Ellisconrad4875

Background Our goal was to analyze the value of the pretreatment neutrophil-to-lymphocyte ratio (NLR) in the prognosis of pediatrics with parotid mucoepidermoid carcinoma (MEC). Methods Patients (≤ 18 years old) undergoing surgical treatment for primary parotid MEC were enrolled from multiple clinical centers retrospectively. The χ2-test was used to analyze the associations between clinicopathological variables and the NLR. Valproic acid research buy The main study endpoints were recurrence-free survival (RFS) and disease-specific survival (DSS). The prognostic value of NLR was assessed by Kaplan-Meier method and Cox model analysis. Results There were 88 patients included in total, with mean NLR of 2.32 (range, 1.8-6.0). Histologic tumor grade and tumor stage were associated with the NLR significantly. The 10-year RFS rates were 98 and 81% for patients with an NLR less then 2.32 and patients with an NLR ≥ 2.32, respectively, the difference was significant (p = 0.010). The 10-year DSS rate was 97 and 81% for patients with an NLR less then 2.32 and patients with an NLR ≥ 2.32, respectively; the difference was not significant (p = 0.072). The independence of NLR in predicting the RFS was further confirmed in Cox model analysis. Conclusion The NLR significantly affects the prognosis in pediatrics with primary parotid MEC. Copyright © 2020 Gao, Gao and Sun.I present the case of a 24-year-old female patient with a guidewire entrapment during central venous catheter insertion. At first, open surgery was considered to remove the entrapped guidewire; however, after vascular surgery consult, it was removed by a simple endovascular procedure described below in detail. Copyright © 2020, The Korean Society for Vascular Surgery.There is a lack of guidelines concerning common carotid artery (CCA) occlusive disease in the presence of a patent internal carotid artery (ICA). A novel surgical technique that disobliterates an occluded CCA was successfully performed in three cases. The detailed surgical steps are presented herein. After proximal division of the CCA behind the sternoclavicular junction, the occluded CCA was endarterectomized via antegrade ring stripping. After removal of the atheromatous core, the CCA was everted, and the wall remnants were cleaned under direct vision. Simultaneous eversion endarterectomy of the ICA was performed when necessary. After reversion of the CCA, it was transposed and anastomosed to the ipsilateral subclavian artery distal to the orifice of the vertebral artery. This novel technique can be used in selected cases by experienced surgeons. Copyright © 2020, The Korean Society for Vascular Surgery.Iodinated contrast is the most common contrast agent used during endovascular abdominal aneurysm repair (EVAR). However, its use may worsen kidney function in patients with renal insufficiency. Previous studies have demonstrated the safety and effectiveness of carbon dioxide (CO2)-EVAR. Here, we report cases of three male patients with mild renal insufficiency (mean age 79 years) that successfully underwent CO2-EVAR using INCRAFT ultra-low profile endografts. CO2 angiography provided the necessary vascular roadmap for safe and effective percutaneous EVAR, eliminating the need for iodinated contrast media and preventing contrast-induced nephropathy. Copyright © 2020, The Korean Society for Vascular Surgery.Purpose Central venous stenosis is a recurring problem affecting dialysis access patency. Increasing evidence suggests that the use of drug-coated balloons (DCBs) improves target lesion primary patency (TLPP) in dialysis access. However, few studies have investigated the use of DCBs specifically in central venous stenosis. Thus, this study presents our initial experience with DCBs in the central vein of a dialysis access circuit. Materials and Methods This is a retrospective cohort study of all hemodialysis patients who underwent central vein angioplasty with DCB between February 2017 and March 2018 at Singapore General Hospital. We compared the primary patency post DCB angioplasty to the primary patency of the patient's previous plain old balloon angioplasty (POBA). Results We observed a 100% anatomic and procedural success rate with no complications. The median follow-up period was 151 days (interquartile range, 85.5-234 days) and no patients were lost to follow-up. The 30- and 90-day TLPPs after DCB were 93.3% and 75.7%, respectively. The mean primary patency in our study group post-DCB during the follow-up period was 164 days (vs. 140 days in the POBA group). However, no statistically significant difference was detected. Conclusion DCB showed a similar TLPP to that for POBA in treating central venous stenosis with a trend toward a longer re-intervention-free period for DCB. However, there were numerous confounding factors and a well-designed randomized controlled trial is warranted to assess the true utility of DCB in treating central venous stenosis. Copyright © 2020, The Korean Society for Vascular Surgery.Purpose To investigate the changes in the infrarenal aortic length and tortuosity in elderly patients. Materials and Methods We retrospectively reviewed the medical records and computed tomography (CT) scans of 857 patients who underwent surgery for colorectal cancer between August 2009 and July 2012. Among these patients, 48 patients who were aged ≥60 years, underwent follow-up CT at least 5 years after surgery, did not have aortic disease, and did not receive radiation therapy were enrolled. The aortic tortuosity index (ATI) was defined by dividing the distance along the central lumen line from the lowest renal artery to the aortic bifurcation (L1) by the straight-line distance from the lowest renal artery to the aortic bifurcation (L2). Aortic diameters were measured at the lowest renal artery level (D1) and 20 mm below (D2). A paired t-test and Wilcoxon signed-rank test were used to compare lengths and diameters between the initial and final CT scan. Spearman's correlation analysis was performed to determine the correlations between time and the changes in L1 and ATI. Results The average follow-up period was 68 months. The mean changes in L1 and L2 were 0.69 mm and -0.59 mm, respectively, while the mean changes in D1 and D2 were 0.77 mm and 0.58 mm, respectively. The mean increase in ATI was 0.015. All findings were statistically significant. On Spearman's correlation analysis, ΔL1 and ΔATI showed no correlation with follow-up duration. Conclusion The infrarenal aortic length and tortuosity of elderly patients increases at a slow rate over time. Copyright © 2020, The Korean Society for Vascular Surgery.