Aortic aneurysms performance

Cocaine abuse is a risk factor for myocardial ischemia, infarction, and dysrhythmias, as well as pulmonary edema, ruptured aortic aneurysm, infectious endocarditis, vascular thrombosis, myocarditis, and dilated cardiomyopathy (32). Acutely, cocaine suppresses myocardial contractility, reduces coronary caliber and coronary blood flow, induces electrical abnormalities in the heart, and increases heart rate and blood pressure. These effects can lead to myocardial ischemia (33,34). However, intranasal cocaine in doses used medicinally or recreationally does not have a deleterious effect on intracardiac pressures or left ventricular performance (35). 

The final chapter of the book is focused on stent grafts that provide the currently preferred and less invasive endovascular therapy for treating thoracic and abdominal aortic aneurysms. This is a comparatively recent development that has brought interventional radiologists into the same operating room as vascular surgeons, which has led to a reappraisal of the role of each type of specialist in providing vascular therapy. Details about the materials, clinical performance, current issues and future directions are all described in Chapter 21. 

In case of type I endoleak, the origin of the sac is catheterized by placing the catheter between the stentgraft and aortic wall and intra-aneurysmal injection is performed for optimal evaluation of the outflow vessels. 

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