Biomechanical Analysis of Diffuse Idiopathic Skeletal Hyperostosis and Osteoporosis: Vertebral Fracture Risk Evaluation Using Finite Element Modeling with Clinical and Micro-CT Data in an Elderly Donor.

Biomechanical analysis of spinal structures is crucial in the evaluation of injuries, the risk of fracture, and age-related changes. Osteoporotic vertebrae are very fragile and therefore constitute a serious risk, especially in the elderly. At present, clinically relevant decision making in fracture risk assessment is predicated upon finite element analysis (FEA), which utilizes high-resolution computed tomography (CT) scans from clinical practice alongside micro-CT scans from laboratory settings.

Regional Variations in the Intra- and Intervertebral Trabecular Microarchitecture of the Osteoporotic Axial Skeleton with Reference to the Direction of Puncture.

Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches.

Transoral balloon kyphoplasty in a myeloma patient with painful osseous destruction of the corpus vertebrae axis.

Multiple myeloma is the most common primary malignant disease of the spine, which can lead to pathological fractures with consecutive instability and immobilizing pain, due to osseous destruction of individual vertebral bodies. The different surgical care is challenging, although good stabilization should be achieved if possible. The resulting blocking of micro-movements leads to pain minimization.

Interobserver variability in the determination of bone mineral density in Hounsfield units from differently configured fields of measurement in the cancellous bone of vertebral bodies from elderly body donors.

Background: Due to the absence of suitable diagnostic procedures, osteoporosis (OP) is frequently detected late or not at all. Many elderly persons undergo computed tomographies (CT). The routine determination of Hounsfield units (HU) in bone as a part of these examinations could close a gap here.

Evaluation of bone density and hand grip strength in the course of drug treatment for osteoporosis : A real-world study.

Background: The aim of this clinical investigation was to assess the physical performance in osteoporotic patients undergoing drug treatment (DT) for years by measuring hand grip strength (HGS) and bone mineral density (BMD). A further aim was to detect the time until the occurrence of vertebral fractures (VF) and influencing factors.

Material And Methods: The investigation comprised 346 persons (276 women, 70 men) aged on average 66.

Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton.

Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae).

A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study.

Aims: Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management, and outcome are sparse.

Methods And Results: This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation.

Comparative outcome of different treatment options for fragility fractures of the sacrum.

Background: Fragility fractures of the sacrum (FFS) have been detected more and more frequently in recent times, and the incidence will continue to increase due to increasing life expectancy. The aim of this study was to compare the clinical outcome of conservative, interventional and surgical treatment of FFS.

Methods: Retrospectively, 292 patients (276 women, 16 men) with confirmed FFS were followed up over a period of 2 years.

EASY-WPW: a novel ECG-algorithm for easy and reliable localization of manifest accessory pathways in children and adults.

Aims: Accessory pathway (AP) ablation is a standard procedure for the treatment of Wolff-Parkinson-White syndrome (WPW). Twelve-lead electrocardiogram (ECG)-based delta wave analysis is essential for predicting ablation sites. Previous algorithms have shown to be complex, time-consuming, and unprecise.

Histomorphometric analysis of osteocyte density and trabecular structure of 92 vertebral bodies of different ages and genders.

Background: Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density - a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies.

Methods: Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072).

The Target Vessel SYNTAX Score: A Novel Pre-Procedural Predictor for Contrast-Induced Acute Kidney Injury After Rotational Atherectomy.

Background: Rotational atherectomy (RA) is a complex procedure often associated with high contrast load. Known risk scores do not predict contrast-induced acute kidney injury (CI-AKI) before RA. We aim to investigate pre-procedural predictors of CI-AKI after RA, and the role of the target vessel SYNTAX score (tvSS).

Side Branch Late Thrombosis After Left Main Coronary Artery Crossover Stenting.

Background: With the established use of crossover stenting technique in bifurcation coronary artery lesions, added clinical benefit of final kissing of the side branch remains debatable. We report a case of a stenosis and thrombus formation of an ostial side branch after crossover stenting. A 38-year-old man was admitted with acute coronary syndrome complicated by acute pulmonary oedema.

Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors.

Background: The purpose of the study was to investigate associations between biomechanical resilience (failure load, failure strength) and the microarchitecture of cancellous bone in the vertebrae of human cadavers with low bone density with or without vertebral fractures (VFx).

Methods: Spines were removed from 13 body donors (approval no. A 2017-0072) and analyzed in regard to bone mineral density (BMD), Hounsfield units (HU), and fracture count (Fx) with the aid of high-resolution CT images.

Ablation of typical atrial flutter as therapeutic component in carcinoid heart disease: a case report.

Background: Carcinoid heart disease is the cardiac manifestation of carcinoid syndrome. There is limited research on rhythm management in patients with carcinoid heart disease. The association of typical atrial flutter and carcinoid heart disease in particular is poorly described.

Outcomes of patients treated with a biodegradable-polymer sirolimus-eluting stent versus durable-polymer everolimus-eluting stents after rotational atherectomy.

Objective: To compare Orsiro biodegradable-polymer sirolimus-eluting stent (Orsiro BP-SES) with durable-polymer everolimus-eluting stent (DP-EES) regarding target lesion failure (TLF) after rotational atherectomy (RA), with a focus on small stents (diameter ≤ 3 mm) where Orsiro BP-SES has 60 µm strut thickness, while DP-EES remains with 81 µm strut thickness.

Background: New-generation drug-eluting stent (DES) is superior to early-generation DES in all percutaneous coronary intervention (PCI) settings including RA. Recently, the Orsiro BP-SES was superior to a DP-EES in an all comer's population.

CT-guided Thoracic Sympathicolysis versus VATS Sympathectomy in the Therapeutic Concept for Severe Primary Palmar Hyperhidrosis.

Background:  The objective was to compare computed tomography (CT)-guided thoracic sympathicolysis (CTSy) and video-assisted thoracoscopic sympathectomy (VATS) with regard to their feasibility, the occurrence of minor and major complications, and the clinical outcome.

Materials And Methods:  In this study, 88 patients treated by CTSy and 86 patients treated by VATS were retrospectively included. CTSy was performed after establishing the entry plane below the level of the intervertebral space T2/3 via a dorsolateral approach using a 22-G coaxial needle.

Typical atrial flutter but not fibrillation predicts coronary artery disease in formerly healthy patients.

Aims: Long-term mortality after ablation of typical atrial flutter has been found to be increased two-fold in comparison to atrial fibrillation ablations through a period of 5 years with unclear mechanism.

Methods And Results: We analysed 189 consecutive patients who underwent ablation for typical atrial flutter (AFL), in which the incidence of AF was the first manifestation of cardiac disease. According to the clinical standards of our centre, the routine recommendation was to evaluate for coronary artery disease (CAD) by invasive angiogram or computed tomography scan.

A comparison, using X-ray micro-computed tomography, of the architecture of cancellous bone from the cervical, thoracic and lumbar spine using 240 vertebral bodies from 10 body donors.

The vertebral trabecular bone has a complex three-dimensional microstructure with an inhomogeneous morphology. Correct identification and assessment of the weakest segments of the cancellous bone may lead to better prediction of fracture risk. The aim of this study was to compare cancellous bone from 240 vertebrae of the cervical, thoracic and lumbar spine of ten body donors with osteoporosis in regard to bone volume fraction (BVF), trabecular thickness, separation, trabecular number and degree of anisotropy, to ascertain why cervical vertebrae rarely fracture, even with severe osteoporosis.

CT-assisted thoracic sympathicolysis for therapy of primary hyperhidrosis palmaris-retrospective analysis of the influence of the amount and position of the sympathetic agent on the therapeutic outcome and side effects.

Purpose:  The objective of the present study was to evaluate the benefit of a thoracic, computed tomography-guided sympathicolysis (CTSy) in patients with primary, focal hyperhidrosis of the hands. In addition, the influence of the amount and distribution of the administered sympathicolytic agent was to be assessed.

Patients And Methods:  Retrospectively, 78 patients [13 (16.

Surgical treatment of abdominal wall weakness and lumbar hernias in Ehlers-Danlos syndrome - Case report.

Introduction: Ehlers-Danlos syndrome (EDS) is a rare and diverse group of heritable connective tissue disorders. Gastrointestinal manifestations and abdominal pain are frequent in most subtypes of EDS. Conservative treatment is the standard of care.

First experience and validation of the extended early meets late (EEML) tool as part of the novel CARTO software HD COLORING.

Background: With CARTO HD COLORING, a new enhanced software-based map visualization is available to highlight among others potential areas of conduction block in complex arrhythmias (extended early meets late (EEML)). The ideal settings of thresholds are still unclear and are examined here by studying 12 left atrial arrhythmias.

Methods: Ten patients with left atrial tachycardia underwent high-density activation mapping of the left atrium.

Predictors of In-Hospital Adverse Outcomes after Rotational Atherectomy: Impact of the Target Vessel SYNTAX Score.

Background: Rotational atherectomy (RA) is an established treatment of calcified lesions, but has some inherent procedural hazards. However, predictors of in-hospital adverse outcomes after RA are poorly investigated.

Objective: To explore the predictors of in-hospital adverse outcomes after RA and to introduce the target vessel SYNTAX score (tvSS) as a potential causal variable.

Safety and Performance Outcomes of a Self-Expanding Transcatheter Aortic Heart Valve: The BIOVALVE Trials.

Objectives: The aim of this study was to assess the safety and performance of a newly introduced transfemoral self-expanding supra-annular transcatheter heart valve.

Background: Transcatheter aortic valve replacement has become an established procedure, and newer transcatheter heart valves aim to supplement the current armamentarium.

Methods: BIOVALVE-I is a prospective, single-center feasibility study enrolling 13 high-risk patients with severe aortic stenosis, and BIOVALVE-II is a multicenter pilot study enrolling a further 55 patients under the same protocol.

Cardiac Mapping Systems: Rhythmia, Topera, EnSite Precision, and CARTO.

Novel cardiac mapping systems allow a safe and highly accurate 3-D reconstruction of cardiac structures as well as fast and accurate visualization of cardiac arrhythmias. In addition, they are increasingly reducing the need for fluoroscopy in these procedures. The current state of the art, as well as the presentation of possible uses of individual systems and their limitations, is presented in this article.