Occlusion Of Infrarenal Abdominal Aorta Research Articles

Prevention and therapy of massive obstetric bleeding with placenta percreta 3b

The objective: to reduce the intra- and postoperative complications, massive intraoperative blood loss during abdominal delivery of pregnant women with placenta percreta 3b using endovascular technique of temporary balloon occlusion of the infrarenal abdominal aorta. Materials and methods. Caesarean section in the uterus fundus was performed in 21 pregnant women with placenta percreta and invasion of perivesical tissue, partial invasion to the posterior wall of the bladder (degree of invasion 3b). The main group included 7 pregnant women who had lower median laparotomy and caesarean section in the uterine fundus with balloon occlusion of the infrarenal abdominal aorta after fetal removal and subsequent hysterectomy without uterine appendages and bladder fundus plastics. The comparison group included 14 pregnant women with caesarean section in the uterus fundus without prior balloon occlusion of the abdominal aorta with subsequent hysterectomy without uterine appendages and suturing of the bladder fundus defect in the area of ​​its invasion of placental tissue. Pregnant women of both groups were representative for age, parity, somatic pathology. The diagnosis in all cases was confirmed by ultrasound examination with Doppler and magnetic resonance imaging. All pregnant women were delivered in 36-37 weeks of gestation. The article also presents a clinical case: delivery of a pregnant woman with placenta percreta and invasion in the posterior wall of the bladder using an innovative technique to minimize blood loss, which was conducted at the Kyiv Regional Perinatal Center. Results. It was determined that delivery by caesarean section with balloon occlusion of the abdominal aorta and subsequent hysterectomy without uterine appendages and bladder fundus plastics reduces blood loss (from 1758.0±110.0 ml to 955.0±70.0 ml), duration of surgery (from 112.0±11.0 min to 87.0±9.0 min), duration of hospitalization (from 11±2 days to 7±1 days), the need for blood transfusions and improves long-term consequences. Conclusions. Innovative technology for temporary balloon occlusion of infrarenal abdominal aorta after cesarean section in the uterus fundus and subsequent hysterectomy without uterine appendages in women with placenta percreta 3b significantly reduces blood loss, the likelihood of massive bleeding, organ damage, duration of hospitalization.

Acute thrombotic occlusion of infrarenal abdominal aorta – rare and catastrophic event after blunt abdominal trauma

Acute thrombotic occlusion of infrarenal abdominal aorta – rare and catastrophic event after blunt abdominal trauma

Advanced Atherosclerosis with Leriche Syndrome, in a Patient with Carney Complex.

Carney complex (CNC) is a rare autosomal dominant syndrome. Spotty skin pigmentation is the major clinical manifestation of CNC, followed by cardiac myxomas, benign tumors that usually present with features from the classical triad of obstructive cardiac, embolic and non-specific constitutional symptoms (NCS). NCS are caused by the overproduction of interleukin-6 (IL-6), a pro-inflammatory cytokine which mediates the induction of intercellular adhesion molecule 1 (ICAM-1) and promotes endothelial dysfunction and atherosclerosis. Thus, myxomas may be directly linked to an increased risk of atherosclerotic events. We report here a case of a 74-year-old woman with left atrial myxoma, skin pigmentary abnormalities, thyroid disorder and extensive atherosclerosis, with non-embolic occlusion of infrarenal abdominal aorta.

Acute thrombotic occlusion of infrarenal abdominal aorta: A case report

Acute thrombotic occlusion of infrarenal abdominal aorta: A case report

Fluoxetine ameliorates imbalance of redox homeostasis and inflammation in an acute kidney injury model.

Ischemia-reperfusion (IR) has been reported to be associated with augmented reactive oxygen radicals and cytokines. Currently, we aimed to examine the influence of fluoxetine, which is already used as a preoperative anxiolytic, in the context of IR induced by occlusion of infrarenal abdominal aorta (60 min of ischemia) and its effects on renal oxidative status, inflammation, renal function, and cellular integrity in reperfusion (120 min post-ischemia). Male rats were randomly assigned as control, IR, and pretreated groups. The pretreated group animals received fluoxetine (20 mg/kg, i.p.) once daily for 3 days. Renal tissue oxidative stress, myeloperoxidase activity, proinflammatory cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6), histology, and function were assessed. As an anti-inflammatory cytokine, interleukin-10 was also assessed. IR led to a significant increase in lipid hydroperoxide, malondialdehyde, and pro-oxidant antioxidant balance and decrease in superoxide dismutase activity and ferric reducing/antioxidant power level (p < 0.05), but fluoxetine was able to restore these parameters. High concentrations of tumor necrosis factor-α, interleukin-1β, interleukin-6, and myeloperoxidase activity caused by IR were significantly decreased in kidney tissue with fluoxetine. In addition, interleukin-10 levels were high in fluoxetine pretreated group. IR resulted in disrupted cellular integrity, infiltration of tissue with leukocytes, and decreased serum creatinine-urea levels (p < 0.05). Fluoxetine significantly restored impaired redox balance and inflammation parameters of rats subjected to IR to baseline values. This beneficial effect of fluoxetine on redox balance might be addressed to an improvement in renal function.

Ischemic preconditioning and N-acetylcysteine in a rat model of skeletal muscle ischemia-reperfusion: does antioxidant therapy have an impact on ischemic preconditioning?

Background: This study aims to investigate the effects of ischemic preconditioning (IPC) and N-acetylcysteine (NAC) on ischemia-reperfusion (I/R) injury and the impact of simultaneous NAC administration, a reactive oxygen species (ROS) scavenger, with IPC. Methods: Twenty-eight male Sprague-Dawley t ype r ats (230-255 g) were randomly assigned to either of four groups each containing seven rats, including a control group. Rats in the control group underwent ischemia of the lower limbs through occlusion of infrarenal abdominal aorta for 120 min, followed by reperfusion for 50 minute. In the IPC group, three cycles of 10 min ischemia, followed by 10 min reperfusion was formed preceding I/R. NAC group rats received an intravenous bolus of NAC (20 mg/kg) at the termination of ischemia and a maintenance dose of 20 mg/kg/hr throughout the reperfusion period. In IPC+NAC group, an equal amount of NAC was given over an identical infusion time during IPC. Tissue samples were obtained at the end of reperfusion then rats were sacrificed. Results: Malondialdehyde (MDA) and myeloperoxidase (MPO) levels were measured to be lower in all study groups, compared to the control group. Reduced glutathione (GSH) level was higher in NAC group than the remaining groups. No significant difference in parameters studied between IPC and IPC+NAC group. However, MDA and MPO levels were found to be lower and GSH level was higher in IPC group. Conclusion: In the experimental model of I/R injury, both IPC and NAC attenuated tissue injury in rat skeletal muscle. Simultaneous administration of ROS scavenger NAC with IPC did not completely block the protective effect of IPC, however resulted in a partial reduction. This finding suggested that several mechanisms other than ROS might be involved in the process of skeletal muscle IPC.

Unusual Congenital Aortic Anomaly with Rare Common Celiamesenteric Trunk Variation: MR Angiography and Digital Substraction Angiography Findings

Magnetic resonance angiography and digital substraction angiography (DSA) findings in a case with a rare congenital thoracoabdominal aortic hypoplasia and common celiamesenteric trunk variation with occlusion of infrarenal abdominal aorta are described here. To our knowledge, this aortic anomaly has not been previously described in the English literature. DSA is the optimum imaging modality for determination of aortic hypoplasia, associated vascular malformations, collateral vessels, and direction of flow within vessels.