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Spinal Cord Ser Cases 2022 May 21;8(1):56. Epub 2022 May 21.

Department of Spinal Cord Injury, Veterans Affairs New Jersey Health Care System, East Orange, NJ, 07018, USA.

Introduction: Oral baclofen is commonly used for spasticity management, especially with neurogenic bladder in spinal cord injury (SCI). A less common side effect of baclofen is transient alterations of consciousness, which can easily be confused for altered mental status secondary to orthostatic hypotension in SCI.

Case Presentation: A 43-year-old man with an acute SCI secondary to an aortic dissection was found to have episodes of confusion after titrating oral baclofen from 5 mg three times per day to 10 mg three times per day at an acute rehabilitation facility. Read More

Heart Lung Circ 2022 May 18. Epub 2022 May 18.

Department of Cardiothoracic Surgery, Waikato District Health Board, Hamilton, New Zealand; Waikato Institute of Surgical Education and Research (WISER), Hamilton, New Zealand; Department of Surgery, University of Auckland, Hamilton, New Zealand.

Objectives: Type A aortic dissection (ATAAD) is hypothesised as a progression of aneurysmal dilation, but 60% of patients in the International Registry of Acute Aortic Dissection (iRAD) registry had a maximum aortic diameter (MAD)<55 mm. We aim to demonstrate that size ratios and aortic wall stress, assessed using a simplified markers, are unique to aortic patients who have had adverse events (ATAAD) compared to those who have not (thoracic aortic aneurysm [TAA]).

Methods: A retrospective cohort analysis of patients who underwent aortic intervention at Waikato Hospital, New Zealand between 2015-2020, comparing dissection (ATAAD) to TAA patients. Read More

Cell Mol Biol Lett 2022 May 20;27(1):40. Epub 2022 May 20.

Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China.

Background: In patients with acute aortic dissection (AAD), increased vascular smooth muscle cell (VSMC) apoptosis has been found. Human cytomegalovirus (HCMV)-miR-US33-5p was significantly increased in the plasma of patients with AAD. However, the roles of miR-US33-5p in human aortic VSMC (HA-VSMC) apoptosis remain to be elucidated. Read More

Ann Vasc Surg 2022 May 17. Epub 2022 May 17.

Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas, USA; Department of Cardiovascular Surgery, CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, Texas, USA; Cardiovascular Research Institute, Baylor College of Medicine, Houston, Texas, USA. Electronic address:

Endovascular aortic repair is widely used to treat patients with degenerative aneurysms or aortic dissection within the distal aorta. Thoracic endovascular aortic repair (TEVAR) is generally associated with fewer short-term complications than open surgical repair, which is particularly important for older patients with significant comorbid conditions. However, for patients with Marfan syndrome, a heritable thoracic aortic disease associated with aortic dilatation, dissection, and rupture, the utility of endovascular aortic repair remains questionable. Read More

Ann Vasc Surg 2022 May 17. Epub 2022 May 17.

Department of Vascular Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Objectives: This study evaluated aortic remodeling in highly tapered type B aortic dissection (TBAD) patients who underwent thoracic endovascular aortic repair (TEVAR) with a proximal tapered stent graft plus a distal restrictive stent graft to maximize thoracic coverage while avoiding distal excessive oversizing.

Methods: Thirty-four patients presenting with highly tapered TABD were randomized to restricted TEVAR (r-TEVAR) and standard TEVAR groups. Highly tapered TBAD was defined as the maximal diameter of the true lumen at proximal and distal thoracic aorta landing zone tapers greater than 8 mm or taper ratio greater than 20%. Read More

Ann Thorac Surg 2022 May 17. Epub 2022 May 17.

Department of Cardiac and Vascular Surgery, University Medical Center, Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Background: It is still controversial as to which cannulation-strategy for acute-type-A-aortic-dissection (AAD) is optimal. Antegrade-perfusion to diminish further organ-mal-perfusion and -ischemia are preferable.

Methods: We retrospectively analyzed a total of 420 patients who underwent AAD-surgery from January 2001 to December 2019. Read More

Comput Methods Programs Biomed 2022 May 11;221:106872. Epub 2022 May 11.

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address:

Background And Objective: The underlying mechanism of aortic dissection (AD) remains unclear and the onset of AD is still unpredictable. Although clinical study with statistical analysis has reported that type III aortic arch may have strong correlation with type B AD (TBD), the effects of different arch types on the wall shear stress (WSS) have not been clarified.

Methods: As a complementary work, this study numerically investigated the distribution of five WSS-based indicators in thirty aortic arches without AD, which were classified into three groups based on the arch types. Read More

Front Cardiovasc Med 2022 3;9:840946. Epub 2022 May 3.

Department of Cardiovascular Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China.

It has been found that postoperative progressive dilatation of aortic root is not rare for adult patients with repaired Tetralogy of Fallot (TOF), which leads to severe aortic regurgitation or even fatal dissection. Therefore, clinically, surgical treatment for both regurgitated aortic valve and dilated root is needed based on preoperative assessments and individual treatment strategies. Read More

Front Surg 2022 3;9:852628. Epub 2022 May 3.

Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Objective: To evaluate the optimal timing (acute or subacute) of thoracic endovascular aortic repair (TEVAR) for uncomplicated B aortic dissection (uTBAD) through a systematic review and meta-analysis.

Method: A comprehensive literature search was undertaken across three major databases (EMBASE/Medline, PubMed, and Cochrane Library) and was assessed until November 2021 to identify studies reporting the outcomes of TEVAR utilized to treat patients with uTBAD. The continuous variables were compared between the two groups using -test and the categorical variables were compared using the χ-test. Read More

Zhonghua Xin Xue Guan Bing Za Zhi 2022 May;50(5):511-513

Cardiac Intensive Care Unit, Wuhan Asia Heart Hospital, Wuhan 430022, China.

Cold Spring Harb Mol Case Stud 2022 May 19. Epub 2022 May 19.

Universidade Estadual do Norte Fluminense Darcy Ribeiro

Aortic diseases arising in Marfan Syndrome (MFS), such as in aneurysms and dissections of the thoracic aorta, are related to genetic alterations in the FBN1 gene. Databases, such as Universal Mutations-FBN1, ClinVar and The Human Gene Mutation, contain more than a thousand FBN1 mutations associated with MFS. The FBN1 gene, which encodes fibrillin-1, is responsible for the integral production of different protein domains. Read More

Ann Vasc Surg 2022 May 16. Epub 2022 May 16.

Department of Vascular Surgery, First Affiliated Hospital of China Medical University, Shenyang, China. Electronic address:

Objective: This study aimed to investigate the influence of abdominal aortic calcification on the distal extent, blood supply, and mid-term outcomes of acute aortic dissection (AAD).

Methods: This single-centre retrospective study was conducted from August 2014 to May 2021. The aortic calcification index (ACI) was used to evaluate abdominal aortic calcification. Read More

Semin Thorac Cardiovasc Surg 2022 May 16. Epub 2022 May 16.

Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan. Electronic address:

With increasing specialization within the field of cardiac surgery and a positive relationship between case volume and surgical outcomes in many areas, the concept of dedicated aortic surgeons performing acute type A aortic dissection (ATAAD) repair was investigated. From 1996 to 2014, 436 patients underwent open surgical repair of an ATAAD and were subsequently divided based on surgeon subspecialization, aortic-surgeon (AS, n=401) vs. non-aortic-surgeon (NAS, n=35). Read More

J Endovasc Ther 2022 May 19:15266028221095018. Epub 2022 May 19.

Houston Methodist Hospital, Houston, TX, USA.

Background: Operative mortality for type A aortic dissection is still 10-20% at centers of excellence. Additionally, 10-20% are not considered as viable candidates for open surgical repair and not offered life-saving emergency surgery. ARISE is a multicenter investigation evaluating the novel GORE® Ascending Stent Graft (ASG; Flagstaff, AZ). Read More

J Vasc Surg Cases Innov Tech 2022 Jun 9;8(2):256-260. Epub 2022 Mar 9.

Division of Vascular Surgery- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

The collapse of an abdominal aortic endograft is a rare event. We present the case of a 60-year-old man with an abdominal endograft who came to the emergency department with chest, back, abdominal, and lower extremity pain in addition to a cool left foot. On imaging, he was found to have a type B aortic dissection and a collapsed abdominal endograft. Read More

Front Cardiovasc Med 2022 2;9:891038. Epub 2022 May 2.

Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Background: This study aimed to construct a model to predict the risk of in-hospital death in patients with acute renal injury (AKI) receiving continuous renal replacement therapy (CRRT) after acute type A aortic dissection (ATAAD) surgery.

Methods: We reviewed the data of patients with AKI undergoing CRRT after ATAAD surgery. The patients were divided into survival and nonsurvival groups based on their vital status at hospital discharge. Read More

Front Cardiovasc Med 2022 2;9:788476. Epub 2022 May 2.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Background: Red blood cell distribution width (RDW) is associated with cardiovascular mortality. However, the relationship between preoperative RDW and outcomes after thoracic endovascular aortic repair (TEVAR) in type B aortic dissection (TBAD) remains to be determined.

Methods: We review the records of 678 patients with TBAD and treated with TEVAR in three centers. Read More

Front Cardiovasc Med 2022 2;9:869505. Epub 2022 May 2.

Department of Vascular and Endovascular Surgery, The First Medical Center of People's Liberation Army of China, Beijing, China.

Background: Endovascular repair of type B aortic dissection (TBAD) with aberrant right subclavian artery (ARSA) is challenging due to anatomical complexity. The embedded modular single-branched stent graft (EMSBSG) could solve this problem. However, the hemodynamic efficacy of this innovative technique has not been fully assessed. Read More

Radiol Case Rep 2022 Jul 9;17(7):2453-2459. Epub 2022 May 9.

Emergency Medicine Department, APHP, Lariboisière Hospital, Paris, France.

From its first use in medicine, ultrasonography has been an excellent non-invasive diagnostic tool. The use of ultrasound increased dramatically especially in the last decade, as it is a painless, safe, and widely accessible, especially with the development of pocket ultrasound machines. In addition, it is crucial in promptly diagnosing unstable patients in emergency settings. Read More

Medicine (Baltimore) 2022 May 13;101(19):e29176. Epub 2022 May 13.

Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Rationale: Currently endovascular treatments are commonly utilized to treat postpancreaticoduodenectomy hemorrhage. However, when endovascular procedure went wrong, open surgery with ligation of the culprit vessels would be the most common salvage method. With Modified Viabahn Open Revascularization TEChnique (VORTEC), we can try to rescue the vessel without sacrificing it by introduction of another endovascular stent under direct method. Read More

J Card Surg 2022 May 17. Epub 2022 May 17.

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Objective: To determine the long-term impact of developing acute renal failure (ARF) on survival after open aortic arch reconstruction for acute type A aortic dissection (ATAAD).

Methods: This was an observational study of consecutive aortic surgeries from 2007 to 2021. Patients with ATAAD were identified via a prospectively maintained institutional database and were stratified by the presence or absence of postoperative ARF (by RIFLE criteria). Read More

World J Cardiol 2022 Apr;14(4):231-238

Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.

Background: Acute type A aortic dissection (ATAAD) is a life-threatening disease associated with high morbidity and mortality.

Aim: To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.

Methods: A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study. Read More

Clin Case Rep 2022 May 9;10(5):e05820. Epub 2022 May 9.

University Hospitals of Leicester NHS Foundation Trust Glenfield Hospital Leicester UK.

Spontaneous or non-traumatic rupture of the renal tract is an infrequent presentation, and it is most frequently caused by ureteric obstruction. Rupture could occur at any level of the upper urinary tract. However, it is most common at the renal calyces and complications that could arise include; urinoma, and or hematoma collection which could progress to abscess formation and sepsis. Read More

Interv Neuroradiol 2022 May 17:15910199211070900. Epub 2022 May 17.

Department of Neurosurgery, 56697Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China.

Background: More data is needed on the short- and medium-term efficacy and safety of the Willis covered stent in treating distal internal carotid artery (DICA) aneurysms and vertebral artery dissecting aneurysms (VADAs).

Methods: Records of all 42 patients with DICA aneurysms or VADAs treated with the Willis covered stents at our institute between July 2014 and January 2019 were retrospectively examined. The patients' demographic information, symptoms, diagnosis, treatment procedure, immediate and follow-up clinical and angiographic outcomes were extracted. Read More

Vascular 2022 May 16:17085381221102785. Epub 2022 May 16.

Division of Vascular and Endovascular Surgery, 12235University of Miami, Miami, FL, USA.

Objectives: The indication, timing, and choice of the treatment modality for penetrating aortic ulcers (PAUs) and intramural hematoma (IMH) are frequently challenging. This article reviews these pathologies and their relation to aortic dissection and proposes a diagnostic and treatment algorithm.

Methods: A review of literature on diagnosis and treatment of PAU and IMH was conducted. Read More

J Cardiothorac Surg 2022 May 16;17(1):118. Epub 2022 May 16.

Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW, 2305, Australia.

Background: The outcomes of surgery for acute Stanford Type A aortic dissection (ATAAD) extend beyond mortality and morbidity. The aim of this systematic review was to summarise the literature surrounding health related quality of life (HR-QOL) following ATAAD, compare the outcomes to the standardised population, and to assess the impact of advanced age on HRQOL outcomes following surgery.

Methods: A systematic review of studies after January 2000 was performed to identify HR-QOL in patients following surgery for ATAAD. Read More

J Card Surg 2022 May 16. Epub 2022 May 16.

First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

Acute type A aortic dissection (ATAAD) is a life-threatening aortic disease. Many systems and organs are affected by malperfusion which presents preoperatively and postoperatively. Postoperative acute renal failure after ATAAD constitutes a severe and insidious complication. Read More

J Card Surg 2022 May 16. Epub 2022 May 16.

First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

A hypothermic circulatory arrest is usually used to correct thoracic aorta pathologies. The emergency treatment of acute type A aortic dissection and elective repair of aortic arch pathologies are the most common indications for using hypothermic circulatory arrest. A hypothermic circulatory arrest can also be used for surgical pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Read More

Curr Probl Cardiol 2022 May 13:101253. Epub 2022 May 13.

The University of Texas M.D. Anderson, Department of Cardiovascular Medicine, 1515 Holcombe Boulevard, Houston TX 77030, USA. Electronic address:

J Stroke Cerebrovasc Dis 2022 May 13;31(8):106487. Epub 2022 May 13.

Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka 530-8480, Japan.

Objectives: An elongated styloid process may cause vascular Eagle syndrome that includes cervical carotid artery (CCA) dissection with stenosis and aneurysm formation. There are only four reported cases with vascular Eagle syndrome-related CCA dissecting aneurysm treated with carotid artery stenting (CAS). This is the first report of applying a dual-layer nitinol micromesh stent (CASPER) for vascular Eagle syndrome-related CCA dissecting aneurysm. Read More