Diagnosis and Treatment of Aortic Diseases

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

Deadline for manuscript submissions: 30 May 2024 | Viewed by 837

Special Issue Editor


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Guest Editor
Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Interests: arteries; vascular diseases; carotid arteries; peripheral vascular diseases; arterial stiffness
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Special Issue Information

Dear Colleagues,

The aorta has a variety of unique characteristics compared to other arteries. Due to its large caliber, the aorta is subject to high hemodynamic stresses and rotational flows influenced by the aortic valve, aortic curvatures in all three planes of space, and the departure of multiple arterial branches. These constraints influence the development of pathologies that play a significant role in overall mortality: atherosclerosis of the aorta, which is responsible for a substantial portion of strokes and systemic embolisms, dissection, and hematoma of the aortic wall. The aortic wall is thus subject to intense remodeling, which is the starting point of these diseases, with the development of plaques, wall inflammation, or matrix alterations leading to zones of fragility. Imaging the aorta remains complex due to the difficulty of thoracic exploration, the thinness of the aorta wall, and the constant movements requiring tracking devices. The therapy is no simpler, as the complex surgery involves cardiac, thoracic, and vascular surgeons, and non- or minimally invasive procedures continue to be developed. In this Special Issue, we welcome original work on innovative aortic imaging techniques, as well as on new applications of medical or interventional therapy of the thoracic or abdominal aorta.

Dr. Guillaume Goudot
Guest Editor

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Keywords

  • aorta
  • aortic surgery
  • aneurysm
  • dissection
  • atherosclerosis
  • vasculitis
  • theranostics
  • imaging
  • magnetic resonance imaging
  • wall shear stress

Published Papers (1 paper)

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Research

12 pages, 2623 KiB  
Article
The Comparison of Endovascular and Open Surgical Treatment for Ruptured Abdominal Aortic Aneurysm in Terms of Safety and Efficacy on the Basis of a Single-Center 30-Year Experience
by Mansur Duran, Amir Arnautovic, Cem Kilic, Julian-Dario Rembe, Joscha Mulorz, Hubert Schelzig, Markus Udo Wagenhäuser and Waseem Garabet
J. Clin. Med. 2023, 12(22), 7186; https://doi.org/10.3390/jcm12227186 - 20 Nov 2023
Cited by 1 | Viewed by 605
Abstract
Objective: Ruptured abdominal aortic aneurysm (rAAA) is a critical condition with a high mortality rate. Over the years, endovascular aortic repair (EVAR) has evolved as a viable treatment option in addition to open repair (OR). The primary objective of this study was to [...] Read more.
Objective: Ruptured abdominal aortic aneurysm (rAAA) is a critical condition with a high mortality rate. Over the years, endovascular aortic repair (EVAR) has evolved as a viable treatment option in addition to open repair (OR). The primary objective of this study was to compare the safety and efficacy of EVAR and OR for the treatment of rAAA based on a comprehensive analysis of our single-centre 30-year experience. Methods: Patients treated for rAAA at the Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Germany from 1 January 1993 to 31 December 2022 were included. Relevant information was retrieved from archived medical records. Patient survival and surgery-related complications were analysed. Results: None of the patient-specific markers, emergency department-associated parameters, and co-morbidities were associated with patient survival. The 30-day and in-hospital mortality was higher in the OR group vs. in the EVAR group (50% vs. 8.7% and 57.1% vs. 13%, respectively). OR was associated with more frequent occurrence of more severe complications when compared to EVAR. Overall patient survival was 56 ± 5% at 12 months post-surgery (52 ± 6% for OR vs. 73 ± 11% for EVAR, respectively) (p < 0.05). Patients ≥70 years of age showed poorer survival in the OR group, with a 12-month survival of 42 ± 7% vs. 70 ± 10% for patients <70 years of age (p < 0.05). In the EVAR group, this age-related survival advantage was not found (12-month survival: ≥70 years: 67 ± 14%, <70 years: 86 ± 13%). Gender-specific survival was similar regardless of the applied method of care. Conclusion: OR was associated with more severe complications in our study. EVAR initially outperformed OR for rAAA regarding patient survival while re-interventions following EVAR negatively affect survival in the long-term. Elderly patients should be treated with EVAR. Gender does not seem to have a significant impact on survival. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Aortic Diseases)
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