On the Relative Effects of Wall and Intraluminal Thrombus Constitutive Material Properties in Abdominal Aortic Aneurysm Wall Stress.

Introduction: An abdominal aortic aneurysm (AAA) is a dilation localized in the infrarenal segment of the abdominal aorta that can expand continuously and rupture if left untreated. Computational methods such as finite element analysis (FEA) are widely used with in silico models to calculate biomechanical predictors of rupture risk while choosing constitutive material properties for the AAA wall and intraluminal thrombus (ILT).

Methods: In the present work, we investigated the effect of different constitutive material properties for the wall and ILT on 21 idealized and 10 unruptured patient-specific AAA geometries.

Case Report: Treatment of Transplanted Renal Artery Anastomotic Pseudoaneurysm With Parallel Stent Grafting.

A 53 year old woman needed surgical management of an anastomotic pseudoaneurysm after renal transplant. Contrast enhanced computed tomography demonstrated a pseudoaneurysm arising off of the right external iliac artery. Considering the risk of potentially sacrificing her renal transplant, we elected to perform endovascular repair with parallel stent grafting.

The fate of the abstract: presentation and publication characteristics of abstracts presented at the Society of Gynecologic Surgeons Annual Scientific Meetings 2013-2020.

Objective: To evaluate what proportion of abstracts presented at the Society of Gynecologic Surgeons (SGS) Annual Scientific Meetings went on to be published in publicly available journals.

Design: Retrospective observational study SETTING: Single organization PARTICIPANTS: Abstracts (oral presentations, oral posters, video presentations, non-oral posters) presented at the SGS Annual Scientific Meeting from 2013-2020 INTERVENTIONS: Variables were collected pertaining to abstract authors, study type, timing of the session presented, and journal factors. To identify possible publication, abstracts were cross-referenced in PubMed and Google Scholar.

Case Report: Successful Treatment of Aberrant Left Subclavian Artery With a Right-Sided Aortic Arch.

Right sided aortic arches with concomitant aberrant left subclavian arteries are exceedingly rare anatomical variants. We present a case of a 45 year old male that presented with symptoms consistent with dysphagia and known right sided aortic arch with an aberrant left subclavian artery. Though previous reports of repair have indeed been reported, we confirm that a hybrid approach to these anatomic variants remain feasible and with symptom resolution for patients.

Association of Device Industry Payments, Physician Supply, and Regional Utilization of Orthopedic and Cardiac Procedures.

Background: Geographic variation in high-cost medical procedure utilization in the USA is not fully explained by patient factors but may be influenced by the supply of procedural physicians and marketing payments.

Objective: To examine the association between physician supply, medical device-related marketing payments to physicians, and utilization of knee arthroplasty (KA) and percutaneous coronary interventions (PCI) within hospital referral regions (HRRs).

Design: Cross-sectional analysis of data from the 2018 CMS Open Payments database and procedural utilization data from the CMS Provider Utilization and Payment database.

A Program to Reduce Post-Operative Opioid Prescribing at a Veteran's Affairs Hospital.

Variability in surgeon prescribing patterns is common in the post-operative period and can be the nidus for dependence and addiction. This project aims to reduce opioid overprescribing at the Veteran's Affairs Pittsburgh Healthcare System (VAPHS). The VAPHS Opioid Stewardship Committee collaborated to create prescribing guidelines for inpatient and outpatient general, thoracic, and vascular surgery procedures.

Prehospital plasma is associated with survival principally in patients transferred from the scene of injury: A secondary analysis of the PAMPer trial.

Background: We sought to characterize if prehospital transfer origin from the scene of injury (SCENE) or from a referral emergency department (REF) alters the survival benefit attributable to prehospital plasma resuscitation in patients at risk of hemorrhagic shock.

Methods: We performed a secondary analysis of data from a recently completed prehospital plasma clinical trial. All of the enrolled patients from either the SCENE or REF groups were included.

Predicting Transcarotid Artery Revascularization Adverse Outcomes by Imaging Characteristics.

Background: Approximately 20-30% of ischemic strokes are caused by internal carotid artery stenosis. Stroke is the leading cause of disability and the second leading cause of death in the United States. Second generation transcarotid arterial revascularization (TCAR) stenting, using the ENROUTE flow reversal technology to prevent embolic stroke during the stenting process, has demonstrated stroke and death outcomes equivalent to carotid endarterectomy with reduced cranial nerve injury.

Disparities in geographic access to medical oncologists.

Objective: The objective of this study is to identify disparities in geographic access to medical oncologists at the time of diagnosis.

Data Sources/study Setting: 2014-2016 Pennsylvania Cancer Registry (PCR), 2019 CMS Base Provider Enrollment File (BPEF), 2018 CMS Physician Compare, 2010 Rural-Urban Commuting Area Codes (RUCA), and 2015 Area Deprivation Index (ADI).

Study Design: Spatial regressions were used to estimate associations between geographic access to medical oncologists, measured with an enhanced two-step floating catchment area measure, and demographic characteristics.

Successful endovascular treatment of severe chronic mesenteric ischemia facilitated by intraoperative positioning system image guidance.

We report our initial experience using the intraoperative positioning system (IOPS), a novel endovascular navigation system that does not require contrast or radiation, in the treatment of chronic mesenteric ischemia (CMI). We used IOPS to help treat three of four consecutive patients with CMI. Technical problems prevented successful use in one patient.

Multifactorial dysphagia: Azygos vein aneurysm (AVA) and esophagogastric junction outflow obstruction (EGJOO).

Introduction: Vascular impingement of the esophagus is a rare cause of dysphagia, and is most commonly due to aortic arch anomalies such as arterial lusoria. Dysphagia resultant from venous compression is even further less likely.

Presentation Of Case: We present a highly unusual case of dysphagia secondary to a large aneurysm of the azygous vein near its confluence with the superior vena cava, which was managed with endovascular modalities.

A Comparative Classification Analysis of Abdominal Aortic Aneurysms by Machine Learning Algorithms.

The objective of this work was to perform image-based classification of abdominal aortic aneurysms (AAA) based on their demographic, geometric, and biomechanical attributes. We retrospectively reviewed existing demographics and abdominal computed tomography angiography images of 100 asymptomatic and 50 symptomatic AAA patients who received an elective or emergent repair, respectively, within 1-6 months of their last follow up. An in-house script developed within the MATLAB computational platform was used to segment the clinical images, calculate 53 descriptors of AAA geometry, and generate volume meshes suitable for finite element analysis (FEA).

A Comparative Study of Biomechanical and Geometrical Attributes of Abdominal Aortic Aneurysms in the Asian and Caucasian Populations.

In this work, we provide a quantitative assessment of the biomechanical and geometric features that characterize abdominal aortic aneurysm (AAA) models generated from 19 Asian and 19 Caucasian diameter-matched AAA patients. 3D patient-specific finite element models were generated and used to compute peak wall stress (PWS), 99th percentile wall stress (99th WS), and spatially averaged wall stress (AWS) for each AAA. In addition, 51 global geometric indices were calculated, which quantify the wall thickness, shape, and curvature of each AAA.

Wall Stress and Geometry Measures in Electively Repaired Abdominal Aortic Aneurysms.

Abdominal aortic aneurysm (AAA) is a vascular disease characterized by the enlargement of the infrarenal segment of the aorta. A ruptured AAA can cause internal bleeding and carries a high mortality rate, which is why the clinical management of the disease is focused on preventing aneurysm rupture. AAA rupture risk is estimated by the change in maximum diameter over time (i.

A prospective, single-blind, randomized, phase III study to evaluate the safety and efficacy of Fibrin Sealant Grifols as an adjunct to hemostasis compared with manual compression in vascular surgery.

Objective: New formulations and applications of hemostatic adjuncts such as fibrin sealant (FS) to support local hemostasis and sutures continue to be developed. In a pivotal, confirmatory, controlled, prospective, single-blinded, randomized, multicenter phase III clinical trial, the efficacy and safety of FS Grifols during vascular surgeries were evaluated.

Methods: Patients undergoing a nonemergency, open, peripheral vascular surgical procedure with moderate arterial bleeding were recruited.

Correction to: Decision Tree Based Classification of Abdominal Aortic Aneurysms Using Geometry Quantification Measures.

This erratum is to correct the variable name on the left hand side of Eq. (2). The correct variable name is "Diameter" rather than the stated "Area.

Decision Tree Based Classification of Abdominal Aortic Aneurysms Using Geometry Quantification Measures.

Abdominal aortic aneurysm (AAA) is an asymptomatic aortic disease with a survival rate of 20% after rupture. It is a vascular degenerative condition different from occlusive arterial diseases. The size of the aneurysm is the most important determining factor in its clinical management.

Geometric surrogates of abdominal aortic aneurysm wall mechanics.

The maximum diameter criterion is the most important factor in the clinical management of abdominal aortic aneurysms (AAA). Consequently, interventional repair is recommended when an aneurysm reaches a critical diameter, typically 5.0 cm in the United States.

Malpractice litigation in the endovascular era.

Objective: The standard of care in the treatment of vascular disease continues to evolve as endovascular therapies develop. Currently, it is unclear how medical malpractice litigation has adapted to the "endovascular era." This retrospective case review is the most comprehensive analysis to date of malpractice actions involving endovascular procedures performed by vascular surgeons (VSs), interventional radiologists (IRs), interventional cardiologists (ICs), and cardiothoracic surgeons (CTSs).

On the Use of Geometric Modeling to Predict Aortic Aneurysm Rupture.

Background: Currently, the risk of abdominal aortic aneurysm (AAA) rupture is determined using the maximum diameter (D) of the aorta. We sought in this study to identify a set of computed tomography (CT)-based geometric parameters that would better predict the risk of rupture than D.

Methods: We obtained CT scans from 180 patients (90 ruptured AAA and 90 elective AAA repair) and then used automated software to calculate 1- , 2- , and 3-dimensional geometric parameters for each AAA.

The Association Between Geometry and Wall Stress in Emergently Repaired Abdominal Aortic Aneurysms.

Abdominal aortic aneurysm (AAA) is a prevalent cardiovascular disease characterized by the focal dilation of the aorta, which supplies blood to all the organs and tissues in the systemic circulation. With the AAA increasing in diameter over time, the risk of aneurysm rupture is generally associated with the size of the aneurysm. If diagnosed on time, intervention is recommended to prevent AAA rupture.

Carotid artery disease and periprocedural stroke risk after transcatheter aortic valve implantation.

Objective/background: To examine the role of carotid stenosis (CS) and other independent risk factors of perioperative stroke, following transcatheter aortic valve implantation (TAVI).

Materials And Methods: Using data from the National Inpatient Sample database for analysis, patients who underwent TAVI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Various preoperative and perioperative risk factors and their association with perioperative strokes were studied.

Pneumatic compression device treatment of lower extremity lymphedema elicits improved limb volume and patient-reported outcomes.

Objectives: Examine the effectiveness of an advanced pneumatic compression device (APCD) in reducing limb volume (LV), and to evaluate clinician and patient-reported outcomes.

Design: Device registry study.

Materials And Methods: Data were collected prospectively for 196 lower extremity lymphedema patients prescribed an APCD.