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aortic aneurysm and chronic disseminated intravascular coagulation： a retrospective study of 235 patients

Frontiers of Medicine 2017年第1期11卷 62-67页

作者： Yun Zhang Chen Li Min Shen Bao Liu Xuejun Zeng Ti Shen Department of General Internal Medicine Peking Union Medical College Hospital Chinese Academy of Meclical Sciences and Peking Union Medical College Beijing 100730 China Department of Rheumatology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Vascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Internal Medicine Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

Chronic disseminated intravascular coagulation （DIC） is a rare but devastating complication of aortic aneurysm （AA）. This study investigated the clinical manifestations, laboratory findings, and treatment of patients with AA-associated chronic DIC （AA-DIC） and explored the mechanisms, duration, and therapeutic response of AA-DIC. We retrospectively reviewed the medical records of 235 AA patients admitted at the Peking Union Medical College Hospital between September 2009 and January 2015. The patients were classified as those with DIC （AA-DIC） and those without DIC （non-DIC）. The AA-DIC group showed a significantly higher proportion of female patients and a significantly longer AA disease course than the non-DIC group did. The AA-DIC patients presented mural thrombi, dissecting aneurysms, a family history of AA, and diabetes significantly more frequently than the non-DIC patients did. Furthermore, multiple regression analyses revealed that sex, mural thrombus, aneurysm type, diabetes, and stent surgery are possible independent risk factors for AA-DIC patients. Fifty-two （22.1%） patients presented AA-DIC. Among these patients, 43 had non-typical DIC and 9 had typical DIC; the mortality rate of the latter was 22.2%. The mean age of the patients with typical DIC was significantly higher than of that of patients with non-typical DIC. The non-typical DIC patients also presented abnormal coagulation disorders of varying degrees. Furthermore, heparin or low-molecular-weight heparin improved the clinical symptoms and laboratory parameters in patients with AA and typical DIC. Thus, chronic DIC should be considered in patients with AA.

关键词： aortic aneurysm disseminated intravascular coagulation anticoagulation therapy

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EXPERIENCE ON SURGICAL MANAGEMENT OF RUPTURE OF ABDOMINAL aortic aneurysm

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Chinese Medical Sciences Journal 2003年第2期18卷 116-119页

作者：管珩郑月宏李拥军刘昌伟刘暴叶炜 Department of Vascular Surgery PUMC hospitalCAMS & PUMCBeijing 100730

Objective. To describe our surgical experience on rupture of abdominal aortic aneurysm .Methods. Two cases of ruptured aortic aneurysms with severe complication were analyzed. Aorta reconstruction procedures were performed using bifurcated e-PTFE grafts during emergency operation. Diagnosis, preoperadve resuscitation, emergency surgical intervention, and postoperative complications of these patients were summarized and discussed.Results. Rupture of aortic aneurysm in both patients presented as a huge retroperitoneum haematoma by computed tomography scan. They were successfully saved by prompt body fluid compensation, emergency procedure, intraoperative resuscitation, and postoperative intensive care.Conclusions. Correct diagnosis, prompt surgical management, immediate intraoperative proximal aorta clamping during procedure, and effective management of postoperative complications were the key points to successful treatment of ruptured aortic aneurysm.

关键词： aortic aneurysm surgical management

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Detection of periodontal pathogens in the patients with aortic aneurysm

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Chinese Medical Journal 2014年第23期127卷 4114-4118页

作者： Ding Fang Lyu Yalin Han Xiao Zhang Hai Liu Dongyu Hei Wei Liu Yinhua Department of S(omatology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Department of Restorative Dentistry School of Dentistry University of Washington Seattle Washington USA

Background The occurrence and development of aortic aneurysm （AA） are associated with *** researchers have detected the DNA of periodontal pathogens in AA samples in certain ***,it has not been done in Chinese *** objective of this study was to evaluate the prevalence of periodontal pathogens in oral tissue samples and aneurysm samples of AA *** Eighty-nine subjects with AA and 59 subjects without AA were *** clinical parameters were *** saliva and subgingival plaque somples were collected from all ***-six dissected AA samples were *** of eight periodontal pathogens including Porphyromonas gingivalis （Pg）,Actinobacillus actinomycetemcomitans （Aa）,Prevotella intermedia （Pi）,Tannerella forsythensis （Tf）,Treponema denticola （Td）,Campylobacter rectus （Cr）,Fusobacterium nucleatum （Fn）,and Prevotella nigrescens （Pn） was ascertained in all samples by 16S rRNA-based polymerase chain reaction （PCR） *** The periodontal indexes including plaque index （PLI）,probing depth （PD）,bleeding index （BI）,and clinical attachment loss （CAL）,of the six Ramfjord index teeth were significantly higher in the AA group than those in the control group （P ＜0.01）.Eight periodontal pathogens in subgingival plaque samples were more frequently detected in the AA group than in control *** difference in prevalence between the groups was significant for six （out of eight） periodontal pathogens assayed （Pg,Pi,Fn,Pn,Tf,and Td,P ＜0.01）.Additionally,all eight periodontal pathogens were more frequently detected in saliva samples of the AA group than in those of the control group,again with six （out of eight）（Pg,Pi,Fn,Cr,Tf,and Td） displaying significant differences in prevalence between the two groups （P ＜0.01）.Out of 26 aneurysm samples examined,Pg,Pi,Fn,Crand Tfwere detected in 6 （23.1％）,2 （7.7％）,3 （11.5％）,1 （3.8％）,2 （7.7％）,respectively,and Aa,Pn,and Td were not detected in diss

关键词： chronic periodontitis aortic aneurysm periodontal pathogens

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Hybrid treatment of recurring thoracoabdominal aortic aneurysm concomitant with retrograde type A aortic dissection

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Chinese Medical Journal 2010年第14期123卷 1942-1944页

作者： ZHANG Min-hong GUO Wei DU Xin XIONG Jiang Department of Vascular Surgery Clinical Division of Surgery Chinese PLA General Hospital and Postgraduate Medical School Beijing 100853 China

So far, standard therapy of complex thoracoabdominal aortic disease is open surgical repair requiring aortic clamping and replacement of the-involved segment. Despite significant improvements, morbidity and mortality of open surgery remain high. As a result, open surgery is often withheld owing to severe comorbidities of the patients. Endovascular technique has emerged as an alternative for treatment of these diseases in high risk patients,

关键词： aortic aneurysm aortic dissection hybrid treatment

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Innovation in pathogenesis and management of aortic aneurysm

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World Journal of Experimental Medicine 2024年第2期14卷 35-45页

作者： Maryam Barkhordarian Hadrian Hoang-Vu Tran Aiswarya Menon Sai Priyanka Pulipaka Izage Kianifar Aguilar Axel Fuertes Shraboni Dey Angel Ann Chacko Tanni Sethi Ayrton Bangolo Simcha Weissman Department of Internal Medicine Palisades Medical CenterNorth BergenNJ 07047United States

aortic aneurysm(AA)refers to the persistent dilatation of the aorta,exceeding three *** the pathophysiology of this condition is important for its prevention and management,given its responsibility for more than 25000 deaths in the United *** are classified based on their location or *** pathophysiologic pathways including inflammation,the immune system and atherosclerosis have been implicated in its *** markers such as transforming growth factorβ,interleukin-1β,tumor necrosis factor-α,matrix metalloproteinase-2 and many more may contribute to this *** genetic disorders such as Marfan syndrome,Ehler-Danlos syndrome and Loeys-Dietz syndrome have also been associated with this *** years has seen the investigation of novel management of AA,exploring the implication of different immune suppressors,the role of radiation in shrinkage and prevention,as well as minimally invasive and newly hypothesized surgical *** this narrative review,we aim to present the new contributing factors involved in pathophysiology of *** also highlighted the novel management methods that have demonstrated promising benefits in clinical outcomes of the AA.

关键词： aortic aneurysm Abdominal aneurysm Thoracic aneurysm Immunotherapy Surgical management Pathophysiology Inflammation and molecular pathways

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Regulation of Matrix Metalloproteinase-2 and Matrix Metalloproteinase-9 in Abdominal aortic aneurysm

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Cardiology Discovery 2023年第3期3卷 212-220页

作者： Shuo Wang Dan Liu Xiaolin Zhang Xiaoxiang Tian Department of Cardiology and Cardiovascular Research Institute General Hospital of Northern Theater CommandShenyang 110016China Department of Cardiology Shengjing Hospital of China Medical UniversityShenyang 110022China.

Abdominal aortic aneurysm (AAA) is a degenerative disease characterized by destruction and progressive expansion of the abdominal aortic wall. An AAA is typically defined as an enlargement of the abdominal aorta with diameter ≥3 cm or ≥50% greater than the suprarenal diameter. The pathological changes associated with AAA include inflammatory cell infiltration, extracellular matrix (ECM) destruction and remodeling, and vascular smooth muscle cell loss. The matrix metalloproteinase (MMP) family of proteins plays an important role in initiation and progression of AAA. Since understanding the regulation of MMP-2 and MMP-9 in AAA is essential for treatment of AAA, this review summarized the regulatory mechanisms of MMPs to provide a reference for exploring novel therapeutic approaches.

关键词： aortic aneurysm abdominal aortic Matrix metalloproteinase-2 Matrix metalloproteinase-9

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Ascending aortic aneurysm and Dissection Secondary to Bicuspid aortic Valve with Concomitant Coarctation of Descending Aorta Successfully Repaired with Extracorporeal Membrane Oxygenation Support: A Case Report

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Cardiology Discovery 2022年第2期2卷 124-126页

作者： Qin Jiang Juan Du Tao Yu Xiaobo Huang Mingliang Zuo Keli Huang Department of Cardiac Surgery Sichuan Provincial People’s HospitalAffiliated Hospital of University of Electronic Science and TechnologyChengduSichuan 610072China Department of Operating Room Sichuan Provincia People’s HospitalAffiliated Hospital of University of Electronic Science and TechnologyChengduSichuan 610072China Department of Surgical Intensive Care Unit Sichuan Provincia People’s HospitalAffiliated Hospital of University of Electronic Science and TechnologyChengduSichuan 610072China Department of Medica Ultrasonics Sichuan Provincia People’s HosptalAffiliated Hospital of University of Electronic Science and TechnologyChengduSichuan 610072China

Type A aortic aneurysm and dissection secondary to bicuspid aortic valve(BAV)with untreated coarctation of the aorta(CoA)in adults is a rare finding because there are almost no“abnormalities”in these patients’medical ***,we report on a 47-year-old man with unexplained weakness followed by *** was diagnosed with cardiogenic shock and underwent venoarterial extracorporeal membrane oxygenation(VA-ECMO).BAV,ascending aortic aneurysm and dissection(based on bedside echocardiography)and concomitant CoA(based on computed tomography angiography)were *** patient then underwent emergency surgery including aortic root replacement with a composite mechanical valve conduit,additional ascending-to-descending aortic bypass,and coronary artery bypass grafting with a saphenous vein graft to the right coronary *** treatment,he recovered ***,here we present a case involving a patient in a critical condition with ascending aortic aneurysm and dissection secondary to complex congenital heart defects,who was successfully treated with composite surgical procedures combined with life-saving VA-ECMO.

关键词： aortic aneurysm Dissection Bicuspid aortic valve Case report Coarctation of the aorta Extracorporeal membrane oxygenation

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XBP1 Deficiency in VSMC Contributes to Abdominal aortic aneurysm via Regulating VSMC Phenotypic Switching

XBP1 Deficiency in VSMC Contributes to Abdominal Aortic Aneu...

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中国生理学会基质生物学专业委员会成立大会暨第一次全国基质生物学学术会议

作者： Guizhen Zhao Yi Fu Qingbo Xu Xian Wang Wei Kong Department of Physiology and Pathophysiology School of Basic Medical SciencesPeking University

Abdominal aortic aneurysm(AAA) is a life-threatening cardiovascular disease,characterized by chronic vascular wall inflammation,extracellular matrix degradation and apoptosis of vascular smooth muscle *** studies showed that VSMC phenotypic switching may also play an important role in the pathogenesis of AAA.X-box binding protein 1(XBP1),a basic-region leucine zipper(bZIP) transcription factor,involves spliced(XBP1s) and unspliced(XBP1u) isoforms translated from XBP1 pre-mRNA with or without inositol requiring enzyme 1 alpha(BRE1)-mediated splicing *** functions of XBP1s in cardiovascular diseases has been recently ***,little is known about the role of XBP1u,especially in vascular smooth muscle cells(VSMCs).Firstly,SMC contractile proteins and XBP1u were decreased in aneurysmal aorta compared with normal aortic ***,SMC-specific XBP 1 knockout mice were more susceptible to CaP04 and angiotensin Ⅱ(Ang Ⅱ)-induced AAA than littermate wildtype *** vitro experiments revealed that XBP1u silencing reduced VSMC contractile proteins expression,but enhanced Ang Ⅱ-induced MCP-1 and IL-6 expression,indicating that VSMCs displayed a proinflammatory phenotype following XBP1u *** XBP1u deficiency in VSMCs has no significant effect on the expression of SRF,myocardin,MRTF(myocardin-related protein factor),KLF4 and FOXOs,the transcriptional factors related to VSMC phenotypic *** XBP1u overexpression inhibited the interaction between FOXO4 and myocardin,thus promoting the transcriptional activity of *** study indicated that XBP1 deficiency in VSMCs promotes the formation of abdominal aortic aneurysm through regulating the phenotypic switching of VSMCs.

关键词： aortic aneurysm XBP1u FOXO4 VSMC phenotypic modulation

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Cervical aortic arch with aneurysm formation and an anomalous right subclavian artery and left vertebral artery:A case report

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World Journal of Clinical Cases 2022年第10期10卷 3291-3296页

作者： Yao-Kun Wu Qi Mao Mao-Ting Zhou Ning Liu Xi Yu Jin-Cheng Peng Yun-Yun Tao Xue-Qin Gong Lin Yang Xiao-Ming Zhang Medical Imaging Key Laboratory of Sichuan Province Nanchong 637000Sichuan ProvinceChina Medical Research Center Department of RadiologyThe Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000Sichuan ProvinceChina

BACKGROUND A cervical aortic arch(CAA)refers to a high-riding aortic arch(AA)that often extends above the level of the *** condition is very rare,with an incidence of less than 1/*** SUMMARY A 29-year-old woman was admitted to the otolaryngology department of our hospital for repeated bilateral purulent nasal discharge for the prior 3 *** patient was diagnosed with chronic sinusitis and chronic rhinitis at admission.A preoperative noncontrast chest computed tomography scan showed a high-riding,tortuous AA extending to the mid-upper level of the first thoracic vertebra with local cystic dilatation.A further computed tomography angiography examination showed that the brachiocephalic trunk,left common carotid artery,left vertebral artery(LVA)(slender),and left subclavian artery sequentially branched off of the aorta from the proximal end to the distal end of the *** proximal end of the right subclavian artery(RSCA)was tortuous and *** AA showed tumorlike local expansion,with a maximum diameter of approximately 4 *** consultation with the department of cardiac macrovascular surgery,the patient was diagnosed with left CAA with aneurysm formation and an anomalous RSCA and LVA and was transferred to that *** patient underwent AA aneurysm resection and artificial blood vessel replacement under general anesthesia and cardiopulmonary *** abnormality was found during the 2-mo follow-up after *** A CAA is a rare congenital anomaly of vascular *** present unique case of CAA with aneurysm formation and an anomalous RSCA and LVA enriches existing CAA data.

关键词： Cervical aortic arch aortic aneurysm aortic anomaly Computed tomography angiography Haughton classification Case report

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A canine model of aortic arch aneurysm created with autologous pericardium

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Journal of Interventional Medicine 2022年第3期5卷 133-137页

作者： Weixiao Li Jun Li Qiang li Mingzhe Cui Rutao Xu Shuiting Zhai Cheshire Nick Tianxiao Li Jiangbo Chen Wenli Zhao Department of Vascular and Endovascular Surgery Zhengzhou University People's HospitalHenan Provincial Peoples HospitalZhenghouChina Operation Department Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina Department of Medical Imaging Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina Department of Vascular Surgery Royal Brompton and Harefield HospitalLondonUK Department of Cerebrovascular Disease Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina

Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic *** and methods:Fifteen mongrel dogs underwent *** autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic *** animals were followed up for 3 months *** tomography angiography was used to visualize and measure the aneurysm *** and eosin staining was used to observe the histological characteristics of the aneurysm *** in aneurysm diameter over time were analyzed using analysis of ***:One dog died of hemorrhage during *** dogs survived the surgical *** of them died on the first postoperative day because of ruptures at the suturing *** diameter of the aneurysm model was twice as large as that of the aortic *** was no significant change in the maximum diameter of the aneurysm model during the follow-up ***:We established a controllable and stable aortic arch aneurysm model created with an autologous pericardium *** aneurysm model can be used to research endoleaks after thoracic endovascular aortic repair and new endovascular techniques can be applied to the aortic arch.

关键词： aortic aneurysm Pericardium patch Ascending aorta aortic arch Animal model

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