Notes

The part involving preimplantation dna testing pertaining to aneuploidy within a great analysis IVF human population throughout different age groups.
PAES and PACD require early diagnosis and intervention, and early surgery may lead to good early- and mid-term results.
PAES and PACD require early diagnosis and intervention, and early surgery may lead to good early- and mid-term results.The use of mobile phones has become an indispensable part of our lives, especially due to widespread use of the internet. We report the case of a 38-year-old male patient who developed internal carotid artery dissection after talking on the phone between her left shoulder and ear by laterally flexing the neck for 20 minutes. In addition to many positive effects of technology that facilitate the daily life, the development of neurological deficits may be observed with widespread use of mobile phones. Misuse of mobile phone should be considered in patients with carotid artery dissection.
Carotid endarterectomy (CEA) is the gold standard operation for treating carotid artery stenosis in patients with symptomatic carotid stenosis of more than 50% and asymptomatic carotid stenosis of more than 80%. Asymptomatic leukocytosis before CEA represents a clinical dilemma for surgeons about the management options. The objectives of this study are to identify the relationship between asymptomatic preoperative leukocytosis and postoperative complications in patients undergoing CEA and to assess the relationship between asymptomatic preoperative leukocytosis and postoperative complications in the cohort of patients with symptomatic carotid stenosis.

The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2011-2019 was utilized for this analysis. Patients with preoperative sepsis, septic shock, pneumonia, wound infections, disseminated cancer, renal failure, and history of chronic steroid use were excluded. The remaining patients were sub-groupedroutine preoperative hematological evaluation may be recommended as a risk assessment tool for patients undergoing CEA, and postponing the elective operation in patients with asymptomatic CEA may be advised unless a thorough preoperative infectious workup is completed.
Patients with asymptomatic preoperative leukocytosis undergoing CEA have a significantly higher risk of stroke and infectious complications in the postoperative period. Furthermore, patients with symptomatic carotid disease are especially at an increased risk of prolonged LOS. A routine preoperative hematological evaluation may be recommended as a risk assessment tool for patients undergoing CEA, and postponing the elective operation in patients with asymptomatic CEA may be advised unless a thorough preoperative infectious workup is completed.Rupture of and abdominal aortic aneurysm (AAA) in a kidney transplant patient is a rare and rarely reported event. Emergent treatment can be challenging and should achieve effective aortic repair while minimizing ischemic damage to the renal graft during aortic cross-clamping. Several renal protective measures have been proposed such as permanent or temporary shunts, renal cold perfusion and general hypothermia. We report the effective treatment of a para-renal AAA in a patient with a functional renal allograft. A temporary extra-corporeal axillofemoral shunt was constructed to maintain graft's perfusion during open surgical repair. EVAR was not an option due to a short aortic neck. The postoperative period was complicated by colon ischemia and aortic graft infection. At three years follow-up the patient was well and graft's function was unchanged. This case is a reminder that renal graft protection must be accounted for when AAA rupture occurs in kidney transplant patients. We reviewed the literature to find previously reported cases and how they were managed.The NTNT ablative method for varicose vein surgery is characterized by low-difficulty, minimally invasive and fast recovery and make surgeon suppose its very low risks of any major complications. We present a case of PTE without DVT confirmed by ultrasonography and CT angiography (CTA) after NTNT ablative methods for varicose vein surgery.
To investigate the long-term outcomes of femoropopliteal bypass surgery in patients with chronic limb-threatening ischemia (CLTI) and TransAtlantic Inter-Society Consensus II (TASC II), type D (TASC D) femoropopliteal disease.

A retrospective analysis was performed for all consecutive patients undergoing above-knee (AK) femoropopliteal bypass surgery at an academic vascular centre between January 2007 and March 2019. see more Patients with claudication (IC) and patients with CLTI were included. Patency rates and freedom from major adverse limb events (MALE) after 5 years were analysed.

In total, 432 femoropopliteal grafts were performed. Indications for surgery were claudication and CLTI in 232 (53.7%) and 200 (46.3%) patients, respectively. Graft material was autologous vein in 186 patients (43.1%), polytetrafluoroethylene (PTFE) in 128 patients (29.6%), and heparin-bonded expanded polytetrafluoroethylene (HePTFE) in 118 patients (27.3%). At the 5-year follow-up, the primary patency rate was 58.1% and 58.3% in h TASC D lesions is safe and effective in the long term. Autologous vein grafts remain the first choice for patients with CLTI, also for bypasses in AK position. However, prosthetic grafts in AK the position are an acceptable alternative for revascularisation when the saphenous vein is not available.
Major Lower Limb Amputation (MLLA) is associated with significant peri- and post-operative pain and has been identified as a research priority by patient and healthcare groups. The PReliMinAry survey was designed to evaluate existing MLLA analgesia strategies; identifying areas of equipoise and informing future research.

A targeted multi-national, multi-disciplinary survey was conducted via SurveyMonkey® (5/10/2020-03/11/2020) and advertised via social media and society email lists. The 10-questions explored 'pain-team' services, pre-operative neuroleptic medication, pre-incision peripheral nerve blocks and catheters, surgically placed nerve catheters, post-operative adjunctive regimens, future research engagement and equipoise.

76 responses were received from 60 hospitals worldwide. Twelve hospitals(20%) had a dedicated MLLA pain team, seven(12%) had none. Most pain teams(n=52; 87%) assessed pain with a 0-10 numerical rating scale. Over half of respondents "never" preloaded patients with oral neurolepte surgically placed likely reflects the difference of literature evaluating these techniques. Most respondents felt there was equipoise surrounding future trials evaluating nerve blocks/catheters, but less so for surgical catheters.Background Anaemia is potentially associated with increased morbidity and mortality following vascular surgery procedures. This study investigated whether peri-procedural anaemia is associated with reduced 1-year amputation-free survival (AFS) in patients undergoing revascularisation for chronic limb-threatening ischemia (CLTI). Methodology A retrospective analysis of patients diagnosed with CLTI between February 2018-February 2019, who subsequently underwent revascularisation, was conducted. Haemoglobin concentration measured at index assessment was recorded and stratified by WHO criteria. Subsequent peri-procedural red blood cell transfusions (RBC) were also recorded. The primary outcome was 1-year AFS. Kaplan Meier survival analysis and Cox's proportional hazard modelling were conducted to assess the effect of anaemia and peri-procedure transfusion on outcomes. Results 283 patients were analysed, of which 148 (52.3%) were anaemic. 53 patients (18.7%) underwent RBC transfusion. Patients with anaemia had a significantly lower 1-year AFS (64.2% vs. 78.5%, p=.009). A significant difference in 1-year AFS was also observed based upon anaemia severity (p=.008) and for patients who received RBC transfusion (45.3% vs 77.0%, p less then .001). On multivariable analysis, moderately severe anaemia was independently associated with increased risk of major amputation/death (aHR 1.90, 95% CI 1.06-3.38, p=.030). After adjusting for severity of baseline anaemia, peri-procedural RBC transfusion was associated with a significant increase in the combined risk of major amputation/death (aHR 3.15, 95% CI 1.91-5.20, p less then .001). Conclusion Moderately severe peri-procedural anaemia and subsequent RBC transfusion are independently associated with reduced 1-year AFS in patients undergoing revascularisation for CLTI. Future work should focus on investigating alternative measures to managing anaemia in this cohort.
Hybrid Deep Venous ARterialisation (DVAR) is offered as a last-ditch attempt for limb salvage in patients with chronic limb threatening ischemia (CLTI). It provides non-selective arterialisation independent of the angiosome, which harnesses the complex venous capillary network bed developed in the leg and foot.

We present two elderly men who underwent DVAR to salvage limb with CLTI. DVAR was performed by creating an arteriovenous connection by anastomosis of the great saphenous vein (GSV) at the level of the distal popliteal and proximal tibio-peroneal trunk. Fasciotomy was performed over the length of the GSV. Subsequently, proximal in-situ catheter valvotomies of the GSV valves were undergone with the adjuvant on-table balloon maturation. The distal tarsal veins underwent balloon valvotomy under direct vision with subsequent proximal and distal tarsal veins valvuloplasties. Completion angiogram demonstrated restoration of the flow in the foot and both the patients were relieved of rest pain.

We successfully performed DVAR in two elderly patients. Our experience shows that DVAR is a simple and safe option that is easily reproducible without the need for complex endovascular hardware, only if a suitable GSV to the foot is available with no history of deep vein thrombosis.
We successfully performed DVAR in two elderly patients. Our experience shows that DVAR is a simple and safe option that is easily reproducible without the need for complex endovascular hardware, only if a suitable GSV to the foot is available with no history of deep vein thrombosis.
Renal artery aneurysms (RAA) have an increased risk of rupture during pregnancy with high mortality rates for the mother and fetus. There are many reports on the treatment of ruptured RAA during pregnancy and the Society for Vascular Surgery recommends to prophylactically treat unruptured RAA of any size in women of reproductive age to limit risk of rupture during pregnancy. However, to the best of our knowledge, there is no reported case of prophylactic treatment of unruptured RAA during pregnancy.

Here we report the case of a 39-year-old G2P1 who had prophylactic endovascular coiling of an unruptured left RAA during her second trimester of pregnancy. Our case report is the first to demonstrate that unruptured RAA can be safely intervened endovascularly to prevent rupture without disrupting the pregnancy.
Here we report the case of a 39-year-old G2P1 who had prophylactic endovascular coiling of an unruptured left RAA during her second trimester of pregnancy. Our case report is the first to demonstrate that unruptured RAA can be safely intervened endovascularly to prevent rupture without disrupting the pregnancy.
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