Mecanisme de croissance et de rupture des anevrysmes de l'aorte abdominale.
Limet, Raymond ; SAKALIHASAN, Natzi ;
in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (1997), 152(7-9), 295-302302-3
The relationship between atherosclerosis and abdominal aortic aneurysm development is well known. Atherosclerosis cannot explain the whole mechanism. Genetic characters of mechanisms leading to abdominal ... [more ▼]
The relationship between atherosclerosis and abdominal aortic aneurysm development is well known. Atherosclerosis cannot explain the whole mechanism. Genetic characters of mechanisms leading to abdominal aortic development is obvious from this study and others. Our study evidences an increased metalloproteases activity in aortic wall proportionally to the size of the abdominal aortic aneurysm. A decrease of aortic wall elastin is evidenced proportionally to the AAA size. Extractable collagen is significantly increased in the aortic wall of patients operated on for aortic rupture. [less ▲]Detailed reference viewed: 10 (3 ULg)
Spinal ischaemia after surgery for abdominal infrarenal aortic aneurysm. Diagnosis with nuclear magnetic resonance.
Defraigne, Jean-Olivier ; OTTO, Bernard ; SAKALIHASAN, Natzi et al
in Acta Chirurgica Belgica (1997), 97(5), 250-6
A 76-year-old man underwent surgery for an infrarenal aortic aneurysm reaching 6 cm in maximal transverse diameter. The aorta was crossclamped below the level of the renal arteries. A tube graft was ... [more ▼]
A 76-year-old man underwent surgery for an infrarenal aortic aneurysm reaching 6 cm in maximal transverse diameter. The aorta was crossclamped below the level of the renal arteries. A tube graft was interposed and tend between the infrarenal aorta and the aortic bifurcation. Due to leakage on the suture line two consecutive episodes of crossclamping for a total duration of 40 min. were required. No hypotension was noted during or after the procedure. After operation, the patient complained of difficulties to move both legs and neurologic examination demonstrated paraparesis, with mild sensory deficit. Faecal and urinary incontinences were also noted and urodynamic testing demonstrated sphincterovesical palsy. Nuclear magnetic resonance imaging detected an ischaemic zone in the spinal cord at the level of T11. Faecal incontinence and motor deficit partially resolved but no bladder function recovery was observed. Spinal ischaemia is a rare complication after abdominal aortic surgery. Several risk factors have been suggested which include level and duration of the aortic crossclamping, possible interruption of the spinal cord blood supply via the greater medullary artery (the so-called artery of Adamkiewicz), presence of intra- or postoperative episodes of hypotension, atheromatous embolization, underlying occlusive arteriosclerosis of spinal arteries, and respect or not of the hypogastric circulation. In our case, the duration of the crossclamping and interruption of the blood flow in lumbar arteries probably supplying the distal spinal cord were likely contributive factors. [less ▲]Detailed reference viewed: 22 (1 ULg)
Une masse cervicale de diagnostic souvent errone: le chemodectome carotidien.
Defraigne, Jean-Olivier ; Antoine, Paul ; SAKALIHASAN, Natzi et al
in Revue Médicale de Liège (1997), 52(7), 485-97Detailed reference viewed: 8 (4 ULg)
Transplantation combinée du foie et du coeur chez un patient souffrant de thalassémie majeure
Detry, Olivier ; Defechereux, Thierry ; Honore, Pierre et al
in Revue Médicale de Liège (1997), 52(8), 532-4Detailed reference viewed: 36 (7 ULg)
Decrease of Plasma Vitamin E (Alpha-Tocopherol) Levels in Patients with Abdominal Aortic Aneurysm
Sakalihasan, Natzi ; Pincemail, Joël ; Defraigne, Jean-Olivier et al
in Annals of the New York Academy of Sciences (1996), 800Detailed reference viewed: 39 (12 ULg)
Activated forms of MMP2 and MMP9 in abdominal aortic aneurysms.
SAKALIHASAN, Natzi ; Delvenne, Philippe ; Richelle, Betty et al
in Journal of Vascular Surgery (1996), 24(1), 127-33
PURPOSE: This consistent observation of a reduction of the elastin concentration in abdominal aortic aneurysms (AAAs) has led us to investigate in AAA specimens two metalloproteinases that display ... [more ▼]
PURPOSE: This consistent observation of a reduction of the elastin concentration in abdominal aortic aneurysms (AAAs) has led us to investigate in AAA specimens two metalloproteinases that display elastase activity, MMP2 (gelatinase A/72kDa) and MMP9 (gelatinase B/92 kDa). METHODS: Samples of full-thickness aortic wall, adherent thrombus, and serum were collected in 10 patients with AAAs. Samples of normal aortic wall and serum were taken from 6 age-matched control patients. Quantitative gelatin-zymography and gelatinolytic soluble assays after acetyl-phenyl mercuric acid activation were performed on serum and tissue extracts, and the results were expressed in units on a comparative wet-weight basis. Histologic analysis was performed in parallel to score the inflammatory infiltrate. RESULTS: The luminal and parietal parts of the thrombus contained, respectively, 20- and 10-fold more gelantinolytic activity than the serum. The predominate form was MMP9. Although the total gelatinolytic activity was in the same range both in AAAs and in normal walls, a significantly higher proportion of MMP9 was found in the aneurysmal aortic walls. Furthermore, a significant proportion of MMP9 was under its processed active form, which was never observed in normal samples. A significantly higher proportion of MMP2 was also present as processed active form in AAA wall. This latter parameter positively correlated with the inflammatory score. CONCLUSIONS: The presence of activated MMP9 and MMP2 might contribute to the degradation of the extracellular matrix proteins that occurs during the development of aneurysms. [less ▲]Detailed reference viewed: 15 (6 ULg)
Une cause parfois meconnue de lesions vasculaires: la maladie de Behcet.
Defraigne, Jean-Olivier ; SAKALIHASAN, Natzi ; Pierard, Gérald et al
in Revue Médicale de Liège (1996), 51(10), 639-46Detailed reference viewed: 8 (1 ULg)
Saphenous vein patch (SVP) is superior to direct closure (DC) for long-term patency of carotid endarterectomy (CEA)
Desiron, Quentin ; Detry, Olivier ; Sakalihasan, Natzi et al
in Cardiovascular Surgery (1995, September), 3(Suppl. 1), 44Detailed reference viewed: 18 (1 ULg)
Involvement of MMP2 and MMP9 in the development of abdominal aortic aneurysms.
SAKALIHASAN, Natzi ; DELVENNE, Philippe ; Nusgens, Betty et al
in Cell Biology International (1995), 19(3), 250-51Detailed reference viewed: 10 (7 ULg)
Aneurysms of the abdominal aorta: familial and genetic aspects in three hundred thirteen pedigrees.
VERLOES, Alain ; SAKALIHASAN, Natzi ; Koulischer, Lucien et al
in Journal of Vascular Surgery (1995), 21(4), 646-55
PURPOSE: Familial clustering of abdominal aortic aneurysm was first noticed in 1977. METHODS: Through questionnaire and phone inquiry, familial data on 324 probands with abdominal aortic aneurysms allowed ... [more ▼]
PURPOSE: Familial clustering of abdominal aortic aneurysm was first noticed in 1977. METHODS: Through questionnaire and phone inquiry, familial data on 324 probands with abdominal aortic aneurysms allowed the establishment of 313 multigenerational pedigrees including 39 with multiple affected patients. RESULTS: There were 276 sporadic cases (264 men, 12 women); 81 cases belonged to multiplex pedigrees (76 men; 5 women). We compared familial and sporadic male cases; the ages at diagnosis were 64.1 +/- 7.9 years and 66.0 +/- 7.3 years (p < 0.05), respectively, the ages at rupture were 65.4 +/- 6.6 years and 75.2 +/- 8.6 years (p < 0.001), and the rupture rate was 32.4% and 8.7% (p < 0.001). Survival curves were computed. Relative risk for male siblings of a male patient was 18. We performed a segregation analysis with the mixed model, the most likely explanation for occurrence of abdominal aortic aneurysm in our families was a single gene effect showing dominant inheritance. The frequency of the morbid allele was 1:250, and its age-related penetrance was not higher than 0.4. CONCLUSION: This analysis indicates the preeminence of genetic factors on multifactorial/environmental effects of the pathogenesis of abdominal aortic aneurysm. [less ▲]Detailed reference viewed: 5 (2 ULg)
Successful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation.
Defraigne, Jean-Olivier ; SAKALIHASAN, Natzi ; DEMOULIN, Julie et al
in Cardiovascular Surgery (1995), 3(3), 321-4
With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm ... [more ▼]
With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up. [less ▲]Detailed reference viewed: 12 (2 ULg)
Isolated Atherosclerotic Aneurysms of the Iliac Arteries
Desiron, Quentin ; Detry, Olivier ; Sakalihasan, Natzi et al
in Annals of Vascular Surgery (1995), 9(Suppl), 62-6
Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two ... [more ▼]
Atherosclerotic aneurysms limited to the iliac arteries are rare and entail a high risk of rupture. To evaluate the efficacy of prophylactic surgery, we retrospectively studied 15 patients (13 men and two women; mean age 69 years) treated for isolated iliac aneurysms in the Department of Cardiovascular Surgery at the University Hospital of Liege over a period of 18 years. They had a total of 25 aneurysms (20 common iliac and five internal iliac). Six patients were treated electively and nine on an emergency basis for rupture. Five of the emergency patients (33%) died in the early postoperative period (< 30 days); in each case the aneurysm had ruptured and an emergency operation was performed (55.5% mortality in the ruptured iliac aneurysm group). On the other hand, all patients treated electively survived. Our study is comparable to other recent series in the literature, which also reported a high incidence of rupture and death in emergency operations. Prophylactic elective surgery is recommended for iliac aneurysms. [less ▲]Detailed reference viewed: 17 (6 ULg)
Histoire naturelle des anévrysmes de l'aorte abdominale
SAKALIHASAN, Natzi ; Limet, Raymond
in Revue Médicale de Liège (1994), 49(10), 545-52Detailed reference viewed: 60 (3 ULg)
"Contribution à la détermination de l’épidémiologie et de l'histoire naturelle des anévrysmes de l'aorte abdominale.”
Doctoral thesis (1994)Detailed reference viewed: 5 (0 ULg)
La myocardiopathie hypertrophique obstructive: options therapeutiques chirurgicales.
Radermecker, Marc ; SAKALIHASAN, Natzi ; et al
in Revue Médicale de Liège (1993), 48(12), 659-65Detailed reference viewed: 16 (3 ULg)
Modifications of the extracellular matrix of aneurysmal abdominal aortas as a function of their size.
SAKALIHASAN, Natzi ; HEYERES, Antoine ; Richelle, Betty et al
in European Journal of Vascular Surgery (1993), 7(6), 633-7
Collagen and elastin are the main extracellular matrix proteins providing the aortic wall with adequate mechanical properties and resistance for proper function. Our study aimed at investigating the ... [more ▼]
Collagen and elastin are the main extracellular matrix proteins providing the aortic wall with adequate mechanical properties and resistance for proper function. Our study aimed at investigating the relationship between the elastin concentration of the wall of normal and aneurysmal abdominal aortas (AAA), the collagen concentration, and its extractability, as a function of their size. Infrarenal aortas were collected from 30 patients undergoing operative repair of abdominal aortic aneurysm. Age-matched control samples were obtained from eight autopsies of individuals without vascular disease. Samples were divided into five groups according to the aortic diameter: control group (group N, n = 8); < 50 mm (group I, n = 6; between 50-75 mm (group II, n = 10); > 75 mm (group III, n = 7); and ruptured (group IV, n = 7). The collagen concentration in samples from group I was similar to the controls. An increased collagen concentration was observed in group II and remained at the same level in the largest and ruptured aneurysms. Extractability of collagen was found to be increased in group III and was even higher in group IV. A highly significant reduction in elastin concentration was observed in group I and there was progressive reduction with increasing diameter and rupture. A significant correlation could be established between aortic diameter, increased collagen extractability and decreased elastin content. [less ▲]Detailed reference viewed: 21 (3 ULg)
Fibromuscular dysplasia of the external iliac artery. A case report.
; SAKALIHASAN, Natzi ; Dekoster, Guy et al
in Vascular Surgery (1992), 26Detailed reference viewed: 6 (2 ULg)
Right Aortic Arch with Aberrant Left Subclavian Artery. Report of Two Cases
SAKALIHASAN, Natzi ; Defraigne, Jean-Olivier ; Limet, Raymond
in Surgical &Radiologic Anatomy [=SRA] (1991), 13(4), 327-31
Two cases of adult asymptomatic right aortic arch with an aberrant subclavian artery are reported. They were discovered at time of coronary surgery. Preoperative coronary arteriography failed to ... [more ▼]
Two cases of adult asymptomatic right aortic arch with an aberrant subclavian artery are reported. They were discovered at time of coronary surgery. Preoperative coronary arteriography failed to demonstrate the anomalies. In one case, the right arch was suspected on chest x-ray and preoperative barium oesophagography. In one case, the proximal suture of one saphenous bypass graft was performed on the left common carotid artery. Right aortic arch is a malformation rarely discovered in adults. It generally produces no symptoms when not associated with cardiac disease. [less ▲]Detailed reference viewed: 7 (0 ULg)