Endovascular Treatment of May-Thurner Syndrome in an Office-Based Laboratory.

May-Thurner syndrome (MTS) is a rare condition that increases the risk of left-sided iliofemoral venous thrombosis due to compression of the left common iliac vein by the right common iliac artery. Treatment for symptomatic MTS typically includes combined anticoagulation and endovascular therapy. This patient presented to the emergency department with acute left lower extremity pain and swelling.

Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting.

Iliac vein stenting is performed when sufficient venous patency is not achieved via angioplasty or lysis. Iliac vein stenting is known to be effective; however, occlusion of the stent occurs occasionally. There is a lack of effective treatment options for those with failed prior venous stents, and traditional methods may involve the removal of the stent and surgical reconstruction.

Fatty acids derived from oviposition systems guide female black soldier flies (Hermetia illucens) toward egg deposition sites.

The black soldier fly, Hermetia illucens, comes with big promises for industrial purposes since its larvae feed polyphagously on a broad spectrum of organic substrates. However, research focusing on adult flies is scarce, which is inconsistent with their reproductive relevance within the rearing cycle. In particular, directed oviposition is a challenge in artificial systems.

Protein- and Carbohydrate-Rich Supplements in Feeding Adult Black Soldier Flies () Affect Life History Traits and Egg Productivity.

The black soldier fly, (BSF; Diptera: Stratiomyidae), has come into the focus of research over the past decade since its larvae are polyphagous feeders with an exceptional substrate range, making them a promising candidate for the bioconversion of various organic side streams into valuable insect protein. While larval nutritional requirements have been studied in detail, basic information on adult feeding is still lacking. The reproduction of adult flies is a bottleneck and key determinant in rearing BSF, which has extensive potential for improvement.

The first use of olives in Africa around 100,000 years ago.

The olive tree was an iconic plant for most of the past Mediterranean civilizations, for which it had important economic value. Here we report the earliest use of fruits and wood from olive trees in Africa so far, around 100,000 years ago. These findings suggest the presence of olive trees on the Atlantic coast of Morocco during most of the last glacial period, and the use of olives by the early Homo sapiens for fuel management and most probably for consumption.

An improved chronology for the Middle Stone Age at El Mnasra cave, Morocco.

North African coastal Middle Stone Age (MSA) sites are key to study the development and expansion of early H. sapiens. El Mnasra cave on the Atlantic coast of Morocco (Témara region) is a crucial site associated with MSA archaeological materials considered advanced cognitive hallmarks of behavioural innovation, such as numerous Nassariidae perforated shells, hematite pigments, bones industry and coastal resources exploitation.

Evolution of fenestrated/branched endovascular aortic aneurysm repair complexity and outcomes at an organized center for the treatment of complex aortic disease.

Background: Fenestrated/branched endovascular aneurysm repair (F/BEVAR) volume has increased rapidly, with favorable outcomes at centers of excellence. We evaluated changes over time in F/BEVAR complexity and associated outcomes at a single-center complex aortic disease program.

Methods: Prospectively collected data of all F/BEVAR (definition: requiring ≥1 fenestration/branch), procedures performed in an institutional review board-approved registry and/or physician-sponsored investigational device exemption trial (IDE# G130210), were reviewed (11/2010-2/2019).

Effect of thoracoabdominal aortic aneurysm extent on outcomes in patients undergoing fenestrated/branched endovascular aneurysm repair.

Objective: The outcomes after open repair of thoracoabdominal aneurysms (TAAAs) have been definitively demonstrated to worsen as the TAAA extent increases. However, the effect of TAAA extent on fenestrated/branched endovascular aneurysm repair (F/BEVAR) outcomes is unclear. We investigated the differences in outcomes of F/BEVAR according to the TAAA extent.

Preoperative functional status predicts 2-year mortality in patients undergoing fenestrated/branched endovascular aneurysm repair.

Background: Fenestrated/branched endovascular aneurysm repair (F/BEVAR) is a minimally invasive alternative for patients at high risk of open repair of complex aortic aneurysms. Nearly all investigative study protocols evaluating F/BEVAR have required a predicted life expectancy of >2 years for study inclusion. However, accurate risk models for predicting 2-year survival in this patient population are lacking.

Computed tomography angiography-derived area stenosis calculations overestimate degree of carotid stenosis compared with North American Symptomatic Carotid Endarterectomy Trial-derived diameter stenosis calculations.

Objective: The degree of carotid artery stenosis, calculated using catheter-based angiography and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, has been shown to predict the stroke risk in several, large, randomized controlled trials. In the present era, patients have been increasingly evaluated using computed tomography (CT) angiography (CTA) before carotid artery revascularization, especially as the use of transcarotid artery revascularization has increased. Interpretation of CTA findings regarding the degree of carotid stenosis has not been standardized, with both NASCET methods and the area stenosis used.

Vascular Surgeons Are Not Adequately Valued by Traditional Productivity Metrics.

Background: Reimbursements for professional services performed by clinicians are under constant scrutiny. The value of a vascular surgeon's services as measured by work relative value units (wRVUs) and professional reimbursement has decreased for some of the most common procedures performed. Hospital reimbursements, however, often remain stable or increases.

Earliest African evidence of carcass processing and consumption in cave at 700 ka, Casablanca, Morocco.

To date, in Africa, evidence for animal processing and consumption in caves routinely used as living spaces is only documented in the late Middle Pleistocene of the North and South of the continent and postdates the Middle Pleistocene in East Africa. Here we report the earliest evidence in a North-African cave (Grotte des Rhinocéros at Casablanca, Morocco) of cut, percussion and human gnawing marks on faunal remains directly associated with lithic knapping activities in the same space and in a well-documented stratified context. Ages for this Acheulean site are provided by the dating of herbivorous teeth to 690-720 ka and 520-550 ka (lower and upper sets) by combined Electron Spin Resonance (ESR) and U-series techniques.

Variation in Ultrasound Diagnostic Thresholds for Carotid Stenosis in the United States.

Background: Individuals with carotid stenosis enter surveillance or are considered for surgery on the basis of disease severity assessed by ultrasound. However, there is variation in the ultrasound diagnostic thresholds used to determine disease severity. Our objective was to describe this variation and its potential impact on patients.

Impact of acute kidney injury on long-term outcomes after fenestrated and branched endovascular aortic aneurysm repair.

Objective: Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its effect on long-term survival after F/BEVAR.

Fire and brief human occupations in Iberia during MIS 4: Evidence from Abric del Pastor (Alcoy, Spain).

There is a relatively low amount of Middle Paleolithic sites in Europe dating to MIS 4. Of the few that exist, several of them lack evidence for anthropogenic fire, raising the question of how this period of global cooling may have affected the Neanderthal population. The Iberian Peninsula is a key area to explore this issue, as it has been considered as a glacial refugium during critical periods of the Neanderthal timeline and might therefore yield archaeological contexts in which we can explore possible changes in the behaviour and settlement patterns of Neanderthal groups during MIS 4.

Carotid Duplex Velocity Criteria Recommended by the Society of Radiologists in Ultrasound and Endorsed by the Intersocietal Accreditation Commission Lack Predictive Ability for Identifying High-Grade Carotid Artery Stenosis.

Background: Carotid duplex is the first-line imaging modality for characterizing degree of carotid stenosis. The Intersocietal Accreditation Commission (IAC), in published guideline documents, has endorsed use of the Society of Radiologists in Ultrasound (SRU) criteria to characterize ≥70% stenosis: peak systolic velocity (PSV) ≥230 cm/s. We sought to perform a validation of the SRU criteria using computed tomography (CT) angiography as a gold standard imaging modality and to perform a sensitivity analysis to determine optimal velocity criteria for identifying ≥80% stenosis.

Fenestrated/Branched Endovascular Aortic Aneurysm Repair Using a Supraceliac Aortic Proximal Seal Zone Versus an Infraceliac Aortic Proximal Seal Zone.

Background: Fenestrated/branched endovascular aneurysm repair (F/B-EVAR) achieves more extensive proximal seal than conventional infrarenal devices, thereby increasing aneurysm exclusion durability. Optimal seal zone length remains undefined. We assessed relative risks and benefits of extending the proximal seal above the celiac artery.

Imaging Obtained Up To 12 Months Preoperatively Is Adequate for Planning Fenestrated/Branched Endovascular Aortic Aneurysm Repair.

Objectives: Patients referred for fenestrated/branched endovascular aortic repair (F/BEVAR) often present with a previous computed tomography angiogram (CTA), but it is unknown how recent the CTA must be to ensure accurate F/BEVAR planning. We sought to determine whether anatomic planning parameters change significantly between a CTA used for F/BEVAR planning and a CTA obtained 6 to 12 months prior.

Methods: Two blinded observers reviewed preoperative CTAs from 21 patients who underwent F/BEVAR.

Peripheral atherectomy practice patterns in the United States from the Vascular Quality Initiative.

Objective: Peripheral atherectomy has been shown to have technical success in single-arm studies, but clinical advantages over angioplasty and stenting have not been demonstrated, leaving its role unclear. We sought to describe patterns of atherectomy use in a real-world U.S.

Reinterventions after fenestrated or branched endovascular aortic aneurysm repair.

Objective: Reinterventions after fenestrated or branched endovascular aneurysm repair (F/B-EVAR) are sometimes necessary to maintain aneurysm exclusion or endograft and target artery patency. These reinterventions are nontrivial, potentially associated with morbidity, mortality, and resource utilization. Whereas rates, types, and outcomes of reintervention after infrarenal EVAR have been well described, they have not been well described for F/B-EVAR.

Increasing the number of integrated vascular surgery residency positions is important to address the impending shortage of vascular surgeons in the United States.

Objective: The demand for vascular surgeons is expected to far exceed the current supply. In an attempt to decrease the training duration and to address the impending shortage, integrated vascular surgery residencies were approved and have expanded nationally. Meanwhile, vascular fellowships have continued to matriculate approximately 120 trainees annually.

Fenestrated endovascular aortic aneurysm repair using physician-modified endovascular grafts versus company-manufactured devices.

Objective: Fenestrated endografts are customized, patient-specific endovascular devices with potential to reduce morbidity and mortality of complex aortic aneurysm repair. With approval from the U.S.