Few internal iliac artery aneurysms rupture under 4 cm

Laine, Matti; Björck, Martin; Beiles, Barry; Szeberin, Zoltán; Thomson, Ian; Altreuther, Martin; Debus, Eike Sebastian; Mani, Kevin; Menyhei, Gábor; Venermo, Maarit

doi:10.1016/j.jvs.2016.06.109

Cited by 62 publications

(39 citation statements)

References 23 publications

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“…In Finland, 8 per cent of ruptured AAAs were below 55 mm in diameter 18 . In a multinational study 19 , 6 per cent of IIAAs were smaller than 40 mm at the time of rupture. Thus, factors other than size influence the risk of rupture.…”

Section: Discussionmentioning

confidence: 95%

Ruptured popliteal artery aneurysm

Cervin

Ravn

Björck

2018

British Journal of Surgery

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BackgroundPopliteal artery aneurysms (PAAs) are generally complicated by thrombosis and distal embolization, whereas rupture is rare. The aim of this study was to describe the clinical characteristics and outcome in a cohort of patients who had surgery for ruptured PAA (rPAA).MethodsOperations for rPAA were identified from the Swedish Vascular Registry, Swedvasc, 1987–2012. Medical records and imaging were reviewed. Comparison was made with patients treated for PAA without rupture.ResultsForty‐five patients with rPAA were identified. The proportion with rupture among those operated on for PAA was 2·5 per cent. Patients with rPAA were 8 years older (77·7 versus 69·7 years; P < 0·001), had more lung and heart disease (P = 0·003 and P = 0·019 respectively), and a larger mean popliteal aneurysm diameter (63·7 versus 30·9 mm; P < 0·001) than patients with PAA treated for other indications. At time of surgery, 22 of 45 patients were already receiving anticoagulants, seven for concomitant deep venous thrombosis (DVT) in the affected leg. There was extensive swelling of the whole leg in 20 patients. In 27 patients, the initial diagnosis was DVT or a Baker's cyst. All patients underwent surgery, all but three by the open method. There were four amputations, all performed within 1 week of surgery. One year after surgery, 26 of the 45 patients were alive. Among these, the reconstructions were patent in 20 of 22 patients.ConclusionThe diagnosis of rPAA is difficult, and often delayed. The condition affects old patients, who often are on anticoagulation treatment and have large aneurysms. The immediate surgical results are acceptable, but the condition is associated with a high risk of death within the first year after surgery.

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Section: Discussionmentioning

confidence: 95%

Ruptured popliteal artery aneurysm

Cervin

Ravn

Björck

2018

British Journal of Surgery

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“…The development and growth of aneurysms involve the complex events of arterial wall cells remodeling (38). Previous studies have demonstrated that apoptosis is involved in the pathogenesis of aneurysms (6,7).…”

Section: Discussionmentioning

confidence: 99%

MicroRNA‑29a contributes to intracranial aneurysm by regulating the mitochondrial apoptotic pathway

Zhao

Zhang

2018

Mol Med Report

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Intracranial aneurysm (IA) is an abnormal expansion in the intracranial arteries that weakens the arterial wall by consistently pushing the vascular wall outwards, which leads to a higher risk of aneurysm rupture. A number of reports have demonstrated that apoptosis is associated with the growth and rupture of IA. MicroRNAs (miRNAs/miRs) perform vital roles in the regulation of the mitochondrial apoptotic pathway and signaling proteins. Increasing evidence has already revealed the role of miR‑29a in injury, including liver injury, cardiovascular injury and ischaemia‑reperfusion injury. However, the role of miR‑29a in IA remains unclear at present. The present study investigated the role of miR‑29a in IA pathogenesis and the underlying mechanisms. By using reverse transcription‑quantitative polymerase chain reaction and western blot analysis, the present study demonstrated that genes, including caspase‑3, ‑8 and ‑9, and proteins, including cytochrome c and myeloid cell leukemia 1 (Mcl‑1), involved in mitochondrial apoptosis pathways were upregulated in IA groups compared with controls. In addition, microarray analysis demonstrated that miR‑29a, one of the most altered miRs in IA mice, was overexpressed in IA mice compared with controls. In vitro experiments revealed that miR‑29a downregulation attenuated human brain vascular smooth muscle cell (HBVSMC) apoptosis, while miR‑29a overexpression increased the apoptosis of HBVSMCs. Furthermore, luciferase reporter analysis revealed that Mcl‑1 is a direct target gene of miR‑29a. An in vivo IA model confirmed that miR‑29a overexpression may promote apoptosis through mitochondrial pathways. It was therefore concluded that miR‑29a may contribute to the progression of IA by regulating mitochondrial apoptotic pathways. Thus, miR‑29a is a potential therapeutic target for IA.

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“…Laine et al. [ 5 ] suggest that a 40-mm threshold for elective treatment might be quite safe, due to low incidence of rupture in IIAA <40 mm.…”

Section: Discussionmentioning

confidence: 99%

Giant internal iliac artery aneurysm successfully treated with endovascular stent-graft placement

Hatzidakis

Touloupakis

Charalambous

et al. 2018

Interventional Medicine and Applied Science

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An 88-year-old male patient of high surgical risk was presented with left sciatic pain symptoms and a palpable pulsatile left lower abdominal mass. He was operated 8 years ago for a large infrarenal aortic aneurysm. Computed tomography angiography (CTA) revealed a giant 161 mm left internal iliac aneurysm with multilocular appearance and left sacral bone erosion causing the symptoms. Endovascular repair was successfully performed using a monotubular iliac stent-graft. Follow-up CTA showed absence of contrast enhancement and a fully thrombosed sac. Patient recovered completely and was discharged 1 month after the procedure in a relatively good condition, nevertheless sciatic symptoms remained.

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Few internal iliac artery aneurysms rupture under 4 cm

Cited by 62 publications

References 23 publications

Ruptured popliteal artery aneurysm

Ruptured popliteal artery aneurysm

MicroRNA‑29a contributes to intracranial aneurysm by regulating the mitochondrial apoptotic pathway

Giant internal iliac artery aneurysm successfully treated with endovascular stent-graft placement

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