Bilateral lower extremity amputation in a transgender female on estrogen therapy suffering from recurrent, medication-resistant arterial thrombi.

This case report presents a 40-year-old transgender female with a history of gender-affirming hormone therapy who experienced recurrent, medication-resistant arterial thrombi leading to bilateral lower extremity amputations. Despite multiple endovascular and surgical interventions, including bypass grafting and catheter-directed thrombolysis, the patient developed recurrent thrombotic events even while on anticoagulation therapy. Hematologic evaluation for coagulopathy was unremarkable.

The rise of endovascular repair for abdominal, thoracoabdominal, and thoracic aortic aneurysms.

Background: Given changes in intervention guidelines and the growing popularity of endovascular treatment for aortic aneurysms, we examined the trends in admissions and repairs of abdominal aortic aneurysms (AAAs), thoracoabdominal aortic aneurysms (TAAAs), and thoracic aortic aneurysms (TAAs).

Methods: We identified all patients admitted with ruptured aortic aneurysms and intact aortic aneurysms repaired in the Nationwide Inpatient Sample between 2004 and 2019. We then examined the use of open, endovascular, and complex endovascular repair (OAR, EVAR, and cEVAR) for each aortic aneurysm location (AAA, TAAA, and TAA), alongside their resulting in-hospital mortality, over time.

Towards a core outcome set for dysarthria after stroke: What should we measure?

Objective: To identify and agree on what outcome domains should be measured in research and clinical practice when working with stroke survivors who have dysarthria.

Design: Delphi process, two rounds of an online survey followed by two online consensus meetings.

Setting: UK and Australia.