Endovascular Treatment of the Descending Thoracic Aorta

AbstractObjectives: to report our initial experience with endovascular stent graft repair of a variety of thoracic aortic pathology.Design: retrospective single center study.Material and methods: between February 2000 and January 2002, endovascular stent graft repair was performed in 26 patients: traumatic aortic isthmus rupture (n=3), Type B dissection (n=11) and descending thoracic aortic aneurysm (n=12). The deployed stent graft systems were AneuRx-Medtronic (n=1), Talent-Medtronic (n=13) and Excluder-Gore (n=12).Results: successful deployment of the stent grafts in the intended position was achieved in all patients. No hospital mortality neither paraplegia were observed. Late, non procedure related, death occurred in four patients (15%). Access artery complications with rupture of the iliac artery occurred in two patients and were managed by iliac-femoral bypass. The left subclavian artery was overstented in seven patients (27%). Only the first patient received a carotido-subclavian bypass. The mean maximal aortic diameter decreased significantly in patients treated for descending thoracic aneurysm. Only one patient had an endoleak type II after 6 months without enlargement of the aneurysm. Complete thrombosis of the thoracic false lumen occurred in all but one patient treated for Type B dissection 6 months postoperatively. Two patients underwent a consecutive stent graft placement, due to a large re-entry tear distal to the first stent graft.Conclusions: endovascular stent graft repair for Type B dissection, descending thoracic aneurysm and aortic isthmus rupture is a promising less-invasive alternative to surgical repair. Further studies are mandatory to determine its long-term efficacy

Ectopic gastric pancreatitis: unusual cause of epigastric pain

Ectopic pancreatic tissue has the same characteristics than normal pancreatic tissue. Therefore it may be affected by the same diseases. We report a rare cause of epigastric pain due to gastric heterotopic pancreatitis. The rare diagnosis was suspected by ultrasound and CT and definitively confirmed by echo-endoscopic guided biopsies

Early Eocene deep-sea benthic foraminiferal faunas: Recovery from the Paleocene Eocene Thermal Maximum extinction in a greenhouse world

<div><p>The early Eocene greenhouse world was marked by multiple transient hyperthermal events. The most extreme was the Paleocene-Eocene Thermal Maximum (PETM, ~56 Ma), linked to the extinction of the globally recognised deep-sea benthic foraminiferal Velasco fauna, which led to the development of early Eocene assemblages. This turnover has been studied at high resolution, but faunal development into the later early Eocene is poorly documented. There is no widely accepted early Eocene equivalent of the Late Cretaceous-Paleocene Velasco fauna, mainly due to the use of different taxonomic concepts. We compiled Ypresian benthic foraminiferal data from 17 middle bathyal-lower abyssal ocean drilling sites in the Pacific, Atlantic and Indian Oceans, in order to characterise early Eocene deep-sea faunas by comparing assemblages across space, paleodepth and time. <i>Nuttallides truempyi</i>, <i>Oridorsalis umbonatus</i>, <i>Bulimina trinitatensis</i>, the <i>Bulimina simplex</i> group, the <i>Anomalinoides spissiformis</i> group, pleurostomellids, uniserial lagenids, stilostomellids and lenticulinids were ubiquitous during the early Eocene (lower-middle Ypresian). <i>Aragonia aragonensis</i>, the <i>Globocassidulina subglobosa</i> group, the <i>Cibicidoides eocaenus</i> group and polymorphinids became ubiquitous during the middle Ypresian. The most abundant early Ypresian taxa were tolerant to stressed or disturbed environments, either by opportunistic behavior (<i>Quadrimorphina profunda</i>, <i>Tappanina selmensis</i>, <i>Siphogenerinoides brevispinosa</i>) and/or the ability to calcify in carbonate-corrosive waters (<i>N</i>. <i>truempyi</i>). <i>Nuttallides truempyi</i>, <i>T</i>. <i>selmensis</i> and other buliminids (<i>Bolivinoides</i> cf. <i>decoratus</i> group, <i>Bulimina virginiana</i>) were markedly abundant during the middle Ypresian. Contrary to the long-lived, highly diverse and equitable Velasco fauna, common and abundant taxa reflect highly perturbed assemblages through the earliest Ypresian, with lower diversity and equitability following the PETM extinction. In contrast, the middle Ypresian assemblages may indicate a recovering fauna, though to some extent persistently disturbed by the lower-amplitude Eocene hyperthermals (e.g., Eocene Thermal Maximum 2 and 3). We propose the name ‘Walvis Ridge fauna’ for future reference to these Ypresian deep-sea benthic foraminiferal assemblages.</p></div

Informal taxonomic groups of similar taxa observed within the lower Eocene (lower and middle Ypresian) at ODP and DSDP sites analysed in this study.

<p>Informal taxonomic groups of similar taxa observed within the lower Eocene (lower and middle Ypresian) at ODP and DSDP sites analysed in this study.</p

Relative abundance of benthic foraminifera from ODP and DSDP sites across the lower Ypresian.

<p>Relative abundance of benthic foraminifera from ODP and DSDP sites across the lower Ypresian.</p