No description available.

Ischemic colitis is a known complication of abdominal aortic aneurysm (AAA) repair. There is still no established consensus regarding the individual significance of factors related to this phenomenon. We detail the hospital course of a patient who unexpectedly developed acute colonic ischemia following open AAA repair. The pathophysiology, diagnostic modalities, potential preventative measures, and effect on patient morbidity and mortality will be presented. Reviewing the current literature, this will focus on the reported statistical importance of various risk factors including the incidence following traditional open repair and endovascular aneurysm repair.

Takanen Niklasson, C. Självrapporterad hälsa hos män som genomgått screening av bukaorta. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Högskola: Hälsa och Samhälle. Utbildningsområde omvårdnad 2012.Abdominellt aortaaneurysm (AAA) är den 13:e vanligaste orsaken till dödsfall i västvärlden på män över 65 år och är fyra gånger vanligare hos män än hos kvinnor. Sedan 2010 erbjuder Region Skåne ultraljuds screening av bukaorta till alla män är 65 år för att upptäcka ev. AAA. AAA uppkommer genom förhöjt kolesterol, rökning kombinerat med högt blodtryck. Även en genetisk faktor spelar roll. Syfte: Studiens syfte var att kartlägga självrapporterat hälsotillstånd och rökvanor hos patienter som via screening diagnostiserats med aortaaneurysm i jämförelse med män med normal aorta. Metod: Studien är en deskriptiv tvärsnittsstudie som bygger på självskattade hälsoformulär som har tagits fram för screeningverksamheten. Dessa fylldes i av männen i hemmet som de sedan lämnade på screeningmottagningen. Data analyserades manuellt i antal och procent i jämförelse mellan män med AAA och de med normal aorta. Resultat: Studiens resultat visade att män med AAA hade högt BMI (Body Mass Index) och led av andra sjukdomar. Vidare hade männen med AAA låg utbildning. Nästan hälften av männen med AAA rökte. Däremot beskrev männen oavsett grupp sin hälsa på liknande sätt i den öppna frågan rörande deras nuvarande hälsotillstånd. Slutsats: Resultatet kan indikera tidigare forskning som visat alla riskfaktorer som leder till ateroskleros även kan leda till utveckling av AAA. Men eftersom ingen statistik har använts i resultatet för att belägga skillnader kan datan endast ses som en trend. Denna kunskap kan utgöra en bas för sjuksköterskans preventiva arbete i mötet med patienter som diagnostiserats med AAA. / Takanen Niklasson, C. Self-reported health of men who underwent abdominal aortascreening. Degree Project, 15 Credit Points. Malmö University: Health and Society, Department of Nursing, 2012.Abdominal aortic aneurysm (AAA) is the 13:th most common cause of death in the western world in men over 65 years old and is four times more common in men than in women. The County Council of Skåne started in 2010 a screening program in men 65 years of age to possibly discover AAA. AAA generates through elevated cholesterol and smoking combined with high blood pressure. There is also a genetic factor involved. Aim: The aim of this study was to chart self-reported state of health and smoking habits of men diagnosed with AAA through screening compared with men with normal aorta. Method: the study is a descriptive cross-sectional survey built on self-rated health questionnaires which was developed for use in the screening program. These were filled out by the men at home and gathered at the screening examination. The data was analyzed manually in numbers and percent and compared between men with AAA and those with normal aorta. Results: The results showed that men with AAA had high BMI (Body Mass Index) and suffered from other diseases. Further had men with AAA a low educational level. Almost 50% of the men with AAA were also smoking. However, all men, irrespective of having AAA or not, described their health in a similar way in the open question regarding their current health status. Conclusion: The result can indicate previous research showing that all risk factors associated with development of atherosclerosis also is associated with the development of AAA. However, no statistics were being used in the result to claim differences so the data can only be a trend. This knowledge can constitute a base for nursing prevention measures in the care of men diagnosed with AAA.

Femoral artery pseudoaneurysm (FAP) is a common complication associated with left heart cardiac catheterization. FAP is a pulsatile encapsulated mass usually formed three to seven days after removal of the arterial sheath post cardiac catheterization. Usually, FAP is asymptomatic. Groin pain and swelling are the most common complaints in symptomatic patients. It can be associated with multiple different complications including rupture, bleeding, and vascular compression leading to venous thrombosis, limb ischemia, and neuropathy. Deep vein thrombosis (DVT) resulting from FAP is an unusual complication with very few cases reported in the literature. We present a case of right-sided DVT secondary to the compression of femoral vein resulting in venous outflow obstruction due to iatrogenic FAP post cardiac catheterization that was successfully managed conservatively.

The goal of this project was to determine whether i) fused deposition modeling could be employed to manufacture molds for vascular constructs, ii) whether vascular constructs could be created from these molds, and iii) to verify practical equivalence between observed fluid velocities. Dye tracking was to be employed to characterize fluid velocity profiles through the in vitro vascular constructs, including a half-vessel model and a full vessel model of an iliac artery aneurysm. A PDMS half-vessel construct was manufactured, and the movement of dye through the construct was tracked by a cellphone camera. Thresholds were applied to each video in HSB or YUV mode in ImageJ, and analyzed to determine the velocity of the fluid through the construct. COMSOL simulations of the half-vessel were conducted for comparison to the empirical observations. Plots describing the flow velocities along the maximum streamline path length were generated, and a one sample t-test was conducted at a 5% significance level to determine whether there was a significant difference between velocity values obtained by dye tracking and the COMSOL simulations. It was determined that the empirical dye tracking trials failed to demonstrate agreement between the measured and predicted flow rates. A full vessel construct was not completed due to unforeseen time constraints. Dye tracking was not determined to be reliable as a means of measuring the maximum velocity of fluid. Discrepancies between the empirical observations and the COMSOL simulation are discussed. The discrepancy was attributed to limitations in the experimental protocol; low frame rate, poor control over lighting conditions, and the subjectivity involved in image processing. Methods of improving upon the manufacturing and experimental protocols used for the half-vessel are proposed for future work, such as improving control over lighting conditions, choosing a camera with a higher frame rate, constructing a more stable fixture, exploring PIV. Additionally, the technical problems leading to the failure to complete the full vessel model are discussed, and changes in the manufacturing process are proposed to allow dissolution or removal of the aneurysm model.

Aortic aneurysms are the 14th leading cause of death in the United States. Annually, abdominal aortic aneurysm (AAA) ruptures are responsible for 4500 deaths. There are another 45,000 repair procedures performed to prevent rupture, and of these approximately 1400 lead to deaths. With proper detection, the aneurysm may be treated using endovascular aneurysm repair (EVAR). Understanding how the flow of the blood within the artery is affected by the aneurysm is important in determining the growth of the aneurysm, as well as how to properly treat the aneurysm. The goal of this project was to develop a physical construct of the AAA, and use this construct to validate a computational model of the same aneurysm through flow visualization. The hypothesis was that the fluid velocities within the physical construct would accurately mimic the fluid velocities used in the computational model. The physical model was created from a CT scan of an AAA using 3D printing and polymer casting. The result was a translucent box containing a region in the shape of the aneurysm. Fluid was pumped through the construct to visualize and quantify the velocity of the fluid within the aneurysm. COMSOL Multiphysics® was used to create a computational model of the same aneurysm, as well as obtain velocity measurements to statistically compare to those from the physical construct. There was no significant difference between the velocity values for the physical construct and the COMSOL Multiphysics® model, confirming the hypothesis. This study used a CT scan to create an anatomically accurate model of an AAA that was used to validate a computational model using a novel technique of flow visualization. As EVAR technologies continue to progress, it will become increasingly important to understand how the blood flow within the aneurysm affects the growth and treatment of AAAs.

Saccular aneurysms are the abnormal plastic deformation of veins and arteries that can lead to lethal thrombus genesis or internal hemorrhaging. Medication and surgery greatly reduce the mortality rates, but treatment is limited by predicting who will develop aneurysms. A common location for saccular aneurysm genesis is at the main middle cerebral artery (MCA) bifurcation. The main MCA bifurcation is comprised of the M1 MCA segment, parent artery, and two M2 segments, daughter arteries. Studies have found that the lateral angle (LA) ratio of the MCA bifurcation is correlated with aneurysm formation. The LA ratio is defined as the angle between the M1 and the larger M2 divided by the angle between the M1 and the smaller M2. When the LA ratio is equal to 1, perfectly symmetrical, no aneurysms are found at the MCA bifurcation. When the LA ratio is greater than 1.6, aneurysms are commonly found at the MCA bifurcation. In the research described here, varying MCA bifurcation angles were compared to uncover any changes to fluid flow and wall shear stress that could stimulate aneurysm growth. Eight pre-aneurysm MCA bifurcation models were created in SolidWorks® using 120 degrees, 90 degrees, and 60 degrees as the angle between the M1 and the larger M2. LA ratios of 1, 1.6 and 2.2 were then used to characterize the other branch angle (60 degrees with a LA ratio of 1 was excluded). These models were imported into COMSOL Multiphysics® where the laminar fluid flow module was used to simulate non-Newtonian blood flow. Fluid flow profiles showed little to no change between the models. Shear stress changed when the LA ratio was increased, but the changed varied between the 120, 90 and 60 degree models. 120 degree models had a 3.87% decrease in max shear stress with a LA ratio of 2.2 while the 90 degree models had 7.5% decrease in max shear stress with a LA ratio of 2.2. Each daughter artery had distinct areas of high shear stress when the LA ratio equaled 1. Increasing the LA ratio or decreasing the bifurcation angle caused the areas of shear stress to merge together. Increasing LA ratio caused shear stress to decrease and spread around the MCA bifurcation. The reduction in max wall shear stress for high LA ratios supports current aneurysm genesis hypothesizes, but additional testing is required before bifurcation geometries can be used to predicted aneurysm genesis.

No description available.

Intracranial aneurysms represent a potentially life-threatening condition and occur in 3–5% of the population. They are increasingly diagnosed due to the broad application of cranial magnetic resonance imaging and computed tomography in the context of headaches, vertigo, and other unspecific symptoms. For each affected individual, it is utterly important to estimate the rupture risk of the respective aneurysm. However, clinically applied decision tools, such as the PHASES score, remain insufficient. Therefore, a machine learning approach assessing the rupture risk of intracranial aneurysms is proposed in our study. For training and evaluation of the algorithm, data from a single neurovascular center was used, comprising 446 aneurysms (221 ruptured, 225 unruptured). The machine learning model was then compared with the PHASES score and proved superior in accuracy (0.7825), F1-score (0.7975), sensitivity (0.8643), specificity (0.7022), positive predictive value (0.7403), negative predictive value (0.8404), and area under the curve (0.8639). The frequency distributions of the predicted rupture probabilities and the PHASES score were analyzed. A symmetry can be observed between the rupture probabilities, with a symmetry axis at 0.5. A feature importance analysis reveals that the body mass index, consumption of anticoagulants, and harboring vessel are regarded as the most important features when assessing the rupture risk. On the other hand, the size of the aneurysm, which is weighted most in the PHASES score, is regarded as less important. Based on our findings we discuss the potential role of the model for clinical practice in geographically confined aneurysm patients.

Objective: While cavernous carotid aneurysms can cause neurological symptoms, their often-uneventful natural course and the increasing options of intravascular aneurysm closure call for educated decision-making. However, evidence-based guidelines are missing. Here, we report 64 patients with cavernous carotid aneurysms, their respective therapeutic strategies, and follow-up. Methods: We included all patients with cavernous carotid aneurysms who presented to our clinic between 2014 and 2020 and recorded comorbidities (elevated blood pressure, diabetes mellitus, and nicotine consumption), PHASES score, aneurysm site, size and shape, therapeutic strategy, neurological deficits, and clinical follow-up. Results: The mean age of the 64 patients (86% female) was 53 years, the mean follow-up time was 3.8 years. A total of 22 patients suffered from cranial nerve deficit. Of these patients, 50% showed a relief of symptoms regardless of the therapy regime. We found no significant correlations between aneurysm size or PHASES score and the occurrence of neurological symptoms. Conclusion: If aneurysm specific symptoms persist over a longer period of time, relief is difficult to achieve despite aneurysm treatment. Patients should be advised by experts in neurovascular centers, weighing the possibility of an uneventful course against the risks of treatment. In this regard, more detailed prospective data is needed to improve individual patient counseling.