Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck
Objective The success of open and endovascular repair of abdominal aortic aneurysms (AAA) is hampered by postoperative dilatation of the anatomical neck of the AAA, which is used for graft attachment. The purpose of this study was to determine whether the macroscopically non-diseased infrarenal aort...
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| Veröffentlicht in: | Journal of vascular surgery 2008-08, Vol.48 (2), p.425-434 |
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| creator | Diehm, Nicolas, MD Di Santo, Stefano, PhD Schaffner, Thomas, MD Schmidli, Juerg, MD Völzmann, Jan, BMS Jüni, Peter, MD Baumgartner, Iris, MD Kalka, Christoph, MD |
| description | Objective The success of open and endovascular repair of abdominal aortic aneurysms (AAA) is hampered by postoperative dilatation of the anatomical neck of the AAA, which is used for graft attachment. The purpose of this study was to determine whether the macroscopically non-diseased infrarenal aortic neck of AAA is histologically and biochemically altered at the time of operative repair. Methods We harvested full-thickness aortic wall samples as longitudinal stripes spanning from AAA neck to aneurysmal sac in 22 consecutive patients undergoing open surgical AAA repair. Control tissue was obtained from five organ donors and five deceased subjects undergoing autopsy without evidence of aneurysmal disease. We assessed aortic media thickness, number of intact elastic lamellar units, media destruction, and neovascularization grade and performed immunohistochemistry for matrix metalloproteinase (MMP)-9 and phosphorylated c-Jun N-terminal kinase (p-JNK). MMP-9 and p-JNK protein expressions were quantified using Western Blots. Results The median thickness of the aortic media was 1150 μm in control tissue (range, 1000-1300), 510 μm in aortic necks (250-900), and 200 μm in aortic sacs (50-500, P from nonparametric test for trend |
| doi_str_mv | 10.1016/j.jvs.2008.03.001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69334479</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0741521408003340</els_id><sourcerecordid>69334479</sourcerecordid><originalsourceid>FETCH-LOGICAL-c545t-be91f2cab1fa2580c62d878fbd50f4e14ee216cede66194b2037ee4709340c7f3</originalsourceid><addsrcrecordid>eNp9kc-L1TAQx4Mo7nP1D_AiveitdSZNmxZBWBZ_wYKHVa8hTadrum26ZtoH7783j_dQ8OAph_l8JzOfEeIlQoGA9duxGPdcSICmgLIAwEdih9DqvG6gfSx2oBXmlUR1IZ4xjwnAqtFPxQU2FUjQ7U78uKU9Rcp4jZtbt2inrLezvaNsGbL1ZyoQzT7cTYcsLCHvPZNl6jMfhmgjhcTbJa7eZTbQFg88Z4Hc_XPxZLAT04vzeym-f_zw7fpzfvP105frq5vcVapa845aHKSzHQ5WVg24WvaNboaur2BQhIpIYu2op7rGVnUSSk2kNLSlAqeH8lK8OfV9iMuvjXg1s2dH05SmWTY2dVuWSuk2gXgCXVyYIw3mIfrZxoNBMEeZZjRJpjnKNFCa5CplXp2bb91M_d_E2V4CXp8By85OyUhwnv9wEqoKsZGJe3fiKKnYe4qGnaeQ9vKR3Gr6xf93jPf_pN3kg08f3tOBeFy2mM7ABg1LA-b2ePXj0aEBSNtD-RvHy6el</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69334479</pqid></control><display><type>article</type><title>Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB Electronic Journals Library</source><creator>Diehm, Nicolas, MD ; Di Santo, Stefano, PhD ; Schaffner, Thomas, MD ; Schmidli, Juerg, MD ; Völzmann, Jan, BMS ; Jüni, Peter, MD ; Baumgartner, Iris, MD ; Kalka, Christoph, MD</creator><creatorcontrib>Diehm, Nicolas, MD ; Di Santo, Stefano, PhD ; Schaffner, Thomas, MD ; Schmidli, Juerg, MD ; Völzmann, Jan, BMS ; Jüni, Peter, MD ; Baumgartner, Iris, MD ; Kalka, Christoph, MD</creatorcontrib><description>Objective The success of open and endovascular repair of abdominal aortic aneurysms (AAA) is hampered by postoperative dilatation of the anatomical neck of the AAA, which is used for graft attachment. The purpose of this study was to determine whether the macroscopically non-diseased infrarenal aortic neck of AAA is histologically and biochemically altered at the time of operative repair. Methods We harvested full-thickness aortic wall samples as longitudinal stripes spanning from AAA neck to aneurysmal sac in 22 consecutive patients undergoing open surgical AAA repair. Control tissue was obtained from five organ donors and five deceased subjects undergoing autopsy without evidence of aneurysmal disease. We assessed aortic media thickness, number of intact elastic lamellar units, media destruction, and neovascularization grade and performed immunohistochemistry for matrix metalloproteinase (MMP)-9 and phosphorylated c-Jun N-terminal kinase (p-JNK). MMP-9 and p-JNK protein expressions were quantified using Western Blots. Results The median thickness of the aortic media was 1150 μm in control tissue (range, 1000-1300), 510 μm in aortic necks (250-900), and 200 μm in aortic sacs (50-500, P from nonparametric test for trend <.001). The number of intact elastic lamellar units was 33 in controls (range, 33-55), 12 in aortic necks (0-31) and three in aortic sacs (0-10, P < .001). The expression of MMP-9 and p-JNK as assessed by Western Blots ( P = .007 and .061, respectively) and zymography ( P for trend <.001) were up regulated in both the AAA neck and sac compared with controls. Except for p-JNK expression, differences between tissues were similar after the adjustment for age, gender, and type of sampling. Conclusion The seemingly non-diseased infrarenal AAA neck in patients with AAA undergoing surgical repair shows histological signs of destruction and upregulation of potential drug targets.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2008.03.001</identifier><identifier>PMID: 18502079</identifier><identifier>CODEN: JVSUES</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal - pathology ; Aortic Aneurysm, Abdominal - surgery ; Biological and medical sciences ; Biomarkers - analysis ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Case-Control Studies ; Diseases of the aorta ; Female ; Humans ; Immunohistochemistry ; JNK Mitogen-Activated Protein Kinases - metabolism ; Laparotomy - methods ; Male ; Matrix Metalloproteinase 9 - metabolism ; Medical sciences ; Middle Aged ; Postoperative Complications - diagnosis ; Reference Values ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Severity of Illness Index ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tissue Culture Techniques ; Tunica Intima - pathology ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - methods</subject><ispartof>Journal of vascular surgery, 2008-08, Vol.48 (2), p.425-434</ispartof><rights>The Society for Vascular Surgery</rights><rights>2008 The Society for Vascular Surgery</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c545t-be91f2cab1fa2580c62d878fbd50f4e14ee216cede66194b2037ee4709340c7f3</citedby><cites>FETCH-LOGICAL-c545t-be91f2cab1fa2580c62d878fbd50f4e14ee216cede66194b2037ee4709340c7f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0741521408003340$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20551182$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18502079$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diehm, Nicolas, MD</creatorcontrib><creatorcontrib>Di Santo, Stefano, PhD</creatorcontrib><creatorcontrib>Schaffner, Thomas, MD</creatorcontrib><creatorcontrib>Schmidli, Juerg, MD</creatorcontrib><creatorcontrib>Völzmann, Jan, BMS</creatorcontrib><creatorcontrib>Jüni, Peter, MD</creatorcontrib><creatorcontrib>Baumgartner, Iris, MD</creatorcontrib><creatorcontrib>Kalka, Christoph, MD</creatorcontrib><title>Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Objective The success of open and endovascular repair of abdominal aortic aneurysms (AAA) is hampered by postoperative dilatation of the anatomical neck of the AAA, which is used for graft attachment. The purpose of this study was to determine whether the macroscopically non-diseased infrarenal aortic neck of AAA is histologically and biochemically altered at the time of operative repair. Methods We harvested full-thickness aortic wall samples as longitudinal stripes spanning from AAA neck to aneurysmal sac in 22 consecutive patients undergoing open surgical AAA repair. Control tissue was obtained from five organ donors and five deceased subjects undergoing autopsy without evidence of aneurysmal disease. We assessed aortic media thickness, number of intact elastic lamellar units, media destruction, and neovascularization grade and performed immunohistochemistry for matrix metalloproteinase (MMP)-9 and phosphorylated c-Jun N-terminal kinase (p-JNK). MMP-9 and p-JNK protein expressions were quantified using Western Blots. Results The median thickness of the aortic media was 1150 μm in control tissue (range, 1000-1300), 510 μm in aortic necks (250-900), and 200 μm in aortic sacs (50-500, P from nonparametric test for trend <.001). The number of intact elastic lamellar units was 33 in controls (range, 33-55), 12 in aortic necks (0-31) and three in aortic sacs (0-10, P < .001). The expression of MMP-9 and p-JNK as assessed by Western Blots ( P = .007 and .061, respectively) and zymography ( P for trend <.001) were up regulated in both the AAA neck and sac compared with controls. Except for p-JNK expression, differences between tissues were similar after the adjustment for age, gender, and type of sampling. Conclusion The seemingly non-diseased infrarenal AAA neck in patients with AAA undergoing surgical repair shows histological signs of destruction and upregulation of potential drug targets.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Aneurysm, Abdominal - pathology</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - analysis</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Diseases of the aorta</subject><subject>Female</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>JNK Mitogen-Activated Protein Kinases - metabolism</subject><subject>Laparotomy - methods</subject><subject>Male</subject><subject>Matrix Metalloproteinase 9 - metabolism</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications - diagnosis</subject><subject>Reference Values</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Tissue Culture Techniques</subject><subject>Tunica Intima - pathology</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><subject>Vascular Surgical Procedures - adverse effects</subject><subject>Vascular Surgical Procedures - methods</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc-L1TAQx4Mo7nP1D_AiveitdSZNmxZBWBZ_wYKHVa8hTadrum26ZtoH7783j_dQ8OAph_l8JzOfEeIlQoGA9duxGPdcSICmgLIAwEdih9DqvG6gfSx2oBXmlUR1IZ4xjwnAqtFPxQU2FUjQ7U78uKU9Rcp4jZtbt2inrLezvaNsGbL1ZyoQzT7cTYcsLCHvPZNl6jMfhmgjhcTbJa7eZTbQFg88Z4Hc_XPxZLAT04vzeym-f_zw7fpzfvP105frq5vcVapa845aHKSzHQ5WVg24WvaNboaur2BQhIpIYu2op7rGVnUSSk2kNLSlAqeH8lK8OfV9iMuvjXg1s2dH05SmWTY2dVuWSuk2gXgCXVyYIw3mIfrZxoNBMEeZZjRJpjnKNFCa5CplXp2bb91M_d_E2V4CXp8By85OyUhwnv9wEqoKsZGJe3fiKKnYe4qGnaeQ9vKR3Gr6xf93jPf_pN3kg08f3tOBeFy2mM7ABg1LA-b2ePXj0aEBSNtD-RvHy6el</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Diehm, Nicolas, MD</creator><creator>Di Santo, Stefano, PhD</creator><creator>Schaffner, Thomas, MD</creator><creator>Schmidli, Juerg, MD</creator><creator>Völzmann, Jan, BMS</creator><creator>Jüni, Peter, MD</creator><creator>Baumgartner, Iris, MD</creator><creator>Kalka, Christoph, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080801</creationdate><title>Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck</title><author>Diehm, Nicolas, MD ; Di Santo, Stefano, PhD ; Schaffner, Thomas, MD ; Schmidli, Juerg, MD ; Völzmann, Jan, BMS ; Jüni, Peter, MD ; Baumgartner, Iris, MD ; Kalka, Christoph, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c545t-be91f2cab1fa2580c62d878fbd50f4e14ee216cede66194b2037ee4709340c7f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Aneurysm, Abdominal - pathology</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - analysis</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Diseases of the aorta</topic><topic>Female</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>JNK Mitogen-Activated Protein Kinases - metabolism</topic><topic>Laparotomy - methods</topic><topic>Male</topic><topic>Matrix Metalloproteinase 9 - metabolism</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Complications - diagnosis</topic><topic>Reference Values</topic><topic>Reverse Transcriptase Polymerase Chain Reaction</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tissue Culture Techniques</topic><topic>Tunica Intima - pathology</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><topic>Vascular Surgical Procedures - adverse effects</topic><topic>Vascular Surgical Procedures - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Diehm, Nicolas, MD</creatorcontrib><creatorcontrib>Di Santo, Stefano, PhD</creatorcontrib><creatorcontrib>Schaffner, Thomas, MD</creatorcontrib><creatorcontrib>Schmidli, Juerg, MD</creatorcontrib><creatorcontrib>Völzmann, Jan, BMS</creatorcontrib><creatorcontrib>Jüni, Peter, MD</creatorcontrib><creatorcontrib>Baumgartner, Iris, MD</creatorcontrib><creatorcontrib>Kalka, Christoph, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diehm, Nicolas, MD</au><au>Di Santo, Stefano, PhD</au><au>Schaffner, Thomas, MD</au><au>Schmidli, Juerg, MD</au><au>Völzmann, Jan, BMS</au><au>Jüni, Peter, MD</au><au>Baumgartner, Iris, MD</au><au>Kalka, Christoph, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>48</volume><issue>2</issue><spage>425</spage><epage>434</epage><pages>425-434</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Objective The success of open and endovascular repair of abdominal aortic aneurysms (AAA) is hampered by postoperative dilatation of the anatomical neck of the AAA, which is used for graft attachment. The purpose of this study was to determine whether the macroscopically non-diseased infrarenal aortic neck of AAA is histologically and biochemically altered at the time of operative repair. Methods We harvested full-thickness aortic wall samples as longitudinal stripes spanning from AAA neck to aneurysmal sac in 22 consecutive patients undergoing open surgical AAA repair. Control tissue was obtained from five organ donors and five deceased subjects undergoing autopsy without evidence of aneurysmal disease. We assessed aortic media thickness, number of intact elastic lamellar units, media destruction, and neovascularization grade and performed immunohistochemistry for matrix metalloproteinase (MMP)-9 and phosphorylated c-Jun N-terminal kinase (p-JNK). MMP-9 and p-JNK protein expressions were quantified using Western Blots. Results The median thickness of the aortic media was 1150 μm in control tissue (range, 1000-1300), 510 μm in aortic necks (250-900), and 200 μm in aortic sacs (50-500, P from nonparametric test for trend <.001). The number of intact elastic lamellar units was 33 in controls (range, 33-55), 12 in aortic necks (0-31) and three in aortic sacs (0-10, P < .001). The expression of MMP-9 and p-JNK as assessed by Western Blots ( P = .007 and .061, respectively) and zymography ( P for trend <.001) were up regulated in both the AAA neck and sac compared with controls. Except for p-JNK expression, differences between tissues were similar after the adjustment for age, gender, and type of sampling. Conclusion The seemingly non-diseased infrarenal AAA neck in patients with AAA undergoing surgical repair shows histological signs of destruction and upregulation of potential drug targets.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>18502079</pmid><doi>10.1016/j.jvs.2008.03.001</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aortic Aneurysm, Abdominal - pathology Aortic Aneurysm, Abdominal - surgery Biological and medical sciences Biomarkers - analysis Blood and lymphatic vessels Cardiology. Vascular system Case-Control Studies Diseases of the aorta Female Humans Immunohistochemistry JNK Mitogen-Activated Protein Kinases - metabolism Laparotomy - methods Male Matrix Metalloproteinase 9 - metabolism Medical sciences Middle Aged Postoperative Complications - diagnosis Reference Values Reverse Transcriptase Polymerase Chain Reaction Sensitivity and Specificity Severity of Illness Index Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue Culture Techniques Tunica Intima - pathology Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - methods |
| title | Severe structural damage of the seemingly non-diseased infrarenal aortic aneurysm neck |
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