Transarterial Coil Embolization for Type II Endoleak After Endovascular Aneurysm Repair (EVAR).

Background Endovascular aneurysm repair (EVAR) has evolved into treatment of choice for infrarenal abdominal aortic aneurysms (AAA). Type II endoleaks, although frequently benign, can lead to sac enlargement and rupture. Management of these endoleaks by endovascular means can be quite challenging and may require complex techniques and assistance of interventional radiologists, not always available in all vascular units.

Cleaning Up the Chimney: Early Renal Stent Graft Thrombosis Following Endovascular Treatment of a Juxtarenal Aortic Aneurysm With the Chimney Technique.

The endovascular management of juxtarenal aortic aneurysms with the chimney technique (ch-EVAR) has gained popularity in recent years. It provides an alternative to open repair, allowing treatment of challenging anatomies with devices readily available in any vascular suite. The primary drawback persists as the occurrence of type-Ia endoleak from gutters and renal stent thrombosis.

Stress, Prevention, and Resilience among First Responders.

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Serum Levels of Matrix Metalloproteinases in Patients Undergoing Endovascular Intervention for Peripheral Arterial Disease.

Background: Matrix metalloproteinases (MMPs) play a significant role in the development and progression of atherosclerotic vascular disease. The purpose of this study was to measure and document the profile of plasma-circulating MMPs in patients with peripheral arterial disease (PAD) undergoing endovascular revascularization.

Methods: This was a single-center prospective observational study with 80 patients with PAD enrolled.

The Importance of WE in POWER: Integrating Police Wellness and Ethics.

In this article, the authors introduce the POWER perspective of police wellness and ethics. POWER stands for Police Officer Wellness, Ethics, and Resilience. The perspective represents the view that wellness and ethics cannot be discussed separately; they are inextricably connected to each other.

Organizational Solutions to the Moral Risks of Policing.

In addition to the physical and emotional challenges faced by law enforcement professionals, the job confronts officers with numerous moral risks. The moral risks include moral distress, moral injury, ethical exhaustion, compassion fatigue, and practices that lead to lapses in ethical decision-making. The paper focuses on what police agencies can do to better address the moral risks of policing.

The Effect of Transfusion of Two Units of Fresh Frozen Plasma on the Perioperative Fibrinogen Levels and the Outcome of Patients Undergoing Elective Endovascular Repair for Abdominal Aortic Aneurysm.

Background: We aimed to investigate whether the transfusion of 2 units of fresh frozen plasma (FFP) immediately post aneurysm exclusion has any effect on the perioperative fibrinogen levels and the outcome of patients undergoing elective endovascular repair (EVAR) of abdominal aortic aneurysm (AAA).

Methods: Consecutive infrarenal AAA patients undergoing elective EVAR with the bifurcated Endurant-II stent-graft (Medtronic) were recruited from 2 vascular units. The first unit has a routine policy of administering 2 units of FFP immediately upon aneurysm exclusion (FFP group), whereas the second unit has no such policy (control group).

Routine Stent Flushing with Heparinized Saline during Distal Filter-Protected Carotid Artery Stenting: A Technical Modification to Reduce Delayed Embolization.

Introduction: Delayed embolization after filter-protected carotid artery stenting (CAS) may occur because of the protrusion and release of loose atherosclerotic plaque fragments through the stent cells.

Methods And Results: We describe a technical modification to the standard filter-protected CAS by introducing an extra step, that of washing away the luminal stent surface debris with heparinized saline while the filter is still in place. Aided by the guiding catheter, flushing heparinized saline under manual pressure against the stent will force all loose fragments distally in the internal carotid artery to be captured by the overlying filter.

Inevitable Loss and Prolonged Grief in Police Work: An Unexplored Topic.

The present manuscript presents foundational constructs related to death and loss (i.e., grief, bereavement, prolonged grief) providing empirical findings from recent research on the impact of death and loss on police officers' health, behavior, and overall functioning.

The Role of Moral Injury in PTSD Among Law Enforcement Officers: A Brief Report.

Exposure to critical incidents and hence potentially traumatic events is endemic in law enforcement. The study of law enforcement officers' experience of moral injury and their exposure to potentially morally injurious incidents, and research on moral injury's relationship with different forms of traumatization (e.g.

New Directions in Police Academy Training: A Call to Action.

The complexities of modern policing require law enforcement agencies to expand how officers are trained to do their jobs. It is not sufficient for training to focus solely on the law or on perishable skills; such as arrest and control; defensive tactics; driving; and firearms. The present manuscript addresses the critical importance of infusing academy training with the psychological skills essential for officers to meet the contemporary challenges of police work.

Endovascular Treatment of a Chronically Thrombosed Abdominal Aortic Aneurysm: Technical Considerations.

Background: Chronic thrombosis of an abdominal aortic aneurysm (AAA) is a rare entity and the ideal management is debatable.

Methods And Results: A 74-year-old man presented with an enlarging chronically thrombosed AAA and incapacitating bilateral claudication, worse on the left side. We opted for an endovascular approach.

Arterial Stiffness in a Toddler with Neurofibromatosis Type 1 and Refractory Hypertension.

Arterial hypertension is a common finding in patients with neurofibromatosis (NF) type 1. Renovascular hypertension due to renal artery stenosis or midaortic syndrome could be the underlying cause. We report the case of a 4-year-old girl with NF type 1 and midaortic syndrome whose changes in blood pressure and pulse wave velocity suggested the evolution of vasculopathy, diagnosis of renovascular hypertension, and provided insights of response to treatment.

Association Between Perioperative Fibrinogen Levels and the Midterm Outcome in Patients Undergoing Elective Endovascular Repair of Abdominal Aortic Aneurysms.

Background: We investigated the potential association between perioperative fibrinogen levels and outcome in patients undergoing elective endovascular abdominal aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs).

Methods: Consecutive patients with an intact AAA undergoing elective EVAR with a specific bifurcated endograft (Endurant, Medtronic) were recruited between December 2012 and October 2016. Preoperative and 24-hr postoperative fibrinogen levels were recorded, and potential associations with outcome were tested.

Retroperitoneal Liposarcoma Masquerading as an Impending Rupture of Inflammatory Abdominal Aortic Aneurysm.

Background: We present a unique case scenario of a periaortic liposarcoma masquerading as an impending rupture of an inflammatory abdominal aortic aneurysm (AAA).

Methods And Results: A 57-year-old man was referred to our unit for an emergency endovascular repair of "an inflammatory AAA with computed tomography (CT) features of impending rupture." He underwent an uneventful endovascular repair with a bifurcated endograft (C3; Gore, Flagstaff, AZ).

Changes in circulating markers of coagulation and fibrinolysis after EVAR.

Introduction: The presence of an abdominal aortic aneurysm (AAA) is associated with increased thrombin formation, fibrin turnover and fibrinolysis.

Evidence Acquisition: The aim of this study was to review the relevant literature and summarize the evidence regarding the impact of endovascular repair on the circulating markers of coagulation and fibrinolysis postprocedure.

Evidence Synthesis: The main findings are that the increased thrombin activation, and formation, as well as fibrinolysis, in patients with AAA is exacerbated after endovascular repair in the short-term and the mid-term, implying that this may be a period associated with an increased likelihood for adverse cardiovascular events.

Endovascular Management of a Distally Migrated Bifurcated Endograft with a New Bifurcated Endograft.

A 75-year-old man presented with abdominal and lumbar pain 6 years after previous endovascular repair of an abdominal aortic aneurysm. At the time of the initial operation, the aneurysm measured 6.0 cm in maximum diameter and a bifurcated Anaconda (Vascutek) endograft had been implanted.

Mindfulness-Based Psychotherapy Approaches for First Responders: From Research to Clinical Practice.

First responders are psychosocially burdened with work-related stressors that occur frequently during required duties. Related mental health difficulties, such as direct and vicarious trauma, depression, and interpersonal problems often affect first responders' ability to perform effectively, and their personal lives may be disrupted. Mindfulness-based interventions have been shown to directly promote first responders' mental and physical health while providing increased resilience when facing work-related stressors.