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Aortic Aneurysm: Latest Insights into Therapeutic Approaches
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Aortic Aneurysm: Latest Insights into Therapeutic Approaches

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (25 June 2024) | Viewed by 4655

Special Issue Editors

Prof. Dr. Athanasios Giannoukas

E-Mail Website
Guest Editor
Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Interests: carotid artery disease; aortic aneurysms; peripheral arterial disease; chronic venous disease; venous thrombosis
Special Issues, Collections and Topics in MDPI journals
Dr. Konstantinos Spanos

E-Mail Website
Guest Editor
Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
Interests: aortic aneurysm; thoracoabdominal aneurysm; aortic dissection; atheromatosis; complex aneurysm; aortic biology; endovascular treatment; peripheral aneurysm
Special Issues, Collections and Topics in MDPI journals
Dr. George N. Kouvelos

E-Mail Website
Guest Editor
Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
Interests: endovascular; aortic aneurysm; thoracoabdominal aneurysm; complex aneurysm carotid stenosis; angioplasty; stenting
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Aortic aneurismal disease is a potentially life-threatening condition, and its prevalence is expected to grow with the increase in the elderly population due to prolonged life expectancy. Thus, the demand for vascular procedures will inevitably rise worldwide. Over the last two decades, endovascular treatment has evolved to become the treatment of choice due its associated low morbidity and mortality, while the procedure has been subjected to various refine-ments with new devices and techniques. Additionally, pre-, peri- and post-operative technological advancements have also improved and new insights have appeared in various fields (imaging, software process, diagnostic tools, perioperative protective measures, and follow-up procedures).

This Special Issue aims to provide an update of new insights into diagnostic and therapeutic approaches, focusing on the whole area of aortic aneurysm management, including perceptions of new technologies and novel devices. Accordingly, this Special Issue will provide a forum for high-quality original research and review articles with up-to-date evidence and knowledge.

Prof. Dr. Athanasios Giannoukas
Dr. Konstantinos Spanos
Dr. George N. Kouvelos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic aneurysm
  • endovascular repair
  • imaging
  • diagnosis
  • therapy epidemiology

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Related Special Issue

Published Papers (4 papers)

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Research

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13 pages, 864 KiB  
Article
Intra- and Early Post-Operative Factors Affecting Spinal Cord Ischemia in Patients Undergoing Fenestrated and Branched Endovascular Aortic Repair
by Allegra Doering, Petroula Nana, José I. Torrealba, Giuseppe Panuccio, Constantin Trepte, Viorel Chindris and Tilo Kölbel
J. Clin. Med. 2024, 13(13), 3978; https://doi.org/10.3390/jcm13133978 - 8 Jul 2024
Viewed by 869
Abstract
Background: Spinal cord ischemia (SCI) is a severe complication after fenestrated/branched endovascular repair (f/bEVAR). The underlying causes of SCI are still under investigation. This study aimed to evaluate intra- and early post-operative parameters that may affect SCI evolution. Methods: A single-center retrospective [...] Read more.
Background: Spinal cord ischemia (SCI) is a severe complication after fenestrated/branched endovascular repair (f/bEVAR). The underlying causes of SCI are still under investigation. This study aimed to evaluate intra- and early post-operative parameters that may affect SCI evolution. Methods: A single-center retrospective analysis was conducted including SCI patients with complete anesthesiologic records (1 January 2011 to 31 December 2023). Values of intra-operative glucose, hemoglobin, lactate, activated clotting time (ACT), and the need for transfusion were collected. The cohort was compared to a matched cohort of non-SCI patients. Results: Fifty-one patients with SCI and complete anesthesiologic records were included (mean age: 69.8 ± 6.2 years; 39.2% male). Intra-operative glucose value < 110 mg/dL (AUC: 0.73; sensitivity 91%, specificity of 83%) and hemoglobin value > 8.5 mg/dL (AUC: 0.61; sensitivity 83%, specificity 78%) were protective for Grade 3 SCI. Twenty-three patients with SCI were matched to 23 patients without SCI. SCI patients presented significantly higher glucose levels intra-operatively (glucose mean value: SCI 150 ± 46 mg/dL vs. non-SCI: 122 ± 30 mg/dL, p = 0.005). ACT (SCI 259 ± 31 svs. non-SCI 288 ± 28 s, p = 0.001), volume input (SCI 4030 ± 1430 mL vs. non-SCI 3020 ± 113 mL, p = 0.009), and need for transfusion (SCI: 52.5% vs. 4.3%, p < 0.001) were related to SCI. Higher glucose levels were detected among patients with SCI, at 24 (SCI: 142 ± 30 mg/dL vs. non-SCI: 118 ± 26 mg/dL, p=0.004) and 48 h (SCI: 140 ± 29 mg/dL vs. non-SCI: 112 ± 20 mg/dL, p < 0.001) post-operatively. Conclusions: SCI is a multifactorial complication after f/bEVAR. Intra-operative and early post-operative glucose levels may be related to SCI evolution. Targeted glucose < 110 mg/dL may be protective for Grade 3 SCI. Full article
(This article belongs to the Special Issue Aortic Aneurysm: Latest Insights into Therapeutic Approaches)
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12 pages, 1409 KiB  
Article
Can Biomarkers and PET Imaging Predict Abdominal Aortic Aneurysm Growth Rate?
by Samuel Bruls, Lucia Musumeci, Audrey Courtois, Roland Hustinx, Sarah Sakalihasan, Gauthier Namur, Jean-Olivier Defraigne and Natzi Sakalihasan
J. Clin. Med. 2024, 13(8), 2448; https://doi.org/10.3390/jcm13082448 - 22 Apr 2024
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Abstract
Background: Abdominal aortic aneurysm (AAA) is a life-threatening condition due to the risk of aneurysm growth and rupture. Biomarkers linked to AAA pathogenesis are attractive candidates for AAA diagnosis and prognosis. The aim of this study was to assess circulating biomarkers levels relationship [...] Read more.
Background: Abdominal aortic aneurysm (AAA) is a life-threatening condition due to the risk of aneurysm growth and rupture. Biomarkers linked to AAA pathogenesis are attractive candidates for AAA diagnosis and prognosis. The aim of this study was to assess circulating biomarkers levels relationship with PET imaging positivity and their predictive value in AAA growth rate. Methods: A total of 164 patients with AAA had whole body [18F]FDG PET/CT examination and blood drawn for biomarkers analysis at inclusion. Of these, 121 patients had at least one follow-up imaging assessment for AAA progression. Median (quartiles) imaging follow-up period was 32.8 months (15.2–69.6 months). Results: At baseline, PET was visually positive in 28 (17%) patients. Among PET+ patients, female proportion was higher compared to PET−patients (respectively, n = 6, 21.4% vs. n = 11, 8.1%, p = 0.046). Biomarkers of inflammation (CRP, CCL18), of proteolytic activity (MMP9), of extracellular matrix, and calcification regulation (OPN, OPG) were all significantly increased in PET+ patients (p < 0.05). During follow-up, rapid AAA growth (increase in size ≥ 1 cm per year) was observed in 36 (29.8%) patients and several biomarkers (CRP, MMP9, OPN, and OPG) were increased in those patients compared to patients without rapid growth (p < 0.05). Conclusions: Although PET positivity at baseline was not associated with rapid growth, CRP levels showed a significant association. Full article
(This article belongs to the Special Issue Aortic Aneurysm: Latest Insights into Therapeutic Approaches)
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Review

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13 pages, 2033 KiB  
Review
CO2 Angiography in the Standard and Complex Endovascular Repair of the Abdominal Aorta—A Narrative Review of the Literature
by Paolo Spath, Stefania Caputo, Federica Campana, Enrico Gallitto, Rodolfo Pini, Chiara Mascoli, Andrea Vacirca, Gianluca Faggioli and Mauro Gargiulo
J. Clin. Med. 2024, 13(16), 4634; https://doi.org/10.3390/jcm13164634 - 7 Aug 2024
Cited by 1 | Viewed by 778
Abstract
Background/Objectives: Carbon dioxide digital-subtraction angiography (CO2-DSA) is an increasingly adopted technique in endovascular aortic repair (EVAR) and fenestrated/branched EVAR (F/B-EVAR); it is used to reduce the amount of iodinate contrast medium (ICM) and prevent postoperative renal function worsening (PO-RFW). Our [...] Read more.
Background/Objectives: Carbon dioxide digital-subtraction angiography (CO2-DSA) is an increasingly adopted technique in endovascular aortic repair (EVAR) and fenestrated/branched EVAR (F/B-EVAR); it is used to reduce the amount of iodinate contrast medium (ICM) and prevent postoperative renal function worsening (PO-RFW). Our aim is to report results from the literature on EVAR and F/B-EVAR procedures using CO2-DSA, together with wider applications in aortic endovascular treatment. Methods: We performed a literature review by searching electronic databases for published data on CO2-DSA during EVAR and F/B-EVAR procedures. The endpoints were postoperative renal function worsening (PO-RFW) and efficacy of intraoperative arterial visualization. Further, applications of CO2 for thoracic endovascular aortic repair (TEVAR) were described. Results: Seventeen studies reporting results on CO2-DSA in EVAR (644 patients) were retrieved. Overall, 372 (58%) procedures were performed with CO2 alone, and 272 (42%) were performed with CO2+ICM. Eight studies analyzed the effect of CO2-DSA angiography on PO-RFW; four studies showed a significantly lower rate of PO-RFW compared to ICM. Five studies (153 patients) analyzed intraoperative arterial visualization with CO2-DSA; renal and hypogastric arteries were effectively visualized in 69% and 99% of cases, respectively. The use of CO2-DSA in F/B-EVAR has not been widely investigated. The largest series reported that PO-RFW was lower in the CO2 vs. ICM group. Conclusions: Carbon dioxide is widely applied in modern aortic endovascular treatment. CO2-DSA for EVAR and F/B-EVAR is an efficient technique for reducing PO-RFW while allowing acceptable arterial intraoperative visualization. Full article
(This article belongs to the Special Issue Aortic Aneurysm: Latest Insights into Therapeutic Approaches)
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Other

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11 pages, 38976 KiB  
Case Report
Management of a Rare Case of Multiple Coronary Artery Fistulas Associated with Ascending Aortic and Root Aneurysm: Case Report and Review of Literature
by Mircea Robu, Bogdan Radulescu, Reza Nayyerani, Robert Enache, Ovidiu Stiru, Andrei Iosifescu, Georgiana Olaru, Raluca Ciomag (Ianula), Vlad Anton Iliescu and Horatiu Moldovan
J. Clin. Med. 2024, 13(8), 2297; https://doi.org/10.3390/jcm13082297 - 16 Apr 2024
Cited by 1 | Viewed by 1070
Abstract
Coronary artery fistulas draining into the left ventricle is a rare finding. They can be associated with other congenital cardiac anomalies like ventricular septal defect or tetralogy of Fallot. While most of them are asymptomatic, they can lead to severe cardiac complications like [...] Read more.
Coronary artery fistulas draining into the left ventricle is a rare finding. They can be associated with other congenital cardiac anomalies like ventricular septal defect or tetralogy of Fallot. While most of them are asymptomatic, they can lead to severe cardiac complications like infective endocarditis, heart failure, or myocardial ischemia. Symptomatic coronary artery fistulas can be managed surgically or percutaneously. We present a case of a 61-year-old male patient with both left anterior descending artery and right coronary artery fistulas draining into the left ventricle associated with ascending aorta and root aneurysm. Preoperative assessment for myocardial ischemia and the size and location of the fistulas was performed. The echocardiography stress test was negative. Surgery consisted of replacement of the ascending aorta and reconstruction of the noncoronary sinus with a Dacron patch with aortic valve preservation and no intervention for the coronary artery fistulas. The surgical strategy was adapted for cardioplegia administration to compensate for the volume of coronary blood drained into the left ventricle and for better protection of the distal myocardium. Full article
(This article belongs to the Special Issue Aortic Aneurysm: Latest Insights into Therapeutic Approaches)
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