Complicated type B aortic dissection in a pregnant woman with Marfan syndrome.

Marfan syndrome is a rare inherited connective tissue disorder that can result in significant morbidity and mortality. We report a case of a 29-year-old pregnant woman presenting with an acute type B aortic dissection. Owing to cardiopulmonary decompensation and intestinal malperfusion, she underwent an emergency cesarean section followed by left subclavian to carotid transposition and thoracic endovascular aortic repair that was complicated by a retrograde type A aortic dissection and was managed surgically.

ChatGPT and retinal disease: a cross-sectional study on AI comprehension of clinical guidelines.

Objective: To evaluate the performance of an artificial intelligence (AI) large language model, ChatGPT (version 4.0), for common retinal diseases, in accordance with the American Academy of Ophthalmology (AAO) Preferred Practice Pattern (PPP) guidelines.

Design: A cross-sectional survey study design was employed to compare the responses made by ChatGPT to established clinical guidelines.

Age is not a sole predictor of outcomes in octogenarians undergoing complex endovascular aortic repair.

Objective: To examine the perioperative, postoperative, and long-term outcomes of fenestrated/branched endovascular aneurysm repair (F/BEVAR) in octogenarians compared with nonoctogenarians.

Methods: A multicenter, retrospective cohort study was conducted using the Vascular Quality Improvement database, which prospectively captures information on patients who undergo vascular surgery across 1021 academic and community hospitals in North America. All patients who underwent F/BEVAR endovascular aortic repair from 2012 to 2022 were included.

Evaluating ChatGPT on Orbital and Oculofacial Disorders: Accuracy and Readability Insights.

Purpose: To assess the accuracy and readability of responses generated by the artificial intelligence model, ChatGPT (version 4.0), to questions related to 10 essential domains of orbital and oculofacial disease.

Methods: A set of 100 questions related to the diagnosis, treatment, and interpretation of orbital and oculofacial diseases was posed to ChatGPT 4.

Exploring the potential utility of AI large language models for medical ethics: an expert panel evaluation of GPT-4.

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight ethical vignettes.

Outcomes of Elective and Non-elective Fenestrated-branched Endovascular Aortic Repair for Treatment of Thoracoabdominal Aortic Aneurysms.

Objective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs).

Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described.

Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed.

Iatrogenic distal aortic rupture in a patient with vascular Ehlers-Danlos syndrome.

Vascular Ehlers-Danlos syndrome is a rare inherited connective tissue disorder that can result in significant morbidity and mortality. This report details an iatrogenic aortic rupture during an endovascular approach in the management of critical limb ischemia in a 27-year-old woman who presented with acute onset of severe sensory deficit of the left leg. Conversion to open repair with a midline laparotomy and an aortic-left popliteal bypass was performed.

Comparison of single- and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms.

Objective: The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs).

Methods: We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts.

Primary Thoracic Endografting for T4 Lung Cancer Aortic Involvement.

Purpose: The aim of the study was to present the results in patients with a T4 thoracic tumor with aortic involvement who were treated with a thoracic endograft before surgical resection.

Description: All consecutive patients undergoing a thoracic endograft procedure before an oncologic resection between January 2012 and December 2019 were reviewed in a single-center retrospective study. Included patients had either a T4 lung tumor or a mediastinal tumor invading the thoracic aorta.

Open descending thoracic aorta aneurysm repair with removal of multiple previous endovascular devices.

False lumen patency is a poor prognostic factor for favorable aortic remodeling in patients with chronic aortic dissection. Several endovascular techniques are available to obliterate the false lumen; however, they are not always successful. We present the case of a 55-year old male with a chronic type B dissection and a large descending thoracic aortic aneurysm with rapid growth, up to 90 mm, despite attempted control of the false lumen with several endovascular devices (thoracic aortic stent graft, Amplatzer device, glue and candy plug).

Impact of Insertion Technique and Iliac Artery Anatomy on Fenestrated Endovascular Aneurysm Repair.

To develop a mechanically realistic aortoiliac model to evaluate anatomic variables associated with stent-graft rotation and to assess common deployment techniques that may contribute to rotation. Idealized aortoiliac geometries were constructed either through direct 3-dimensional (3D) printing (rigid) or through casting with polyvinyl alcohol using 3D-printed molds (flexible). Flexible model bending rigidity was controlled by altering wall thickness.

Evaluating a Multiscale Mechanistic Model of the Immune System to Predict Human Immunogenicity for a Biotherapeutic in Phase 1.

A mechanistic model of the immune response was evaluated for its ability to predict anti-drug antibody (ADA) and their impact on pharmacokinetics (PK) and pharmacodynamics (PD) for a biotherapeutic in a phase 1 clinical trial. Observed ADA incidence ranged from 33 to 67% after single doses and 27-50% after multiple doses. The model captured the single dose incidence well; however, there was overprediction after multiple dosing.

Comparison of Qualitative and Quantitative Assessments of Iliac Artery Tortuosity and Calcification.

Introduction: During endovascular aneurysm repair, the iliac artery typically serves as a conduit for device delivery. The degree of tortuosity and calcification in the iliac artery ultimately determines whether the device can successfully traverse the vessel. These 2 parameters can be assessed using qualitative approaches or calculated using quantitative methods based on the Society for Vascular Surgery (SVS) reporting standards.

Multicenter Analysis of Endovascular Aortic Arch In Situ Stent-Graft Fenestrations for Aortic Arch Pathologies.

Background: In situ fenestration of aortic stent grafts for treatment of aortic arch aneurysms is a new option for endovascular aortic arch repair. So far, only few reports have shown perioperative and short-term results of in situ fenestrations for aortic arch diseases. We present the multicenter experience with the aortic arch in situ fenestration technique documented in the AARCHIF registry for treatment of aortic arch aneurysms or localized type A aortic dissections and analyzed perioperative outcome and midterm follow-up.

Impact of fenestrated stent graft misalignment on patient outcomes.

Objective: During fenestrated endovascular aneurysm repair (FEVAR), accurate alignment of the fenestration and the target artery is necessary to prevent complications. This study's objective is to determine the incidence of clinical outcomes following fenestration misalignment during FEVAR.

Methods: A single-center, retrospective chart review was performed for all elective FEVARs between January 2008 and April 2015.

Predicting Rotation in Fenestrated Endovascular Aneurysm Repair Using Finite Element Analysis.

Fenestrated endovascular aneurysm repair (FEVAR) is a minimally invasive method of abdominal aortic aneurysm (AAA) repair utilized in patients with complex vessel anatomies. Stent grafts (SG) used in this process contain fenestrations within the device that need to be aligned with the visceral arteries upon successful SG deployment. Proper alignment is crucial to maintain blood flow to these arteries and avoid surgical complications.

Analysis of Iliac Artery Geometric Properties in Fenestrated Aortic Stent Graft Rotation.

Introduction: A complication of fenestrated endovascular aneurysm repair is the potential for stent graft rotation during deployment causing fenestration misalignment and branch artery occlusion. The objective of this study is to demonstrate that this rotation is caused by a buildup of rotational energy as the device is delivered through the iliac arteries and to quantify iliac artery geometric properties associated with device rotation.

Methods: A retrospective clinical study was undertaken in which iliac artery geometric properties were assessed from preoperative imaging for 42 cases divided into 2 groups: 27 in the nonrotation group and 15 in the rotation group.

Prediction of advanced endovascular stent graft rotation and its associated morbidity and mortality.

Objective: Advanced endovascular aneurysm repair (EVAR) with fenestrated and branched stent grafts is increasingly being used to repair complex aortic aneurysms; however, these devices can rotate unpredictably during deployment, leading to device misalignment. The objectives of this study were to quantify the short-term clinical outcomes in patients with intraoperative stent graft rotation and to identify quantitative anatomic markers of the arterial geometry that can predict stent graft rotation preoperatively.

Methods: A prospective study evaluating all patients undergoing advanced EVAR was conducted at two university-affiliated hospitals between November 2015 and December 2016.

A systematic study of the effect of low pH acid treatment on anti-drug antibodies specific for a domain antibody therapeutic: Impact on drug tolerance, assay sensitivity and post-validation method assessment of ADA in clinical serum samples.

We developed a homogeneous bridging anti-drug antibody (ADA) assay on an electro chemiluminescent immunoassay (ECLIA) platform to support the immunogenicity evaluation of a dimeric domain antibody (dAb) therapeutic in clinical studies. During method development we evaluated the impact of different types of acid at various pH levels on polyclonal and monoclonal ADA controls of differing affinities and on/off rates. The data shows for the first time that acids of different pH can have a differential effect on ADA of various affinities and this in turn impacts assay sensitivity and drug tolerance as defined by these surrogate controls.

Publication outcomes for research presented at a Canadian surgical conference.

Background: The failure of investigators to publish research in peer-reviewed journals following acceptance at a national or international meeting can lead to significant publication biases in the literature. Our objective was to evaluate the abstract to manuscript conversion rate for abstracts presented at the Canadian Society for Vascular Surgery (CSVS) annual meeting and to evaluate the conversion rate for CSVS-awarded research grants.

Methods: We searched for authors of abstracts accepted at the CSVS Annual Meeting (2007-2013) and recipients of CSVS research awards (2005-2013) on Scopus and PubMed databases to identify related publications.