Article
Medicine, General & Internal
Thierry Carrel, Thoralf M. Sundt, Yskert von Kodolitsch, Martin Czerny
Summary: Despite advancements in the prevention, diagnosis, and treatment of acute aortic dissection, it remains a complex cardiovascular event with high mortality and morbidity rates. Recent research has improved our understanding of the disease's pathophysiology and led to reevaluations of existing classifications. There is a shift towards a unified naming system based on morphology and function. The location and extent of the initial tear, as well as the affected aortic segments, determine the appropriate management approach - emergency surgery, endovascular intervention, or medical treatment. Ongoing scientific evidence continues to shape the management and follow-up of acute aortic dissection, the most severe form of acute aortic syndrome.
Article
Cardiac & Cardiovascular Systems
Hong Liu, Ying-yuan Zhang, Xiao-hang Ding, Si-chong Qian, Ming-yu Sun, Al-Wajih Hamzah, Ya-nan Gao, Yong-feng Shao, Hai-yang Li, Kai Wang, Bu-qing Ni, Hong-jia Zhang
Summary: This study evaluated the impact of proximal vs extensive repair on mortality in patients with acute type A aortic dissection and examined how patient characteristics influence this impact. The results showed that extensive repair had a higher operative mortality compared to proximal repair, indicating a higher risk. The choice of surgery should be based on individualized risk prediction and treatment effectiveness.
ANNALS OF THORACIC SURGERY
(2023)
Article
Multidisciplinary Sciences
Yu-Ting Cheng, Kuang-Tso Lee, Chih-Hsiang Chang, Victor Chien-Chia Wu, Yi-Shin Chan, Dong-Yi Chen, Pao-Hsien Chu, An-Hsun Chou, Kuo-Sheng Liu, Shao-Wei Chen
Summary: This study evaluated the effectiveness of dexmedetomidine in patients who received surgery for type A aortic dissection. The results showed that post-operative dexmedetomidine infusion significantly reduced the risk of severe acute kidney injury and newly-onset dialysis in these patients.
SCIENTIFIC REPORTS
(2022)
Article
Medicine, General & Internal
Zhiwei Tang, Yongfeng Shao
Summary: This study aims to investigate whether postoperative thrombocytopenia following open aortic surgery with a median sternotomy can predict morbidity and mortality. The results indicate a significant association between postoperative thrombocytopenia and early-term mortality and acute renal injury.
ANNALS OF MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Kevin R. An, Charles de Mestral, Derrick Y. Tam, Feng Qiu, Maral Ouzounian, Thomas F. Lindsay, Harindra C. Wijeysundera, Jennifer C-Y Chung
Summary: This study found poor adherence to guideline-directed imaging surveillance following ATAAD repair, while long-term mortality and reinterventions rates remained high. Further research is needed to determine if guidelines should be modified.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Physiology
Likun Sun, Jiehua Li, Lunchang Wang, Quanming Li, Hao He, Xin Li, Ming Li, Tun Wang, Chenglei Zhao, Xiaolong Zhang, Chang Shu
Summary: The study aimed to investigate the alterations in aortic geometric parameters associated with acute type B aortic dissection (aTBAD) and found that sharper angulation and higher tortuosity of the aortic arch, as well as type III aortic arch, were specific geometric factors correlated with aTBAD occurrence.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Multidisciplinary Sciences
Anna Oudin, Henrik Bjursten, Daniel Oudin Astroem, Shahab Nozohoor, Khalil Ahmad, Mariann Tang, Markus Bjurbom, Emma C. Hansson, Anders Jeppsson, Christian H. Moeller, Mikko Jormalainen, Tatu Juvonen, Ari Mennander, Peter S. Olsen, Christian Olsson, Anders Ahlsson, Emily Pan, Peter Raivio, Anders Wickbom, Johan Sjogren, Arnar Geirsson, Tomas Gudbjartsson, Igor Zindovic
Summary: A study conducted in 10 Nordic cities found that national holidays and weekends have a negative impact on the incidence of surgery for acute type A aortic dissection (ATAAD), leading to a decrease in the number of surgical repairs.
SCIENTIFIC REPORTS
(2022)
Article
Cardiac & Cardiovascular Systems
Manabu Yamasaki, Hideaki Yoshino, Takashi Kunihara, Koichi Akutsu, Tomoki Shimokawa, Hitoshi Ogino, Mitsuhiro Kawata, Toshiyuki Takahashi, Michio Usui, Kazuhiro Watanabe, Hiroshi Masuhara, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
Summary: This study found that male sex, use of percutaneous circulatory assist devices, shock, cardiac and cerebral ischemia are independent preoperative risk factors for early mortality after acute type A aortic dissection repair, while cardiac tamponade, cerebral and mesenteric ischemia are independent postoperative risk factors.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Toshiyuki Takahashi, Hideaki Yoshino, Koichi Akutsu, Tomoki Shimokawa, Hitoshi Ogino, Takashi Kunihara, Michio Usui, Kazuhiro Watanabe, Mitsuhiro Kawata, Hiroshi Masuhara, Manabu Yamasaki, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
Summary: This study found that female patients with type B acute aortic dissection are typically older, have more intramural hematoma cases, less end-organ malperfusion, and higher in-hospital mortality compared to male patients. However, after multivariable adjustment, gender was not associated with in-hospital mortality.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Surgery
Xuelian Chen, Miao Fang, Jia Yang, Siwen Wang, Xin Wang, Linji Li, Jiaojiao Zhou, Lichuan Yang
Summary: The study aimed to investigate the risk factors for acute kidney disease (AKD) after surgery for acute type A aortic dissection and its impact on early and late mortality. AKI stage 2 and AKI stage 3 were identified as independent risk factors for the development of AKD, and AKD was found to be an independent risk factor for early mortality.
ASIAN JOURNAL OF SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Kevin M. Harris, Christoph A. Nienaber, Mark D. Peterson, Elise M. Woznicki, Alan C. Braverman, Santi Trimarchi, Truls Myrmel, Reed Pyeritz, Stuart Hutchison, Craig Strauss, Marek P. Ehrlich, Thomas G. Gleason, Amit Korach, Daniel G. Montgomery, Eric M. Isselbacher, Kim A. Eagle
Summary: This study examined the early mortality rates for patients with TAAAD in the contemporary era and found that the mortality rate for the medical group was 0.5% per hour (23.7% at 48 hours), while for the surgical group, 48-hour mortality decreased to 4.4%.
Article
Cardiac & Cardiovascular Systems
Domenico Spinelli, Fred A. Weaver, Ali Azizzadeh, Gregory A. Magee, Gabriele Piffaretti, Filippo Benedetto, Charles C. Miller, Harleen K. Sandhu, Dennis R. Gable, Santi Trimarchi
Summary: The study aimed to analyze the outcomes of thoracic endovascular aortic repair for complicated and uncomplicated acute type B aortic dissections. The data from WL Gore's Global Registry for Endovascular Aortic Treatment showed that the 30-day mortality and perioperative complications were equally low for both complicated and uncomplicated type B aortic dissections, and the midterm outcome was positive.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Endocrinology & Metabolism
Shi-Pan Wang, Yuan Xue, Hai-Yang Li, Wen-Jian Jiang, Hong-Jia Zhang
Summary: This study indicated that preoperative high-TSH subclinical hypothyroidism is an independent predictor of postoperative mortality in ATAAD patients undergoing aortic surgery. Patients with preoperative high-TSH subclinical hypothyroidism were associated with longer hospitalization stays, as well as higher 30-day and postoperative mortality rates.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Medicine, General & Internal
Zhiqiang Dong, He Yang, Gang Li, Xinyang Xu, Hong Liu, Jiaxi Gu, Minghui Li, Weidong Gu, Yongfeng Shao, Buqing Ni
Summary: This study collected clinical and imaging data of patients treated with TEVAR for TBAD, and found that preoperative partial thrombosis of the FL and an increase in the maximum aortic diameter are strongly associated with late aortic expansion, suggesting that additional interventions of the FL may improve the prognosis of high-risk patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Klaus Kallenbach, Christopher Buesch, Bartosz Rylski, Daniel-Sebastian Dohle, Tobias Krueger, Thomas Holubec, Jens Brickwedel, Jochen Poeling, Thilo Noack, Christian Hagl, Philipp Jawny, Andreas Boening, Khaled Chalabi, Matthias Karck, Rawa Arif
Summary: This study aimed to interpret the strategies of aortic root surgery in German AADA patients. The results showed that supracommissural replacement was the preferred surgical method for elderly and compromised patients. Extended root preservation techniques may be used for selected patients, even in combination with extended aortic arch surgery, with promising early outcomes.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Talha Butt, Leena Lehti, Jan Apelqvist, Anders Gottsater, Stefan Acosta
Summary: The study evaluated the diagnostic performance of CTA for calf arteries in acute limb ischemia, finding that the sensitivity of CTA for assessing infra-popliteal TASC D lesions was lower in patients with diabetes mellitus compared to those without diabetes. Alternative imaging options should be considered for diabetic patients in the assessment of arterial occlusions.
Article
Peripheral Vascular Disease
Axel Wrede, Leena Lehti, Jonas Peter Eiberg, Stefan Acosta
Summary: The majority of patients undergoing ER for PAA did not adhere to the IFU, mainly due to diameter size difference exceeding 1 mm between overlapping stent grafts leading to a lower primary patency rate at one year. Further multi-center studies with larger sample sizes and longer follow-up periods are needed to evaluate patency outcomes.
Article
Surgery
Andrea Kulezic, Martin Macek, Stefan Acosta
Summary: This study investigated the association between adherence to guidelines on the clinical diagnosis of acute lower limb ischemia (ALI) and outcomes at 1 year. The results showed that better examination was associated with favorable outcomes.
ANNALS OF VASCULAR SURGERY
(2022)
Article
Surgery
Emil Karonen, Frida Eek, Talha Butt, Stefan Acosta
Summary: This study compared the effects of prophylactic fasciotomy (PF) and therapeutic fasciotomy (TF) on renal function and wound outcomes in patients. The study found that both groups had similar improvements in renal function, but the TF group had a higher wound infection rate, while the PF group had a higher rate of other wound complications. Therefore, a more conservative approach to fasciotomy may be possible and safe if early diagnosis and treatment of ACS can be ensured, avoiding unnecessary fasciotomies and reducing wound complications while preserving renal function.
ANNALS OF VASCULAR SURGERY
(2023)
Editorial Material
Surgery
Stefan Acosta
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
(2022)
Article
Peripheral Vascular Disease
Andrea Kulezic, Stefan Acosta, Olle Ekberg, Leena Lehti
Summary: This study aimed to evaluate the incidence of extravascular incidental findings (EVIFs) in emergency computed tomography angiography (CTA) in patients with acute lower limb ischaemia (ALI), and investigate their association with emergency revascularization and amputation-free survival at 1 year. The results showed that clinically relevant EVIFs were associated with reduced emergency revascularization and increased rate of combined major amputation/mortality at 1 year.
Article
Surgery
Robert Svensson-Bjork, Julien Hasselmann, Giuseppe Asciutto, Moncef Zarrouk, Jonas Bjork, Linda Bilos, Artai Pirouzram, Stefan Acosta
Summary: This study evaluated the effect of negative pressure wound therapy (NPWT) on surgical site infection (SSI) incidence in groin incisions after endovascular aneurysm repair (EVAR). The results showed no difference in SSI incidence between NPWT and standard dressings at 90 days postoperatively.
WORLD JOURNAL OF SURGERY
(2022)
Review
Medicine, General & Internal
Kadri Tamme, Annika Reintam Blaser, Kaja-Triin Laisaar, Merli Mandul, Jaak Kals, Alastair Forbes, Olga Kiss, Stefan Acosta, Martin Bjorck, Joel Starkopf
Summary: This study estimated the incidence, proportions, and mortality rates of acute mesenteric ischaemia (AMI) and found that AMI is a rare condition with high mortality, though there have been improvements in treatment outcomes over the last decades.
Article
Cardiac & Cardiovascular Systems
Anna Johansson, Stefan Acosta, Pascal M. M. Mutie, Emily Sonestedt, Gunnar Engstrom, Isabel Drake
Summary: Diet quality and leisure-time physical activity are associated with a reduced risk of atherothrombotic ischemic stroke. Higher diet quality and leisure-time physical activity are associated with a lower risk, while total, occupational, and domestic physical activity levels are not associated with the risk.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Biology
Rita Jacobs, Robert D. Wise, Ivan Myatchin, Domien Vanhonacker, Andrea Minini, Michael Mekeirele, Andrew W. Kirkpatrick, Bruno M. Pereira, Michael Sugrue, Bart De Keulenaer, Zsolt Bodnar, Stefan Acosta, Janeth Ejike, Salar Tayebi, Johan Stiens, Colin Cordemans, Niels Van Regenmortel, Paul W. G. Elbers, Xavier Monnet, Adrian Wong, Wojciech Dabrowski, Philippe G. Jorens, Jan J. De Waele, Derek J. Roberts, Edward Kimball, Annika Reintam Blaser, Manu L. N. G. Malbrain
Summary: This review summarizes the current knowledge on the association between fluid administration and intra-abdominal pressure in patients at risk of intra-abdominal hypertension and abdominal compartment syndrome. Most studies confirm the association between fluid resuscitation and intra-abdominal hypertension, but optimal fluid management strategies for these patients remain controversial.
Article
Surgery
Stefan Acosta, Emil Karonen, Frida Eek, Talha Butt
Summary: This study compared the effects, complications, and outcomes of pharmaco-mechanical thrombolysis (PMT) first versus catheter-directed thrombolysis (CDT) first in patients with acute lower limb ischemia (ALI). The results showed that PMT first may be a good treatment alternative for ALI patients, but further research is needed to confirm these findings.
ANNALS OF VASCULAR SURGERY
(2023)
Article
Peripheral Vascular Disease
Axel Wrede, Stefan Acosta, Leena Lehti, Ulver S. Lorenzen, Alexander H. Zielinski, Jonas P. Eiberg
Summary: CEUS is sensitive in detecting endoleaks after EPAR, and shrinkage of the aneurysm sac was observed in both patients with and without endoleaks. CEUS may be useful for targeted examinations rather than routine surveillance after EPAR.
INTERNATIONAL ANGIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Sakshi Vats, Kristina Sundquist, Jan Sundquist, Naiqi Zhang, Xiao Wang, Stefan Acosta, Anders Gottsater, Ashfaque A. Memon
Summary: The study investigates the impact of genetic variations in genes related to oxidative stress, intake of antioxidant vitamins, and potential interactions on abdominal aortic aneurysm (AAA) and its rupture. Results show that a variant in NOX3 is associated with increased risk of AAA and rupture. Higher intake of antioxidant vitamins, riboflavin, and folate are associated with reduced incidence of AAA. The relationship between riboflavin and vitamin B12 intake and AAA risk is modified by sex.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Health Care Sciences & Services
Johan Nyman, Stefan Acosta, Christina Monsen, Julien Hasselmann, Francis Rezk, Ann-Christine Andersson
Summary: The PICO(TM) dressing system is well accepted by most patients, although some patients express concerns about inconvenience and lack of information.
JOURNAL OF PATIENT EXPERIENCE
(2022)
Review
Medicine, General & Internal
Sara Bergwall, Anna Johansson, Emily Sonestedt, Stefan Acosta
Summary: The effects of low intake of added sugar on cardiovascular disease risk factors are uncertain. Future studies with longer follow-up time are needed to clarify the impact of added sugar on cardiovascular events and all-cause mortality.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)
