Iliac artery dissection in α1-antitrypsin deficiency

Cattan, Stéphane; Mariette, Xavier; Labrousse, F; Brouet, Jean‐Claude

doi:10.1016/s0140-6736(94)92513-5

Cited by 32 publications

(14 citation statements)

References 2 publications

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“…Spontaneous dissection of the iliac artery is an extremely rare event and may occur as a complication of traumatic injuries or systemic disorders such as Marfan syndrome and ␣-1 antitrypsin deficiency [3,4]. ADPKD has been associated with a large number of cardiovascular disorders.…”

Section: Discussionmentioning

confidence: 99%

Dissection of Iliac Artery in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report

Courtois

Nusgens

Delvenne

et al. 2013

aorta

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Autosomal dominant polycystic kidney disease (ADPKD) is a risk factor for several cardiovascular disorders such as intracranial aneurysm or aortic dissection, preferentially occurring at the thoracic or abdominal level. A 47-year-old man suffering from ADPKD had renal transplantation. Sixteen hours after surgery, he presented with left leg pain. Clinical and ultrasound examination revealed thrombosis of the external left iliac artery. Therefore, we decided to perform intra-arterial angiography to evaluate the possibility of an endovascular treatment. Aortofemorography showed an obstruction of the external left iliac artery that was found during emergency surgery, consecutive to a dissection, which occurred following the surgery for kidney transplantation. The resected segment of the dissected vessel was analyzed by histology. Collagen fibers organization and density in the adventitia and smooth muscle cells density in the media were similar in the dissected and a normal artery from a healthy donor. By contrast, an almost complete disappearance and fragmentation of elastic lamellae were observed in the media of the dissected artery, most likely responsible for the weakening of the arterial wall and its dissection. Association between ADPKD and single dissection of the iliac artery has been rarely reported. Relationship between inactivation of polycystin/PKD genes and elastic fibers degradation through elevated TGF␤ signaling and matrix metalloproteinase 2 (MMP2) elastolytic activity, as recently reported in ADPKD, would be worth investigating.

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Section: Discussionmentioning

confidence: 99%

Dissection of Iliac Artery in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report

Courtois

Nusgens

Delvenne

et al. 2013

aorta

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“…[35][36][37] For fibromuscular dysplasia, an association with ␣ 1 -AT deficiency is also suspected. 20 -22 For sCAD, 6 case reports and 1 case series suggest an etiologic role of ␣ 1 -AT for spontaneous arterial dissections: dissection of the internal and external iliac arteries occurred in a 34-year-old man with Pi-SZ genotype, 38 a dissecting hematoma of the left coronary trunk in an ␣ 1 -AT-deficient 46-year-old woman, 39 ICA dissections occurred in a 38-yearold woman and a 50-year-old male with Pi-MZ genotype, 12,40 and sCAD with multiple aneurismal dilatations in a man with M 1 S genotype. 33 Our group reported a 45-year-old male patient with Pi-ZZ genotype who had spontaneous ICA dissection with embolic middle cerebral artery occlusion and was successfully treated by systemic thrombolysis.…”

Section: Discussionmentioning

confidence: 99%

Protease Inhibitors in Spontaneous Cervical Artery Dissections

Konrad

Langer²,

Müller³

et al. 2005

Stroke

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Background and Purpose-Observations in patients with arterial aneurysms, fibromuscular dysplasia, and spontaneous cervical artery dissection (sCAD) indicate that protease inhibitor deficiency might boost the enzymatic destruction of arterial tissue and increase the risk of these arterial wall diseases. Here we present the first large investigation of the protease inhibitor hypothesis in patients with sCAD. Methods-Eighty patients with sCAD were compared with 80 age-and sex-matched healthy individuals. ␣ 1 -antitrypsin (␣ 1 -AT) and ␣ 2 -macroglobulin (␣ 2 -MG) levels, and ␣ 1 -AT genotypes were assessed and compared between groups. Results-␣ 1 -AT and ␣ 2 -MG levels as well as ␣ 1 -AT genotypes did not differ significantly between patients and controls.The frequency of Z alleles in the patient group was higher than in the control group and than in other cohorts from Europe; however, the difference remained nonsignificant. All patients with Z alleles had internal carotid artery dissections. Conclusions-Overall, this data does not support the hypothesis that protease inhibitor levels or ␣ 1 -AT genotypes play an important role in the etiology of sCAD. The present data does not exclude that the Pi-Z allele might have an influence on subgroups of sCAD, such as internal carotid artery dissections. (Stroke. 2005;36:9-13.)

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“…Including our cases, 3 of the 13 patients reported with splenic artery aneurysms who underwent OLT had alpha-l-antitrypsin deficiency [l, 2, 8, 111. Ruptured splenic artery aneurysm has also been reported in a patient with cirrhosis secondary to alpha-l-antitrypsin deficiency [17], as well as in a patient with iliac artery dissection [4]. Alpha-1 -antitrypsin content in the aortic wall has been found to be significantly lower in patients with multiple infra-renal aneurysms and ruptured abdominal aortic aneurysms [5].…”

Section: Discussionmentioning

confidence: 99%

Splenic artery aneurysm and orthotopic liver transplantation

Robertson¹,

Rela²,

Karani³

et al. 1999

Transplant Int

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Splenic artery aneurysms are a rare but potentially fatal complication after liver transplantation. We report three cases presenting in a 12-month period in adult patients who underwent transplantation for chronic liver disease. Doppler ultrasound of the splenic artery should be performed in all patients with cirrhosis and portal hypertension who are being assessed for liver transplantation. The aneurysm can be ligated at the time of transplantation. Key words

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Iliac artery dissection in α1-antitrypsin deficiency

Cited by 32 publications

References 2 publications

Dissection of Iliac Artery in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report

Dissection of Iliac Artery in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report

Protease Inhibitors in Spontaneous Cervical Artery Dissections

Splenic artery aneurysm and orthotopic liver transplantation

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