Pharmacokinetic Evaluation in Pregnancy-Current Status and Future Considerations: Workshop Summary.

As pregnant individuals have traditionally been excluded from clinical trials, there is a gap in knowledge at the time of drug approval regarding safety, efficacy, and appropriate dosing for most prescription medications used during pregnancy. Physiologic changes in pregnancy can result in changes in pharmacokinetics that can impact safety or efficacy. This highlights the need to foster further research and collection of pharmacokinetic data in pregnancy to ensure appropriate drug dosing in pregnant individuals.

The effect of chemotherapy for malignancy on the natural history of aortic aneurysm.

Objective: Surgical dogma holds that chemotherapy increases the risk of aneurysm growth and rupture. We sought to determine the effect of cytotoxic chemotherapy on the growth of aortic aneurysms.

Methods: All patients undergoing chemotherapy for malignancy with coexisting aortic aneurysms at our institution between 2000 and 2011 were identified.

Decision analysis of retrievable inferior vena cava filters in patients without pulmonary embolism.

Background: Retrievable filters are increasingly implanted for prophylaxis in patients without pulmonary embolism (PE) but who may be at transient risk. These devices are often not removed after the risk of PE has diminished. This study employs decision analysis to weigh the risks and benefits of retrievable filter use as a function of the filter's time in situ.

Computed tomography-based anatomic characterization of proximal aortic dissection with consideration for endovascular candidacy.

Background: Proximal aortic dissections are life-threatening conditions that require immediate surgical intervention to avert an untreated mortality rate that approaches 50% at 48 hours. Advances in computed tomography (CT) imaging techniques have permitted increased characterization of aortic dissection that are necessary to assess the design and applicability of new treatment paradigms.

Methods: All patients presenting during a 2-year period with acute proximal aortic dissections who underwent CT scanning were reviewed in an effort to establish a detailed assessment of their aortic anatomy.

Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms.

Objectives: To assess outcomes and develop duplex scan criteria that will reliably determine the luminal status of covered and uncovered renal stents following fenestrated and branched endovascular repair.

Methods: A prospective database of patients treated with fenestrated and branched endografts between 2001 and 2006 was reviewed. All patients with evidence of renal artery pathology including duplex scan assessed peak systolic velocity (PSV) <50 or >200 cm/s, renal aortic ratio (RAR) >3.

Supra-aortic vessels aneurysms: diagnosis and prompt intervention.

Purpose: Aneurysms involving the supra-aortic vessels are rare but carry serious risk of embolization, thrombosis, and rupture. We describe our experience with the diagnosis, treatment strategies, and outcomes in patients with extended follow-up.

Methods: Data during a 17-year period (January 1990 to December 2007) was analyzed.

Endoleaks following endovascular repair of thoracic aortic aneurysm: etiology and outcomes.

Purpose: To evaluate the incidence and natural history of endoleaks following thoracic endovascular aortic repair (TEVAR) of thoracic aortic aneurysm (TAA).

Methods: A retrospective review was conducted on 200 TAA patients (122 men; mean age 69+/-12 years) who underwent elective TEVAR in the descending thoracic aorta between January 2001 and December 2006. The mean aneurysm diameter was 66 mm (range 50-124), and most (75%) of the aneurysms were atherosclerotic in origin.

Thoracic aortic lesions treated with the Zenith TX1 and TX2 thoracic devices: intermediate- and long-term outcomes.

Objective: Little data exist to support the durability of thoracic endovascular repair during prolonged periods of follow-up. This study examines the durability and long-term results with the Zenith TX1 and TX2 thoracic devices (Cook Inc, Bloomington, Ind) in high-risk patients.

Methods: Data were collected prospectively from 2001 to 2007 on high-risk patients who presented with thoracic aneurysms, chronic aortic dissection, or fistulas treated with a Zenith thoracic device.

Cold saline irrigation of the renal pelvis during Radiofrequency Ablation of a central renal neoplasm: a case report.

Introduction: Thermal destruction mediated by radiofrequency ablation (RFA) is gaining attention as an alternative treatment for patients with renal cell carcinoma (RCC), particularly in those who are not candidates for open surgery. Treatment of central tumours is occasionally associated with complications such as ureteric stricture, injury to the psoas muscle, haematuria and vascular laceration.

Case Presentation: We have used infusion of cold saline during RFA, through a retrograde ureteric catheter with its tip in the renal pelvis, in a patient with a central renal tumour.

Combined percutaneous radiofrequency ablation and ethanol injection of renal tumours: midterm results.

Objectives: To evaluate the safety and efficacy of combined percutaneous, image-guided, radiofrequency (RF) ablation and ethanol injection of renal tumours, and to present our midterm results.

Methods: Since February 2002, 27 consecutive patients (22 men, 5 women; age range: 39-84 yr; mean: 69) with 28 renal tumours (mean diameter: 2.87cm) were treated with combined percutaneous RF and ethanol ablation, and were prospectively evaluated.

Alleviation of severe compressive symptoms in a patient with advanced lung carcinoma using tracheal and superior vena cava stents.

Lung cancer is now the leading cause of death from cancer worldwide. Although surgery remains the treatment of choice, the majority of patients will be unresectable at presentation with a poor survival outcome. In those patients who also have tracheobronchial involvement; the aim of intervention is to restore airway patency, thus improving quality of life in a minimally invasive way.

Quality improvement guidelines for placement of esophageal stents.

Esophageal cancer is now the sixth leading cause of death from cancer worldwide. During the past three decades, important changes have occurred in the epidemiologic patterns associated with this disease. Due to the distensible characteristics of the esophagus, patients may not recognize any symptoms until 50% of the luminal diameter is compromised, explaining why cancer of the esophagus is generally associated with late presentation and poor prognosis.

Embolization of a bleeding renal angiomyolipoma in pregnancy: case report and review.

A case is described of a woman 10 weeks pregnant who had severe bleeding, secondary to a renal angiomyolipoma (AML), that was treated with embolization. Subsequent pregnancy was uneventful and she delivered a normal female infant 28 weeks after the procedure. One month after delivery, liquefaction of the AML occurred, which eventually required surgical drainage.

Serological screening for cysticercosis in mentally altered individuals.

The parasitic infection neurocysticercosis may give rise to a variety of psychiatric manifestations that resemble, but are different from, primary psychiatric disorders. The aim of this study was to determine if among individuals from a neurocysticercosis-endemic area of Colombia who apparently had a psychiatric manifestation with associated neurological finding ('cases'), some could have been infected with Taenia solium cysticerci. This case-control study was done in individuals hospitalized in two mental institutions.