Category: General

Ann Vasc Surg. 2024 Dec 13;112:22-31. doi: 10.1016/j.avsg.2024.11.095. Online ahead of print.

ABSTRACT

BACKGROUND: Echinococcosis is a parasitic disease caused by Echinococcus granulosus that most commonly affects the liver (70%) and lungs (20%). Despite rarely reported, arterial echinococcosis represents a severe and potentially life-threatening condition but management strategies and related outcomes have not been fully investigated.

METHODS: A comprehensive review of the international English literature was performed on PubMed, Scopus, and Web of Science from inception to May 30, 2024 to identify relevant articles about arterial echinococcosis. Data regarding epidemiology, pathogenesis, clinical presentation, diagnostic methods, and treatment were investigated.

RESULTS: A total of 143 articles were screened and 30 articles were included. Overall 32 cases were identified. About half of the patients were female (18, 56.2%) and the mean age was 40.6 years (range 12-60 years). Echinococcus cyst was more commonly detected on the aorta (27, 84.3%) in association or not with other cysts on the iliofemoral axis. Five cases (15.2%) affected only peripheral arteries. Most patients presented with chronic pain due to vascular obstruction or thromboembolism, while one patient was asymptomatic. In most cases (31, 96.8%) a total surgical excision was done in association with antiparasitic treatment using albendazole (17, 53.1%) or mebendazole (4, 12.5%). Arterial reconstruction was required in 19 cases (59.4%) and done with prosthetic substitutes or bovine pericardium. Only one case (3%) was treated with an endovascular approach. Four patients (12.5%) died in-hospital from hemorrhagic shock (3) or respiratory failure (1). During the follow-up period (mean 14 months, range 2-72 months) only one recurrence was reported.

CONCLUSIONS: Arterial echinococcosis is an extremely rare condition that may potentially be lethal. The current review showed favorable outcomes following complete surgical excision and antiparasitic drug that currently remain the only definitive treatment.

PMID:39675696 | DOI:10.1016/j.avsg.2024.11.095

Histol Histopathol. 2024 Oct 31:18842. doi: 10.14670/HH-18-842. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze and compare, in an animal model, the treatment of thoracoabdominal aneurysms with multilayer stents and its hemodynamic effects through the biomechanical and histological analysis of the aortic wall in contact with the stent.

METHODS: Large White pigs were randomized into two groups: Stent (n=6) and Control (n=5, non-stent). All animals were subjected to the creation of a suprarenal aneurysm with a bovine pericardial patch. In the Stent group, a multilayer stent was implanted immediately after aneurysm formation. After four weeks, all animals were subjected to angiographic assessment and intravascular ultrasound, and the stent was explanted before euthanasia for histological and biomechanical analyses.

RESULTS: At histological analysis, the groups did not differ significantly in maximum thickness of the intima (p=0.526), media (p=0.129), or adventitia (p=0.662). Thrombus formation was observed in 100% of the animals on the intima and media layers of the stented aorta vs. none in the Control group (p=0.048). At biomechanical analysis, no statistical differences were observed in aortic wall elasticity (p=0.158), strength (p=0.360), or thickness (p=0.323).

CONCLUSION: We identified thrombosis of the aneurysmal sac through the presence of thrombi on the intima of the aorta in 100% of the animals in the Stent group; as for the biomechanical analysis, this study showed no statistical differences in vessel wall thickness, strength, and elasticity between groups.

PMID:39552283 | DOI:10.14670/HH-18-842