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Deployment techniques and crossability of the EVO stent in wide-neck bifurcation aneurysms: An in vitro evaluation
No full textBackground: Stent-assisted coiling (SAC) is a well-established technique for treating wide-neck and bifurcation intracranial aneurysms. The second-generation Low-Profile Visualized Intraluminal Support (LVIS) EVO stent offers improved fluoroscopic visibility and deployment control; however, bench data on its performance in complex configurations remains limited.Objective: To evaluate the deployment and crossability of the LVIS EVO stent using shouldering and Y-stenting (crossing and parallel) techniques in a flow model, given their complexity and clinical relevance in the treatment of wide-neck bifurcation aneurysms. Methods: Two silicone basilar tip aneurysm replicas were used in a flow model under physiological conditions. LVIS EVO stents were deployed using the three techniques. A 0.014-inch microwire and 0.017-inch microcatheter were used to assess crossability through inner and outer vessel curvatures. Outcomes included device tracking under fluoroscopy, deployment success, and crossability profile. Results: All stent deployments were technically successful with accurate positioning, excellent fluoroscopic visibility, and no evidence of migration, prolapse, or deformation. Crossability testing confirmed that a 0.017-inch microcatheter and 0.014-inch microwire could be advanced smoothly through both the stent lumen and across the stent walls in all configurations without the need for additional maneuvers. Conclusion: The LVIS EVO stent demonstrated reliable deployment and crossability across complex bifurcation configurations in a flow model. Its radiopacity and flexible design support its use in advanced SAC techniques
Molecular characteristics of non-small cell lung cancer in Venezuela: A multicenter study
No full textComparative outcomes of transarterial radioembolization in hepatocellular carcinoma patients with large tumor burden (\u3e5 cm) vs. small tumor burden (\u3c=5 cm)
No full textIllinois Masonic Medical Center House Staff, 1984-85
No full textIllinois Masonic Medical Center, Chicago, IL: House staff roster with photos of IMMC residents in 1984-1985 for the specialties of anesthesiology, cardiology, dentistry, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pathology, pediatrics, radiology, surgery, and transitional year.https://institutionalrepository.aah.org/alldocuments/2157/thumbnail.jp
Management of the disconnected pancreatic duct in pancreatic necrosis
No full textDisconnected pancreatic duct (DPD) and the associated syndrome are increasingly recognized as complications of severe pancreatitis. Despite the increased appreciation for this disorder and its treatment, there remain many questions regarding definition, diagnosis, and management. We utilized the expertise of the US Pancreatic Disease Study Group to address 7 important questions derived from review of the literature pertaining to DPD in the setting of endoscopic treatment for necrotizing pancreatitis. Seven important questions were derived and following review by each member, consensus was reached. The 7 questions followed by recommendations included the appropriate definition for the syndromes, the radiographic definition for diagnosis; the appropriate timing for evaluation for diagnosis; the ideal diagnostic method; the use of pancreatic duct stents in this syndrome; the utility and safety of double plastic stents following endoscopic transmural drainage, and the role of surgical therapy. Important diagnostic and therapeutic questions were derived which should be useful for the management of these patients as well as important research questions going forward
Temporal trends in outcomes of nonelective versus elective transcatheter edge-to-edge repair of the mitral valve
No full textBackground: Data are limited on outcomes of elective vs nonelective mitral transcatheter edge-to-edge repair (M-TEER).
Methods: Using the National Inpatient Sample, all adult patients who had M-TEER from 2013-2020 were included in the study. Univariate and multivariate linear and logistic regression were used to evaluate outcomes.
Results: Of 43,920 patients who underwent M-TEER, with a mean age (SE) of 77 (0.13) years, 46% were women. Of these, 23% were nonelective, and 77% were elective cases. Whites were more likely to have elective, and African Americans and Hispanics were more likely to have nonelective M-TEER. In-hospital mortality and resource utilization decreased over time in elective cases, but no significant change was seen in nonelective cases. Risk-adjusted odds of in-hospital mortality were higher in nonelective vs elective cases (adjusted odds ratio, 2.85; P \u3c .001). Risk-adjusted length of stay was also higher in nonelective vs elective cases (adjusted beta-coefficient, 7.16; P \u3c .001). Finally, the risk-adjusted inflation-adjusted cost was also higher in nonelective vs elective cases (adjusted beta-coefficient, 23,673; P \u3c .001).
Conclusions: Nonelective M-TEER is associated with poor outcomes. Hence, these patients should be treated in a timely fashion and should not be deferred if they meet the criteria for M-TEER. Rapid up-titration of guideline-directed medical therapy should be considered in patients with moderate to severe secondary mitral regurgitation to avoid an emergent need for transcatheter edge-to-edge repair and associated poor outcomes
