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Checking out this halloween tactical in numerous manufacturing periods using genomic models.

BACKGROUND To report the postoperative renal function stratified according to the visceral vessels (VV) revascularization technique used during proximal abdominal aortic aneurisms (p-AAA) open surgical repair (OR). METHODS Data from all patients with p-AAA who were submitted to OR between 2010 and 2015 at our Institute were prospectively collected and analyzed. A postoperative deterioration of the estimated glomerular filtration rate (eGFR) by 25% within four days was defined as acute kidney injury (AKI) 1. Only AKI 2 (50% decrease in eGFR) and AKI 3 (75% decrease in eGFR) were considered significant for renal impairment after the procedure. Primary study end point was defined as the presence of AKI 2 or 3. Secondary end points were 30-day mortality and/or any major adverse event. RESULTS During the study period, 157 consecutive patients (145 men and 12 women; mean age 72±7 years) were treated. Sixty (38,2%) were cross-clamped supraceliac, 53 (33,8%) were cross-clamped suprarenal and 44 (28%) were cross- clam period. CONCLUSIONS Postoperative renal failure after p-AAAs repair is still a major concern although perfusion techniques and organ protection are important to reduce its frequency. Despite recent development of complex endovascular techniques, OR, when offered in high-volume centers, remains safe, effective and durable.BACKGROUND Vascular Services Quality Improvement Program (VSQIP) was introduced to reduce mortality from elective repair of AAA in the United Kingdom. This study examines the differences in perioperative mortality and postoperative survival between men and women following elective repair of AAAs in the 10 years after implementation of the (VSQIP). METHODS Consecutive patients who underwent elective repair of AAA between 1stJanuary 2008 and 31st March 2018 were included. All patients were assessed using the nationally agreed VSQIP pathway which involved cardiopulmonary exercise testing as well as contrast enhanced CT scan of aorta and multidisciplinary assessment to plan each treatment. CT scans were examined to assess the morphology of AAA. Patients were stratified by age, gender, AAA morphology and preoperative anaerobic threshold. Postoperative survival was assessed using Kaplan-Meier analysis. Cox regression analysis was used to determine predictors of postoperative mortality. RESULTS A total of 702 patienIONS Following the implementation of VSQIP female gender is no longer a significant risk factor for perioperative mortality or reduced survival following elective repair of large asymptomatic AAA.BACKGROUND Acute popliteal artery occlusion is a frequent clinical entity with a risk of major amputation. Several attitudes are possible and treatment is not standardized. The purpose of this study is to demonstrate safety and effectiveness of intra-arterial thrombolysis in acute popliteal artery occlusion. METHODS This is a retrospective analysis of a prospective database of patients treated by intra-arterial thrombolysis for acute lower-limb ischemia due to popliteal artery occlusion between 2001 and 2014.The primary endpoint was technical and clinical success. Etiologies and etiologic treatment, amputation-free survival, in-hospital mortality and bleeding complications rates were secondary endpoints. RESULTS Seventy-one patients, with a mean 6-day-old ischemic time before thrombolysis, were analyzed. Technical and clinical success was 90% and 87% respectively. Etiology was embolic in 33 patients (cardiac n = 14, aortic = 6, unknown = 13) and thrombotic in 38 (atheromatous n = 19, entrapment n= 4, popliteal aneurysm n = 11, Buerger n = 2, thrombophilia n = 1, hyperhomocysteinemia n = 1). Survival and amputation-free survival at 30 days were 97% and 94% respectively. There were no major bleeding complications. CONCLUSIONS Intra-arterial thrombolysis of acute popliteal artery occlusion is an effective technique which reduces the rate of open surgery. find more The risk of bleeding complications is very low.BACKGROUND TAVR in patients with CKD is challenging due to the high risk of CIN and acute kidney injury (AKI). AKI dramatically reduces the clinical benefit of TAVR and is one of the strongest predictors of 30-day mortality as well as long-term adverse outcomes after TAVR. The aim of this study is to evaluate a protocol specifically designed to reduce the incidence of contrast-induced nephropathy (CIN) in advanced chronic kidney disease (CKD) patients screened for and undergoing transcatheter aortic valve replacement (TAVR). METHODS 12 consecutive patients with severe aortic valve stenosis suffering from at least stage 4 CKD underwent both screening with pre-procedural computed tomography scan (CT scan) and bioprosthetic valve implantation without contrast medium. All the TAVR procedures were performed using the CoreValve Evolut R/PRO transcatheter aortic valve (Medtronic Inc, Minneapolis, Minnesota). find more The annulus and the optimal implantation projection were identified on the non-contrast medium CT scans with T scan analysis and procedural planning, appears to be safe and feasible permitting to preserve renal function. The avoidance of contrast medium during preprocedural analysis and TAVR implantation could reduce the incidence of AKI and consequently could improve outcomes in this complex patient cohort.Objectives. To evaluate the feasibility of brachial plexus schwannoma enucleation under intraoperative neuromonitoring. Methods. Five patients who were treated for brachial plexus schwannoma under intraoperative neuromonitoring from 2008 to 2018 were included in this retrospective review. Neuromonitoring was performed with a 100-μV event threshold of the neuromonitoring system (NIM-2 or 3) at the deltoid, biceps brachii, triceps brachii, and brachioradialis muscles. Patient characteristics, tumor size and location, intraoperative neuromonitoring findings, and postoperative function were evaluated. Results. The intraoperative neuromonitoring findings were in accordance with the preoperative assessment of the included nerve root. Three patients had no postoperative morbidity, one patient had temporary paresthesia of the forearm for 2 months, and one patient mild loss of grip strength for 1 month. Conclusion. Intraoperative neuromonitoring of the arm and forearm muscles during enucleation of brachial plexus schwannoma promoted confident and successful surgery with minimal postoperative morbidity.