Abstract:Large, symptomatic and ruptured abdominal aortic aneurysms are usually treated surgically if patients are deemed fit enough. This may be achieved through endovascular or open surgical repair. The type of treatment that a patient receives is dependant on many factors, such as the rupture status of the aneurysm. Each approach is also associated with different risks and postoperative complications. Multiple guidelines exist to inform the surgical management of abdominal aortic aneurysms. This literature review co… Show more
“…We would like to thank Kyriacou et al ( 15 ), Parvizi et al ( 88 ) and Hosoyama et al ( 87 ) for permission to use their figures.…”
Section: Acknowledgmentsmentioning
confidence: 99%
“… Figure 1 Regenerative therapies for the management of abdominal aortic aneurysm. Illustrations in top right panel adapted with permission from [Kyriacou et al ( 15 )], licensed under CC BY 4.0, https://doi.org/10.1177/1750458920947352 . Created with BioRender.com .…”
Abdominal aortic aneurysm (AAA) is a significant source of mortality worldwide and carries a mortality of greater than 80% after rupture. Despite extensive efforts to develop pharmacological treatments, there is currently no effective agent to prevent aneurysm growth and rupture. Current treatment paradigms only rely on the identification and surveillance of small aneurysms, prior to ultimate open surgical or endovascular repair. Recently, regenerative therapies have emerged as promising avenues to address the degenerative changes observed in AAA. This review briefly outlines current clinical management principles, characteristics, and pharmaceutical targets of AAA. Subsequently, a thorough discussion of regenerative approaches is provided. These include cellular approaches (vascular smooth muscle cells, endothelial cells, and mesenchymal stem cells) as well as the delivery of therapeutic molecules, gene therapies, and regenerative biomaterials. Lastly, additional barriers and considerations for clinical translation are provided. In conclusion, regenerative approaches hold significant promise for in situ reversal of tissue damages in AAA, necessitating sustained research and innovation to achieve successful and translatable therapies in a new era in AAA management.
“…We would like to thank Kyriacou et al ( 15 ), Parvizi et al ( 88 ) and Hosoyama et al ( 87 ) for permission to use their figures.…”
Section: Acknowledgmentsmentioning
confidence: 99%
“… Figure 1 Regenerative therapies for the management of abdominal aortic aneurysm. Illustrations in top right panel adapted with permission from [Kyriacou et al ( 15 )], licensed under CC BY 4.0, https://doi.org/10.1177/1750458920947352 . Created with BioRender.com .…”
Abdominal aortic aneurysm (AAA) is a significant source of mortality worldwide and carries a mortality of greater than 80% after rupture. Despite extensive efforts to develop pharmacological treatments, there is currently no effective agent to prevent aneurysm growth and rupture. Current treatment paradigms only rely on the identification and surveillance of small aneurysms, prior to ultimate open surgical or endovascular repair. Recently, regenerative therapies have emerged as promising avenues to address the degenerative changes observed in AAA. This review briefly outlines current clinical management principles, characteristics, and pharmaceutical targets of AAA. Subsequently, a thorough discussion of regenerative approaches is provided. These include cellular approaches (vascular smooth muscle cells, endothelial cells, and mesenchymal stem cells) as well as the delivery of therapeutic molecules, gene therapies, and regenerative biomaterials. Lastly, additional barriers and considerations for clinical translation are provided. In conclusion, regenerative approaches hold significant promise for in situ reversal of tissue damages in AAA, necessitating sustained research and innovation to achieve successful and translatable therapies in a new era in AAA management.
“…Four-dimensional flow with MRI enables the visualization and quantification of complex flow patterns ( Figure 5 ), and this modality, in particular, is showing promise in evaluating predictive factors to determine who would benefit most from prophylactic thoracic endovascular repair. 17 18 19 False lumen pressures and the identification and hemodynamic measurements of small flap fenestrations may prove useful in patient selection as well as optimal placement of thoracic endografts in the future. 12 20 Therefore, select CMR fellowship programs are needed to provide training on how to interpret these images, the basics of image post-processing, and research opportunities to improve these techniques in the future.…”
Section: Vascular Imaging Gaps In Knowledgementioning
confidence: 99%
“…The blood flow patterns are represented in the colored vectors, which represent velocity with blue being closer to 0 m/s and red up to 1 m/s. 17 18 19 …”
Section: Vascular Imaging Gaps In Knowledgementioning
Advances in medical imaging have redefined the practice of vascular surgery. Current training programs for vascular surgery do not incorporate formal training in vascular imaging other than in duplex ultrasound when a physician is undergoing the vascular interpretation certification process. Yet imaging modalities and techniques have grown exponentially in the adjacent fields of interventional radiology, interventional and diagnostic cardiology, and neuroradiology, so much so that advanced imaging fellowships have been established in these fields. This article reviews the current state of vascular imaging training, identifies gaps in the current training regimen, and proposes an advanced vascular imaging fellowship for the future.
“…There is interest in population screening to detect, monitor, and repair abdominal aortic aneurysms before rupture [ 3 ]. AAA repair can be endovascular or with open surgical repair (OSR) [ 5 ], depending on the availability of endovascular repair and surgical team preference.…”
An abdominal aortic aneurysm (AAA) is a disease characterized by an abnormal bulge or swelling in the aorta. It could be serious if left unobserved, and with time, it swells and eventually ruptures, resulting in massive bleeding inside, and, more likely, causes death. This report presents a case study of a 61-year-old male who presented with back pain; no other fatal symptoms such as breathlessness or rapid heart rate were seen. His abdominal ultrasound report showed the presence of a distal aortic dissecting aneurysm, resulting in rapid diagnosis and treatment.
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