1,721,227 research outputs found
Is It Time to Move Beyond the 5.0/5.5 cm Diameter Thresholds for AAA Repair? Time Resolved Ultrasound Imaging for Assessment of AAA Wall Motion
No full textN/
New Technical Approach to Overcome Anatomical Challenges During Branched Endovascular Aortic Repair with off-the-Shelf Multibranched Stent-Grafts: Are We Sequentially and Progressively Scraping the Sky?: Commentary on “Sequential catheterization and progressive deployment of the Zenith tBranchTM device for branched endovascular aortic aneurysm repair”
No full textN/
The Relationship Between Shaggy Aorta and Embolic Complications After Thoracic Endovascular Aneurysm Repair: Can We Smooth the Rough Covering?
No full textAbstract not availabl
Complications and failures of endovascular surgery A practical textbook of diagnosis and treatment
No full textIn the last decades, the field of vascular surgery has been revolutionized by the introduction and ever-rising growth of endovascular techniques, mainly owing to their reduced morbidity and mortality rates as compared with conventional open surgical approaches. However, as for the open surgical approach, peri- and post-procedural complications remain just around the corner to restrain the potential benefit of the endovascular treatment for the patients and dampen the mood of vascular specialists. Complications and failures after invasive procedures may still represent one of the most challenging scenarios that physicians will face in their practice. How to prevent, recognize and manage these instances in a prompt and effective manner is an area of never-ending effort for healthcare practitioners. For the above reasons, it is reasonable to say that the “endovascular revolution” has created a new spectrum of complications and failures, and no safety net exists even after minimally invasive endovascular procedures. Despite the abundance of textbooks devoted to endovascular techniques, there is still a paucity of academic resources that specifically address these challenging scenarios. How to address those complications and failures instances is not commonplace even at major scientific meetings and it is not unusual for many operators to share their complications and failures only privately. Furthermore, clinical trials are not ideally suited to answer these many questions, as the incidence and quality of adverse events will continue to change as new treatment modalities come into play. This book, titled “Complications and failures of endovascular surgery. A practical textbook of diagnosis and treatment” addresses the management of a wide range of early complications and late failures resulting from endovascular treatment of vascular pathologies, thereby providing all physicians involved in endovascular interventions with a concise, yet exhaustive, reference that will conveniently help their everyday practice
Artificial river ponds storing flood water as a resource for agriculture and groundwater recharge
No full textMicrosurgical Salvage of Acute Lower Limb Ischemia after Iatrogenic Femoral Injury during Orthopedic Surgery in a Pediatric Patient
Full text linkAcute lower limb ischemia (ALLI) in the pediatric population is rare but may lead to limb loss and life-long complications. We report the technique and outcomes of microsurgical salvage of ALLI in a preterm newborn after open reduction of congenital hip dysplasia. A 2-month-old girl was born premature at week 36 with congenital bilateral hip dysplasia. The initial management attempted was conservative and entailed placement of bilateral Von Rosen splints. The treatment was successful on the left side, but the patient had recurrent unstable hip dislocation on the right side. Subsequently, 2 attempts at close reduction under general anesthesia were done and both were unsuccessful in maintaining the right hip in the acetabulum. Therefore, an open reduction of the right hip was planned through a medial/obturator approach. During the surgical procedure, the neurovascular femoral bundle (including the superficial femoral artery [SFA], femoral vein [FV], and femoral nerve) was accidently transected with subsequent development of ALLI. Therefore, the FV was harvested distally to the injury site and a 4-cm long healthy segment was obtained. It was reversed, flushed with heparin, spatulated at both extremities, and interposed to the SFA in end-to-end fashion using two 9/0 polypropylene interrupted sutures under microscope. Reperfusion of the limb was noted immediately after releasing the vascular clamps. The final ischemia time at completion of the surgical procedure was 6 hr. Thereby, prophylactic 4-compartment fasciotomies were performed in the right leg. The patient tolerated the procedure well and the postoperative clinical course was free from adverse events. Duplex ultrasound examination at 6 weeks after the intervention confirmed sustained clinical success and showed no signs of venous thromboembolism. At the same time, X-ray examination of the right hip confirmed adequate and stable reduction of the joint in the acetabulum. ALLI due to accidental arterial injury during orthopedic surgical procedures for congenital defects in newborns is a rare but potentially devastating complication. Microsurgical salvage is a safe, feasible, and effective option to restore limb flow. Multidisciplinary expertise and meticulous technique are mandatory in order to achieve satisfactory and durable outcomes
Trend di precipitazione e temperature: confronti fra informazione storica e modelli climatici di previsione
No full textLa memoria analizza i trend temporali delle precipitazioni e delle temperature, storicamente osservate, e le future proiezioni climatiche con riferimento alla parte set-tentrionale della Toscana. I trend sono identificati e quantificati a scala mensile e an-nuale presso stazioni di misura con a disposizione lunghe serie storiche di dati (60-90 anni). Sono stati poi considerati 13 modelli climatici regionali (RCM), basati su due scenari di emissione di gas serra (RCP4.5 e RCP8.5), allo scopo di ottenere le proiezioni di precipitazione e temperatura del futuro e rappresentare l'incertezza dei risultati. I dati storici evidenziano, globalmente, una modesta diminuzione delle precipitazioni annua-li, mentre la temperatura media annua appare in crescita. Con riferimento alle proie-zioni dei 13 modelli e alle precipitazioni annuali, invece, i risultati non sono concordan-ti; un riscaldamento dell'area di studio è invece constatabile univocamente dalle simu-lazioni esaminate. Infine, per verificare i segnali di cambiamento osservati, le proiezioni dei modelli climatici sono state confrontate con le tendenze basate sui dati storici. Si ottiene un accordo soddisfacente con riferimento alle precipitazioni; viene invece os-servata una sottostima sistematica dei valori di tendenza storicamente osservata rispet-to ai modelli, a medio e lungo termine, per i dati di temperatura
Quantitative flood hazard assessment methods: A review
Full text linkFlood hazard assessment is a fundamental step in flood risk mapping. Quantitative assessment requires hydrodynamic modelling of the flooding process in order to calculate the spatial distribution of suitable flood hazard indicators representative of flooding intensity and frequency, hence its potential to result in harm. Flood hazard indicators are usually defined by combining relevant flooding parameters, mainly flood depth and flow velocity, but also flooding arrival time, flooding duration, sediment or contamination load, and so forth. A flood hazard classification is commonly introduced to assign a hazard level to areas potentially subject to flooding. This article presents a systematic review of quantitative methods proposed in the scientific literature or prescribed by government authorities to assess the hazard associated with natural or anthropic flooding. Flood hazard classification methods are listed and compared by specifying their underlying approach (heuristic, conceptual, empirical), the exposed element which they were designed for (people, buildings, vehicles, etc.), and their fields of application (river overflow, dam-break, levee breach, debris flow). Perspectives and future challenges in quantitative flood hazard analysis are also discussed. This review aims to help modellers and practitioners to select the most suitable flood hazard assessment method for the case study of interest
Probabilistic mapping and sensitivity assessment of dam-break flood hazard
Full text linkQuantitative assessment of dam-break flood hazard is central in dam emergency action planning and is typically performed deterministically. In structural failure of concrete or masonry dams the collapse is assumed to be total and instantaneous, with the reservoir level at the spillway crest level. A probabilistic method is here proposed based on a set of dam-break scenarios characterized by different breach widths and reservoir levels in order to provide an appraisal of uncertainties in flood hazard indicators. Each scenario is attributed a weight, defined as a conditional probability given a dam-break event. Probabilistic flood hazard and inundation maps are produced for the case study of the hypothetical collapse of the Mignano dam (River Arda, northern Italy), and a sampling-based global sensitivity analysis is performed. Dam-break flooding was simulated using a two-dimensional hydrodynamic model on a high-resolution mesh. The probabilistic maps inherently provide quantitative information on the uncertainty of dam-break flood hazard
Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update
No full textEndoleaks (ELs), defined as continued perfusion of the aneurysm sac despite stent-graft deployment, are the most common adverse event after endovascular aortic repair (EVAR) and account for most of the reinterventions. Type 2 EL (T2EL), caused by backflow of collateral arteries into the aneurysm sac, are the most frequently encountered and may account for the need for secondary interventions after EVAR in up to 40% of the cases. Contrast-enhanced ultrasound and magnetic resonance imaging may be better able to quantify and characterize low-flow T2EL as compared with computed tomography angiography. Support for conservative management of T2EL derives from the relatively high percentage of T2EL that will resolve spontaneously over a variable period (more than 30%) and the estimated low risk of post-EVAR rupture secondary to isolated T2EL (less than 1%). Current guidelines are that a conservative approach is appropriate for isolated T2EL without sac expansion while intervention is recommended when sac enlargement of ≥10 mm as compared with pre-EVAR is detected. Although generally safe, secondary interventions for T2EL are often unsatisfactory since persistence and recurrence are commonly encountered problems and long-term follow-up is mandatory. Further investigation is required to determine the factors associated with abdominal aortic aneurysm progression in the presence of isolated T2EL and the most cost-effective technique to manage this complication
- …
