Complications of cerebrospinal fluid drainage in thoracoabdominal aortic procedures.

Background: Cerebrospinal fluid (CSF) drainage is used to reduce spinal cord ischemia (SCI) in patients undergoing thoracoabdominal aortic procedures. Recent literature has found high rates of complication associated with CSF drainage, which has led to changes in practice. The aim of this study was to investigate rates of CSF drain-related complications in patients undergoing a thoracoabdominal aortic procedure with perioperative placement of a CSF drain.

Endovascular Aortic Balloon control versus open Aortic cross Clamp in open ruptured abdominal Aortic aneurysm repair.

Background: To determine 30-day mortality of endovascular aortic balloon control compared with open aortic cross clamp in open surgical repair (OSR) of ruptured abdominal aortic aneurysms (rAAAs).

Methods: A retrospective cohort review was performed of all adult patients who underwent OSR of an infrarenal rAAA between 2001 and 2018 at a single tertiary care center. A total of 174 patients were identified, of which 21 patients received endovascular aortic balloon control and 137 patients received an open aortic cross clamp.

Enabling extracorporeal ultrasound imaging with the da Vinci robot for transoral robotic surgery: a feasibility study.

Purpose: Transoral robotic surgery (TORS) is a challenging procedure due to its small workspace and complex anatomy. Ultrasound (US) image guidance has the potential to improve surgical outcomes, but an appropriate method for US probe manipulation has not been defined. This study evaluates using an additional robotic (4th) arm on the da Vinci Surgical System to perform extracorporeal US scanning for image guidance in TORS.

The Aortic Team Model for the Management of the Distal Arch, Descending Thoracic and Thoracoabdominal Aorta: Appraisal at 3 Years.

Background:  This study aimed to assess feasibility, logistical challenges, and clinical outcomes associated with the implementation of an Aortic Team model for the management of distal arch, descending thoracic and thoracoabdominal aortic disease.

Methods:  An Aortic Team care pathway was implemented in November 2019. Working as a unit, two cardiac surgeons, two vascular surgeons, an interventional radiologist, a cardiologist, and an anesthesiologist collectively determined care decisions via multispecialty presence at an Aortic Clinic.

A hybrid approach to complex bilateral common iliac artery and internal iliac artery aneurysm repair.

A case of a young patient with incidental bilateral internal iliac artery aneurysms and common iliac artery aneurysms is described. A staged hybrid surgical approach was performed to preserve pelvic perfusion, with bilateral stent grafts deployed into an ipsilateral anterior division branch and contralateral posterior division branch of the internal iliac arteries. One week later, an open infrarenal aorto-bi-iliac graft was performed with distal anastomoses to the previously deployed stent grafts.

Aortic arch endovascular branch and fenestrated repair: Initial Canadian experience with novel technology.

Objective: The objective is to describe the initial Canadian experience using novel aortic arch branched endograft technologies.

Methods: We performed a retrospective consecutive case series of all patients undergoing aortic arch branched repair with newly available endograft technology since 2020 at our site. We describe the patient characteristics, treatment characteristics, and postoperative outcomes.

Characterizing the impact of Enterococcus cecorum infection during late embryogenesis on disease progression, cecal microbiome composition, and early performance in broiler chickens.

Enterococcus cecorum (EC) has been associated with septicemia and early mortality in broiler chickens. There is limited research investigating the pathogenicity of EC field strains obtained from affected birds. The purpose of this study was to evaluate the effect of in-ovo administration into the amnion with different EC field isolates at d 18 of embryogenesis (DOE18).

AI-powered assessment of biomarkers for growth prediction of abdominal aortic aneurysms.

Objective: The purpose of this study was to employ biomechanics-based biomarkers to locally characterize abdominal aortic aneurysm (AAA) tissue and investigate their relation to local aortic growth by means of an artificial intelligence model.

Methods: The study focused on a population of 36 patients with AAAs undergoing serial monitoring with electrocardiogram-gated multiphase computed tomography angiography acquisitions. The geometries of the aortic lumen and wall were reconstructed from the baseline scans and used for the baseline assessment of regional aortic weakness with three functional biomarkers, time-averaged wall-shear stress, in vivo principal strain, and intra-luminal thrombus thickness.

Total Aortic Arch Endograft and Double In Situ Fenestration for Aortobronchial Fistula.

This case highlights the challenges of treating an aortobronchial fistula. Emergent total aortic arch stent grafting is limited by inability to maintain cerebral perfusion during in situ fenestration. We describe the application of a new technique to maintain cerebral perfusion using a gutter balloon adjacent to the aortic endograft while great vessel fenestrations are being performed in an urgent setting.

Curriculum Mapping Post-Baccalaureate Registered Nurse Residency Curriculum to Accrediting Agency Standards.

This article examines the process of mapping a post-baccalaureate registered nurse residency curriculum with Commission on Collegiate Nursing Education standards for nurse residencies. Curriculum mapping revealed gaps and redundancies in the curriculum as well as documented compliance with accreditation standards. Curriculum mapping is instrumental to developing, evaluating, and refining curricular elements.

Mortality and risk factors for ruptured abdominal aortic aneurysm after repair endovascular (rARE).

Objective: The aim of this study was to characterize risk factors for infrarenal abdominal aortic aneurysm rupture after endovascular repair (rARE) and evaluate 30-day mortality in comparison to primary ruptured abdominal aortic aneurysm (rAAA).

Methods: A retrospective review of all adult patients with rAAA at a single tertiary university care center between February 11, 2006, and December 31, 2018, was performed. A total of 267 patients with rAAA were identified, 11 of whom had rARE.

Deep-learning method for fully automatic segmentation of the abdominal aortic aneurysm from computed tomography imaging.

Abdominal aortic aneurysm (AAA) is one of the leading causes of death worldwide. AAAs often remain asymptomatic until they are either close to rupturing or they cause pressure to the spine and/or other organs. Fast progression has been linked to future clinical outcomes.

Efficacy of cold renal perfusion protection for open complex aortic aneurysm repair: a meta-analysis.

Background: Cold renal perfusion (CRP) with 4°C crystalloid fluids has been described as a method to reduce renal injury during open surgical repair of complex aortic aneurysms (cAAs) (those requiring at least a suprarenal clamp site). We performed a meta-analysis to ascertain whether CRP improves kidney-related outcomes after open surgical cAA repair.

Methods: Patients of any age or gender who had undergone open surgical repair of cAAs were included.

A Systematic Review of Total Endovascular Aortic Arch Repair: A Promising Technology.

Background: Total endovascular aortic arch repair (TEAAR) represents an emerging alternative for the treatment of aortic arch disease in patients at prohibitive risk for open surgery. A systematic review of TEAAR was performed to delineate early outcomes with this new technology.

Methods: All studies (excluding single-patient case reports) of CE-certified "custom made" or "off-the-shelf" zone 0 stent graft deployments were included.

Diagnosing and treating Mycobacterium kansasii.

This article describes an 18-year-old immunocompetent patient who developed Mycobacterium kansasii, manifested with shortness of breath and a cavitary lung lesion seen on radiograph. Initial sputum smears were negative; however, after 2 weeks, the cultures grew M. kansasii and the patient was started on an antimycobacterial regimen.

Impact of an emergency endovascular aneurysm repair protocol on 30-day ruptured abdominal aortic aneurysm mortality.

Objective: To characterize the longstanding impact of an emergency endovascular aneurysm repair (EVAR) protocol for ruptured abdominal aortic aneurysm (rAAA) on 30-day mortality.

Methods: All adult patients with an rAAA who underwent a surgical or endovascular intervention at a tertiary care center between March 2001 and December 2018 were evaluated. An emergency EVAR protocol was introduced in January 2004.

Zone 0 Aortic Arch Reconstruction Using the RelayBranch Thoracic Stent Graft.

Endovascular therapies have had a considerable impact on contemporary management of thoracic aortic disease. Still, with the anatomic challenges of the aortic arch, endovascular experience with devices that traverse the arch and deploy in the Zone 0 position remains limited. We report the first Canadian experience with the RelayBranch Thoracic Stent Graft (Terumo Aortic, Sunrise, FL) with Zone 0 deployment for total endovascular aortic arch repair in a patient at very high risk for redo open surgery.

Rapid endovascular bailout revascularization of the renal arteries with a steerable guiding sheath after endovascular abdominal aortic aneurysm repair.

Advancements in endovascular therapy have made it increasingly available for patients with complex cases but not without complications. Unintentional coverage of the renal arteries is a rare occurrence during endovascular aortic aneurysm repair. Given the potentially devastating repercussions, it is important that surgeons understand the suitability and the risks and benefits of the available revascularization options.

The Many Care Models to Treat Thoracic Aortic Disease in Canada: A Nationwide Survey of Cardiac Surgeons, Cardiologists, Interventional Radiologists, and Vascular Surgeons.

Background: Several specialties treat thoracic aortic disease, resulting in multiple patient care pathways. This study aimed to characterize these varied care models to guide health policy.

Methods: A 57-question e-survey was sent to staff cardiac surgeons, cardiologists, interventional radiologists, and vascular surgeons at 7 Canadian medical societies.

Linking Aortic Mechanical Properties, Gene Expression and Microstructure: A New Perspective on Regional Weakening in Abdominal Aortic Aneurysms.

Current clinical practice for the assessment of abdominal aortic aneurysms (AAA) is based on vessel diameter and does not account for the multifactorial, heterogeneous remodeling that results in the regional weakening of the aortic wall leading to aortic growth and rupture. The present study was conducted to determine correlations between a novel non-invasive surrogate measure of regional aortic weakening and the results from invasive analyses performed on corresponding aortic samples. Tissue samples were evaluated to classify local wall weakening and the likelihood of further degeneration based on non-invasive indices.

A novel combined fluid dynamic and strain analysis approach identified abdominal aortic aneurysm rupture.

Clinical decision-making for surgical repair of abdominal aortic aneurysms based on maximum aortic diameter presents limitations as rupture can occur below threshold for some aneurysms, whereas others are stable at large sizes. The proposed approach combines hemodynamics and geometric indices with in vivo deformation analysis to assess local weakening of the aortic wall for a case of impending rupture that was confirmed during open surgical repair. A new combined index, the Regional Rupture Potential, is introduced to help the assessment of individual aneurysms and their rupture risk, providing a rationale for clinical decisions.

Correction to: Mycotic aortic aneurysms post-Intravesical BCG treatment for early-stage bladder carcinoma.

In the published article [1] the statement under the subheading 'Consent for publication' is incorrect.

The latest diagnostic criteria and treatment options for neuromyelitis optica.

Neuromyelitis optica, also known as Devic disease, is an autoimmune disorder that affects the spinal cord and optic nerve. This atypical demyelinating syndrome can be difficult to diagnose and responds poorly to treatments that are used for multiple sclerosis, a similar demyelinating disease. This article discusses the epidemiology, pathophysiology, clinical presentation, latest diagnostic criteria, and treatment options for neuromyelitis optica and neuromyelitis spectrum disorders.