Circulating Extracellular Vesicles: Their Role in Patients with Abdominal Aortic Aneurysm (AAA) Undergoing EndoVascular Aortic Repair (EVAR).

Abdominal aortic aneurysm (AAA) is a frequent aortic disease. If the diameter of the aorta is larger than 5 cm, an open surgical repair (OSR) or an endovascular aortic repair (EVAR) are recommended. To prevent possible complications (i.e., endoleaks), EVAR-treated patients need to be monitored for 5 years following the intervention, using computed tomography angiography (CTA). However, this radiological method involves high radiation exposure in terms of CTA/year. In such a context, the study of peripheral-blood-circulating extracellular vesicles (pbcEVs) has great potential to identify biomarkers for EVAR complications. We analyzed several phenotypes of pbcEVs using polychromatic flow cytometry in 22 patients with AAA eligible for EVAR. From each enrolled patient, peripheral blood samples were collected at AAA diagnosis, and after 1, 6, and 12 months following EVAR implantation, i.e. during the diagnostic follow-up protocol. Patients developing an endoleak displayed a significant decrease in activated-platelet-derived EVs between the baseline condition and 6 months after EVAR intervention. Furthermore, we also observed, that 1 month after EVAR implantation, patients developing an endoleak showed higher concentrations of activated-endothelial-derived EVs than patients who did not develop one, suggesting their great potential as a noninvasive and specific biomarker for early identification of EVAR complications.

[Endovascular treatment of traumatic lesions of thoracic aorta. Our experience]. / Trattamento endovascolare delle lesioni traumatiche dell'aorta toracica. Nostra esperienza.

OBJECTIVES: To report our experience with endovascular repair of descending thoracic aorta in patients with acute and chronic traumatic lesions due to blunt chest trauma in last 4 years. MATERIAL AND METHODS: From January 2002 to September 2006, 5 patients underwent endovascular repair of descending thoracic aorta for acute (3 cases) and chronic (2 cases) traumatic lesions due to road traffic accidents (motorcycle crash: 1; car crash: 4). RESULTS: Stent-graft placement was successful in all cases with good early outcomes and without late complications (follow up 3-48 months). CONCLUSION: Endovascular repair of descending thoracic aorta lesions, due to blunt chest trauma, is a feasible and valid alternative to conventional open operation.