Rupture of Tuberculous Aortic Aneurysm Into Lung

deProphetis, Nino; Armitage, Harry V.; Triboletti, Eleanor D.

doi:10.1097/00000658-195912000-00012

Cited by 50 publications

(10 citation statements)

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“…In this study, each acquisition was classified into one of these four stages based on the associated B-mode image. An aneurysm was deemed to have occurred if a localized increase of 50% or more in the inner diameter of the vessel was present (de Prophetis et al, 1959; Klevay, 2000), while fissures and ruptures were defined as an opening in the vessel wall in a region that eventually developed an aneurysm (fissure) or previously contained an aneurysm (rupture). Figure 2 shows representative examples of B-modes associated with each disease stage.…”

Section: Methodsmentioning

confidence: 99%

“…In the murine angiotensin II AAA model, three distinct phases of disease progression can be observed: first, the appearance of a fissure in the aortic wall; second, the development of the aneurysm with a sac and possibly an intraluminal thrombus (Thubrikar et al, 2003; Wilson et al, 2013), usually in the anterior wall near the superior mesenteric or coeliac arteries (Lemaître, 2002; Manning et al., 2002); and third, the rupture of the aneurysm. In the existing literature (de Prophetis et al, 1959; Klevay, 2000), aneurysms are typically defined as a localized increase of 50% or more in the inner diameter of the vessel, while the terms “fissure” and “rupture” refer to an opening in the vessel wall in a region that eventually develops an aneurysm (fissure) or previously contained an aneurysm (rupture). Previous work by Luo et al (2009) demonstrated the feasibility of using PWI to distinguish normal aortas from aneurysmal ones qualitatively in the murine AAA model, but did not examine the progression of the disease between the administration of angiotensin II and the appearance of aneurysms.…”

Section: Introductionmentioning

confidence: 99%

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Monitoring and Staging Abdominal Aortic Aneurysm Disease With Pulse Wave Imaging

Nandlall¹,

Goldklang²,

Kalashian³

et al. 2014

Ultrasound in Medicine & Biology

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The Abdominal Aortic Aneurysm (AAA) is a silent and often deadly vascular disease caused by the localized weakening of the arterial wall. Previous work has shown that local changes in wall stiffness can be detected with Pulse Wave Imaging (PWI), which is a noninvasive technique for tracking the propagation of pulse waves along the aorta at high spatial and temporal resolutions. This study aims at assessing the capability of PWI to monitor and stage AAA progression in a murine model of the disease. ApoE/TIMP-1 knockout mice (N = 18) were given angiotensin II for 30 days via subcutaneously implanted osmotic pumps. The suprarenal sections of the abdominal aortas were imaged every 2-3 days after implantation using a 30 MHz Visualsonics Vevo 770 with 115 μm lateral resolution. Pulse wave propagation was monitored at an effective frame rate of 8 kHz by using retrospective electrocardiogram (ECG) gating and by performing 1-D cross-correlation on the radio-frequency (RF) signals to obtain the displacements induced by the waves. In normal aortas, the pulse waves propagated at constant velocities (2.8±0. 9 m/s, r2 = 0.89±0.11), indicating that the composition of these vessels was relatively homogeneous. In the mice that developed AAAs (N = 10), the wave speeds in the aneurysm sac were 45% lower (1.6±0.6 m/s) and were more variable (r2 = 0.66±0.23). Moreover, the wave-induced wall displacements were at least 80% lower within the sacs compared to the surrounding vessel. Finally, in mice that developed fissures (N = 5) or ruptures (N = 3) at the sites of their AAA, higher displacements directed out of the lumen and with no discernible wave pattern (r2 < 0.20) were observed throughout the cardiac cycle. These findings show that PWI can be used to distinguish normal murine aortas from aneurysmal, fissured, and ruptured ones. Hence, PWI could potentially be used to monitor and stage human aneurysms by providing information complementary to standard B-modes.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Monitoring and Staging Abdominal Aortic Aneurysm Disease With Pulse Wave Imaging

Nandlall¹,

Goldklang²,

Kalashian³

et al. 2014

Ultrasound in Medicine & Biology

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show abstract

“…), who had 3 years of experience in small-animal US imaging. An aneurysm was deemed to have developed if a localized increase of at least 50% in the inner maximum AP diameter of the vessel was present (24,25); this occurred for all 26 mice between days 10 and 15.…”

Section: Study Timelinementioning

confidence: 99%

Assessing the Stability of Aortic Aneurysms with Pulse Wave Imaging

Nandlall¹,

Konofagou²

2016

Radiology

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Purpose:To assess whether the stability of murine aortic aneurysms is associated with the homogeneity of pulse wave propagation within the saccular wall. Materials and Methods:All animal procedures were approved by the institutional Animal Care and Use Committee. Apolipoprotein E and tissue inhibitor of metalloproteinases-1 knockout mice (n = 26) were infused with angiotensin II by using subcutaneously implanted osmotic pumps, with an additional control mouse used for histologic examination (n = 1). Pulse wave imaging (PWI) was performed just before infusion and 15 days after infusion by using 40-MHz ultrasonography at 8000 frames per second (with electrocardiographic gating). Aneurysm appearance on B-mode images was monitored every 2-3 days for 30 days. On the basis of B-mode images obtained after 30 days, aneurysms were deemed to have been unstable if they had ruptured; otherwise, they were deemed stable. Statistical significance was assessed by using two-tailed t tests. Results:In normal aortas, the pulse waves propagated at relatively constant velocities (mean 6 standard deviation, 2.8 m/sec 6 0.9). Fifteen days after infusion, all mice had developed aneurysms, with significant (P , .001/12) changes in maximum anterior-posterior diameter (increase of 54.9% 6 2.5) and pulse wave velocity (PWV) (decrease of 1.3 m/ sec 6 0.8). While there was no significant difference in these parameters (P = .45 for diameter and P = .55 for PWV) between stable aneurysms (n = 12) and unstable aneurysms (n = 14), the standard deviation of the highresolution PWV was significantly higher (P , .001/12) in unstable aneurysms (5.7 m/sec 6 1.6) than in stable ones (3.2 m/sec 6 0.9). Conclusion:High-resolution PWI was used to measure the local homogeneity of pulse wave propagation within the saccular wall, which is lower in unstable aneurysms than in stable ones. Hence, if proven to add additional information beyond size and appearance in human studies, PWI could potentially be used to assess the stability of aneurysms by providing information that is complementary to the anatomic data obtained with conventional B-mode imaging.q RSNA, 2016

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“…The patient died of a massive gastrointestinal hemorrhage on the sixth day after surgery. In 1959, Prophetis [5] reported a successful resection of such pseudoaneurysm in the thoracic aorta. But tuberculous pseudoaneurysms may occur anywhere along the arterial system via different infectious pathways of the arterial wall [6,7,10,12,16,17,19,25,27].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous abdominal aortic pseudoaneurysm with renal and vertebral tuberculosis: a case and literature review

Zhang

Chen

et al. 2014

J Infect Dev Ctries

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Tuberculous pseudoaneurysm of the aorta is rare and exposes patients to a very high risk of unpredictable rupture. To our best knowledge, only 32 cases have been reported related to all arterial systems from 1993 to 2013 in the literature. We report a 44-year-old male who presented with an aortic pseudoaneurysm and tuberculosis of the kidney and vertebrae. He underwent endovascular repair and antibiotic therapy for tuberculosis, combined with a bare stent implanted to seal endoleaks after endograft stenting. The postoperative course was uneventful and the patient recovered and lived well afterwards. Epidemiology, pathogenesis, presentation, management, and mortality of this entity were reviewed and discussed.

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Rupture of Tuberculous Aortic Aneurysm Into Lung

Cited by 50 publications

References 2 publications

Monitoring and Staging Abdominal Aortic Aneurysm Disease With Pulse Wave Imaging

Monitoring and Staging Abdominal Aortic Aneurysm Disease With Pulse Wave Imaging

Assessing the Stability of Aortic Aneurysms with Pulse Wave Imaging

Tuberculous abdominal aortic pseudoaneurysm with renal and vertebral tuberculosis: a case and literature review

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