Advertisement

Abdominal Radiology

, Volume 43, Issue 5, pp 1067–1083 | Cite as

Acute non-traumatic disease of the abdominal aorta

  • William Curtis
  • Motoyo Yano
Article

Abstract

Acute pathology in the abdominal aorta is associated with significant morbidity and mortality. The most feared complication of abdominal aortic disease is acute rupture in the setting of atherosclerotic abdominal aortic aneurysm. Although frank rupture often is easily diagnosed on CT, other findings such as a hyperattenuating crescent, discontinuous intimal calcium, and draping of the aorta are subtle signs of aneurysm instability. A true aneurysm should be distinguished from a rapidly growing, saccular pseudoaneurysm in the setting of infectious aortitis, as treatment strategy differs. Acute aortic syndrome involving the abdominal aorta, such as dissection and intramural hematoma, often is an extension of thoracic aortic disease, whereas penetrating atherosclerotic ulcers occasionally involve only the abdominal aorta. The goal of treating acute aortic pathology is to repair and prevent rupture, as well as restore and maintain perfusion of the lower extremities, kidneys, and mesentery. However, both open and endovascular repair of the abdominal aorta may become acutely complicated, resulting in compromise of these goals. Examples include aortoenteric fistula, endoleak, anastomotic pseudoaneurysm, graft infection, and thrombosis or kinking of a stent graft resulting in ischemia of the limbs and mesentery.

Keywords

Aortic aneurysm Aortic injury Aortic rupture Aortic instability Non-traumatic aortic injury 

Notes

Compliance with ethical standards

Conflicts of interest

There are no potential conflicts of interest from either author. There were no human or animal participants in this work

References

  1. 1.
    Laine MT, Laukontaus SJ, Kantonen I, Venermo M (2016) Population-based study of ruptured abdominal aortic aneurysm. Br J Surg 103(12):1634–1639.  https://doi.org/10.1002/bjs.10200 CrossRefPubMedGoogle Scholar
  2. 2.
    Healey CT, Neilson M, Clark D, et al. (2017) Predicting mortality of ruptured abdominal aortic aneurysms in the era of endovascular repair. Ann Vasc Surg 38:59–63.  https://doi.org/10.1016/j.avsg.2016.09.006 CrossRefPubMedGoogle Scholar
  3. 3.
    Reimerink JJ, van der Laan MJ, Koelemay MJ, Balm R, Legemate DA (2013) Systematic review and meta-analysis of population-based mortality from ruptured abdominal aortic aneurysm. Br J Surg 100(11):1405–1413.  https://doi.org/10.1002/bjs.9235 CrossRefPubMedGoogle Scholar
  4. 4.
    Lederle FA, Johnson GR, Wilson SE, et al. (2002) Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA 287(22):2968–2972CrossRefPubMedGoogle Scholar
  5. 5.
    Singh M, Koyfman A, Martinez JP (2016) Abdominal vascular catastrophes. Emerg Med Clin North Am 34(2):327–339.  https://doi.org/10.1016/j.emc.2015.12.014 CrossRefPubMedGoogle Scholar
  6. 6.
    Siegel CL, Cohan RH, Korobkin M, et al. (1994) Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR Am J Roentgenol 163(5):1123–1129.  https://doi.org/10.2214/ajr.163.5.7976888 CrossRefPubMedGoogle Scholar
  7. 7.
    Albertyn LE (1988) Perirenal cobwebs: a sign of aortic aneurysm rupture. Australas Radiol 32(1):98–103CrossRefPubMedGoogle Scholar
  8. 8.
    Jones CS, Reilly MK, Dalsing MC, Glover JL (1986) Chronic contained rupture of abdominal aortic aneurysms. Arch Surg 121(5):542–546CrossRefPubMedGoogle Scholar
  9. 9.
    Halliday KE, Al-Kutoubi A (1996) Draped aorta: CT sign of contained leak of aortic aneurysms. Radiology 199(1):41–43.  https://doi.org/10.1148/radiology.199.1.8633170 CrossRefPubMedGoogle Scholar
  10. 10.
    Nakagawa Y, Masuda M, Shiihara H, et al. (1990) A chronic contained rupture of an abdominal aortic aneurysm complicated with severe back pain. Ann Vasc Surg 4(2):189–192.  https://doi.org/10.1007/BF02001378 CrossRefPubMedGoogle Scholar
  11. 11.
    Apter S, Rimon U, Konen E, et al. (2010) Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature. Abdom Imaging 35(1):99–105.  https://doi.org/10.1007/s00261-008-9488-1 CrossRefPubMedGoogle Scholar
  12. 12.
    Pillari G, Chang JB, Zito J, et al. (1988) Computed tomography of abdominal aortic aneurysm. An in vivo pathological report with a note on dynamic predictors. Arch Surg 123(6):727–732CrossRefPubMedGoogle Scholar
  13. 13.
    Mehard WB, Heiken JP, Sicard GA (1994) High-attenuating crescent in abdominal aortic aneurysm wall at CT: a sign of acute or impending rupture. Radiology 192(2):359–362.  https://doi.org/10.1148/radiology.192.2.8029397 CrossRefPubMedGoogle Scholar
  14. 14.
    Arita T, Matsunaga N, Takano K, et al. (1997) Abdominal aortic aneurysm: rupture associated with the high-attenuating crescent sign. Radiology 204(3):765–768.  https://doi.org/10.1148/radiology.204.3.9280256 CrossRefPubMedGoogle Scholar
  15. 15.
    Rakita D, Newatia A, Hines JJ, Siegel DN, Friedman B (2007) Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. Radiographics 27(2):497–507.  https://doi.org/10.1148/rg.272065026 CrossRefPubMedGoogle Scholar
  16. 16.
    Mellnick VM, Heiken JP (2015) Acute disorders of the abdominal aorta. Radiol Clin N Am 53:1209–1224CrossRefPubMedGoogle Scholar
  17. 17.
    Torres WE, Maurer DE, Steinberg HV, Robbins S, Bernardino ME (1988) CT of aortic aneurysms: the distinction between mural and thrombus calcification. AJR Am J Roentgenol 150(6):1317–1319.  https://doi.org/10.2214/ajr.150.6.1317 CrossRefPubMedGoogle Scholar
  18. 18.
    Machida K, Tasaka A (1980) CT patterns of mural thrombus in aortic aneurysms. J Comput Assist Tomogr 4(6):840–842CrossRefPubMedGoogle Scholar
  19. 19.
    Bhalla S, Menias CO, Heiken JP (2003) CT of acute abdominal aortic disorders. Radiol Clin North Am 41(6):1153–1169CrossRefPubMedGoogle Scholar
  20. 20.
    Vu KN, Kaitoukov Y, Morin-Roy F, et al. (2014) Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms. Insights Imaging 5(3):281–293.  https://doi.org/10.1007/s13244-014-0327-3 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Iino M, Kuribayashi S, Imakita S, et al. (2002) Sensitivity and specificity of CT in the diagnosis of inflammatory abdominal aortic aneurysms. J Comput Assist Tomogr 26(6):1006–1012CrossRefPubMedGoogle Scholar
  22. 22.
    Macedo TA, Stanson AW, Oderich GS, et al. (2004) Infected aortic aneurysms: imaging findings. Radiology 231(1):250–257.  https://doi.org/10.1148/radiol.2311021700 CrossRefPubMedGoogle Scholar
  23. 23.
    Katabathina VS, Restrepo CS (2012) Infectious and noninfectious aortitis: cross-sectional imaging findings. Semin Ultrasound CT MR 33(3):207–221.  https://doi.org/10.1053/j.sult.2011.12.001 CrossRefPubMedGoogle Scholar
  24. 24.
    Rozenblit A, Bennett J, Suggs W (1996) Evolution of the infected abdominal aortic aneurysm: CT observation of early aortitis. Abdom Imaging 21(6):512–514CrossRefPubMedGoogle Scholar
  25. 25.
    Muller BT, Wegener OR, Grabitz K, et al. (2001) Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg 33(1):106–113.  https://doi.org/10.1067/mva.2001.110356 CrossRefPubMedGoogle Scholar
  26. 26.
    Miller DV, Oderich GS, Aubry MC, Panneton JM, Edwards WD (2004) Surgical pathology of infected aneurysms of the descending thoracic and abdominal aorta: clinicopathologic correlations in 29 cases (1976 to 1999). Hum Pathol 35(9):1112–1120CrossRefPubMedGoogle Scholar
  27. 27.
    Oderich GS, Panneton JM, Bower TC, et al. (2001) Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg 34(5):900–908.  https://doi.org/10.1067/mva.2001.118084 CrossRefPubMedGoogle Scholar
  28. 28.
    Molacek J, Treska V, Baxa J, Certik B, Houdek K (2014) Acute conditions caused by infectious aortitis. Aorta (Stamford) 2(3):93–99.  https://doi.org/10.12945/j.aorta.2014.14-004 CrossRefGoogle Scholar
  29. 29.
    Long R, Guzman R, Greenberg H, Safneck J, Hershfield E (1999) Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest 115(2):522–531CrossRefPubMedGoogle Scholar
  30. 30.
    Woods JMT, Schellack J, Stewart MT, Murray DR, Schwartzman SW (1988) Mycotic abdominal aortic aneurysm induced by immunotherapy with bacille Calmette–Guerin vaccine for malignancy. J Vasc Surg 7(6):808–881PubMedGoogle Scholar
  31. 31.
    Rozenblit A, Wasserman E, Marin ML, et al. (1996) Infected aortic aneurysm and vertebral osteomyelitis after intravesical bacillus Calmette–Guerin therapy. AJR Am J Roentgenol 167(3):711–713.  https://doi.org/10.2214/ajr.167.3.8751686 CrossRefPubMedGoogle Scholar
  32. 32.
    Alpern RJ, Dowell VR Jr (1969) Clostridium septicum infections and malignancy. JAMA 209(3):385–388CrossRefPubMedGoogle Scholar
  33. 33.
    Mohamed HK, Elliott BM, Brothers TE, Robison JG (2006) Suprarenal Clostridium septicum aortitis with rupture and simultaneous colon cancer. Ann Vasc Surg 20(6):825–829.  https://doi.org/10.1007/s10016-006-9073-4 CrossRefPubMedGoogle Scholar
  34. 34.
    Rucker CM, Menias CO, Bhalla S, Geraghty P, Heiken JP (2004) Clostridium septicum infrarenal aortitis secondary to occult cecal adenocarcinoma. AJR Am J Roentgenol 183(5):1316–1318.  https://doi.org/10.2214/ajr.183.5.1831316 CrossRefPubMedGoogle Scholar
  35. 35.
    Bossone E, Pluchinotta FR, Andreas M, et al. (2016) Aortitis. Vasc Pharmacol 80:1–https://doi.org/10.  https://doi.org/10.1016/j.vph.2015.11.084 CrossRefGoogle Scholar
  36. 36.
    Cho SJ, Park SM, Ryu SM, Jin ES, Lee KH (2014) Nonaneurysmal infectious aortitis. Ann Vasc Surg 28(5):1313–1316.  https://doi.org/10.1016/j.avsg.2013.09.012 CrossRefPubMedGoogle Scholar
  37. 37.
    Fillmore AJ, Valentine RJ (2003) Surgical mortality in patients with infected aortic aneurysms. J Am Coll Surg 196(3):435–441.  https://doi.org/10.1016/S1072-7515(02)01607-1 CrossRefPubMedGoogle Scholar
  38. 38.
    Ihaya A, Chiba Y, Kimura T, Morioka K, Uesaka T (2001) Surgical outcome of infectious aneurysm of the abdominal aorta with or without SIRS. Cardiovasc Surg 9(5):436–440CrossRefPubMedGoogle Scholar
  39. 39.
    Moneta GL, Taylor LM Jr, Yeager RA, et al. (1998) Surgical treatment of infected aortic aneurysm. Am J Surg 175(5):396–399.  https://doi.org/10.1016/S0002-9610(98)00056-7 CrossRefPubMedGoogle Scholar
  40. 40.
    Razavi MK, Razavi MD (2008) Stent-graft treatment of mycotic aneurysms: a review of the current literature. J Vasc Interv Radiol 19(6):S51–S56.  https://doi.org/10.1016/j.jvir.2008.02.012 CrossRefPubMedGoogle Scholar
  41. 41.
    Luo CY, Ko WC, Kan CD, Lin PY, Yang YJ (2003) In situ reconstruction of septic aortic pseudoaneurysm due to Salmonella or Streptococcus microbial aortitis: long-term follow-up. J Vasc Surg 38(5):975–982.  https://doi.org/10.1016/S0741 CrossRefPubMedGoogle Scholar
  42. 42.
    Topel I, Zorger N, Steinbauer M (2016) Inflammatory diseases of the aorta: part 1: Non-infectious aortitis. Gefasschirurgie 21(2):80–86.  https://doi.org/10.1007/s00772-016-0143-9 CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Jennette JC, Falk RJ, Bacon PA, et al. (2013) 2012 revised international chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheum 65(1):1–11.  https://doi.org/10.1002/art.37715 CrossRefPubMedGoogle Scholar
  44. 44.
    Prete M, Indiveri F, Perosa F (2016) Vasculitides: proposal for an integrated nomenclature. Autoimmun Rev 15(2):167–173.  https://doi.org/10.1016/j.autrev.2015.10.008 CrossRefPubMedGoogle Scholar
  45. 45.
    Perugino CA, Wallace ZS, Meyersohn N, et al. (2016) Large vessel involvement by IgG4-related disease. Medicine (Baltimore) 95(28):e3344.  https://doi.org/10.1097/MD.0000000000003344 CrossRefGoogle Scholar
  46. 46.
    Capoccia L, Riambau V (2015) Endovascular repair vs. open repair for inflammatory abdominal aortic aneurysms. Cochrane Database Syst Rev .  https://doi.org/10.1002/14651858.cd010313.pub2 PubMedGoogle Scholar
  47. 47.
    Igari K, Kudo T, Toyofuku T, Inoue Y (2017) Open surgical repair for inflammatory abdominal aortic and iliac artery aneurysms. Ann Vasc Surg 39:105–1https://doi.org/10.  https://doi.org/10.1016/j.avsg.2016.05.107 CrossRefPubMedGoogle Scholar
  48. 48.
    Nathan DP, Boonn W, Lai E, et al. (2012) Presentation, complications, and natural history of penetrating atherosclerotic ulcer disease. J Vasc Surg 55(1):10–15.  https://doi.org/10.1016/j.jvs.2011.08.005 CrossRefPubMedGoogle Scholar
  49. 49.
    Ventura M, Mastromarino A, Cucciolillo L, Calvisi G, Spartera C (2003) Abdominal aortic intramural hematoma related to penetrating ulcer: an inappropriate indication for endovascular repair? J Endovasc Ther 10(2):392–396.  https://doi.org/10.1177/152660280301000237 CrossRefPubMedGoogle Scholar
  50. 50.
    Trimarchi S, Tsai T, Eagle KA, et al. (2007) Acute abdominal aortic dissection: insight from the International Registry of Acute Aortic Dissection (IRAD). J Vasc Surg 46(5):913–919.  https://doi.org/10.1016/j.jvs.2007.07.030 CrossRefPubMedGoogle Scholar
  51. 51.
    Georgiadis GS, Antoniou GA, Georgakarakos EI, et al. (2013) Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review. J Vasc Interv Radiol 24(10):1437–1449.  https://doi.org/10.1016/j.jvir.2013.05.067 CrossRefPubMedGoogle Scholar
  52. 52.
    Chao CP, Walker TG, Kalva SP (2009) Natural history and CT appearances of aortic intramural hematoma. Radiographics 29(3):791–804.  https://doi.org/10.1148/rg.293085122 CrossRefPubMedGoogle Scholar
  53. 53.
    Evangelista A, Czerny M, Nienaber C, et al. (2015) Interdisciplinary expert consensus on management of type B intramural haematoma and penetrating aortic ulcer. Eur J Cardiothorac Surg 47(2):209–217.  https://doi.org/10.1093/ejcts/ezu386 CrossRefPubMedGoogle Scholar
  54. 54.
    McMahon MA, Squirrell CA (2010) Multidetector CT of aortic dissection: a pictorial review. Radiographics 30(2):445–460.  https://doi.org/10.1148/rg.302095104 CrossRefPubMedGoogle Scholar
  55. 55.
    Gargiulo M, Bianchini Massoni C, Gallitto E, et al. (2014) Lower limb malperfusion in type B aortic dissection: a systematic review. Ann Cardiothorac Surg 3(4):351–367.  https://doi.org/10.3978/j.issn.2225-319X.2014.07.05 PubMedPubMedCentralGoogle Scholar
  56. 56.
    Vedantham S, Picus D, Sanchez LA, et al. (2003) Percutaneous management of ischemic complications in patients with type-B aortic dissection. J Vasc Interv Radiol 14(2 Pt 1):181–194CrossRefPubMedGoogle Scholar
  57. 57.
    Henke PK, Williams DM, Upchurch GR Jr, et al. (2006) Acute limb ischemia associated with type B aortic dissection: clinical relevance and therapy. Surgery 140(4):532–539 (discussion 539-540).  https://doi.org/10.1016/j.surg.2006.06.019 CrossRefPubMedGoogle Scholar
  58. 58.
    Orihashi K (2016) Mesenteric ischemia in acute aortic dissection. Surg Today 46(5):509–516.  https://doi.org/10.1007/s00595-015-1193-4 CrossRefPubMedGoogle Scholar
  59. 59.
    Yagdi T, Atay Y, Engin C, et al. (2006) Impact of organ malperfusion on mortality and morbidity in acute type A aortic dissections. J Card Surg 21(4):363–369.  https://doi.org/10.1111/j.1540-8191.2006.00246.x CrossRefPubMedGoogle Scholar
  60. 60.
    Meinel FG, Nikolaou K, Weidenhagen R, et al. (2012) Time-resolved CT angiography in aortic dissection. Eur J Radiol 81(11):3254–3261.  https://doi.org/10.1016/j.ejrad.2012.03.006 CrossRefPubMedGoogle Scholar
  61. 61.
    Angelelli G, Scardapane A, Memeo M, Stabile Ianora AA, Rotondo A (2004) Acute bowel ischemia: CT findings. Eur J Radiol 50(1):37–47.  https://doi.org/10.1016/j.ejrad.2003.11.013 CrossRefPubMedGoogle Scholar
  62. 62.
    Becquemin JP, Allaire E, Desgranges P, Kobeiter H (2005) Delayed complications following EVAR. Tech Vasc Interv Radiol 8(1):30–40.  https://doi.org/10.1053/j.tvir.2005.03.011 CrossRefPubMedGoogle Scholar
  63. 63.
    Jim J, Sanchez LA (2010) Abdominal aortic aneurysms: endovascular repair. Mt Sinai J Med 77(3):238–249.  https://doi.org/10.1002/msj.20180 CrossRefPubMedGoogle Scholar
  64. 64.
    Bosanquet DC, Wilcox C, Whitehurst L, et al. (2017) Systematic review and meta-analysis of the effect of internal iliac artery exclusion for patients undergoing EVAR. Eur J Vasc Endovasc Surg 53(4):534–548.  https://doi.org/10.1016/j.ejvs.2017.01.009 CrossRefPubMedGoogle Scholar
  65. 65.
    Siracuse JJ, Gill HL, Graham AR, et al. (2014) Comparative safety of endovascular and open surgical repair of abdominal aortic aneurysms in low-risk male patients. J Vasc Surg 60(5):1154–1158.  https://doi.org/10.1016/j.jvs.2014.05.018 CrossRefPubMedGoogle Scholar
  66. 66.
    Antoniou GA, Georgiadis GS, Antoniou SA, et al. (2015) Late rupture of abdominal aortic aneurysm after previous endovascular repair: a systematic review and meta-analysis. J Endovasc Ther 22(5):734–744.  https://doi.org/10.1177/1526602815601405 CrossRefPubMedGoogle Scholar
  67. 67.
    Matsushita M, Ikezawa T, Banno H (2008) Type I endoleak-like phenomenon causing rupture of the replaced aneurysm sac 12 years after open repair of abdominal aortic aneurysm. Ann Vasc Dis 1(2):118–120.  https://doi.org/10.3400/avd.AVDcr07009 CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Fransen GA, Vallabhaneni SR Sr, van Marrewijk CJ, et al. (2003) Rupture of infra-renal aortic aneurysm after endovascular repair: a series from EUROSTAR registry. Eur J Vasc Endovasc Surg 26(5):487–493CrossRefPubMedGoogle Scholar
  69. 69.
    Chan CL, Ray SA, Taylor PR, Fraser SC, Giddings AE (2000) Endoleaks following conventional open abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg 19(3):313–317.  https://doi.org/10.1053/ejvs.1999.1046 CrossRefPubMedGoogle Scholar
  70. 70.
    Kaza AK, Cope JT, Kern JA, et al. (2001) A technique for adequate coverage of the proximal suture line during abdominal aortic aneurysm repair. J Vasc Surg 34(2):367–368.  https://doi.org/10.1067/mva.2001.115805 CrossRefPubMedGoogle Scholar
  71. 71.
    Mantoni M, Neergaard K, Christoffersen JK, Lambine TL, Baekgaard N (2006) Long-term computed tomography follow-up after open surgical repair of abdominal aortic aneurysms. Acta Radiol 47(6):549–553CrossRefPubMedGoogle Scholar
  72. 72.
    Gupta PK, Sundaram A, Kent KC (2015) Morbidity and mortality after use of iliac conduits for endovascular aortic aneurysm repair. J Vasc Surg 62(1):22–26.  https://doi.org/10.1016/j.jvs.2015.02.027 CrossRefPubMedGoogle Scholar
  73. 73.
    Nzara R, Rybin D, Doros G, et al. (2015) Perioperative outcomes in patients requiring iliac conduits or direct access for endovascular abdominal aortic aneurysm repair. Ann Vasc Surg 29(8):1548–1553.  https://doi.org/10.1016/j.avsg.2015.06.065 CrossRefPubMedGoogle Scholar
  74. 74.
    Deijen CL, Smulders YM, Coveliers HM, et al. (2016) The importance of early diagnosis and treatment of patients with aortoenteric fistulas presenting with herald bleeds. Ann Vasc Surg 36:28–34.  https://doi.org/10.1016/j.avsg.2016.03.028 CrossRefPubMedGoogle Scholar
  75. 75.
    Saers SJ, Scheltinga MR (2005) Primary aortoenteric fistula. Br J Surg 92(2):143–152.  https://doi.org/10.1002/bjs.4928 CrossRefPubMedGoogle Scholar
  76. 76.
    Vu QD, Menias CO, Bhalla S, et al. (2009) Aortoenteric fistulas: CT features and potential mimics. Radiographics 29(1):197–209.  https://doi.org/10.1148/rg.291075185 CrossRefPubMedGoogle Scholar
  77. 77.
    Lonn L, Dias N, Veith Schroeder T, Resch T (2010) Is EVAR the treatment of choice for aortoenteric fistula? J Cardiovasc Surg (Torino) 51(3):319–327Google Scholar
  78. 78.
    Capoccia L, Mestres G, Riambau V (2014) Current technology for the treatment of infection following abdominal aortic aneurysm (AAA) fixation by endovascular repair (EVAR). J Cardiovasc Surg (Torino) 55(3):381–389Google Scholar
  79. 79.
    Lejay A, Monnot A, Georg Y, et al. (2017) Pathology of graft and stent-graft infections: lessons learned from examination of explant materials. Semin Vasc Surg 30(2–3):70–74.  https://doi.org/10.1053/j.semvascsurg.2017.10.002 CrossRefPubMedGoogle Scholar
  80. 80.
    Arnaoutoglou E, Kouvelos G, Koutsoumpelis A, et al. (2015) An update on the inflammatory response after endovascular repair for abdominal aortic aneurysm. Mediat Inflamm 2015:945035.  https://doi.org/10.1155/2015/945035 CrossRefGoogle Scholar
  81. 81.
    Maldonado TS, Rockman CB, Riles E, et al. (2004) Ischemic complications after endovascular abdominal aortic aneurysm repair. J Vasc Surg 40(4):703–709 (discussion 709-710).  https://doi.org/10.1016/j.jvs.2004.07.032 CrossRefPubMedGoogle Scholar
  82. 82.
    Patel SD, Constantinou J, Hamilton H, Davis M, Ivancev K (2014) Editor’s choice: a shaggy aorta is associated with mesenteric embolisation in patients undergoing fenestrated endografts to treat paravisceral aortic aneurysms. Eur J Vasc Endovasc Surg 47(4):374–379.  https://doi.org/10.1016/j.ejvs.2013.12.027 CrossRefPubMedGoogle Scholar
  83. 83.
    Becquemin JP, Majewski M, Fermani N, et al. (2008) Colon ischemia following abdominal aortic aneurysm repair in the era of endovascular abdominal aortic repair. J Vasc Surg 47(2):258–263 (discussion 263).  https://doi.org/10.1016/j.jvs.2007.10.001 CrossRefPubMedGoogle Scholar
  84. 84.
    Dadian N, Ohki T, Veith FJ, et al. (2001) Overt colon ischemia after endovascular aneurysm repair: the importance of microembolization as an etiology. J Vasc Surg 34(6):986–996.  https://doi.org/10.1067/mva.2001.119241 CrossRefPubMedGoogle Scholar
  85. 85.
    Panthee N, Ono M (2015) Spinal cord injury following thoracic and thoracoabdominal aortic repairs. Asian Cardiovasc Thor Ann 23(2):235–246.  https://doi.org/10.1177/0218492314548901 CrossRefGoogle Scholar
  86. 86.
    Berg P, Kaufmann D, van Marrewijk CJ, Buth J (2001) Spinal cord ischaemia after stent-graft treatment for infra-renal abdominal aortic aneurysms. Analysis of the Eurostar database. Eur J Vasc Endovasc Surg 22(4):342–347.  https://doi.org/10.1053/ejvs.2001.1470 CrossRefPubMedGoogle Scholar
  87. 87.
    Eagleton MJ, Shah S, Petkosevek D, Mastracci TM, Greenberg RK (2014) Hypogastric and subclavian artery patency affects onset and recovery of spinal cord ischemia associated with aortic endografting. J Vasc Surg 59(1):89–94.  https://doi.org/10.1016/j.jvs.2013.07.007 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA

Personalised recommendations