Long-term outcomes of the Endurant endograft in patients undergoing endovascular abdominal aortic aneurysm repair.

Objective/background: To investigate the long-term outcomes after endovascular aneurysm repair (EVAR) in a real-world setting using the Endurant endograft (EG).

Methods: 184 EVAR candidates treated with the Endurant family EGs in a single vascular center were prospectively enrolled from January 2009 to December 2016. Kaplan-Meir estimates of long-term standardized primary and secondary outcome measures were performed.

How deregulation, drought and increasing fire impact Amazonian biodiversity.

Biodiversity contributes to the ecological and climatic stability of the Amazon Basin, but is increasingly threatened by deforestation and fire. Here we quantify these impacts over the past two decades using remote-sensing estimates of fire and deforestation and comprehensive range estimates of 11,514 plant species and 3,079 vertebrate species in the Amazon. Deforestation has led to large amounts of habitat loss, and fires further exacerbate this already substantial impact on Amazonian biodiversity.

A Paraganglioma in the Right Supraclavicular Fossa: Mistaken for a Thyroid Mass.

Paragangliomas are rare lesions of the endocrine system that can be treated either by embolization preoperatively followed by surgical excision or by surgical excision or radiotherapy. In this report, we present an extremely rare location of a nonfunctional paraganglioma in the head and neck region, located in the right supraclavicular fossa, which was misdiagnosed as a thyroid tumor, in a 72-year-old female patient. Imaging revealed a 2.

Lessons Learned from Open Surgical Conversion after Failed Previous EVAR.

Background: Delayed open conversion (OpC) after endovascular aortic aneurysm repair (EVAR) is becoming increasingly common worldwide. We reviewed our experience to characterize the perioperative spectrum of OpC repairs.

Materials And Methods: A retrospective analysis of a prospectively maintained institutional database to identify patients who underwent late OpC after failed EVAR was performed.

Floods and rivers: a circular causality perspective.

An improved understanding of changes in flood hazard and the underlying driving mechanisms is critical for predicting future changes for better adaptation strategies. While recent increases in flooding across the world have been partly attributed to a range of atmospheric or landscape drivers, one often-forgotten driver of changes in flood properties is the variability of river conveyance capacity. This paper proposes a new framework for connecting flood changes to longitudinal variability in river conveyance, precipitation climatology, flows and sediment connectivity.

Correlation of Baseline Plasma and Inguinal Connective Tissue Metalloproteinases and Their Inhibitors With Late High-Pressure Endoleak After Endovascular Aneurysm Repair: Long-term Results.

To investigate whether plasma and connective tissue matrix metalloproteinases (MMP) and their inhibitors (TIMP) may predict late high-pressure endoleak after endovascular aneurysm repair (EVAR). Samples of inguinal fascia and blood were collected in 72 consecutive patients (mean age 73.1 years; 68 men) undergoing primary EVAR with the Endurant stent-graft.

Observational evidence on the effects of mega-fires on the frequency of hydrogeomorphic hazards. The case of the Peloponnese fires of 2007 in Greece.

Even though rare, mega-fires raging during very dry and windy conditions, record catastrophic impacts on infrastructure, the environment and human life, as well as extremely high suppression and rehabilitation costs. Apart from the direct consequences, mega-fires induce long-term effects in the geomorphological and hydrological processes, influencing environmental factors that in turn can affect the occurrence of other natural hazards, such as floods and mass movement phenomena. This work focuses on the forest fire of 2007 in Peloponnese, Greece that to date corresponds to the largest fire in the country's record that burnt 1773km, causing 78 fatalities and very significant damages in property and infrastructure.

Clinical outcomes after crossed-limb vs. conventional endograft configuration in endovascular AAA repair.

Purpose: To report a case controlled analysis of endovascular aneurysm repair (EVAR) outcomes using the crossed-limb (CxL) endovascular configuration vs. the straight-limb configuration (SLC).

Methods: From January 2007 to July 2012, 27 patients (25 men; mean age 73.

Antiplatelet treatment and prothrombotic diathesis following endovascular abdominal aortic aneurysm repair.

Prothrombotic diathesis expressed by elevated levels of coagulation-specific biomarkers has been reported in patients with abdominal aortic aneurysm (AAA) and after AAA endovascular repair (EVAR). This study investigates the effect of antiplatelet agents (APLs) on the prothrombotic diathesis in the post-EVAR period. Forty elective EVAR patients had thrombin-antithrombin complex, d-dimer, fibrinopeptide A, and high-sensitivity C-reactive protein measured before, at 24 hours, 1 month, and 6 months after EVAR.

Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review.

Little is known regarding the outcomes of endovascular and surgical treatment of penetrating ulcers in the abdominal aorta. The potential benefit of conservative management of asymptomatic disease is also debatable. A systematic review of the literature was undertaken to investigate these issues.

Endovascular therapy for penetrating ulcers of the infrarenal aorta.

Background: We sought to investigate the short- and mid-term results of the endovascular repair of infrarenal abdominal penetrating aortic ulcers (aPAUs).

Methods: Patients with infrarenal aPAUs treated by endovascular means between March 2004 and June 2012 were recruited. Pre-interventional imaging included computed tomography (CT) or CT angiography.

Hybrid endografts combinations for the treatment of endoleak in endovascular abdominal aortic aneurysm repair.

Hybrid endografting in endovascular abdominal aortic aneurysm repair (EVAR) is defined as the process of placing a series of two or more different types of covered stents, usually to treat a complex abdominal aortic aneurysm (AAA) or a primary or secondary endoleak. We describe the treatment of a type III, a type Ib, and a type Ia endoleak in three patients respectively, using hybrid solutions, assembling components from different manufacturers. An update of the current clinical and experimental evidence on the application of anatomically compatible, hybrid endograft systems in conventional EVAR is also provided.

Successful endovascular treatment of a ruptured gigantic pseudoaneurysm of the common iliac artery secondarily complicated by infection.

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm of the right common iliac artery, with a maximal diameter of 7 cm and retroperitoneal hematoma.

Thromboprophylaxis practices following varicose veins surgery.

Objective: It is not clear whether patients undergoing varicose veins operations should receive thromboprophylaxis. A nationwide survey was conducted to assess thromboprophylaxis practice patterns in patients undergoing conventional vein surgery or endovenous procedures.

Methods: A questionnaire was e-mailed to all members of the Greek Society of Vascular and Endovascular Surgery (n = 163).

Technical advances with newer aortic endografts provide additional support to withhold the early endovascular repair of small abdominal aortic aneurysms until it is really needed.

The idea of early endovascular aortic repair (EVAR) of "small" abdominal aortic aneurysms (AAAs) has gained attention over "watchful waiting," mostly due to the concern for losing the anatomic suitability for endovascular repair over time. Generally, small AAAs have longer, smaller, less angulated necks, and less tortuous iliac arteries than larger ones. Though the borderline anatomic characteristics were assumed to be contraindications for older generation endografts, the modifications of modern devices seem promising to overcome those limitations, in order to treat the small AAAs when reaching the 5.

Endovascular management of peripheral arterial trauma in patients presenting in hemorrhagic shock.

Aim: This study investigated patients who sustained peripheral arterial trauma, presented with clinical signs of shock, and underwent urgent endovascular repair (endo-R).

Methods: Eighteen patients (11 men) aged 62.8 ± 17.

An overview of the hemodynamic aspects of the blood flow in the venous outflow tract of the arteriovenous fistula.

Upper limb vein aneurysms complicate all types of autogenous arteriovenous fistulae (AVF) and comprise false aneurysms secondary to venipuncture trauma as well as true aneurysms, characterized by dilatation of native veins. The dilatation of a normal vein and the development of a true aneurysm are strongly influenced by local hemodynamic factors affecting the flow in the drainage venous system and are also the target of operative interventions. This review article focuses on the description of these hemodynamic aspects which all physicians involved in the management of dialysis patients should be aware of.

Early results of the Endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy.

Objective: To evaluate and compare the outcome after endovascular abdominal aortic aneurysm repair (EVAR) with the newly released Endurant endograft system in patients with different aortoiliac anatomic characteristics.

Methods: We conducted a prospective observational study assigning patients with infrarenal abdominal aortic aneurysm (AAA) treated with the Endurant endoprosthesis from February 2009 to March 2010. Two groups were studied, according to the presence of a friendly (group I [GI] = 43) or hostile (group II [GII] = 34) infrarenal aortoiliac anatomy.

A hybrid approach to salvage a failing long-standing autogenous aneurysmal fistula in a hemodialysis patient.

Very few studies have addressed the repair of autogenous and prosthetic-related false arteriovenous access (AVA) aneurysms in hemodialysis patients. Surgical management of complicated AVA-related aneurysms remains the gold standard method although covered stents have recently been introduced for the exclusion of such aneurysms, offering a minimally invasive therapy. In this paper, we describe a combination of open and endovascular repair for treating an anastomotic and a puncture-site aneurysm to salvage a failing long-standing autogenous radial-cephalic fistula in the wrist.

Current tips for ensuring successful transfemoral short limb cannulation in modular aortic endografts: a new method for incorporation in practice.

One of the most crucial steps in endovascular infrarenal abdominal aortic aneurysm repair is the short limb catheterization of the modular device and the confirmation of the intrastent position of the guidewire. Failed connection of the contralateral iliac limb to the main body because of malposition of the catheterizing guidewire may lead to serious complications. A new method confirming successful passage of the guidewire in the short leg of the main body of the modular stent graft, thus ensuring that the extension will be accurately docked within the short limb, is described in detail.

Mediterranean diet and upper aerodigestive tract cancer: the Greek segment of the Alcohol-Related Cancers and Genetic Susceptibility in Europe study.

Several dietary factors have been associated with the occurrence of cancers of the oral cavity and oropharynx, larynx and oesophagus, collectively called upper aerodigestive tract (UADT) cancers, but the evidence is considered as inconclusive. We hypothesised that the traditional Mediterranean dietary pattern may be more strongly inversely associated with UADT cancer risk than individual dietary components, and may explain the unexpectedly low incidence of these cancers in Greece. In the context of the European alcohol-related cancers and genetic susceptibility in Europe project, we have conducted a hospital-based case-control study in Athens, Greece, comparing 239 incident UADT cases and 194 hospital controls with admission diagnoses unrelated to tobacco, alcohol or diet.

Lower-extremity arteriovenous access for haemodialysis: a systematic review.

Background: The lower extremity is increasingly used as an access site in end-stage renal disease patients. However, reports present conflicting results, creating confusion regarding the feasibility and outcomes. Our objective is to review the available literature and analyse the patency rates and complications of various types of lower-extremity arteriovenous access.

A case of heterogeneous breast cancer with clonally expanded T-Cells in the HER2+ and metastasis of the HER2- tumor cells.

We report a case of an invasive ductal breast carcinoma with significant heterogeneity: a HER-2+ tumor component was densely infiltrated by T-cells, whereas the HER2- tumor component, including two axillary lymph node metastases, showed much fewer tumor infiltrating lymphocytes. Array comparative genomic hybridization of dissected tumor cells from both components revealed many shared chromosomal aberrations but also unique alterations of the HER2+ tumor cell population besides HER2 amplification. We found a clonally dominated T-cell receptor rearrangement of the tumor infiltrating lymphocytes in the HER2+, but not in the HER2- tumor component.

Genome-wide analysis of genetic alterations in Barrett's adenocarcinoma using single nucleotide polymorphism arrays.

We performed genome-wide analysis of copy-number changes and loss of heterozygosity (LOH) in Barrett's esophageal adenocarcinoma by single nucleotide polymorphism (SNP) microarrays to identify associated genomic alterations. DNA from 27 esophageal adenocarcinomas and 14 matching normal tissues was subjected to SNP microarrays. The data were analyzed using dChipSNP software.

Microarray comparative genomic hybridization analysis of tubular breast carcinoma shows recurrent loss of the CDH13 locus on 16q.

Tubular breast carcinoma is a highly differentiated carcinoma with an excellent prognosis. Distinct genetic alterations in tubular breast carcinoma cells have been described, especially broad genetic losses on the q-arm of chromosome 16. These are more common in lobular breast carcinoma and low-grade ductal carcinoma in situ than in ductal breast carcinoma and high-grade ductal carcinoma in situ.