Severe obstructive calcifications affecting the descending and suprarenal abdominal aorta without coexisting peripheral atherosclerotic disease – coral reef aorta

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 206-208 ◽  
Author(s):  
Teebken ◽  
Pichlmaier ◽  
Kühn ◽  
Haverich
Keyword(s):  
Coral Reef ◽  
Abdominal Aorta ◽  
Bypass Graft ◽  
Retroperitoneal Approach ◽  
Rare Form ◽  
Iliac Arteries ◽  
Descending Aorta ◽  
Aortic Replacement ◽  
Thoracic And Abdominal ◽  
Common Iliac Arteries

The case of a 58-year-old woman with leg claudication due to a very rare form of atherosclerosis affecting the descending thoracic and abdominal aorta – known as coral reef aorta – without involvement of the femoro-distal vessels is reported. The patient was treated with a polyester bifurcation graft from the proximal descending aorta to both common iliac arteries via a left dorsal minithoracotomy and a second left retroperitoneal approach. This unusual approach was chosen instead of direct aortic replacement in order to prevent paraplegia. In case of future visceral or left renal malperfusion the diseased artery can be connected to the prosthesis directly or by the use of an additional bypass graft. This would not be the case with a conventional axillo-bifemoral graft.

Biaxial mechanical properties of the human thoracic and abdominal aorta, common carotid, subclavian, renal and common iliac arteries

2014 ◽  
Vol 13 (6) ◽  
pp. 1341-1359 ◽  
Author(s):  
Alexey V. Kamenskiy ◽  
Yuris A. Dzenis ◽  
Syed A. Jaffar Kazmi ◽  
Mark A. Pemberton ◽  
Iraklis I. Pipinos ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Abdominal Aorta ◽  
Iliac Arteries ◽  
Thoracic And Abdominal ◽  
Biaxial Mechanical Properties ◽  
Common Iliac Arteries

scholarly journals Variations in the aortic - common iliac bifurcation in man - a cadaveric study

2013 ◽  
Vol 02 (02) ◽  
pp. 056-060
Author(s):  
Maneesha Sharma ◽  
Tripta Sharma ◽  
Richhpal Singh
Keyword(s):  
Abdominal Aorta ◽  
Abdominal Cavity ◽  
Lumbar Vertebra ◽  
Anatomical Variations ◽  
Iliac Arteries ◽  
Medical College ◽  
Great Vessels ◽  
Exact Position ◽  
Vertebral Bodies ◽  
Common Iliac Arteries

Abstract Background and aims: The abdominal aorta usually terminates at the level of L4 vertebral body into common iliac arteries. With the present day advancements in vascular surgery and neurological surgeries involving approach to lumbar vertebral bodies, we need to know any variations from this normal course. So, the present study aimed at knowing the anatomical variations in the termination of abdominal aorta and in common iliac arteries which might prove to be of some help in some of such surgeries. Material and methods: The study was conducted on 35 adult (29 males and 6 females) embalmed cadavers obtained from anatomy departments of Govt. Medical college, Amritsar and Gian Sagar Medical college, Ramnagar, Punjab. The abdominal cavity was opened, peritoneum stripped off from aorta at its bifurcation, variations in its termination, common iliac arteries and their branches were carefully observed and recorded. Results: In 54.29% cases the level of aortic bifurcation was found opposite 4th Lumbar vertebra, in the rest it was variable between L3 and L5 vertebra. Conclusions: These variations may lead to some trouble during vertebral surgeries, making it essential to investigate and locate the exact position of great vessels before the commencement of surgery.

scholarly journals Regional distribution and severity of arterial calcification in patients with chronic kidney disease stages 1–5: a cross-sectional study of the Copenhagen chronic kidney disease cohort

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ida Maria Hjelm Sørensen ◽  
Sasha Asbøll Kepler Saurbrey ◽  
Henrik Øder Hjortkjær ◽  
Philip Brainin ◽  
Nicholas Carlson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Abdominal Aorta ◽  
Cross Sectional Study ◽  
Arterial Calcification ◽  
Sectional Study ◽  
Cross Sectional ◽  
Iliac Arteries ◽  
High Calcium ◽  
Thoracic And Abdominal

Abstract Background Patients with chronic kidney disease (CKD) and arterial calcification are considered at increased risk of adverse cardiovascular outcomes. However, the optimal site for measurement of arterial calcification has not been determined. The primary aim of this study was to examine the pattern of arterial calcification in different stages of CKD. Methods This was an observational, cross-sectional study that included 580 individuals with CKD stages 1–5 (no dialysis) from the Copenhagen CKD Cohort. Calcification of the carotid, coronary and iliac arteries, thoracic and abdominal aorta was assessed using non-contrast multidetector computed tomography scans and quantified according to the Agatston method. Based on the distribution of Agatston scores in the selected arterial region, the subjects were divided into calcium score categories of 0 (no calcification), 1–100, 101–400 and > 400. Results Participants with CKD stages 3–5 had the highest prevalence of calcification and the highest frequency of calcium scores > 400 in all arterial sites. Calcification in at least one arterial site was present in > 90% of patients with CKD stage 3. In all five CKD stages prevalence of calcification was greatest in both the thoracic and abdominal aorta, and in the iliac arteries. These arterial sites also showed the highest calcium scores. High calcium scores (> 400) in all five arterial regions were independently associated with prevalent cardiovascular disease. In multivariable analyses, after adjusting for cardiovascular risk factors, declining creatinine clearance was associated with increasing calcification of the coronary arteries (p = 0.012) and the thoracic aorta (p = 0.037) only. Conclusions Arterial calcification is highly prevalent throughout all five CKD stages and is most prominent in both the thoracic and abdominal aorta, and in the iliac arteries. Follow-up studies are needed to explore the potential of extracardiac calcification sites in prediction of cardiovascular events in the CKD population.

scholarly journals Determination of the layer-specific distributed collagen fibre orientations in human thoracic and abdominal aortas and common iliac arteries

2011 ◽  
Vol 9 (71) ◽  
pp. 1275-1286 ◽  
Author(s):  
Andreas J. Schriefl ◽  
Georg Zeindlinger ◽  
David M. Pierce ◽  
Peter Regitnig ◽  
Gerhard A. Holzapfel
Keyword(s):  
Wall Thickness ◽  
Dispersion Model ◽  
Collagen Fibre ◽  
Tangential Plane ◽  
Tissue Samples ◽  
Iliac Arteries ◽  
The Media ◽  
The Common ◽  
Thoracic And Abdominal ◽  
Common Iliac Arteries

The established method of polarized microscopy in combination with a universal stage is used to determine the layer-specific distributed collagen fibre orientations in 11 human non-atherosclerotic thoracic and abdominal aortas and common iliac arteries (63 ± 15.3 years, mean ± s.d.). A dispersion model is used to quantify over 37 000 recorded fibre angles from tissue samples. The study resulted in distinct fibre families, fibre directions, dispersion and thickness data for each layer and all vessels investigated. Two fibre families were present for the intima, media and adventitia in the aortas, with often a third and sometimes a fourth family in the intima in the respective axial and circumferential directions. In all aortas, the two families were almost symmetrically arranged with respect to the cylinder axis, closer to the axial direction in the adventitia, closer to the circumferential direction in the media and in between in the intima. The same trend was found for the intima and adventitia of the common iliac arteries; however, there was only one preferred fibre alignment present in the media. In all locations and layers, the observed fibre orientations were always in the tangential plane of the walls, with no radial components and very small dispersion through the wall thickness. A wider range of in-plane fibre orientations was present in the intima than in the media and adventitia. The mean total wall thickness for the aortas and the common iliac artery was 1.39 and 1.05 mm, respectively. For the aortas, a slight thickening of the intima and a thinning of the media in increasingly distal regions were observed. A clear intimal thickening was present distal to the branching of the celiac arteries. All data, except for the media of the common iliac arteries, showed two prominent collagen fibre families for all layers so that two-fibre family models seem most appropriate.

Coral reef aorta: case report and review of the literature

Vascular ◽  
2013 ◽  
Vol 21 (4) ◽  
pp. 251-259 ◽  
Author(s):  
Aleksandra Policha ◽  
Neil Moudgill ◽  
Joshua Eisenberg ◽  
Atul Rao ◽  
Paul DiMuzio
Keyword(s):  
Case Report ◽  
Coral Reef ◽  
Lower Extremity ◽  
English Literature ◽  
Lower Extremities ◽  
Retroperitoneal Approach ◽  
Review Of The Literature ◽  
Rare Form ◽  
Arterial Insufficiency

Coral reef aorta (CRA) is a rare form of atherosclerosis that affects the paravisceral and pararenal aorta and its branches. Patients typically present with arterial insufficiency of the bowels, kidneys and lower extremities. The current mainstay of treatment is operative, typically involving transaortic endarterectomy. Herein, we describe a 54-year-old woman with incapacitating lower extremity claudication secondary to a paravisceral coral reef atheroma treated successfully with transaortic endarterectomy via a left retroperitoneal approach. In addition, we present a complete review of modern English literature on CRA.

scholarly journals Extra-anatomic thoracic aortic bypass operations

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 373
Author(s):  
Arūnas Valaika ◽  
Gediminas Norkūnas ◽  
Gintaras Kalinauskas ◽  
Giedrė Nogienė ◽  
Jurgis Verižnikovas ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Abdominal Aorta ◽  
Bypass Graft ◽  
Emergency Operation ◽  
Aortic Aneurysms ◽  
Major Surgery ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Aortic Bypass ◽  
Thoracic Aneurysms

Objective. When the patient condition contraindicates major surgery for descending thoracic aneurysms, the surgeon should consider using an ascending aorta to abdominal aorta bypass graft, leaving the diseased segment undisturbed. Our experience with eight patients is presented. Material and methods. Between 1988 and 2008, eight patients were treated for the following indications: reoperation for coarctation (two patients), complicated descending aortic aneurysms (five patients), and posttraumatic descending aorta dissection (one patient). The mean age of the patients was 44±8 years (range, 27–53 years). There were 6 (75%) males and 2 (25%) females. Emergency operations were performed in three patients (two with aortic recoarctation, one with posttraumatic aortic dissection). Two cases were reoperations (both after recoarctation). Descending aorta was ligated in seven cases. Distal anastomosis was connected with abdominal aorta in four cases and with iliac arteries in four patients. Results. Three early deaths occurred. Two patients died after emergency operation after recoarctation and posttraumatic aortic dissection, and one patient died after descending aorta aneurysm correction because of bleeding. Conclusions. In complex aortic coarctation, extra-anatomic bypass operation remains an effective procedure. The usage of these procedures in patients with descending aortic aneurysms remains complicated.

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