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PubMedDate not supplied

False aneurysms of the proximal anastomosis of the arterial prosthesis and the abdominal aorta.

Due to a false aneurysms of the aortic-prosthetic anastomosis ten patients aged 42-74 years underwent surgery. In three patients, an aneurysm occurred twice. One was operated on after the aneurysm had ruptured. Six patients were treated for hypertension. In the course of the primary procedure, in six cases aortic-bifemoral grafts were implanted, in four--an aortic-femoral, and in two aortic-biiliac grafts were used. In six patients end-to-end anastomoses were performed, and in four--end-to-side. Surgical corrections due to the occurrence of a false aneurysm were performed 3 months to 10 years after the original surgery. On reoperation, purulent matter was found in the site of the prosthesis. In two patients, aortic-intestinal fistulas were detected, and in one--an aortic-cecal fistula. In six patients the anastomoses were totally separated. In the course of 13 procedures performed in false aneurysms, five times replaced, single sutures were applied to the entire circumference of the anastomosis in four cases, including one case where an oblong patch was also used, in three cases an extra segment was sutured between the aorta and the previously implanted prosthesis, and the aneurysmal sac was filled with wire in one patient. Eight patients were reoperated, including three repeated procedures due to a false aneurysm of the proximal anastomosis. Moreover, the patency of prostheses was restored, abscesses were surgically opened and procedures were performed in the colon. Four patients have survived, including one with bilateral amputation of lower limbs. The most common cause of death was myocardial infarction. Two patients died due to massive hemorrhage, and one as a result of uremia.

Adult↗
PubMed2001

N-acetyl-cysteine reduces neointimal thickening and procoagulant activity after balloon-induced injury in abdominal aortae of New Zealand white rabbits.

BACKGROUND: Procoagulant activity and oxidative stress generated by balloon injury to normal vessels promote the migration of medial smooth muscle cells and their proliferation in the intima. We hypothesised that administering levo N-acetyl-cysteine (NAC) i.v. at the time of injury, and s.c. before and after injury would reduce neointimal formation 4 weeks later and would regulate procoagulant activity in vessels with neointima undergoing ballooning a second time. METHODS AND RESULTS: at the time of injury rabbits received: NAC, unfractionated heparin (HEP) or both (NAC + HEP). Neointimal thickening at 28 days, calculated as the ratio between the intimal and medial area, was attenuated after NAC, HEP and NAC+HEP by 39%, 30% and 47% respectively when compared to untreated injured animals (CONTROLS) (p <0.05). At 28 days, bound thrombin activity and platelet adhesion 1 h after a repeated balloon injury decreased in animals receiving NAC, HEP and NAC+HEP bv 54%, 63% and 64% for thrombin activity (p <0.05 vs CONTROLS), and by 56%, 66% and 75% respectively for 111Indium-platelet deposition (p <0.05 vs CONTROLS). CONCLUSIONS: NAC in-vivo was effective in reducing neointimal thickening and procoagulant response after balloon injury.

Acetylcysteine↗