Predictors of Mortality in Ruptured Abdominal Aortic Aneurysms.

Introduction The outcome of a ruptured abdominal aortic aneurysm (AAA) without any interventions is close to uniformly fatal. The Society for Vascular Surgery suggests a door-to-intervention time of less than 90 minutes in a patient with a ruptured AAA. Admission factors associated with poor outcomes in ruptured AAAs include hypotension, renal insufficiency, severe anemia, advanced age, and cardiac arrest.

Perioperative and intermediate outcomes of patients with pulmonary embolism undergoing catheter-directed thrombolysis vs percutaneous mechanical thrombectomy.

Objective: Thrombolytic therapy has been a mainstay of treatment for massive or submassive pulmonary embolism (PE), a common and highly morbid pathology. New percutaneous mechanical thrombectomy (PMT) devices have recently become widely available and have been used increasingly for the treatment of acute PE, but evidence demonstrating its efficacy over standard catheter-directed lytic protocol remains limited.

Methods: Using TriNetX Data Network, a global federated database of >250 million patients, we conducted a retrospective cohort study of patients from January 2017 to August 2023 with a diagnosis of PE, treated with either PMT or catheter-directed thrombolysis (CDT).

Vascular stenting of a malignant arterial blowout as a bridge to effective systemic and regional therapy.

Locally advanced cutaneous squamous cell carcinoma can erode into blood vessels, leading to vascular blowout, requiring emergent surgical intervention. We describe a first case of this disease complication which was effectively managed with endovascular stenting as a bridge to effective systemic and regional therapy. We discuss the efficacy of this staged approach which is novel and timely in a clinical environment of increasingly effective systemic therapies.

Endovascular Treatment of a Multi-visceral Aortic Conduit Blowout With Parallel Stent Grafts and Coils.

Multi-visceral transplantation (MVT) is a complex surgical procedure involving the transplantation of multiple abdominal organs as a single unit, typically used as bailout treatment of patients with devastating abdominal pathologies. Due to the complexity of the procedure, major and even life-threatening complications can happen. Vascular complications, including anastomotic breakdowns or pseudoaneurysms due to infections, can be universally lethal.

Feasibility and Intermediate Results of Transcarotid Revascularization with a Prosthetic Conduit.

Background: Transcarotid artery revascularization (TCAR) is a hybrid technique with excellent initial outcomes. The technical success and safety of TCAR is heavily dependent on an anatomically suitable common carotid artery (CCA). Many patients do not meet anatomic criteria and therefore are not eligible for this therapy.

D-dimer as a Rule-Out for Aortic Dissection.

Introduction Acute aortic dissection (AAD) represents a significant diagnostic challenge with a high mortality rate if not treated promptly. This challenge arises from the diverse clinical presentations of AAD, and its symptom overlap with other medical conditions. Although both helical CT and transesophageal echocardiography are reliable diagnostic tools for AAD, they are not feasible for every suspected case.

Endovascular Management of Aortic Stump Blowout by Parallel Grafting and Coil Embolization of Visceral Aorta.

Aortic graft and endograft infections remain a significant source of morbidity and mortality after abdominal aortic aneurysm repair. With graft excision and extra-anatomic bypass, an infrarenal aortic stump remains which can have suture line dehiscence and catastrophic stump blowout. Treatment of this is extremely challenging, especially for severely co-morbid patients who cannot undergo major surgery, or in patients with a hostile abdomen.

Quantum transport of high-dimensional spatial information with a nonlinear detector.

Information exchange between two distant parties, where information is shared without physically transporting it, is a crucial resource in future quantum networks. Doing so with high-dimensional states offers the promise of higher information capacity and improved resilience to noise, but progress to date has been limited. Here we demonstrate how a nonlinear parametric process allows for arbitrary high-dimensional state projections in the spatial degree of freedom, where a strong coherent field enhances the probability of the process.

Real-time Stokes polarimetry using a polarization camera.

This Lab Note introduces the "Stokes Camera," a simple experimental arrangement for real-time measurement of spatial amplitude and polarization and thus spatially resolved Stokes parameters. It uses a polarization sensitive camera and a fixed quarter-wave plate, providing a one-shot, digital solution for polarization measurement that is only limited by the frame rate of the camera and the computation speed of the provided code. The note also provides background information on relevant polarization theory and vector vortex beams, which are used as a demonstration of the device.

Beam wander prediction with recurrent neural networks.

Among the problems that prevent free-space optical communication systems from becoming a truly mainstream technology is beam wander, which is especially important for structured light beams since beam misalignment introduces additional crosstalk at the receiver. The paper suggests a recurrent neural network-based (RNN) solution to predict beam wander in free space optics (FSO). The approach uses past beam center of mass positions to predict future movement, significantly outperforming various prediction types.

Restoring Venous Patency with the ClotTriever Following Deep Vein Thrombosis.

Background: Although randomized data remain inconclusive, invasive endovenous therapy is increasingly favored in patients with extensive iliocaval or iliofemoral deep vein thrombosis (DVT) to reduce the rates of postthrombotic syndrome. Previously, pharmacomechanical thrombectomy was the therapy of choice, but the Inari ClotTriever device is an appealing, purely mechanical, alternative. It may reduce bleeding risk, intensive care unit admission, and the need for multiple procedures when compared with traditional thrombolysis.

Vertebral artery transection with pseudoaneurysm and arteriovenous fistula requiring antegrade and retrograde embolization.

Traumatic vertebral artery injury is a rare, life-threatening injury that has been increasingly managed with endovascular intervention. However, an antegrade endovascular approach alone can fail to occlude traumatic pseudoaneurysms (PSAs) and arteriovenous fistulas (AVFs), requiring high-risk surgical reoperation. We have presented the case of a 27-year-old man with traumatic right vertebral artery PSA and AVF.

Efficient channel modeling of structured light in turbulence using generative adversarial networks.

We present a fast and efficient simulation method of structured light free space optics (FSO) channel effects from propagation through a turbulent atmosphere. In a system that makes use of multiple higher order modes (structured light), turbulence causes crosstalk between modes. This crosstalk can be described by a channel matrix, which usually requires a complete physical simulation or an experiment.

Interferometric orbital angular momentum mode detection in turbulence with deep learning.

Orbital angular momentum (OAM) modes are topical due to their versatility, and they have been used in several applications including free-space optical communication systems. The classification of OAM modes is a common requirement, and there are several methods available for this. One such method makes use of deep learning, specifically convolutional neural networks, which distinguishes between modes using their intensities.

Retrograde Transamputation Revascularization: A Case Report.

Below-knee amputation remains the most common level of amputation in patients with lower extremity gangrene and critical limb ischemia. Failure to heal, requiring additional operative debridement or conversion to an above-knee amputation remains a significant cause of patient morbidity. There remains no definitive diagnostic test that can accurately predict healing of the amputation site.

Fritchman modeling for correlated turbulence-induced errors in FSO communication.

Free-space-optics-based communication links are an attractive potential solution for solving the last mile challenge but suffer from turbulence-induced fading. This fading causes errors in the received signal. While models exist to predict how turbulence affects the signal, these models often do not account for the channel's memory.

Converting a Texas Instruments DLP4710 DLP evaluation module into a spatial light modulator.

Digital micro-mirror devices (DMDs) are a popular alternative to liquid crystal spatial light modulators for laser beam shaping due to their relatively low cost, high speed, and polarization and wavelength independence. Here we describe in detail how to convert a low-cost digital light projector (DLP) evaluation module that uses a Texas Instruments DLP4710 DMD into a spatial light modulator using a 3D printed mount. The resulting device is shown to accurately shape Laguerre-Gauss modes, is able to operate in real-time over HDMI without modification with a 180 Hz hologram refresh rate, and has a resolution of 1920×1080 pixels and diagonal screen size of 0.

When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS).

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin.

Modal analysis of structured light with spatial light modulators: a practical tutorial.

A quantitative analysis of optical fields is essential, particularly when the light is structured in some desired manner, or when there is perhaps an undesired structure that must be corrected for. A ubiquitous procedure in the optical community is that of optical mode projections-a modal analysis of light-for the unveiling of amplitude and phase information of a light field. When correctly performed, all the salient features of the field can be deduced with high fidelity, including its orbital angular momentum, vectorial properties, wavefront, and Poynting vector.

Cerebral monitoring during transcarotid artery revascularization with flow reversal via transcranial doppler ultrasound examination.

Objective: Transcarotid artery revascularization (TCAR) is a hybrid technique for carotid artery revascularization that relies on proximal carotid occlusion with flow reversal for distal embolic protection. The hemodynamic response of the intracranial circulation to flow reversal is unknown. In addition, the rate and pattern of cerebral embolization during flow reversal has yet to be investigated.

Safety and Feasibility of Simultaneous Transcarotid Revascularization With Flow Reversal and Coronary Artery Bypass Grafting for Concomitant Carotid Artery Stenosis and Coronary Artery Disease.

Objective: The management of patients with combined severe carotid artery and coronary artery disease (CAD) is controversial. Transcarotid stenting with flow reversal (TCAR) is a novel hybrid technique for carotid revascularization. We sought to investigate the safety and feasibility of simultaneous TCAR and coronary artery bypass grafting (CABG) for concomitant carotid and CAD.

A space division multiplexed free-space-optical communication system that can auto-locate and fully self align with a remote transceiver.

Free-Space Optical (FSO) systems offer the ability to distribute high speed digital links into remote and rural communities where terrain, installation cost or infrastructure security pose critical hurdles to deployment. A challenge in any point-to-point FSO system is initiating and maintaining optical alignment from the sender to the receiver. In this paper we propose and demonstrate a low-complexity self-aligning FSO prototype that can completely self-align with no requirement for initial manual positioning and could therefore form the opto-mechanical basis for a mesh network of optical transceivers.

Simultaneous transcarotid artery revascularization with flow reversal and coronary artery bypass grafting: A novel hybrid technique.

Optimal management of concomitant coronary artery disease and carotid artery stenosis remains unknown. Current treatment strategies for patients with significant dual disease burden include simultaneous carotid endarterectomy and coronary artery bypass grafting (CABG) or staged carotid endarterectomy and CABG. Herein we present the case of a patient with severe coronary artery disease and carotid artery stenosis and discuss a novel hybrid approach to management of concomitant coronary and carotid disease using transcarotid artery revascularization with flow reversal before CABG.