One-pot synthesis for gradient copolymers concurrent tandem living radical polymerization: mild and selective transesterification of methyl acrylate through Al(acac) with common alcohols.

A series of gradient copolymers were synthesized by the ruthenium-catalyzed living radical polymerization (LRP) of methyl acrylate (MA) and aliphatic alcohols using aluminum acetylacetonate Al(acac). In this polymerization system, Al(acac) was successfully used not only as an additive for the Ru-catalyzed LRP but also as a catalyst for the selective transesterification of an unsaturated ester monomer in mild conditions in a process known as concurrent tandem living radical polymerization. The resulting MA-based gradient copolymers showed well-controlled molecular weight and distribution in a one-pot reaction and exhibited a well-controlled gradient sequence in their polymer chain.

Percutaneous retrograde left external carotid artery coil embolization for management of hemorrhage from a persistent proatlantal intersegmental artery type 2.

Persistent fetal communications between the carotid and vertebrobasilar systems are rare and most often discovered incidentally. We present the case of a patient with oropharyngeal cancer status post chemotherapy, radiation therapy, and surgical resection who developed acute oropharyngeal hemorrhage on postoperative day 36, originating from branches of the ligated external carotid artery stump by retrograde flow through a proatlantal intersegmental artery type 2. This hemorrhage was successfully controlled with coil embolization through percutaneous access of the external carotid artery without recurrence at 1-year follow-up.

Phlegmasia cerulea dolens following internal hemipelvectomy: Case report and literature review.

Phlegmasia cerulea dolens (PCD) results from near complete venous thrombosis and occlusion in an extremity resulting in pain, cyanosis, and edema and potentially death. While PCD can result from a variety of mechanisms including trauma, iatrogenic instrumentation, the majority of cases occur in the setting of malignancy. PCD is often managed medically with anticoagulation.

Robotic Postchemotherapy Retroperitoneal Lymph Node Dissection for Testicular Cancer.

Background: Postchemotherapy retroperitoneal lymph node dissection (pcRPLND) is mandated in patients with nonseminomatous germ cell tumor found to have residual masses after chemotherapy. Performed via the open approach, pcRPLND can incur significant perioperative morbidity.

Objective: To demonstrate the feasibility of robotic pcRPLND (r-pcRPLND) and provide evidence for its selection criteria.

Risk of bleeding after ultrasound-guided jugular central venous catheter insertion in severely thrombocytopenic oncologic patients.

Introduction: We sought to assess the incidence and risk factors of bleeding after ultrasound-guided internal jugular (USGIJ) catheter insertion in severely thrombocytopenic cancer patients, as safe platelet (PLT) count threshold remains controversial.

Methods: Retrospective study of 52 patients with hematologic malignancies and severe thrombocytopenia who underwent USGIJ catheter insertion between 2014 and 2016. Group A included patients with prophylactic PLT transfusion and Group B without.

Development of a predictive model for 6 month survival in patients with venous thromboembolism and solid malignancy requiring IVC filter placement.

Purpose: Our purpose was to develop a predictive model for short-term survival (i.e. <6 months) following inferior vena cava filter placement in patients with venous thromboembolism (VTE) and solid malignancy.

Nonmaturing Fistulae: Epidemiology, Possible Interventions, and Outcomes.

Autogenous arteriovenous fistulae are the best method for prolonged, successful dialysis access. However, a substantial limitation of dialysis fistulae is their high primary failure rate, estimated to be as high as 70% for radiocephalic fistulae. Fistula maturation is influenced by demographic risk factors as well as anatomical barriers, the latter of which can be readily identified by noninvasive ultrasound imaging and physical examination.

Volume Flow Measurements in Arteriovenous Dialysis Access in Patients with and without Steal Syndrome.

Introduction. Dialysis associated steal syndrome (DASS) constitutes a serious risk for patients undergoing vascular access operations. We aim to assess the measured volume flow using ultrasound in patients with clinically suspected steal syndrome and determine differences in flow among types of arteriovenous (AV) access.

Hybrid interventions in limb salvage.

Hybrid interventions have become an integral part of our strategy for limb salvage in patients with multilevel arterial occlusive disease. In this article, we describe the commonly used hybrid interventions and review their indications and outcomes. Iliac stenting and femoral endarterectomy are the two most frequently performed procedures in hybrid cases.

Limb salvage in women.

The prevalence of peripheral arterial occlusive disease (PAD) in women and men is equal. Studies to date present conflicting data of gender effects on the risk factors, clinical presentation, and treatment outcomes. Clinical trials have often failed to analyze results by gender or to recruit sufficient women to enable such an analysis.

Diseases of the thoracic aorta in women.

Women have now equaled or surpassed men in the number of cardiovascular deaths per year in published statistics. In 2006, according to the National Center for Health Statistics and the Center for Disease Control, cardiovascular disease was the cause of death in 428,906 women (35% of all deaths in women) and in 394,840 men (33% of all deaths in men). Of those numbers, it was estimated that 5506 women (0.

Subintimal placement of covered stent versus subintimal balloon angioplasty in the treatment of long-segment superficial femoral artery occlusion.

Background: Subintimal endovascular intervention has been used widely in the treatment of symptomatic superficial femoral artery (SFA) occlusion. The relative effectiveness of subintimal placement of a covered stent (CS) versus balloon-only subintimal angioplasty (SIA) remains uncertain.

Methods: We performed a retrospective cohort study of consecutive patients with symptomatic SFA occlusions (>15 cm) who underwent subintimal endovascular intervention, either CS or SIA, in a single institution.

How optimal is the medical management of patients prior to major reconstructive vascular surgery? The results of a cross-sectional study.

Background: Risk factor modification is important in patients with vascular disease. Guidelines suggest that this patient population benefits from a medical regimen of antiplatelets, statins, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors.

Materials And Methods: The medical regimen of consecutive patients who presented for major vascular surgery intervention over 18 months was examined.

Emergent embolization of the gastroduodenal artery in the treatment of upper gastrointestinal bleeding. The experience from a surgeon-initiated interventional program.

Background: Intractable nonvariceal upper gastrointestinal bleeding (UGIB) is associated with significant morbidity and mortality. Endovascular therapy is an alternative to surgery for high-risk patients.

Materials And Methods: Review of prospectively collected data from patients who underwent emergent gastroduodenal artery embolization for UGIB.

Symptomatic aneurysm rupture without bleeding secondary to endotension 4 years after endovascular repair of an abdominal aortic aneurysm.

Purpose: To demonstrate the absence of bleeding from a ruptured abdominal aortic aneurysm (AAA) without evidence of endoleak following endovascular aneurysm repair (EVAR).

Case Report: A 72-year-old woman developed aneurysm enlargement 4 years after EVAR of an infrarenal AAA. During surgical exploration for abdominal pain and presumed aneurysm rupture, the ruptured aneurysm sac was found to be filled with gelatinous material without evidence of thrombus or active bleeding.

Endovascular repair of traumatic thoracic aortic injuries: a critical appraisal.

Blunt trauma to the thoracic aorta is life-threatening, with instant fatality in at least 75% of victims. If left untreated, nearly half of those who survive the initial injury will die within the first 24 hours. Surgical repair has been the standard treatment of blunt aortic injury, but immediate operative intervention is frequently difficult due to concomitant injuries.

Assessment of aortic pathology and peripheral arterial disease using multidetector computed tomographic angiography.

The development of multidetector computed tomography represents a remarkable diagnostic advancement because this imaging modality has been widely used in the evaluation of the cardiovascular system. With scanner-adjusted image acquisition and contrast medium administration, multidetector computed tomographic angiography provides a cost-effective and accurate imaging assessment in patients with aortic pathologies or peripheral arterial occlusive disease. Multidetector computed tomographic angiography is associated with several advantages, including high image spatial resolution and rapid imaging acquisition speed.

Descending thoracic aortic dissection: evaluation and management in the era of endovascular technology.

Acute aortic dissection is a relatively uncommon but highly lethal condition. Without proper treatment, devastating consequences can occur due to aortic rupture, cardiac tamponade, or irreversible ischemia involving the spinal cord or the visceral organs. The treatment strategy of this condition is in part influenced by the location and the severity of aortic dissection as immediate surgical intervention is necessary in acute ascending aortic dissection, whereas medical therapy is the initial treatment approach in uncomplicated descending aortic dissection.

Concomitant colorectal cancer and abdominal aortic aneurysm: evolution of treatment paradigm in the endovascular era.

Background: Although the incidence of patients presenting with concomitant colorectal cancer (CRC) and abdominal aortic aneurysm (AAA) is low, current treatment strategies in patients with both lesions remains controversial. Given recent advances in endovascular aortic aneurysm repair (EVAR), we sought to analyze the surgical outcomes of patients with concomitant CRC and AAA.

Study Design: A retrospective chart review was performed on all patients with CRC and AAA between December 1984 and July 2007.

Endovascular treatment of postlaminectomy aortic pseudoaneurysm.

Aortic pseudoaneurysm following lumbar laminectomy is a rare but potentially life-threatening complication. We report a case of a 49-year-old female patient who developed a pulsatile abdominal mass and pain following a lumbar laminectomy procedure. An aortic pseudoaneurysm was diagnosed which was successfully treated with endovascular stent-graft exclusion.

Endovascular repair of hemodialysis graft-related pseudoaneurysm: an alternative treatment strategy in salvaging failing dialysis access.

Introduction: Hemodialysis access-related pseudoaneurysm is a known complication in patients requiring hemodialysis via prosthetic arteriovenous grafts (AVGs). The traditional treatment strategy of AVG-related pseudoaneurysms is either AVG ligation or interposition replacement with another prosthetic graft segment or autogenous veins.

Patients And Methods: From June 2002 to August 2007, 32 self-expanding stent grafts were implanted in 26 patients with AVG pseudoaneurysms.

Primary prophylaxis of venous thromboembolism in surgical patients.

Venous thromboembolism is a major risk for surgical patients during the perioperative period. Prevention of perioperative venous thromboembolism remains a critical component of surgical patient care. The risk for venous thromboembolism in surgical patients can be stratified by their risk factors and by the type of operation.