Surgical treatment of multiple inflammatory aortic aneurysms of the aortic arch and thoracoabdominal aorta

Iha, Kiyoshi; Ikemura, Ryo; Horikawa, Yoshifumi; Akasaki, Mitsuru; Kuniyoshi, Yukio; Koja, Kageharu

doi:10.1007/bf03218187

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…described a case of IgG4‐related tumorous lesion in the coronary artery that occurred together with inflammatory AAA 25 . The involvement of IgG4‐positive plasma cells, however, had not been evaluated in the previously reported inflammatory aneurysms of the ascending aorta and aortic arch 3–14 . In the present case serum IgG4 concentration was not evaluated either before or after operation, but the histopathological findings were similar to those seen in IgG4‐related inflammatory AAA, 15,24,25 and immunohistochemistry indicated abundant IgG4‐positive plasma cell infiltration in the aneurysm wall and an extremely high ratio of IgG4‐positive plasma cells/IgG‐positive plasma cells (84%).…”

Section: Discussionmentioning

confidence: 47%

“…Connery et al. first described a case of inflammatory aneurysm of the ascending aorta 3 and to our knowledge, 12 cases of inflammatory aneurysm of the ascending aorta and aortic arch have been reported in the English‐language literature 3–14 . These inflammatory aneurysms of the ascending aorta and aortic arch had the same histopathological findings as those of inflammatory AAA.…”

mentioning

confidence: 82%

“…Inflammatory aortic aneurysms preferentially develop in the infrarenal abdominal aorta and their presence in the ascending aorta and aortic arch is extremely rare 3–14 . Connery et al.…”

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confidence: 99%

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IgG4‐related inflammatory aneurysm of the aortic arch

Ishida

Hotta

Kushima³

et al. 2009

Pathology International

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IgG4-related sclerosing disease can occur in the cardiovascular system and some inflammatory abdominal aortic aneurysms have been shown to belong to IgG4-related sclerosing disease. Herein is reported a case of IgG4-related inflammatory aortic aneurysm of the aortic arch. A 71-year-old Japanese man was found to have an aneurysm of the aortic arch with maximum dimension of 5.5 cm. The surgically resected aneurysm wall had conspicuous fibrosclerotic changes, dense lymphoplasmacytic infiltration and occasional obliterative phlebitis in the adventitia; the thickness of the adventitia was 6.5 mm. Immunohistochemistry indicated numerous IgG4-positive plasma cell infiltrates; 84% of the IgG-bearing cells were IgG4 positive. The diagnosis of IgG4-related inflammatory aortic aneurysm of the aortic arch was made. Although previously reported IgG4-related inflammatory aortic aneurysms were confined to the abdominal aorta, the present case report demonstrates that IgG4-related inflammatory aortic aneurysm can occur in the aortic arch, thereby extending the spectrum of IgG4-related periaortitis. Further studies are needed to clarify the spectrum of IgG4-related sclerosing disease in the cardiovascular system.

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Section: Discussionmentioning

confidence: 47%

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confidence: 82%

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IgG4‐related inflammatory aneurysm of the aortic arch

Ishida

Hotta

Kushima³

et al. 2009

Pathology International

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“…[10][11][12] Thus, "inflammatory TAA" is considered to be a vague and rarely reported entity, in contrast with inflammatory AAA. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Indeed, patient 1(0.8%), with inflammatory TAA with thicker adventitia (Ͼ5 mm), met our criteria for IgG4-SD. IgG4-related inflammatory TAA has also been reported more recently, 21 and that case was consistent with our findings for IgG4-TAA.…”

Section: Discussionmentioning

confidence: 99%

A clinicopathologic study of immunoglobulin G4-related sclerosing disease of the thoracic aorta

Kasashima

Zen

Kawashima

et al. 2010

Journal of Vascular Surgery

108

107

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“…However, previous reports suggest the rapid enlargement of inflammatory aneurysms. 1,7) In addition, the risk of paraplegia was lower than the risk of rupture in the current patient because the aneurysm of the descending thoracic aorta was a saccular type and it was therefore not necessary to replace a long segment of the descending aorta.…”

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confidence: 99%

A Case of Double Inflammatory Aneurysms in the Thoracic and Abdominal Aorta Repaired Simultaneously

Kanamitsu¹,

Yamada²

2010

Annals of Vascular Diseases

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Intoroduction Inflammatory aortic aneurysms are commonly found in the infrarenal abdominal aorta and represent 3%-10% of all infrarenal abdominal aortic aneurysms; 1) however, multiple inflammatory aortic aneurysms are rare. This report presents a case of multiple inflammatory aortic aneurysms of the descending thoracic aorta and abdominal aorta. CaseA 54-year-old male who had been experiencing a high fever for a month was admitted to a local hospital for examination. He had no history of medical treatment.Blood tests showed a white blood cell count of 6100/mm 3 , C-reactive protein (CRP) of 15.38 mg/dl. The autoimmune screen was negative and included anti-nuclear antibody, C-ANCA (cytoplasmic antineutrophil cytoplasmic autoantibody), P-ANCA (perinuclear anti-neutrophilic cytoplasmic antibody), rheumatoid factor, IgG, Complement C3, anti-SS-A antibody, and anti-SS-B antibody. The bacterial blood tests and serum endotoxin were also negative. Computed tomography (CT) showed saccular aneurysms in the descending thoracic aorta and infrarenal abdominal aorta. The walls of the aneurysms were thickened and enhanced by intravenous contrast which suggested an inflammatory change (Fig. 1, 2).Mycotic aneurysms were suspected and the patient was treated with antibiotics. However, the CRP did not improve and the fever continued. So the patient was transferred to this hospital for further examination and treatment.The aneurysms were diagnosed to be inflammatory aneurysms and the patient was treated with prednisolone because the bacterial blood tests were negative, and CT showed no evidence of intramural air or fluid collection suggestive of an infective etiology. The CRP improved to 1.12 mg/dl in a week which also supported the diagnosis of inflammatory aneurysms. However, CT scan after improvement of CRP showed the descending thoracic aorta aneurysm diameter had grown from 30 mm to 32 mm A 54-year-old male who had been experiencing a high fever for a month was admitted to a local hospital for examination. Computed tomography revealed saccular aneurysms in the descending thoracic aorta and infrarenal abdominal aorta. The walls of the aneurysms were thickened and enhanced by intravenous contrast which suggested the inflammatory change. He was transferred to this hospital and underwent graft replacement of both the descending thoracic aorta and the abdominal aorta simultaneously. Simultaneous surgery should be considered in patients presenting with multiple inflammatory aneurysms, since inflammatory aneurysms have a risk of demonstrating rapid enlargement.

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Surgical treatment of multiple inflammatory aortic aneurysms of the aortic arch and thoracoabdominal aorta

Cited by 4 publications

References 6 publications

IgG4‐related inflammatory aneurysm of the aortic arch

IgG4‐related inflammatory aneurysm of the aortic arch

A clinicopathologic study of immunoglobulin G4-related sclerosing disease of the thoracic aorta

A Case of Double Inflammatory Aneurysms in the Thoracic and Abdominal Aorta Repaired Simultaneously

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