Cureus 2023 Aug 25;15(8):e44117. Epub 2023 Aug 25.

Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, MAR.

Marfan syndrome (MFS) is a heritable connective tissue disorder that is caused by a mutation of the  gene. It is characterized by cardiovascular, skeletal, and ocular manifestations, with thoracic aortic aneurysms being the main cardiovascular complication. Unconventionally, MFS can present with left ventricular noncompaction (LVNC), which introduces a supplementary aspect of cardiac dysfunction. Read More

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Simultaneous Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm Combined with Saccular Thoracic Aortic Aneurysm.

Vasc Specialist Int 2023 Sep 25;39:29. Epub 2023 Sep 25.

Department of Surgery, Biomedical Research Institue, Pusan National University School of Medicine, Busan, Korea.

With the recent increase in imaging tests, coexisting abdominal aortic aneurysms (AAAs) and thoracic aortic aneurysms (TAAs) are being discovered accidentally. We report two cases of simultaneous endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) for AAA and TAA. Both 74-year-old and 79-year-old male with infrarenal AAA and saccular TAA were treated simultaneously with EVAR and TEVAR. Read More

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September 2023

A ruptured descending thoracic aorta pseudo aneurysm in a child presented with chest pain having untreated aortic coarctation: A case report.

Int J Surg Case Rep 2023 Sep 19;111:108849. Epub 2023 Sep 19.

Cardiothoracic Surgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Ethiopia.

Introduction: Coarctation of aorta is a congenital narrowing of the aorta commonly involving periductal segment of descending aorta. It commonly occurs as an isolated lesion and if left untreated it may result in hypertension, aneurysm and aortic rupture.

Case Presentation: A previously healthy 10 years old male child presented with sudden onset of chest pain associated with shortness breath. Read More

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September 2023

Current Medicare reimbursement for complex endovascular aortic repair is inadequate based on results from a multi-institutional cost analysis.

J Vasc Surg 2023 Sep 19. Epub 2023 Sep 19.

Vascular and Endovascular Surgery, Mayo Clinic Scottsdale, Scottsdale, AZ.

Objectives: Complex endovascular juxta-, para- and suprarenal abdominal aortic aneurysm repair (comEVAR) is frequently accomplished with commercially available fenestrated (FEVAR) devices or off-label use of aortoiliac devices with parallel branch stents (chEVAR). We sought to evaluate the implantable vascular device costs incurred with these procedures as compared to standard Medicare reimbursement to determine the financial viability of comEVAR in the modern era.

Methods: Five geographically distinct institutions with high-volume, complex aortic centers were included. Read More

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September 2023

Using a polygenic score to account for genomic risk factors in a model to detect individuals with dilated ascending thoracic aortas.

medRxiv 2023 Sep 8. Epub 2023 Sep 8.

Background: Ascending thoracic aortic dilation is a complex trait that involves modifiable and non-modifiable risk factors and can lead to thoracic aortic aneurysm and dissection. Clinical risk factors have been shown to predict ascending thoracic aortic diameter. Polygenic scores (PGS) are increasingly used to assess clinical risk for multifactorial diseases. Read More

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September 2023

ER stress mediates Angiotensin II-augmented innate immunity memory and facilitates distinct susceptibilities of thoracic from abdominal aorta to aneurysm development.

Front Immunol 2023 4;14:1268916. Epub 2023 Sep 4.

Centers of Cardiovascular Research, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States.

To determine the roles of endoplasmic reticulum (ER) stress and trained immunity, we performed transcriptome analyses on the thoracic aorta (TA) and abdominal aorta (AA) from the angiotensin II (Ang II)-HFD-ApoE-KO aneurysm model and made significant findings: 1) Ang II bypassed HFD-induced metabolic reprogramming and induced stronger inflammation in AA than in TA; 2) Ang II and HFD upregulated 890 genes in AA versus TA and induced cytokine signaling; 3) Ang II AA and TA upregulated 73 and 68 cytokines, scRNA-Seq identified markers of macrophages and immune cells, cell death regulators, respectively; transdifferentiation markers of neuron, glial, and squamous epithelial cells were upregulated by Ang II-AA and TA; and pyroptosis signaling with IL-1β and caspase-4 were more upregulated in Ang II-AA than in TA; 4) Six upregulated transcriptomes in patients with AAA, Ang II AA, Ang II TA, additional aneurysm models, PPE-AAA and BAPN-Ang II-AAA, were partially overlapped with 10 lists of new ER stress gene sets including 3 interaction protein lists of ER stress regulators ATF6, PERK, and IRE1, HPA ER localization genes, KEGG signal genes, XBP1 transcription targets, ATF4 (PERK) targets, ATF6 targets, thapsigargin ER stress genes, tunicamycin-ER stress genes, respectively; 5) Ang II-AA and TA upregulated ROS regulators, MitoCarta genes, trained immunity genes, and glycolysis genes; and 6) Gene KO transcriptomes indicated that ATF6 and PERK played more significant roles than IRE1 in promoting AAA and trained immunity whereas antioxidant NRF2 inhibited them. Our unprecedented ER-focused transcriptomic analyses have provided novel insights on the roles of ER as an immune organelle in sensing various DAMPs and initiating ER stress that triggers Ang II-accelerated trained immunity and differs susceptibilities of thoracic and abdominal aortas to diseases. Read More

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September 2023

Urgent Juxtarenal Aortic Aneurysm Repair With Modified Off-the-shelf Endograft to Preserve Intercostal Arteries and Branch Incorporation by Transfemoral Access.

J Endovasc Ther 2023 Sep 20:15266028231199042. Epub 2023 Sep 20.

Department of Vascular and Endovascular Surgery, SITE Endovascular, Casa de Saúde São José, Rio de Janeiro, Brazil.

Purpose: To demonstrate the feasibility of the modification to preserve intercostal arteries of the t-Branch Endograft (Cook Medical, Bloomington, IN) in an urgent setting, associated with a less invasive approach for branch incorporation from percutaneous femoral access with steerable sheaths.

Technique: A 73-year-old female patient presented at our institution with intense abdominal pain. Angiotomography showed a 50-mm juxtarenal aortic aneurysm, with no signs of rupture. Read More

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September 2023

Postoperative Hypoalbuminemia as a Predictor of Acute Kidney Injury After Open Repair of Ruptured Abdominal Aortic Aneurysm.

World J Surg 2023 Sep 20. Epub 2023 Sep 20.

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea.

Background: Perioperative hypoalbuminemia has a prognostic effect on mortality and morbidity in various cohorts. Patients undergoing open repair of ruptured abdominal aortic aneurysms (rAAA) are at a high risk of hypoalbuminemia due to bleeding and underlying diseases. Hence, this study aimed to investigate the predictive value of immediate postoperative hypoalbuminemia for the risk for acute kidney injury (AKI) in patients undergoing open rAAA repair. Read More

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September 2023

Aortic sarcoma: a challenging diagnosis.

BMJ Case Rep 2023 Sep 20;16(9). Epub 2023 Sep 20.

Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam

Sarcomas of the aorta are rare tumours with various clinical presentations. The most common symptoms are embolic events, constitutional symptoms, claudication, abdominal complaints, aneurysm/pseudoaneurysm, back pain and hypertension. We present a case of a woman in her early 60s having fever, fatigue and cough for 3 months. Read More

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September 2023

Computed Tomography and Magnetic Resonance Imaging Findings of Bicuspid Aortic Valve and Related Abnormalities of the Heart and Thoracic Aorta.

Korean J Radiol 2023 Sep 14. Epub 2023 Sep 14.

Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. Read More

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September 2023

Variable clinical expression of a Belgian founder variant suggests the presence of a genetic modifier.

Front Genet 2023 31;14:1251675. Epub 2023 Aug 31.

Cardiogenomics and Functional Genomics, Center for Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.

variants cause Loeys-Dietz syndrome type 5, a syndromic form of thoracic aortic aneurysm and dissection. The exact disease phenotype is hard to delineate because of few identified cases and highly variable clinical representation. We provide the results of a haplotype analysis and a medical record review of clinical features of 27 individuals from 5 different families, originating from the Campine region in Flanders, carrying the NM_003239. Read More

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National Cross-Sectional Epidemiological Analysis of the Impact of Pandemic COVID-19 on Vascular Procedures in Public Health System: 521,069 procedures over 4 years.

Ann Vasc Surg 2023 Sep 15. Epub 2023 Sep 15.

Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, São Paulo, SP, 05652-900, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, Av. Prof. Francisco Morato, 4293, São Paulo, SP, 05521-200, Brazil.

Introducion: During the COVID-19 pandemic, there was a dramatic increase in healthcare demand. Resources were redirected to care patients with COVID-19. Therefore, surgical treatments were affected, including those of vascular diseases. Read More

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September 2023

Risk Factors for Stroke Development After Thoracic Aortic Surgery.

J Cardiothorac Vasc Anesth 2023 Aug 19. Epub 2023 Aug 19.

Department of Cardiovascular Surgery, MedStar Washington Hospital Center, Georgetown University, Washington, DC.

Objectives: Stroke after thoracic aortic surgery is a complication that is associated with poor outcomes. The aim is to characterize the intraoperative risk factors for stroke development.

Design: A retrospective analysis. Read More

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Impact of retraining a deep learning algorithm for improving guideline-compliant aortic diameter measurements on non-gated chest CT.

Eur J Radiol 2023 Sep 12;168:111093. Epub 2023 Sep 12.

Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland. Electronic address:

Purpose/objective: Reliable detection of thoracic aortic dilatation (TAD) is mandatory in clinical routine. For ECG-gated CT angiography, automated deep learning (DL) algorithms are established for diameter measurements according to current guidelines. For non-ECG gated CT (contrast enhanced (CE) and non-CE), however, only a few reports are available. Read More

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September 2023

Functional interaction of aortic valve and ascending aorta in patients after valve-sparing procedures.

Sci Rep 2023 Sep 15;13(1):15340. Epub 2023 Sep 15.

Universitätsklinik für Innere Medizin - Kardiologie, Klinikum Oldenburg, Rahel Strauss Strasse 10, Oldenburg, Germany.

Pressure recovery (PR) is essential part of the post stenotic fluid mechanics and depends on the ratio of EOA/A, the effective aortic valve orifice area (EOA) and aortic cross-sectional area (A). In patients with advanced ascending aortic aneurysm and mildly diseased aortic valves, the effect of A on pressure recovery and corresponding functional aortic valve opening area (ELCO) was evaluated before and after valve-sparing surgery (Dacron graft implantation). 66 Patients with ascending aortic aneurysm (mean aortic diameter 57 +/- 10 mm) and aortic valve-sparing surgery (32 reimplantation technique (David), 34 remodeling technique (Yacoub)) were routinely investigated by Doppler echocardiography. Read More

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September 2023

Variations of azygos vein: a cadaveric study with clinical relevance.

Anat Cell Biol 2023 Sep 15. Epub 2023 Sep 15.

Department of Anatomy, Christian Medical College, Ludhiana, India.

The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. Read More

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September 2023

Intravascular Ultrasound in Detection of Bridging Stent Graft Instability During Fenestrated and Branched Endovascular Aneurysm Repair Procedures: A Multicentre Study on 274 Target Vessels.

Eur J Vasc Endovasc Surg 2023 Sep 11. Epub 2023 Sep 11.

Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany.

Objective: The use of intravascular ultrasound (IVUS) reduces contrast medium usage and radiation exposure during conventional endovascular aneurysm repair (EVAR). The aim of this study was to evaluate safety and efficacy of IVUS in detecting bridging stent graft (bSG) instability during fenestrated and branched EVAR (F/B-EVAR).

Methods: This was a prospective observational multicentric study. Read More

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September 2023

Trends in SAVR with biological vs. mechanical valves in middle-aged patients: results from a French large multi-centric survey.

Front Cardiovasc Med 2023 28;10:1205770. Epub 2023 Aug 28.

Department of Cardiac Surgery, University Hospital of Angers, Angers, France.

Background/introduction: Currently, despite continued issues with durability ( 1), biological prosthetic valves are increasingly chosen over mechanical valves for surgical aortic valve replacement (SAVR) in adult patients of all ages, at least in Western countries. For younger patients, this choice means assuming the risks associated with a redo SAVR or valve-in-valve procedure.

Purpose: To assess the use of mechanical vs. Read More

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Comparison of artery diameters in the Aachen minipig serving as a human intracranial in vivo model.

Lab Anim 2023 Sep 12:236772231169809. Epub 2023 Sep 12.

Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Germany.

Minipigs are used as in vivo endovascular models, particularly in stroke and aneurysm research. However, detailed knowledge of the diameters of forelimb arteries that are commonly used as surrogates for human brain-supplying arteries are lacking. This study aimed to determine the diameters of forelimb and neck arteries in Aachen minipigs and to compare those to the diameters of human cerebral brain-supplying arteries in order to assess the validity of the Aachen minipig as a human intracranial in vivo model. Read More

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September 2023

Endovascular repair of thoracic aortic disease with isolated left vertebral artery and unfavorable proximal landing zone using fenestrated castor stent-graft.

Front Cardiovasc Med 2023 24;10:1168180. Epub 2023 Aug 24.

Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, China.

Objective: The main purpose of this study was to evaluate the safety and efficacy of Castor single-branched stent-graft combined with fenestrated technique in treatment of thoracic aortic disease (TAD) with unfavorable proximal landing area (PLZ) and isolated left vertebral artery (ILVA).

Methods: From January 2018 to March 2022, 8 patients with TAD (6 patients with type B aortic dissections, 1 patient with type B intramural hematomas, and 1 patient with thoracic aortic aneurysm) underwent thoracic endovascular aortic repair with fenestrated Castor stent-graft due to the existence of ILVA and unfavorable PLZ. Demographic characteristics, surgical details, postoperative complications, follow-up and postoperative CTA imaging results were collected and analyzed. Read More

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Total arch replacement versus hybrid operation for aortic arch aneurysm in elderly patients: a retrospective cohort analysis.

J Thorac Dis 2023 Aug 31;15(8):4357-4366. Epub 2023 Jul 31.

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: There is not sufficient evidence of the superiority of hybrid procedures over total arch replacement (TAR) for the aortic arch aneurysm of an elderly patients. This retrospective study aimed to compare total arch replacement and hybrid procedures for treatment of aortic arch aneurysms in patients aged ≥75.

Methods: This study was a multicenter retrospective investigation of peri-operative outcomes of patients undergoing aortic arch aneurysm repair using either TAR or hybrid procedures between January 2012 and May 2021. Read More

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Transvenous Access for Emergent Thoracic and Thoracoabdominal Aortic Aneurysm Repair in Patients Without Femoral Access.

J Endovasc Ther 2023 Sep 9:15266028231197972. Epub 2023 Sep 9.

German Aortic Center Hamburg, Department of Vascular Medicine, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Purpose: To describe the technique of transvenous access for emergent endovascular repair of thoracic and thoracoabdominal aneurysms exemplified with 2 cases.

Technique: Transvenous access to the aorta is described as an alternative access method to deliver aortic endografts in emergency situations. A 68-year-old female patient with severely compromised iliac and subclavian artery access was treated for a ruptured extent V thoraco-abdominal aortic aneurysm with a t-Branch (Cook Medical, Bjaeverskov, Denmark) delivered through a transcaval access. Read More

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September 2023

17 β-Estradiol Impedes Aortic Root Dilation and Rupture in Male Marfan Mice.

Int J Mol Sci 2023 Sep 1;24(17). Epub 2023 Sep 1.

Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.

Marfan syndrome causes a hereditary form of thoracic aortic aneurysms with worse outcomes in male compared to female patients. In this study, we examine the effects of 17 β-estradiol on aortic dilation and rupture in a Marfan mouse model. Marfan male mice were administered 17 β-estradiol, and the growth in the aortic root, along with the risk of aortic rupture, was measured. Read More

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September 2023

Hybrid Treatment of Complex Diseases of the Aortic Arch and Descending Thoracic Aorta by Frozen Elephant Trunk Technique.

J Clin Med 2023 Sep 1;12(17). Epub 2023 Sep 1.

Department of Vascular Surgery, Centre Hospitalier Universitaire de Poitiers, 86000 Poitiers, France.

The surgical management of acute and chronic complex diseases involving the aortic arch and the descending thoracic aorta remains challenging. Hybrid procedures associating total open arch replacement and stent-grafting of the proximal descending aorta were developed to allow a potential single-stage treatment, promote remodeling of the downstream aorta, and facilitate a potential second-stage thoracic endovascular aortic repair by providing an ideal landing zone. While these approaches initially used various homemade combinations of available conventional prostheses and stent-grafts, the so-called frozen elephant trunk technique emerged with the development of several custom-made hybrid prostheses. Read More

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September 2023

Comparison of Chimney and Fenestrated Techniques for Supra-Aortic Branch Revascularization During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis.

Cardiovasc Intervent Radiol 2023 Sep 8. Epub 2023 Sep 8.

Department of Vascular and Thyroid Surgery, The First Hospital, China Medical University, 155 Nanjing Bei St, Shenyang, China.

Purpose: To compare the technical and clinical outcomes of fenestrated thoracic endovascular aortic repair (F-TEVAR) and chimney thoracic endovascular aortic repair (CH-EVAR) of aortic disease.

Methods: PubMed, Embase and Cochrane databases were systematically searched to identify studies on the management of thoracic aortic pathologies using chimney or fenestrated techniques published between 2000 and 2022. Individual studies provided at least one of the following essential outcomes: technical success, immediate and follow-up type I endoleak, 30-day and aorta-related mortality, cerebral events and supra-aortic branch patency. Read More

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September 2023

Identification of co-diagnostic effect genes for aortic dissection and metabolic syndrome by multiple machine learning algorithms.

Sci Rep 2023 Sep 8;13(1):14794. Epub 2023 Sep 8.

Vascular Surgery, the First Affiliated Hospital of Dali University, Dali, 671000, China.

Aortic dissection (AD) is a life-threatening condition in which the inner layer of the aorta tears. It has been reported that metabolic syndrome (MS) has a close linkage with aortic dissection. However, the inter-relational mechanisms between them were still unclear. Read More

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September 2023

Unraveling the Role of TGFβ Signaling in Thoracic Aortic Aneurysm and Dissection Using Fbn1 Mutant Mouse Models.

Matrix Biol 2023 Sep 6. Epub 2023 Sep 6.

Department of Molecular & Medical Genetics, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239. Electronic address:

Although abnormal TGFβ signaling is observed in several heritable forms of thoracic aortic aneurysms and dissections including Marfan syndrome, its precise role in aortic disease progression is still disputed. Using a mouse genetic approach and quantitative isobaric labeling proteomics, we sought to elucidate the role of TGFβ signaling in three Fbn1 mutant mouse models representing a range of aortic disease from microdissection (without aneurysm) to aneurysm (without rupture) to aneurysm and rupture. Results indicated that reduced TGFβ signaling and increased mast cell proteases were associated with microdissection. Read More

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September 2023

The circular RNA Ataxia Telangiectasia Mutated regulates oxidative stress in smooth muscle cells in expanding abdominal aortic aneurysms.

Mol Ther Nucleic Acids 2023 Sep 17;33:848-865. Epub 2023 Aug 17.

Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University Munich, 81675 Munich, Germany.

An abdominal aortic aneurysm (AAA) is a pathological widening of the aortic wall characterized by loss of smooth muscle cells (SMCs), extracellular matrix degradation, and local inflammation. This condition is often asymptomatic until rupture occurs, leading to high morbidity and mortality rates. Diagnosis is mostly accidental and the only currently available treatment option remains surgical intervention. Read More

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September 2023