The calcifications are often similar in appearance to growths of hyperplastic bone, though abnormalities in serum calcium are not found. Renovascular arterial hypertension symptoms are also common 1. Heavy calcification of visceral part of aorta, extending into its lumen and causing malperfusion of limbs or viscera is known as ‘coral reef aorta’ [1]. 2008 Oct;23(10):3263-71. doi: 10.1093/ndt/gfn226. CORAL REEF CALCIFICATION AND CLIMATE CHANGE: THE EFFECT OF OCEAN WARMING B. I. McNeil1, R. J. Matear2 and D. J. Barnes3 1 Centre for Environmental Modelling and Prediction, University of New South Wales, Sydney, NSW, Australia 2 CSIRO Marine Research and Antarctic, Climate and Ecosystem CRC, Hobart, Australia 3 Australian Institute of Marine Science, Townsville, Queensland, Australia Shishkova D, Velikanova E, Sinitsky M, Tsepokina A, Gruzdeva O, Bogdanov L, Kutikhin A. Int J Mol Sci. Invest. Positive vascular immunostaining and low serum levels of both fetuin-A and ucMGP suggest a pathophysiologic role of these calcification inhibitors in the development of coral reef aorta. 3,4 Surgical treatment involves thromboendarterectomy or a bypass surgery, although the operative mortality ranges between 8.7% and 11.6%. 7. Patients present with arterial occlusion-like symptoms such as intermittent claudication and visceral ischemia such as bowel involvement causing diarrhea, weight loss, and abdominal pain. USA.gov. It may cause hypertension due to involvement of renal arteries, which was the commonest finding noted in about 44 percent of patients in one series with 70 patients [2]. The serum protein alpha 2-Heremans-Schmid glycoprotein/fetuin-A is a systemically acting inhibitor of ectopic calcification. Conclusion: Belczak SQ, Sincos IR, Aun R, Costa KV, Araujo EA. {"url":"/signup-modal-props.json?lang=us\u0026email="}. Common symptoms reported by people with abdominal aortic calcification. These calcifications often resemble the growths of hyperplastic bone, … thoracoabdominal aorta: coral reef aorta (CRA) (Figure 1). Relative postoperative complications include acute ischemia of the lower extremities and viscera such as the bowel 1. The estimated frequency of this disease ranges between 0.6% and 1.8% in the aortoiliac occlusive disease [2] . Methods: The frequency of CRA is estimated to be 6 in 1,000 (0.6%) 1. (2020). (2014) Einstein (Sao Paulo, Brazil). It predominantly involves the posterior thoracic and abdominal aorta. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. As assessed by immunohistochemistry, most MGP was detected in the vicinity of calcified regions. COVID-19 is an emerging, rapidly evolving situation. 12 (2): 237-41. Coral reef aorta (CRA), a rare disease, is characterized by severe calcification of the juxta-renal and suprarenal aorta that grows into the lumen and leads to severe stenosis. The circulating calcification inhibitors, fetuin-A and osteoprotegerin, but not matrix Gla protein, are associated with vascular stiffness and calcification in children on dialysis. Coral reef aorta (CRA) is a rare disease characterized by atherosclerosis, calcification, and stenosis of the abdominal aorta, being described as rock-hard calcifications in the  |  Int. "coral reef" atherosderosis should be considered if visceral, renal, and limb ischemia is not adequately explained by the arteriographic pattern of conventional atherosclerosis. Coral reef aorta (Cra) is a rare condition, characterised by rock-hard calcification of the juxta-renal and supra-renal aorta with luminal encroachment causing significant stenosis of the aorta and its branches. Coral reef aorta (CRA) is a condition of extreme atherosclerosis and calcification of the aorta that can present with severe post-aortic valve obstruction. Recognition of the extensive endoluminal calcifications can have important implications for planning interventions and treatment, particularly for vascular surgeons and interventional radiologists 2. Other techniques include aortoiliac and aortofemoral bypass. Kojima S, Hiraoka E, Tabata M, Nakanaga H, Hiraiwa N, Noguchi M, Iwata F, Sakai M, Obunai K, Watanabe H. J Cardiol Cases. Over 60 years ago, the discovery that light increased calcification in the coral plant-animal symbiosis triggered interest in explaining the phenomenon and understanding the mechanisms involved. We report the case of a patient with CRA who underwent endovascular treatment (EVT). Coral reef aorta, emergency surgical: case report and literature review. in 1984 in patients with heavily calcified polypoid atherosclerotic lesions in the thoracoabdominal aorta. Coral reef aorta (CRA) is an uncommon syndrome caused by a distribution of rock-hard calcifications in the visceral part of the aorta [ 3 ]. Conclusion: The coral reef aorta represents an extreme exophytic growth of vascular calcification with multiple nuclei which resemble typical media calcification. Policha A, Moudgill N, Eisenberg J et-al. Communications Earth & Environment 1:55. How bad it is. Successful Surgery for Coral Reef Aorta Owing to Takayasu’s Arteritis Complicated by Infected Aortic Aneurysms. The condition has an association with the clogging of arteries with fatty tissue. Teebken, OE, Pichlmaier, MA, Kühn, C. Severe obstructive calcifications affecting the descending and suprarenal abdominal aorta without coexisting peripheral atherosclerotic disease—coral reef aorta. A computed tomography scan showed a preocclusive calcified lesion in the infrarenal aorta. 6. Pathology examination of both the coral reef lesions and the aortic atheromas showed fibrosis of the intima and media with loss of the internal elastic lamina, focal intraplaque hemorrhage, and calcification. Coral reef aorta (CRA) is a rare disease characterized by aortic calcification in the visceral aorta that grows into the lumen and leads to severe stenosis. Schulte K et.al, Coral reef aorta: a long-term study of 21 patients. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The coral reef aorta, which Qvarfordt et al. 1. Lesions demonstrate a coral reef shape 2. There may be a calcification regulation defect secondary to lack of serum fetuin-A (also known as alpha-2-Heremans-Schmid glycoprotein) which acts to inhibit ectopic calcification 1,3. Copyright (c) 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. Communications Earth & Environment. Coral reef aorta can sometimes lead to heart failure. Get the latest public health information from CDC: https://www.coronavirus.gov. Epub 2014 Nov 13. thoracic aortic dilatation (differential), D-loop transposition of the great arteries, L-loop transposition of the great arteries. Serum levels of the calcification inhibitors ucMGP, fetuin-A, and osteoprotegerin were 370+/-107 nmol/L, 0.57+/-0.03 g/L, and 5.64+/-0.79 pmol/L, respectively. Coral Reef Aorta . Coral reef aorta (CRA) is a rare disease, described as hard calcifications involving the arterial wall which protrude into the lumen. J. Clin. 2015 Oct;23(5):555-7. doi: 10.1177/1708538114559325. The pathogenesis of this disease with its topographic and morphologic characteristics is unknown. Patients present with arterial occlusion-like symptoms such as intermittent claudication and visceral ischemia such as bowel involvement causing diarrhea, weight loss, and abdominal pain. Cores of corals from the Great Barrier Reef indicate a 14% decrease in calcification rates from 1990 to 2005. Coral reef aorta, a rare condition that was first described in 1984 by Qvarfordt et al. 4. 18 December, 2018. J. Angiol. What people are taking for it. Moe SM, Reslerova M, Ketteler M, O'neill K, Duan D, Koczman J, Westenfeld R, Jahnen-Dechent W, Chen NX. ‘Ocean warming and acidification uncouple calcification from calcifier biomass which accelerates coral reef decline’. The circulating inactive form of matrix gla protein is a surrogate marker for vascular calcification in chronic kidney disease: a preliminary report. Corals generally maintain a high Ω at the site of calcification, but with decreasing CO 32-, precipitation of aragonite requires more energy, hence the decrease in calcification rate. 2019 Nov 15;20(22):5728. doi: 10.3390/ijms20225728. Vessel walls were also assessed by electron microscopic techniques including electron energy-lost spectroscopy, electron dispersive spectroscopy, and electron diffraction. This can cause the aorta to narrow and restrict blood flow. Figure 1: Coral reef aorta. The term coral reef aorta was coined in 1984 by Qvarfordt et al 1. Vascular. eCollection 2018 Sep-Dec. Ishigaki T, Matsuda H, Henmi S, Yoshida M, Mukohara N. Ann Vasc Dis. … Calcified specimens were investigated by immunohistochemical techniques for the expression of the calcification inhibitors matrix gla protein (MGP) and fetuin-A. Harada M, Miyashita Y, Ichikawa T, Kobayashi M. Case Rep Nephrol Dial. 2018 Nov 27;8(3):253-260. doi: 10.1159/000494716. Severe Obstructive Calcification of the Descending Aorta: A Case Report of "Coral Reef Aorta". CRA luminal lesions can cause significant aortic stenosis. There are few reports of coral reef aorta resulting in severely congestive heart failure in the literature. It usually presents as resistant hypertension, renal dysfunction, mesenteric ischaemia, limb claudication Coral reef aorta (CRA) is a rare aortic occlusive disease with calcified intraluminal lesions.  |  2005 Jun;67(6):2295-304. doi: 10.1111/j.1523-1755.2005.00333.x. Grotemeyer D, Pourhassan S, Rehbein H et-al. first identified in nine patients over a period of 13 years, is a rare entity of calcifying aortic disease localized to the suprarenal aorta . Ten patients with coral reef aorta were examined. Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). However, the coral reef lesions had much more extensive calcification (>70%, or 0.74 gm/gm wet tissue) in the form of multiple irregularly shaped, calcified densities, somewhat reminiscent of those seen in calcified heart valve … Abdominal aortic calcification occurs when calcium crystals are deposited in the abdominal aorta. Non-contrast CT demonstrates dense, serpiginous, exophytic, calcifications of the aortic wall which protrude into the aortic lumen. Coral reef aorta (CRA), a rare disease, is characterized by severe calcification of the juxta-renal and suprarenal aorta that grows into the lumen and leads to severe stenosis. Coral reef aorta (CRA) is a rare disease characterized by atherosclerosis, calcification, and stenosis of the abdominal aorta, being described as rock-hard calcifications in the visceral part of the aorta. Common symptoms. (2000) Annals of vascular surgery. Unable to process the form. Positive vascular immunostaining and low serum levels of both fetuin-A and ucMGP suggest a pathophysiologic role of these calcification inhibitors in the development of coral reef aorta. Such a condition is called stenosis of aortic valve which blocks the blood circulation throughout the body. Typically treatment is invasive surgery, most commonly thromboendarterectomy. Calcium Phosphate Bions Cause Intimal Hyperplasia in Intact Aortas of Normolipidemic Rats through Endothelial Injury. Ocean warming and acidification uncouple calcification from calcifier biomass which accelerates coral reef decline. 3. This unusual atheroma exhibited extensive calcification and metaplastic bone formation, NIH Results: The aim of our study was to investigate calcification inhibitors and the ultrastructure of calcifications in patients with coral reef aorta. 2012;16 (3): 98-105. It is normally treated using conventional surgery such as thromboendarterectomy, covered stent graft replacement of the aorta, and thoracoabdominal bypass graft. It usually presents as resistant hypertension, renal dysfunction, mesenteric ischaemia, limb claudication or embolic manifestations. Check for errors and try again. The coral reef aorta represents an extreme exophytic growth of vascular calcification with multiple nuclei which resemble typical media calcification. 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