Objective: The aim of this study was to evaluate long-term outcomes of endovascular aneurysm repair (EVAR) using a standard suprarenal fixation endograft in abdominal aortic aneurysms (AAAs) with infrarenal neck length ≤10 mm (short-neck AAA [SN-AAA]).
Methods: From 2005 to 2010, data of high-risk patients with SN-AAA, unfit for open repair (OR) and fenestrated EVAR, were prospectively collected. Follow-up was performed by duplex ultrasound and contrast-enhanced ultrasound or computed tomography angiography at 1 month, 6 months, and 12 months and yearly thereafter. The primary end point was AAA-related mortality. Secondary end points were proximal type I endoleak, freedom from reintervention, and AAA shrinkage (>5 mm).
Results: Sixty patients (mean age, 74.9 ± 6.2 years; American Society of Anesthesiologists class 3 [85%] and class 4 [15%]) were enrolled. The mean aneurysm diameter and neck length and diameter were 60.4 ± 12.2 mm, 8.4 ± 1.6 mm, and 23.5 ± 3 mm, respectively. Four (7%) patients were symptomatic and 15 (25%) had rapid AAA enlargement (>5 mm/6 months). Cook Zenith Flex (Cook Medical, Bloomington, Ind) endografts (32) and Medtronic Endurant (Medtronic, Santa Rosa, Calif) endografts (28) were implanted. The mean follow-up was 51 ± 18 months. Survival at 5 years was 70%. There were three (5%) type I endoleaks. One was sealed by endovascular reintervention, and two (3%) underwent conversion to OR for AAA rupture at 8 and 36 months. Both patients died (2/60; 3% AAA-related mortality). Reinterventions were necessary for another five (8%) patients, and they were not proximal neck related. Freedom from reintervention at 5 years was 90%. In 49 (82%) cases, there was AAA shrinkage; the AAA diameter remained stable in nine (15%) and increased in two (3%) cases. Severe proximal angle (α neck angle ≥60 degrees) was associated with type I endoleak (P = .010) and reinterventions (P = .010). The neck length <7 mm (P = .030) was associated with reinterventions (P = .017).
Conclusions: Suprarenal fixation EVAR in SN-AAA with a straight, not wide neck and 7- to 10-mm aortic neck length can be considered safe and effective in patients who are unfit for OR and fenestrated EVAR. For these cases, long-term data showed acceptable results in preventing aneurysm rupture and related mortality.
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http://dx.doi.org/10.1016/j.jvs.2016.02.018 | DOI Listing |
Sci Rep
December 2024
School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China.
Microtextured microneedles are tiny needle-like structures with micron-scale microtextures, and the drugs stored in the microtextures can be released after entering the skin to achieve the effect of precise drug delivery. In this study, the skin substitution model of Ogden's hyperelastic model and the microneedle array and microtexture models with different geometrical parameters were selected to simulate and analyse the flow of the microtexture microneedle arrays penetrating the skin by the finite-element method, and the length of the microneedles was determined to be 200 μm, the width 160 μm, and the value of the gaps was determined to be 420 μm. A four-pronged cone was chosen as the shape of microneedles, and a rectangle was chosen as the shape of the drug-carrying microneedle.
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December 2024
College of Electrical Engineering, Anhui Polytechnic University, Wuhu, 241000, Anhui, China.
The quantity of cable conductors is a crucial parameter in cable manufacturing, and accurately detecting the number of conductors can effectively promote the digital transformation of the cable manufacturing industry. Challenges such as high density, adhesion, and knife mark interference in cable conductor images make intelligent detection of conductor quantity particularly difficult. To address these challenges, this study proposes the YOLO-cable model, which is an improvement made upon the YOLOv10 model.
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December 2024
Healthy Longevity Center, University of Zurich, Zurich, Switzerland.
Past research has demonstrated the association between social engagement and the maintenance of cognitive abilities. However, inconsistent definitions of social engagement have posed challenges to systematically investigate this association. This paper addresses the role of social relationships in cognitive functioning among older adults, focusing on the real-life communication indicator-length of own speech-as a measure of social activity.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Anesthesiology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
Objectives: This study aimed to evaluate the predictive abilities of the 5-item modified Frailty Index (5-mFI), Prognostic Nutrition Index (PNI), and their combination in older adult patients undergoing oral cancer resection and free flap reconstruction.
Design: Retrospective cohort study.
Setting: Secondary care involving multiple centres treating older adult patients for oral cancer.
J Craniofac Surg
October 2024
Department of Neurosurgery, Northern Jiangsu People's Hospital, Northern Jiangsu People's Hospital affiliated Yangzhou University.
Objective: To explore the anatomic characteristics of C7 nerve localization, course, and length during cross-transfer surgery of the C7 nerve through the anterior vertebral approach and investigate the feasibility, safety, and clinical efficacy of C7 nerve transfer surgery through the anterior vertebral approach for the treatment of central upper limb spastic paralysis.
Methods: Four fresh-frozen adult head and neck samples were selected. C7 nerve transfer surgery was simulated through the anterior vertebral approach.
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