Evidence for HLA-DQA1 locus being associated with abdominal aortic aneurysms in the Belgian population
; ; et al
in Circulation (2005, April 12), 111(14), 219Detailed reference viewed: 4 (0 ULg)
Le cas clinique du mois. Le Twiddler's syndrome.
SAKALIHASAN, Natzi ; ; et al
in Revue Médicale de Liège (2005), 60(7-8), 647-8
The Twiddler's syndrome is characterized by the migration of pacemaker's leads due to rotation of the pulse generator. In our case, ventricular leads coiled in the upper side of the right atrium with ... [more ▼]
The Twiddler's syndrome is characterized by the migration of pacemaker's leads due to rotation of the pulse generator. In our case, ventricular leads coiled in the upper side of the right atrium with stimulation of pectoralis major muscle during left decubitus lateralis position. [less ▲]Detailed reference viewed: 86 (10 ULg)
Abdominal aortic aneurysm.
SAKALIHASAN, Natzi ; Limet, Raymond ;
in Lancet (2005), 365(9470), 1577-89
Abdominal aortic aneurysms cause 1.3% of all deaths among men aged 65-85 years in developed countries. These aneurysms are typically asymptomatic until the catastrophic event of rupture. Repair of large ... [more ▼]
Abdominal aortic aneurysms cause 1.3% of all deaths among men aged 65-85 years in developed countries. These aneurysms are typically asymptomatic until the catastrophic event of rupture. Repair of large or symptomatic aneurysms by open surgery or endovascular repair is recommended, whereas repair of small abdominal aortic aneurysms does not provide a significant benefit. Abdominal aortic aneurysm is linked to the degradation of the elastic media of the atheromatous aorta. An inflammatory cell infiltrate, neovascularisation, and production and activation of various proteases and cytokines contribute to the development of this disorder, although the underlying mechanisms are unknown. In this Seminar, we aim to provide an updated review of the pathophysiology, current and new diagnostic procedures, assessment, and treatment of abdominal aortic aneurysm to provide family practitioners with a working knowledge of this disorder. [less ▲]Detailed reference viewed: 57 (6 ULg)
MMP-9 regulates both positively and negatively collagen gel contraction - A nonproteolytic function of MMP-9
; ; et al
in Cardiovascular Research (2005), 66(2), 402-409
Objective: Constrictive remodeling accounts for lumen loss in postangioplasty restenosis. Matrix metalloproteinase-9 (MMP-9) has been shown to prevent constrictive remodeling in vivo. To investigate ... [more ▼]
Objective: Constrictive remodeling accounts for lumen loss in postangioplasty restenosis. Matrix metalloproteinase-9 (MMP-9) has been shown to prevent constrictive remodeling in vivo. To investigate potential mechanisms for this observation, we investigated the role of MMP-9 in smooth muscle cell (SMC)-mediated collagen gel contraction, an in vitro model of constrictive remodeling. Methods: Fischer rat SMCs were stably transfected with a construct-expressing rat-MMP-9 under the control of a tetracycline (Tet)-off promoter. SMCs were seeded in type 1 collagen gels (2.4 mg/ml) in the presence or not of tetracycline (1 mu g/ml), and gel contraction was defined as the percentage of retraction of the collagen gel. The depletion of MMP-9 was obtained by using siRNA targeting MMP-9 mRNA or a blocking antibody. Results: Gel contraction was significantly reduced at all times when MMP-9 was overexpressed (Tet-) as compared with the control condition (Tet+). However, MMP-9 depletion of control (Tet+) SMCS (using siRNA or antibody) also inhibited gel contraction. To resolve the apparent discrepancy and determine if MMP-9 exerts a dose-dependent biphasic effect on gel contraction, conditioned medium and purified rat-MMP-9 were prepared. Gel contraction was significantly increased by addition of 0.8 mg/ml of MMP-9, while high concentrations of MMP-9 (>= 100 mg/ml) inhibited contraction. The addition of BB94 and TIMP-1 did not alter the inhibitory or stimulatory effect of MMP-9. Conclusions: Our data Suggest that MMP-9, independent of its proteolytic function, has a biphasic effect on SMC-mediated collagen gel contraction. Understanding the different roles of MMP-9 Should allow the development of better therapeutic strategies for restenotic vascular disease. (c) 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved. [less ▲]Detailed reference viewed: 15 (2 ULg)
De l’observation clinique à l’étude génomique : contribution à la connaissance des mécanismes de formation et de rupture des anévrysmes de l’aorte abdominale.
Thèse d’agrégation de l’enseignement supérieur (2005)Detailed reference viewed: 15 (1 ULg)
Gradient of proteolytic enzymes, their inhibitors and matrix proteins expression in a ruptured abdominal aortic aneurysm
; Colige, Alain ; Lambert, Charles et al
in European Journal of Clinical Investigation (2004), 34(7), 513-514Detailed reference viewed: 29 (4 ULg)
Contribution of Pet Scanning to the Evaluation of Abdominal Aortic Aneurysm
Sakalihasan, Natzi ; Hustinx, Roland ; Limet, Raymond
in Seminars in Vascular Surgery (2004), 17(2), 144-53
The size of abdominal aortic aneurysms (AAA) is the most usual predictor of the risk for rupture. Because chronic metalloproteinases production and activation by inflammatory cells causes degradation of ... [more ▼]
The size of abdominal aortic aneurysms (AAA) is the most usual predictor of the risk for rupture. Because chronic metalloproteinases production and activation by inflammatory cells causes degradation of elastin and collagen in the aneurysmal wall, the detection of an increased metabolic process preceding fissuration and rupture could be a more sensitive predictor of rupture risk. We investigated the metabolic activity of the aneurysmal wall by whole-body positron emission tomography (PET) in 26 patients with a documented AAA (mean diameter 63 mm, extremes 45 mm and 78 mm). A positive (18)F-fluorodeoxyglucose ((18)F-FDG) uptake at the level of the AAA was observed in 38% of the cases (10 of 26 patients). Nine of these 10 patients required emergent or urgent aneurysmectomy for ruptured (n = 1), leaking (n = 1), rapidly expanding (n = 2), or painful (n = 5) aneurysms; the negative (18)F-FDG uptake patients had a more benign course. This preliminary study suggests a possible correlation between (18)F-FDG uptake by the aneurysm wall and the triggering of processes leading to rupture. The (18)F-FDG uptake in the aneurysm wall may correspond to the accumulation of inflammatory cells responsible for the production and activation of degrading enzymes. PET scan seems useful in high-risk patients. Positive PET imaging in these cases would help us to decide to proceed with surgery, despite factors favoring a surveillance strategy. [less ▲]Detailed reference viewed: 53 (8 ULg)
MECHANICAL STRAIN MODULATES MONOCYTE CHEMOTACTIC PROTEIN-1 AND IL-1BETA EXPRESSION BY CULTURED HUMAN AORTIC SMOOTH MUSCLE CELLS
; Colige, Alain ; Deroanne, Christophe et al
in Cardiovascular Pathology (2004), 13(3 suppl), 189Detailed reference viewed: 17 (1 ULg)
Genome scan for familial abdominal aortic aneurysm using sex and family history as covariates suggests genetic heterogeneity and identifies linkage to chromosome 19q13.
; ; et al
in Circulation (2004), 109(17), 2103-8
BACKGROUND: Abdominal aortic aneurysm (AAA) is a relatively common disease, with 1% to 2% of the population harboring aneurysms. Genetic risk factors are likely to contribute to the development of AAAs ... [more ▼]
BACKGROUND: Abdominal aortic aneurysm (AAA) is a relatively common disease, with 1% to 2% of the population harboring aneurysms. Genetic risk factors are likely to contribute to the development of AAAs, although no such risk factors have been identified. METHODS AND RESULTS: We performed a whole-genome scan of AAA using affected-relative-pair (ARP) linkage analysis that includes covariates to allow for genetic heterogeneity. We found strong evidence of linkage (logarithm of odds [LOD] score=4.64) to a region near marker D19S433 at 51.88 centimorgans (cM) on chromosome 19 with 36 families (75 ARPs) when including sex and the number of affected first-degree relatives of the proband (N(aff)) as covariates. We then genotyped 83 additional families for the same markers and typed additional markers for all families and obtained a LOD score of 4.75 (P=0.00014) with sex, N(aff), and their interaction as covariates near marker D19S416 (58.69 cM). We also identified a region on chromosome 4 with a LOD score of 3.73 (P=0.0012) near marker D4S1644 using the same covariate model as for chromosome 19. CONCLUSIONS: Our results provide evidence for genetic heterogeneity and the presence of susceptibility loci for AAA on chromosomes 19q13 and 4q31. [less ▲]Detailed reference viewed: 8 (4 ULg)
Effect of cardiac resynchronization therapy on functional mitral regurgitation in heart failure.
Lancellotti, Patrizio ; MELON, Pierre ; SAKALIHASAN, Natzi et al
in American Journal of Cardiology (2004), 94(11), 1462-5
Cardiac resynchronization therapy (CRT) reduces functional mitral regurgitation (MR) at rest. This study assessed exercise-induced changes in MR in patients with heart failure who were helped by CRT. The ... [more ▼]
Cardiac resynchronization therapy (CRT) reduces functional mitral regurgitation (MR) at rest. This study assessed exercise-induced changes in MR in patients with heart failure who were helped by CRT. The determinants of these exercise-induced changes in MR were analyzed in asynchronous and resynchronized left ventricles. [less ▲]Detailed reference viewed: 15 (6 ULg)
Le rôle de la mise à plat des anévrysmes de l’aorte abdominale dans la prévention de la mort par rupture.
SAKALIHASAN, Natzi ; Limet, Raymond
in Revue Médicale de Liège (2003), 58(6), 404-408Detailed reference viewed: 7 (3 ULg)
Familial abdominal aortic aneurysms: collection of 233 multiplex families.
; ; et al
in Journal of Vascular Surgery (2003), 37(2), 340-5
OBJECTIVE: This study investigated a large number of families in which at least two individuals were diagnosed with abdominal aortic aneurysms to identify the relationship of the affected relatives to the ... [more ▼]
OBJECTIVE: This study investigated a large number of families in which at least two individuals were diagnosed with abdominal aortic aneurysms to identify the relationship of the affected relatives to the proband. Subjects and Methods: Families for the study were recruited through various vascular surgery centers in the United States, Finland, Belgium, Canada, the Netherlands, Sweden, and the United Kingdom and through our patient recruitment website (www.genetics.wayne.edu/ags). RESULTS: We identified 233 families with at least two individuals diagnosed with abdominal aortic aneurysms. The families originated from nine different nationalities, but all were white. There were 653 aneurysm patients in these families, with an average of 2.8 cases per family. Most of the families were small, with only two affected individuals. There were, however, six families with six, three with seven, and one with eight affected individuals. Most of the probands (82%) and the affected relatives (77%) were male, and the most common relationship to the proband was brother. Most of the families (72%) appeared to show autosomal recessive inheritance pattern, whereas in 58 families (25%), abdominal aortic aneurysms were inherited in autosomal dominant manner, and in eight families, the familial aggregation could be explained by autosomal dominant inheritance with incomplete penetrance. In the 66 families where abdominal aortic aneurysms were inherited in a dominant manner, 141 transmissions of the disease from one generation to another were identified, and the male-to-male, male-to-female, female-to-male, and female-to-female transmissions occurred in 46%, 11%, 32%, and 11%, respectively. CONCLUSION: Our study supports previous studies about familial aggregation of abdominal aortic aneurysms and suggests that first-degree family members, male relatives, in particular, are at increased risk. No single inheritance mode could explain the occurrence of abdominal aortic aneurysms in the 233 families studied here, suggesting that abdominal aortic aneursyms are a multifactorial disorder with multiple genetic and environmental risk factors. [less ▲]Detailed reference viewed: 35 (5 ULg)
TIMP-2 and PAI-1 mRNA levels are lower in aneurysmal as compared to athero-occlusive abdominal aortas.
; Colige, Alain ; Lambert, Charles et al
in Cardiovascular Research (2003), 60(1), 205-13
OBJECTIVE: Significant alterations of the vascular wall occurs in abdominal aortic aneurysm (AAA) and atherosclerotic occlusive disease (AOD) that ultimately may lead to either vascular rupture or ... [more ▼]
OBJECTIVE: Significant alterations of the vascular wall occurs in abdominal aortic aneurysm (AAA) and atherosclerotic occlusive disease (AOD) that ultimately may lead to either vascular rupture or obstruction. These modifications have been ascribed to one or a group of proteases, their inhibitors or to the matrix macromolecules involved in the repair process without considering the extent of the observed variations. METHODS: The mRNA steady-state level of a large spectrum of proteolytic enzymes (matrix metalloproteinases: MMP-1, -2, -3, -8, -9, -11, -12, -13, -14; urokinase plasminogen activator: u-PA), their physiological inhibitors (tissue inhibitors of MMPs: TIMP-1, -2, -3; plasminogen activator inhibitor: PAI-1) and that of structural matrix proteins (collagens type I and III, decorin, elastin, fibrillins 1 and 2) was determined by RT-PCR made quantitative by using a synthetic RNA as internal standard in each reaction mixture. The profile of expression was evaluated in AAA (n=7) and AOD (n=5) and compared to non-diseased abdominal (CAA, n=7) and thoracic aorta (CTA, n=5). RESULTS: The MMPs -8, -9, -12 and -13 mostly associated with inflammatory cells were not or barely detected in CAA and CTA while they were largely and similarly expressed in AAA and AOD. Expression of protease inhibitors or structural proteins were only slightly increased in both pathological conditions with the exception of elastin which was reduced. The main significant difference between AAA and AOD was a lower expression of TIMP-2 and PAI-1 in the aneurysmal lesions. CONCLUSIONS: The remodeling of the aortic wall in AAA and AOD involves gene activation of a large and similar spectrum of proteolytic enzymes while the expression of two physiological inhibitors, TIMP-2 and PAI-1, is significantly lower in AAA compared to AOD. The repair process in the aneurysmal disease seems similar to that of the occlusive disease. [less ▲]Detailed reference viewed: 47 (7 ULg)
Axillary artery injury secondary to anterior shoulder dislocation: report of two cases.
MAWEJA, Sylvie ; SAKALIHASAN, Natzi ; VAN DAMME, Hendrik et al
in Acta Chirurgica Belgica (2002), 102(3), 187-91
Vascular injuries secondary to isolated shoulder dislocation are rare. Unawareness for closed axillary artery trauma by many physicians treating shoulder dislocations, counts often for missed or delayed ... [more ▼]
Vascular injuries secondary to isolated shoulder dislocation are rare. Unawareness for closed axillary artery trauma by many physicians treating shoulder dislocations, counts often for missed or delayed diagnosis. The authors describe two cases that presented with an anterior shoulder dislocation, complicated by a disruption of the axillary artery with subsequent thrombosis. The various pathogenic mechanisms are discussed. The pathognomic triad consists of anterior shoulder dislocation, absent or diminished distal pulse and an axillary protruding hematoma. Prompt surgical arterial repair is mandatory. [less ▲]Detailed reference viewed: 19 (3 ULg)
Positron emission tomography (PET) evaluation of abdominal aortic aneurysm (AAA)
SAKALIHASAN, Natzi ; Van Damme, Hendrik ; et al
in European Journal of Vascular and Endovascular Surgery (2002), 23(5), 431-436
Background: aneurysmal disease is associated with all inflammatory Cell infiltrate and enzymatic degradation of the vessel wall. Aim of the study: to detect increased metabolic activity in abdominal ... [more ▼]
Background: aneurysmal disease is associated with all inflammatory Cell infiltrate and enzymatic degradation of the vessel wall. Aim of the study: to detect increased metabolic activity in abdominal aortic aneurysms (AAA) by means of positron emission tomography (PET-imaging). Study design: twenty-six patients with AAA underwent PET-imaging Results: in tell patients, PET-imaging revealed increased, fluoro-deoxy-glucose (18-FDG) uptake at the level of the aneurysm. Patients with positive PET-imaging had one or more of the following elements in their clinical history: history Of recent non-aortic surgery (n = 4) a painful inflammatory aortic aneurysm (n = 2). moderate low back pain (n = 2), rapid (>5 mm in 6 months) expansion (n = 4), discovery by PET-scan of a previously undiagnosed lung cancer (n = 3) or parotid tumour (n = 1). Five patients with a positive PET scan required urgent surgery within two to 30 days. Among the 16 patients with negative PET-imaging of their aneurysm, only one had recent non-aortic surgery, none of them required urgent surgery, only two had a rapidly expanding AAA, and in only one patient, PET-imaging revealed an unknown lung cancer. Conclusion: these data suggest a possible association between increased 18-FDG uptake and AAA expansion and rupture. [less ▲]Detailed reference viewed: 61 (5 ULg)
Chronic rupture of abdominal aortic aneurysm manifesting as crural neuropathy.
Defraigne, Jean-Olivier ; SAKALIHASAN, Natzi ; LAVIGNE, Jean-Paul et al
in Annals of Vascular Surgery (2001), 15(3), 405-11
Chronic rupture of abdominal aortic aneurysm (AAA) resulting in unusual clinical manifestations can occur if the resistance of structures surrounding the aorta is sufficient to contain hemorrhage. In this ... [more ▼]
Chronic rupture of abdominal aortic aneurysm (AAA) resulting in unusual clinical manifestations can occur if the resistance of structures surrounding the aorta is sufficient to contain hemorrhage. In this report, we describe five cases of chronic ruptured AAA in which the presenting feature was crural neuropathy. All patients were male with a mean age of 74 +/- 1.8 years. At the time of presentation, crural neuropathy had been ongoing for 3 to 9 weeks. In three cases, AAA was not initially suspected because an inadequate clinical examination was performed (not in the vascular surgery department) and because of the small diameter of the aorta in relation to the patient's morphology. Two patients had one episode of hypotension that was wrongly attributed to vagal attack. Abdominal CT scanning was always diagnostic of chronic rupture. In two cases, rupture was associated with erosion of the body of one or more vertebrae and laboratory evidence of inflammation, i.e., increase in sedimentation rate and fibrinogen level. The mean diameter of the AAA was 7.1 +/- 0.9 cm (range 5-10 cm). All patients underwent midline laparotomy, which was performed under emergency conditions in two cases, under semi-emergency conditions in one case, and electively in two cases. Perforation was consistently located on the posterolateral wall of the aorta and varied from 1 to 3 cm in length. Repair was performed using an aortobifemoral prosthesis in four cases, and a straight tube in one case. The patient who underwent emergency surgery died 4 days after the procedure. The remaining four patients recovered uneventfully and were discharged after 10 days. In the elderly, ruptured AAA should be included in the differential diagnosis of crural neuropathy. An episode of hypotension, regardless of its duration, in an elderly patient should be given serious consideration as a possible sign of ruptured AAA with ongoing retroperitoneal hemorrhage. [less ▲]Detailed reference viewed: 31 (2 ULg)
Renal Artery Occlusion Following Blunt Abdominal Trauma
Elen, Philippe ; ; SAKALIHASAN, Natzi et al
in Acta Chirurgica Belgica (2000), 100(3, May-Jun), 107-10Detailed reference viewed: 8 (1 ULg)
Le cas clinique du mois. Diagnostic et traitement du kyste adventitiel de l'artere poplitee.
; SAKALIHASAN, Natzi ; VAN DAMME, Hendrik et al
in Revue Médicale de Liège (1999), 54(6), 514-6
The authors report the case of a 66-year-old patient with unilateral intermittent claudication, in whom no evidence of intravascular occlusive disease was found. Surgical approach revealed an ... [more ▼]
The authors report the case of a 66-year-old patient with unilateral intermittent claudication, in whom no evidence of intravascular occlusive disease was found. Surgical approach revealed an intraparietal cystic adventitial disease of the popliteal artery. An excision of the affected segment and bypass grafting with the internal saphenous vein was done. [less ▲]Detailed reference viewed: 25 (2 ULg)
Le cas clinique du mois. Rupture couverte d'un anevrysme infectieux post-typhique de l'aorte abdominale sous-renale.
SCHILS, Fabian ; SAKALIHASAN, Natzi ; et al
in Revue Médicale de Liège (1999), 54(10), 786-8
Mycotic aneurysms are uncommon but remain one of the most challenging clinical problems for the vascular surgeon. They are associated with high morbidity and mortality, and the clinical signs and symptoms ... [more ▼]
Mycotic aneurysms are uncommon but remain one of the most challenging clinical problems for the vascular surgeon. They are associated with high morbidity and mortality, and the clinical signs and symptoms are non specific. We report here the case of an abdominal aorta mycotic aneurysm due to salmonellosis treated by insertion of an arterial homograft. [less ▲]Detailed reference viewed: 28 (4 ULg)
Fibromuscular dysplasia of the internal carotid artery. Personal experience with 13 cases and literature review.
VAN DAMME, Hendrik ; SAKALIHASAN, Natzi ; Limet, Raymond
in Acta Chirurgica Belgica (1999), 99(4), 163-8
From January 1990 to December 1997, the authors observed 13 cases of fibromuscular dysplasia of the internal carotid artery. Four patients presented transient ischemic attacks, one amaurosis fugax, two ... [more ▼]
From January 1990 to December 1997, the authors observed 13 cases of fibromuscular dysplasia of the internal carotid artery. Four patients presented transient ischemic attacks, one amaurosis fugax, two suffered from a minor stroke, four had non-focalized ischemic cerebral symptoms and two were asymptomatic. At angiography, all patients showed a typical image of "string of beads". Seven patients were operated on. Six had endoluminal graduated dilatation, with rigid dilators up to 4.5 mm, associated with thrombendarterectomy of the bifurcation in three and to correction of a kink in one case. In one case a venous interposition graft was done to exclude a saccular microaneurysm of the dysplasic internal carotid artery. In another case, backflow was insufficient after endoluminal dilatation, and a long venous patch allowed to restitute a normal vascular lumen. There was neither postoperative mortality nor stroke. Six patients, asymptomatic or with non focalized symptoms, were treated medically. During a mean follow-up of 47 months, only one of the 13 patients developed a transient ischemic attack; the patient had not been operated on and received only medical treatment. Prevalence, etiopathology, diagnosis and management of fibromuscular dysplasia of the internal carotid artery are discussed. Fibromuscular dysplasia is a rare cause of cerebral ischemia. For asymptomatic lesions, a conservative approach seems appropriate. Surgery is only to be considered for symptomatic lesions. Surgical graduated endoluminal dilatation, where necessary combined with standard endarterectomy of the carotid bifurcation, is a safe, efficient and durable operation. Some complex cases of fibromuscular dysplasia may necessitate patch insertion or excision and graft interposition. [less ▲]Detailed reference viewed: 11 (1 ULg)