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Carotid artery atherosclerosis is a risk factor to develop cerebrovascular disease. Atheroma plaque can become instable and provoke a cerebrovascular event or else remain stable as asymptomatic type. The exact mechanism involved in plaque destabilization is not known but includes among other events smooth muscle cell (SMC) differentiation. The goal of this study was to perform thorough analysis of gene expression differences in SMCs isolated from carotid symptomatic versus asymptomatic plaques. Comparative transcriptomics analysis of SMCs based on RNAseq technology identified 67 significant differentially expressed genes and 143 significant differentially expressed isoforms in symptomatic SMCs compared with asymptomatic. 37 of top-scoring genes were further validated by digital PCR. Enrichment and network analysis shows that the gene expression pattern of SMCs from stable asymptomatic plaques is suggestive for an osteogenic phenotype, while that of SMCs from unstable symptomatic plaque correlates with a senescence-like phenotype. Osteogenic-like phenotype SMCs may positively affect carotid atheroma plaque through participation in plaque stabilization via bone formation processes. On the other hand, plaques containing senescence-like phenotype SMCs may be more prone to rupture. Our results substantiate an important role of SMCs in carotid atheroma plaque disruption.

Background Because of the unique electromagnetic characteristics of the magnetoelastic microwire, the changes in the pressure of a fluid will provoke a variation of the mechanical pressure on the sensor, which will cause a variation of its magnetization that will be detectable wirelessly. Thus, a wireless system can be developed for following up vascular surgery procedures. Methods and Results The sensor consists of a magnetoelastic microwire ring, which was integrated into an in vitro model with pulsatile flow. Different degrees of stenosis were simulated in different locations both in bovine artery as well as in a polytetrafluoroethylene anastomosis. A Fourier analysis of the registered signals and a statistical analysis using Pearson test and receiver operating characteristic ( ROC ) curves were made. A Pearson index of 0.945 ( P ROC curves upon analyzing the signals registered, both in the case of preanastomotic stenosis (area under the curve [ AUC ], 0.98; 95% CI , 0.97–1.00), of anastomosis ( AUC , 0.93; 95% CI , 0.86–0.99), as well as distal ( AUC , 0.88; 95% CI , 0.79–0.98), compared to the control group. Conclusions The magnetoelastic microwire has shown that it is capable of detecting, locating, and quantifying the degree of stenosis in bovine artery, as well as in a latero‐terminal anastomosis, with a high statistical potency. For the first time, a wireless in vitro sensor has been developed for the postoperative follow‐up of vascular surgery procedures.

Resumen Objetivo El objetivo del presente estudio es determinar si el empleo de dispositivos de autotransfusian es util en las reconstrucciones del sector aortoiliaco por patologia oclusiva. Material y metodos Se analizo de forma retrospectiva el empleo del autotransfusor en 227 procedimientos electivos primarios realizados sobre la aorta por patologia oclusiva del sector aortoiliaco. Se valoraron los factores de riesgo, valores hematologicos preoperatorios, volumen reinfundido por el autotransfusor y administracion de sangre homologa. Se realizo, ademas, una valoracion del coste economico derivado del uso de AT. Resultados De los 227 procedimientos, 201 fueron bypasses aortobifemorales y 26 aortofemorales. El uso del autotransfusor se asocio a una disminucion en la cantidad de unidades de sangre homologa administrada en los pacientes intervenidos de bypass aortobifemoral (1,7 frente a 3 unidades, p El coste del dispositivo de autotransfusian se justifico con recuperaciones superiores a 440 ml de sangre. Siguiendo este criterio, el autotransfusor resulto rentable desde un punto de vista de costes en el 36% de los pacientes (37% en los aortobifemorales y 20% en los aortofemorales). El uso de autotransfusor supone en nuestro medio un coste aproximado adicional de unas 3.000 ptas. por paciente en el caso de un bypass aortobifemoral y de 19.000 ptas. en un bypass aortofemoral. Conclusiones El empleo rutinario del autotransflisor esta justificado en el bypass aortobifemoral por patologia oclusiva. Reduce el consumo de sangre, con un discreto aumento de costes. En la cirugia unilateral, el empleo rutinario del autotransfusor no esta justificado, no reduce el consumo de sangre de banco y no es coste-efectivo.

We review the association between surgically resolvable aortic disease and horseshoe kidney with a discussion of diagnostic problems and therapeutic options. Male patient 81 years of age with horseshoe kidney and an abdominal aortic aneurysm that was discovered by chance in an abdominal ultrasound during a check-up for his prostate condition. A retroperitoneal approach was used in order to resect the aneurysm and perform an aorto-aortic bypass with no complications occurring. Two years after the diagnosis, the patient is still asymptomatic from a vascular point of view. The co-presence of horseshoe kidney and aortic disease needing surgical correction is infrequent, but it significantly increases the technical complexity of aortic reconstruction. A literature review is included.

Se analiza la relación entre enfermedad aórtica quirúrgica y riñón en herradura, y se comentan los problemas diagnósticos y las diferentes posibilidades terapéuticas. Paciente de 81 años con riñones en herradura que, durante el seguimiento de su enfermedad prostática, se descubre de forma casual por ecografía un aneurisma de aorta abdominal. Se realizó mediante abordaje retroperitoneal una resección del aneurisma y bypass aortoaórtico, sin complicaciones. A los 2 años del diagnóstico, el paciente continúa asintomático en cuanto a la alteración vascular. La coexistencia de riñón en herradura y afección aórtica que precise corrección quirúrgica ocurre con poca frecuencia, pero incrementa de forma significativa la complejidad técnica de la reconstrucción aórtica. Se realiza una revisión de la literatura.

To report a successfully treated case of inflammatory aortic aneurysm.A 57-year-old patient reported low back pain and urinary infections. An abdominal CT scan revealed a large inflammatory aneurysm in the abdominal aorta. An aortic bypass was performed with no complications.Patient course since surgery has been uneventful, and currently has no symptoms.Contribution of the radiographic team, mainly with the CT scan, is of great value both for differential diagnosis and adequate management and follow-up. Surgery is indicated to prevent aneurysm rupture, but an increased postoperative morbidity and mortality should be assumed.

Resumen Objetivo Presentamos un caso de aneurisma aortico inflamatorio resuelto con exito. Material y metodos Paciente de 57 anos que consulta por dolor lumbar e infecciones urinarias. Se realiza una angio-TC y se descubre un aneurisma de aorta abdominal inflamatorio de gran tamano. Se interviene quirurgicamente, realizando un bypass aortoaortico, sin complicaciones intraoperatorias. Resultados El paciente evoluciona favorablemente desde la cirugia; en la actualidad, se encuentra asintomatico. Conclusiones La participacion del equipo de radiologia, fundamentalmente con el angio-TC, es de gran valor, tanto para el establecimiento de un diagnostico diferencial, como para un tratamiento y seguimiento correctos. La cirugia esta indicada para prevenir la rotura de estos aneurismas, asumiendo un incremento en la morbimortalidad postoperatoria.