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Int J Angiol. 2007;16(3):98-105. doi: 10.1055/s-0031-1278258.

The coral reef aorta - a single centre experience in 70 patients.

The International journal of angiology : official publication of the International College of Angiology, Inc

Dirk Grotemeyer, Siamak Pourhassan, Hermann Rehbein, Adina Voiculescu, Petra Reinecke, Wilhelm Sandmann

Affiliations

  1. Department of Vascular Surgery and Renal Transplantation.

PMID: 22477301 PMCID: PMC2733021 DOI: 10.1055/s-0031-1278258

Abstract

Coral reef aorta (CRA) is described as rock-hard calcifications in the visceral part of the aorta. These heavily calcified plaques grow into the lumen and can cause significant stenoses, which may lead to malperfusion of the lower limbs, visceral ischemia or hypertension due to renal ischemia. From January 1984 to February 2007, 70 patients (24 men, 46 women, mean age 59.5 years, range 14 to 81 years) underwent treatment in the Department of Vascular Surgery and Renal Transplantation, University Hospital, Heinrich-Heine-University (Düsseldorf, Germany) for CRA. The present study is based on a review of patients' records and the prospective follow-up in the outpatient clinic. The most frequent finding was renovascular arterial hypertension (44.3%) causing headache, vertigo and visual symptoms. Intermittent claudication due to peripheral arterial occlusive disease was found in 28 patients (40.0%). Seventeen patients (24.3%) presented with chronic visceral ischemia causing diarrhea, weight loss and abdominal pain. Sixty-nine of the 70 patients (98.6%) underwent surgery; in 57 patients, aortic reconstruction was achieved with thromboendarterectomy, performed on an isolated suprarenal segment in six cases (8.7%), an infrarenal segment in 15 cases (21.7%), and the supra- and infrarenal aorta in 43 cases (62.3%). Eight patients (11.6%) died during or soon after surgery. Postoperative complications requiring corrective surgery occurred in 11 patients (15.9%). Almost one-third of the patients (n=19, 27.5%) returned for follow-up after a mean of 52.6 months (range six to 215 months). Of the 19 patients, there was significant clinical and diagnostic improvement in 16 patients (84.2%) and three patients (15.8%) were unchanged. Impairment was not observed. Despite the existing and improving surgical techniques for the treatment of CRA, its pathophysiological basis and genesis is not yet understood.

References

  1. Angiology. 2002 Sep-Oct;53(5):605-8 - PubMed
  2. Kidney Int Suppl. 2003 May;(84):S84-7 - PubMed
  3. Ann Vasc Surg. 2000 Nov;14(6):626-33 - PubMed
  4. J Thorac Surg. 1955 Jan;29(1):66-100; discussion, 100-4 - PubMed
  5. Vasa. 1985;14(4):357-9 - PubMed
  6. Surgery. 1966 May;59(5):709-12 - PubMed
  7. Angiology. 2000 Jun;51(6):525-8 - PubMed
  8. Blood Purif. 2002;20(5):473-6 - PubMed
  9. J Can Assoc Radiol. 1981 Sep;32(3):155-8 - PubMed
  10. J Vasc Surg. 2006 Jul;44(1):194-7 - PubMed
  11. Rev Esp Cardiol. 2002 Jun;55(6):682-5 - PubMed
  12. Presse Med. 1985 Feb 2;14(4):209-11 - PubMed
  13. J Thorac Cardiovasc Surg. 1959 Sep;38:369-73 - PubMed
  14. Cardiovasc Intervent Radiol. 1981;4(4):242-4 - PubMed
  15. Arch Pathol (Chic). 1946 Jan;41:63-5 - PubMed
  16. Ann Vasc Surg. 1989 Apr;3(2):181-6 - PubMed
  17. J Vasc Surg. 1986 Apr;3(4):679-80 - PubMed
  18. Rontgenblatter. 1990 Dec;43(12):536-8 - PubMed
  19. J Mal Vasc. 1997 Mar;22(1):43-7 - PubMed
  20. Vasa. 2006 Aug;35(3):206-8 - PubMed
  21. Am J Surg. 1969 Jul;118(1):112-6 - PubMed
  22. Br J Surg. 1963 Sep;50:811-3 - PubMed
  23. Am J Med. 1971 Jul;51(1):134-40 - PubMed
  24. AJR Am J Roentgenol. 1976 Aug;127(2):227-33 - PubMed
  25. Surgery. 1957 Mar;41(3):488-90 - PubMed
  26. J Vasc Surg. 1984 Nov;1(6):903-9 - PubMed
  27. Lancet. 2003 Mar 8;361(9360):827-33 - PubMed
  28. Rofo. 1986 Dec;145(6):721-3 - PubMed
  29. Radiology. 1964 Mar;82:443-6 - PubMed
  30. Ann Vasc Surg. 1995 Nov;9(6):561-4 - PubMed
  31. Rev Port Cir Cardiotorac Vasc. 2006 Jul-Sep;13(3):159-63 - PubMed
  32. Br Heart J. 1963 Sep;25:610-8 - PubMed

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