bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic Carotid Artery Dissection and Pseudoaneurysm Treated with Endovascular Coils and Stent
Authors: Matsuura John H. , Rosenthal David , Jerius Hilde , Clark Michael D. , Owens David S. 
Published: March 2015

Purpose: To report a case of post-traumatic internal carotid artery dissection and pseudoaneurysm formation at the C-1 level successfully treated by a percutaneous endovascular technique. Methods and Results: A 20-year-old female presented 72 hours after a motor vehicle accident with incomplete occulosympathetic paresis (Horner's syndrome), carotidynia, and left-sided weakness. Arteriography confirmed the diagnosis of carotid dissection and an associated 1.5-cm × 2.5-cm pseudoaneurysm at the C-1 level. Neuroradiologists embolized the pseudoaneurysm with Guglielmi detachable coils and controlled the dissection with placement of a Wallstent. Conclusions: This report illustrates successful percutaneous endovascular treatment of a carotid dissection and pseudoaneurysm near the base of the skull.
Three-Year Experience with Modular Stent-Graft Devices for Endovascular AAA Treatment
Authors: Stelter Wolf , Umscheid Thomas , Ziegler Peter 
Published: March 2015

Purpose: To evaluate feasibility and present early results of endovascular abdominal aortic aneurysm (AAA) exclusion using modular stent-grafts. Methods: In a 3-year period ending July 1997, 201 patients were treated with self-expanding stent-grafts for AAAs with infrarenal necks ≥ 10 to 15 mm long and ≤ 32 mm wide; subtotal mural thrombus, calcification, and even angulation to some extent were acceptable, as were iliac arteries up to 18 mm wide. The patients were treated with either the Stentor/Vanguard device (178 cases) or the Talent endograft (23 cases). Follow-up on all patients was conducted at 3, 6, 12, 18, and 24 months. Results: The technical aneurysm exclusion rate was 89% (178/201). There were 18 primary endoleaks (9.0%; 2 proximal, 16 distal), 4 (2.0%) conversions to open surgery, and 1 (0.5%) failure to deploy the graft. Seven (3.5%) patients died in the perioperative period, 5 due to multiorgan failure early in the series and two of hemorrhagic complications. Five (2.5%) renal artery occlusions were encountered; in one case, the graft was removed after 3 weeks. Nineteen late endoleaks were found in follow-up, related primarily to the iliac limb graft extensions of the Stentor device, graft material problems, or unknown causes. To date, 10 primary and 13 secondary endoleaks have been treated endovascularly. Twenty (10.0%) graft-limb thromboses were treated either by thrombolysis, thrombectomy, or a femorofemoral bypass. Conclusions: Endovascular grafting is technically feasible and becomes easier with improvements of the introducer systems and the grafts. The seemingly high complication rate in this series is due to the liberal patient selection criteria.
Silicon Carbide-Coated Stents: Clinical Experience in Coronary Lesions with Increased Thrombotic Risk
Authors: Heublein Bernd , Özbek Cem , Pethig Klaus 
Published: March 2015

Purpose: To report the results of a prospective, nonrandomized, multicenter study of a semiconductor-coated stent in coronary lesions at high risk for stent thrombosis. Methods: A balloon-expandable tantalum stent was coated with silicon carbide to enhance thromboresistance (Tensum). Patients were enrolled in an observational study that compared coronary stenting with the Tensum stent in patients at low risk for stent thrombosis against those with factors predisposing to local thrombosis (acute myocardial infarction, small vessel diameter, recanalized chronic total occlusion, saphenous vein bypass grafts, and coronary allograft vascular disease). Results: In 294 patients with 364 coronary lesions, 111 patients with 142 lesions were assigned to the high-risk group. Overall, 406 Tensum stents were implanted (94% procedural success) using antiplatelet medication only after the procedure. The stent thrombosis rate (2.7% overall) in the high-risk group (3.6%) was not significantly different from that of the low-risk patients (2.1%). Conclusions: Silicon carbide coating on coronary stents may inhibit acute/subacute stent thrombosis even in patients at high risk. Randomized trials are underway for further evaluation of this promising coated stent.
Intravascular Ultrasound in Endovascular Stent-Grafts for Peripheral Aneurysm: A Clinical Study
Authors: van Sambeek Marc RHM , Gussenhoven Elma J. , van Overhagen Hans , Honkoop Jan , van der Lugt Aad , du Bois Nico AJJ , van Urk Hero 
Published: March 2015

Purpose: To evaluate the potential diagnostic information of intraprocedural intravascular ultrasound (IVUS) in patients undergoing endovascular stent-grafting for peripheral aneurysm. Methods: IVUS was used in 17 patients preprocedurally to measure the diameter of the proximal and distal neck and the length of the aneurysm. Balloon and stent-graft sizes were selected based on these measurements. Following stent-graft deployment, angiography and IVUS were used to document stent apposition and the configuration and diameter of the stent-graft. Results: Stent-graft insertion was considered successful in 8 patients based on angiography and IVUS images. In 9 others, both imaging modalities showed inadequate results, necessitating 12 additional procedures: balloon angioplasty for stent-graft stenosis (2) and inadequate stent-graft apposition (1); an additional stent-graft (4); an extra stent (1); thrombectomy (2); and conversion (2) for inadequate stent-graft position and a graft rupture. In these patients, intraprocedural IVUS was superior to angiography in contributing vital information to aid in the selection of the additional interventions. Conclusions: During management of peripheral aneurysms with endovascular stent-grafts, IVUS monitoring was a useful adjunct when the initial procedure was unsatisfactory and/or when intraprocedural angiographic studies were inconclusive.
Diameter of Large Balloons Used in Endoluminal Graft Deployment Varies with Inflation Pressure
Authors: Chaufour Xavier , White Geoffrey H. , Yu Weiyun , May James , Stephen Michael S. 
Published: March 2015

Purpose: To evaluate the characteristics of large-diameter balloon catheters used during endoluminal repair of aortic aneurysms. Methods: Thirty-three large balloon dilatation catheters in the diameter range of 15 to 30 mm were measured at controlled pressures from 1 to 4 atm. The balloons were inflated with water using an inflation syringe connected to a pressure transducer. Diameters at stable pressure and pressure changes against time were recorded for each balloon. Results: Dilation catheters in the range of 15 to 20 mm in diameter were significantly smaller (p < 0.005) than their nominal diameter at 1 and 2 atm; they reached nominal diameter only at the relatively high pressure of 4 atm. Most larger diameter balloons (25 and 30 mm) did not attain their nominal diameter even with pressures up to 4 atm. All sizes of balloon catheters tested became relatively compliant at pressures > 3 atm. Conclusions: The large balloon catheters tested in this study were designed for arterial angioplasty or valvuloplasty. They attained a significantly smaller size than their nominal diameter at pressures < 3 atm and became compliant at pressures exceeding 3 atm. Interventionists should be aware of these characteristics when using balloon catheters such as these during endoluminal graft deployment. Large balloons that reach predictable diameter at lower pressures should be designed specifically for use in endoluminal graft procedures.
Iliofemoral Venous Thrombosis Caused by Compression of an Internal Iliac Artery Aneurysm: A Minimally Invasive Treatment
Authors: Rosenthal David , Matsuura John H. , Jerius Hilde , Clark Michael D. 
Published: March 2015

Purpose: To report the success of a minimally invasive treatment for phlegmasia cerulea dolens without gangrene caused by compression from an internal iliac artery aneurysm. Methods and Results: An 81-year-old male with a 1-month history of paralysis owing to a hemorrhagic stroke presented with massive edema and skin mottling of the right lower extremity. Imaging confirmed right iliofemoral deep vein thrombosis caused by compression from a 4-cm internal iliac artery aneurysm. With thrombolysis ruled out, a minimally invasive treatment plan was undertaken, featuring percutaneous coil embolization of the aneurysm and surgical venous thrombectomy with proximal arteriovenous fistula creation and iliac vein stent placement. Failure of the coils to embolize the iliac aneurysm prompted the use of an endovascular graft to exclude the aneurysm. The patient's symptoms subsided, and he has a patent right iliofemoral venous system and internal iliac artery at his latest (16-month) follow-up. Conclusions: This case demonstrates that minimally invasive endovascular and open techniques can be combined to achieve an optimum outcome in patients at high risk for standard surgical approaches.
Torsion and Kinking of Unsupported Aortic Endografts: Treatment by Endovascular Intervention
Authors: Boyle Jonathan R. , Thompson Matthew M. , Clode-Baker Edward G. , Green Jeremy , Bolia Amman , Fishwick Guy , Bell Peter R.F. 
Published: March 2015

Purpose: To describe the management strategies used to deal with twisted aortic endografts. Methods and Results: Two patients with successfully excluded aortic aneurysms developed symptoms referable to previously undetected twists in their endografts (one EndoVascular Technologies [EVT] and one customized aortomonoiliac device). The limb graft occlusion in the EVT graft was treated surgically with a femorofemoral bypass, but the aortomonoiliac endograft was salvaged with percutaneous implantation of a Wallstent. During another aortomonoiliac procedure, suboptimal flow through the endograft was traced to contortion of the endograft as it passed over an angulated proximal aneurysm neck. An X-large Palmaz stent was deployed to support the graft at this point. Conclusions: Unsupported aortic endografts may develop twists and kinks during deployment that can lead to low outflow and graft occlusion. Endovascular techniques are available to repair these defects postoperatively, although more precise intraoperative assessment tools may identify these problems so that they can be corrected at the initial intervention.
Outpatient Endovascular Intervention: Is it Safe?
Authors: Criado Frank J. , Abdul-Khoudoud Omran , Twena Mordechai , Clark Nancy S. , Patten Peggy 
Published: March 2015

Purpose: To evaluate the feasibility and safety of outpatient percutaneous endovascular intervention in the treatment of arterial occlusive disease. Methods: The records of 134 patients who underwent 151 outpatient endovascular procedures between 1992 and 1997 were reviewed retrospectively. According to established protocol, focal lower limb (n = 145) and subclavian (n = 6) arterial lesions requiring relatively straightforward endoluminal interventions were appropriate for outpatient management provided the patients were free of significant comorbidities. A percutaneous transfemoral approach was used for lower limb lesions, while subclavian angioplasty was performed via a brachial access. Heparin anticoagulation was administered conservatively. Patients were discharged 3 hours after sheath removal. Results: The majority (98%) of patients were discharged as planned. Three (2%) patients were observed overnight in the hospital for treatment of acute iliac artery thrombosis, puncture-site bleeding, and suboptimal angioplasty. No patient required hospitalization following discharge. Periprocedural morbidity Was confined to 2 (1.5%) groin hematomas and 1 (0.7%) femoral pseudoaneurysm. Conclusions: Outpatient endovascular intervention appears safe; however, proper case selection and technical excellence are inseparable components for the success of this strategy.
Aortoenteric Fistula Caused by a Ruptured Stent-Graft: A Case Report
Authors: Norgren Lars , Jernby Bengt , Engellau Lena 
Published: March 2015

Purpose: To report a case of aortoenteric fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. Methods and Results: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An aortoenteric fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to fistula formation. The patient recovered after placement of a conventional aortic graft. Conclusions: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts.
Late Aortic Arch Perforation by Graft-Anchoring Stent: Complication of Endovascular Thoracic Aneurysm Exclusion
Authors: Malina Martin , Brunkwall Jan , Ivancev Krasnodar , Lindblad Bengt , Malina Janne , Nyman Ulf , Risberg Bo 
Published: March 2015

Purpose: To describe a fatal case of late aortic perforation by an endograft-anchoring stent. Methods and Results: A 69-year-old woman presented 2 years after thoracoabdominal aneurysm repair with a 9-cm dilatation of the descending thoracic aorta proximal to the conventional aortic graft. A 38-mm Dacron graft with multiple Gianturco Z-stents sutured inside was placed transluminally across the aortic arch such that part of the uncovered portion of the proximal stent was partially across the left subclavian orifice. Four months later, the patient died from massive hemorrhage. Autopsy showed that the uncovered portion of the proximal stent had perforated the aortic arch. Conclusions: This case stresses the need for low-profile stent-grafts and smaller, more flexible introducer systems. Anchoring stents must be flexible, less traumatic, and strong enough to create a watertight seal even in tortuous vessels. To avoid aortic arch damage by thoracic stent-grafts, the proximal stent should be fully covered by the fabric.
Endovascular Repair of Abdominal Aortic Aneurysm Using the EVT Device: Limited Increased Utilization with Availability of a Bifurcated Graft
Authors: Sarkar Rajabrata , Moore Wesley S. , Quiñones-Baldrich William J. , Gomes Antoinette S. 
Published: March 2015

Purpose: To determine if the availability of a bifurcated graft would increase the percentage of patients eligible for endovascular repair of abdominal aortic aneurysms (AAAs). Methods: One hundred eighty-five consecutive patients were evaluated prospectively for endovascular AAA repair at a university referral center. Data were collected on eligibility for tube or bifurcated endovascular grafts, reasons for exclusion, aneurysm morphology, and the interventions performed. Results: Forty-six (25%) patients were eligible for endovascular treatment using the first-generation Endovascular Technologies (EVT) system: 19 (10%) for a tube graft and 27 (15%) for a bifurcated device. An unsuitable proximal neck was the reason for exclusion in 48% of patients (excess diameter in 27%, inadequate length in 21%). Unsuitable iliac configuration was present in 41% of those excluded; 29% of the common iliac arteries were enlarged or aneurysmal, while 12% were small or tortuous. Conclusions: Although a bifurcated graft more than doubles the eligibility of AAA patients for endovascular repair, the configuration of the proximal neck and iliac disease excluded the majority of AAA patients from endovascular therapy using the first generation EVT device.
Concurrent Multivessel Stenting in a Patient with Multifocal Arterial Disease
Authors: Vlahopoulos Panagiotis , Papageorgiou George , Balas Panagiotis , Ioannou Nikos , Masouridou Efi 
Published: March 2015

Purpose: To report the concurrent endovascular treatment of multiple stenoses in different vascular territories. Methods and Results: A 45-year-old male presented with an aortic arch syndrome, renovascular hypertension, and Leriche syndrome. Intra-arterial digital arteriography disclosed occlusion of the left subclavian artery and stenoses in the left common carotid artery (CCA), the right CCA at the bifurcation, the left renal artery, and both iliac arteries. In a single procedure, the patient received 5 stents in 2 carotid, 1 renal, and 2 iliac arteries. At 3-month follow-up, color flow duplex imaging confirmed continued patency of all stented arteries. Conclusions: This case illustrates the feasibility, safety, and cost effectiveness of treating multivessel stenoses using a single-session endovascular approach executed by experienced interventionists.
Endovascular Repair of an Aortoenteric Fistula in a High-Risk Patient
Authors: Deshpande Arvind , Lovelock Mark , Mossop Peter , Denton Michael , Vidovich John , Gurry John 
Published: March 2015

Purpose: To describe the endovascular repair of an aortoenteric fistula in a high-risk patient. Methods and Results: A Vanguard tube stent-graft was deployed at the upper anastomotic suture line of a secondary aortoenteric fistula, successfully sealing the communication between the aorta and the third part of the duodenum without occlusion of the renal arteries. Conclusions: Endovascular stent-graft repair of aortoenteric fistulae is possible, but further evaluation of this technique will determine its role in the management of this complication.
Acute Toxicity From Breast Cancer Radiation Using Helical Tomotherapy With a Simultaneous Integrated Boost
Authors: Wojcieszynski Andrzej P. , Olson Anna K. , Rong Yi , Kimple Randall J. , Yadav Poonam 
Published: March 2015

Purpose: To evaluate 2 simultaneous integrated boost treatment planning techniques using helical tomotherapy for breast conserving therapy with regard to acute skin toxicity and dosimetry. Methods: Thirty-two patients were studied. The original approach was for 16 patients and incorporated a directional block of the ipsilateral lung and breast. An additional 16 patients were planned for using a modified approach that incorporates a full block of the ipsilateral lung exclusive of 4 cm around the breast. Dose–volume histograms of targets and critical structures were evaluated. Skin toxicity monitoring was performed throughout treatment and follow-up using the Common Terminology Criteria for Adverse Events. Results: Treatment was well tolerated with patients receiving a median dose of 59.36 Gy. Of the 16 patients in both groups, 8 had grade 2 erythema immediately after radiation. On 3-week follow-up, 10 and 7 patients in the original and modified groups showed grade 1 erythema. On 3- and 6-month follow-up, both groups had minimal erythema, with all patients having either grade 0 or 1 symptoms. No grade 2 or 3 toxicities were reported. Mean treatment time was 7.5 and 10.4 minutes using the original and modified methods. Adequate dose coverage was achieved using both methods (V95 = 99.5% and 98%). Mean dose to the heart was 10.5 and 1.8 Gy, respectively ( P < .01). For right-sided tumors, the original and modified plans yielded a mean of 8.8 and 1.1 Gy ( P < .01) versus 11.7 and 2.4 Gy for left-sided tumors ( P < .01). The mean dose to the ipsilateral lung was also significantly lower in the modified plans (11.8 vs 5.0 Gy, P < .01). Conclusions: Tomotherapy is capable of delivering homogeneous treatment plans to the whole breast and lumpectomy cavity using simultaneous integrated boost treatment. Using the treatment methods described herein, extremely low doses to critical structures can be achieved without compromising acute skin toxicity.
How I treat hyperleukocytosis in acute myeloid leukemia
Authors: Röllig Christoph , Ehninger Gerhard 
Published: March 2015

AbstractHyperleukocytosis (HL) per se is a laboratory abnormality, commonly defined by a white blood cell count >100 000/µL, caused by leukemic cell proliferation. Not the high blood count itself, but complications such as leukostasis, tumor lysis syndrome, and disseminated intravascular coagulation put the patient at risk and require therapeutic intervention. The risk of complications is higher in acute than in chronic leukemias, and particularly leukostasis occurs more often in acute myeloid leukemia (AML) for several reasons. Only a small proportion of AML patients present with HL, but these patients have a particularly dismal prognosis because of (1) a higher risk of early death resulting from HL complications; and (2) a higher probability of relapse and death in the long run. Whereas initial high blood counts and high lactate dehydrogenase as an indicator for high proliferation are part of prognostic scores guiding risk-adapted consolidation strategies, HL at initial diagnosis must be considered a hematologic emergency and requires rapid action of the admitting physician in order to prevent early death.
Enforced fucosylation of cord blood hematopoietic cells accelerates neutrophil and platelet engraftment after transplantation
Authors: Popat Uday , Mehta Rohtesh S. , Rezvani Katayoun , Fox Patricia , Kondo Kayo , Marin David , McNiece Ian , Oran Betul , Hosing Chitra , Olson Amanda , Parmar Simrit , Shah Nina , Andreeff Michael , Kebriaei Partow , Kaur Indreshpal , Yvon Eric , de Lima Marcos , Cooper Laurence J. N. , Tewari Priti , Champlin Richard E. , Nieto Yago , Andersson Borje S. , Alousi Amin , Jones Roy B. , Qazilbash Muzaffar H. , Bashir Qaiser , Ciurea Stefan , Ahmed Sairah , Anderlini Paolo , Bosque Doyle , Bollard Catherine , Molldrem Jeffrey J. , Chen Julianne , Rondon Gabriela , Thomas Michael , Miller Leonard , Wolpe Steve , Simmons Paul , Robinson Simon , Zweidler-McKay Patrick A. , Shpall Elizabeth J. 
Published: March 2015

Key Points
Ex vivo fucosylation of cord blood cells improves their homing capacities, leading to faster neutrophil and platelet engraftments. This method is quick, safe, and does not require a GMP laboratory; therefore, it can be used widely.
Predicting one-year mortality of critically ill patients with early acute kidney injury: data from the prospective multicenter FINNAKI study
Authors: Poukkanen Meri , Vaara Suvi T , Reinikainen Matti , Selander Tuomas , Nisula Sara , Karlsson Sari , Parviainen Ilkka , Koskenkari Juha , Pettilä Ville ,   the FINNAKI Study Group
Published: March 2015

Abstract
Introduction
No predictive models for long-term mortality in critically ill patients with acute kidney injury (AKI) exist. We aimed to develop and validate two predictive models for one-year mortality in patients with AKI based on data (1) on intensive care unit (ICU) admission and (2) on the third day (D3) in the ICU.

Methods
This substudy of the FINNAKI study comprised 774 patients with early AKI (diagnosed within 24 hours of ICU admission). We selected predictors a priori based on previous studies, clinical judgment, and differences between one-year survivors and non-survivors in patients with AKI. We validated the models internally with bootstrapping.

Results
Of 774 patients, 308 (39.8%, 95% confidence interval (CI) 36.3 to 43.3) died during one year. Predictors of one-year mortality on admission were: advanced age, diminished premorbid functional performance, co-morbidities, emergency admission, and resuscitation or hypotension preceding ICU admission. The area under the receiver operating characteristic curve (AUC) (95% CI) for the admission model was 0.76 (0.72 to 0.79) and the mean bootstrap-adjusted AUC 0.75 (0.74 to 0.75). Advanced age, need for mechanical ventilation on D3, number of co-morbidities, higher modified SAPS II score, the highest bilirubin value by D3, and the lowest base excess value on D3 remained predictors of one-year mortality on D3. The AUC (95% CI) for the D3 model was 0.80 (0.75 to 0.85) and by bootstrapping 0.79 (0.77 to 0.80).

Conclusions
The prognostic performance of the admission data-based model was acceptable, but not good. The D3 model for one-year mortality performed fairly well in patients with early AKI.