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      Spontaneous Arterial Calcification: A Possible Etiology for Spontaneous Splenic Rupture in a Patient on Maintenance Hemodialysis

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          Spontaneous splenic rupture (SSR) is a rare condition in contrast to traumatic splenic hematoma, and vascular abnormality has rarely mentioned as an etiology in SSR with patients who had chronic kidney disease. We reported a 80-year-old female whose SSR might be related to splenic arterial calcification. i 2014 S. Karger AG, Basel

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          Most cited references 11

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          Atherosclerotic plaque progression and vulnerability to rupture: angiogenesis as a source of intraplaque hemorrhage.

          Observational studies of necrotic core progression identify intraplaque hemorrhage as a critical factor in atherosclerotic plaque growth and destabilization. The rapid accumulation of erythrocyte membranes causes an abrupt change in plaque substrate characterized by increased free cholesterol within the lipid core and excessive macrophage infiltration. Neoangiogenesis is associated closely with plaque progression, and microvascular incompetence is a likely source of intraplaque hemorrhage. Intimal neovascularization is predominantly thought to arise from the adventitia, where there are a plethora of pre-existing vasa vasorum. In lesions that have early necrotic cores, the majority of vessels invading from the adventitia occur at specific sites of medial wall disruption. A breech in the medial wall likely facilitates the rapid in-growth of microvessels from the adventitia, and exposure to an atherosclerotic environment stimulates abnormal vascular development characterized by disorganized branching and immature endothelial tubes with "leaky" imperfect linings. This network of immature blood vessels is a viable source of intraplaque hemorrhage providing erythrocyte-derived phospholipids and free cholesterol. The rapid change in plaque substrate caused by the excessive accumulation of erythrocytes may promote the transition from a stable to an unstable lesion. This review discusses the potential role of intraplaque vasa vasorum in lesion instability as it relates to plaque rupture.
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            Calcification as a risk factor for rupture of abdominal aortic aneurysm.

            Abdominal aortic aneurysm (AAA) is a major cause of death in developed countries. The AAA diameter is still the only validated prognostic measure for rupture, and therapeutic interventions are initiated accordingly. This still leads to unnecessary interventions in some cases or unidentified impending ruptures. Vascular calcification has been validated abundantly as a risk factor in the cardiovascular field and may strengthen the rupture risk assessment of the AAA. With this study we aim to assess the correlation between AAA calcification and rupture risk in a retrospective unmatched case-control population.
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              Cardiovascular Calcification


                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                December 2014
                31 October 2014
                : 38
                : 2
                : 96-99
                aDepartment of Internal Medicine, bDepartment of Pathology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, Hsin-Tien District, New Taipei City, Taiwan
                Author notes
                *Dr. Kuo-Cheng Lu, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, 362 Chung-Cheng Road, Hsin-Tien District, New Taipei City 23148 (Taiwan), E-Mail
                365385 Blood Purif 2014;38:96-99
                © 2014 S. Karger AG, Basel

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                Page count
                Figures: 3, Tables: 1, Pages: 4
                Case Report


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