Aortic dissection due to sildenafil abuse

Tiryakioğlu, Selma Kenar; Tiryakioğlu, Osman; Turan, Tamer; Kumbay, Ethem

doi:10.1510/icvts.2009.205849

Cited by 26 publications

(14 citation statements)

References 7 publications

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“…We recently found that PDE5 isoforms A1 and A3 are both up-regulated by Notch3 in VSMCs in vitro, while all the three isoforms are strongly downregulated in thoracic aortic aneurysms (TAAs) (Cesarini et al, 2019). In line with our reports, three independent case reports of patients experiencing aortic aneurysm dissection following the abuse of sildenafil have been described (Famularo et al, 2001;Nachtnebel et al, 2006;Tiryakioglu et al, 2009).…”

Section: Aortasupporting

confidence: 79%

Type 5 phosphodiesterase (PDE5) and the vascular tree: From embryogenesis to aging and disease

Cesarini

Guida

Campolo

et al. 2020

Mechanisms of Ageing and Development

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Vascular tree development depends on the timely differentiation of endothelial and vascular smooth muscle cells. These latter are key players in the formation of the vascular scaffold that offers resistance to the blood flow. This review aims at providing an overview on the role of PDE5, the cGMP-specific phosphodiesterase that historically attracted much attention for its involvement in male impotence, in the regulation of vascular smooth muscle cell function. The overall goal is to underscore the importance of PDE5 expression and activity in this cell type in the context of the organs where its function has been extensively studied.

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Section: Aortasupporting

confidence: 79%

Type 5 phosphodiesterase (PDE5) and the vascular tree: From embryogenesis to aging and disease

Cesarini

Guida

Campolo

et al. 2020

Mechanisms of Ageing and Development

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“…), aortitis, aneurisma aórtico torácico, valva aórtica bicúspide, fármacos, coartación de la aorta, embarazo, estenosis aórtica congénita, enfermedad renal poliquística, feocromocitoma, síndrome de Sheehan y sín-drome de Cushing (Coady et al, 1999a. ;Zinkernagel et al, 2005;Matura et al, 2007;Wakiyama et al, 2007;Reece et al, 2008;Tiryakioglu et al, 2009;Lentini et al, 2009).…”

Section: Discussionunclassified

Hematoma Disecante de la Parte Torácica de la Aorta: Estudio Anatomopatológico de Siete Casos de Autopsias

Guerini¹,

Squintone²,

Borchert³

et al. 2011

Int. J. Morphol.

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RESUMEN:El hematoma disecante de aorta (HDA) se define como la disección de la pared aórtica por la sangre, con formación de una nueva luz. Es la patología letal de la aorta más frecuentemente diagnosticada y ocurre con una frecuencia tres veces mayor que la rotura del aneurisma de la aorta abdominal. Nuestro objetivo es presentar siete casos de HDA observados en autopsias, describir los hallazgos anatomopatológicos y comentar la literatura. Los casos estudiados corresponden al Servicio de Patología del Instituto de Medicina Forense de Córdoba, Argentina. Los tejidos fueron fijados en formol al 10%, incluidos en parafina y coloreados con hematoxilinaeosina, tricrómico de Masson y PAS (Peryodic Acid Schiff). De los siete casos presentados cuatro correspondieron a mujeres (57,1%) y tres a hombres (42,8%). Todos los casos estudiados tenían antecedentes de hipertensión arterial. La evolución posible de la disección aórtica incluye: rotura de la adventicia con hemorragia masiva y muerte, comunicación nuevamente con la luz aórtica, propagación al ostium coronario, isquemia de órganos y la formación de un aneurisma.

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“…There are many studies on aortic and vertebral artery dissections after sildenafil use (2,3,4,5). However, to our knowledge, the presented case is the first one to address the relationship between sildenafil use and intracranial artery dissection.…”

mentioning

confidence: 81%

“…In another study on clinical imaging and neuroimaging in 18 ACA dissection cases, the etiological reasons were hypertension in 8 patients, smoking in 6, and diabetes mellitus in 4 (7). In a study on the relationship between aortic dissection and sildenafil use, the pathological mechanism was proposed to be an increase in the risk of intimal rupture because the vasodilatory property of sildenafil causes a decrease in arterial wall stiffness (5). The antiproliferative effect of sildenafil on human pulmonary artery muscle cell cultures has been observed (8).…”

mentioning

confidence: 99%

Anterior Cerebral Artery Dissection Due to Sildenafil Use

Kelleci

Yalçın

Demir

et al. 2017

Arch Neuropsychiatr

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Dear Editor, Dissection is defined as the leakage of blood from an intravascular compartment into the vessel wall. Craniocervical dissections are a major cause of stroke, particularly among young adults. Mortality and morbidity rates vary based on the dissected vessel and dissection location. Although mortality rates for extracranial carotid and vertebral artery dissections are reported to be between 5% and 10%, mortality rates increase to above 70% for intracranial carotid and basilar artery dissections (1).Sildenafil has been commonly used for treating erectile dysfunction since 1998. This study presents a case in which anterior cerebral artery (ACA) dissection occurred after the recent use of sildenafil.A 45-year-old male was admitted to the emergency department with headache and left-sided weakness. He had a medical history of hypertension and diabetes mellitus, but he was not regularly using any recommended medicine. He had been using sildenafil once or twice a month for the last year for sexual enhancement. He took 100 mg sildenafil 2 h before his complaints had started. He did not have sexual intercourse or trauma before symptom onset. He was a non-smoker. Moreover, he did not have a family history of vascular disease and stroke. At the emergency room, his blood pressure was 160/90 mmHg, and he suffered from a throbbing, persistent headache at the front of his head. He was conscious and oriented. A neurological examination revealed only left-sided hemiplegia. Cranial computed tomography (CT) (Optima CT 660; GE Healthcare, Fairfield, USA) showed hypodensity in the right ACA territory and subarachnoid hemorrhage in the interhemispheric fissure and convexity sulci (Figure 1). Cranial magnetic resonance imaging (Optima MR 450w 1.5 Tesla; GE Healthcare, Fairfield, USA) showed a right ACA acute infarct (Figure 2). Doppler ultrasonography imaging of the carotid and vertebral arteries was normal. Cerebral angiography revealed a dissection at the right ACA between the A1 and A2 segments (Figure 3). Antiplatelet (300 mg/day acetylsalicylic acid) (Coraspin; Bayer, Leverkusen, Germany) and prophylactic antiepileptic (1000 mg/day levetiracetam) (Keppra; UCB, Brussels, Belgium) medication were administered. The high blood glucose level and mildly elevated blood pressure decreased to normal levels with the medication. There was no change in the patient' s level of consciousness. His neurological examination showed stable results. Repeat cranial CT revealed almost full absorption of blood at the subarachnoid space. His physical examination did not indicate any collagen tissue disease symptom. Clinical and laboratory analyses did not reveal any sign of systemic infection. According to his cerebral angiography findings, there was no evidence of cerebral vasculitis or fibromuscular dysplasia. Anti-nuclear antibody (ANA), anti-double stranded DNA (anti-ds DNA), anticardiolipin, anti-Ro, anti-La, and anti-Scl antibodies were within normal limits. The patient did not have migraine-type headache, and his homocysteine level wa...

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Aortic dissection due to sildenafil abuse

Cited by 26 publications

References 7 publications

Type 5 phosphodiesterase (PDE5) and the vascular tree: From embryogenesis to aging and disease

Type 5 phosphodiesterase (PDE5) and the vascular tree: From embryogenesis to aging and disease

Hematoma Disecante de la Parte Torácica de la Aorta: Estudio Anatomopatológico de Siete Casos de Autopsias

Anterior Cerebral Artery Dissection Due to Sildenafil Use

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