Ultrasound-guided percutaneous thrombin for the management of superior mesenteric artery pseudoaneurysm

Visceral aneurysms are a well-recognized and potentially fatal occurrence in the event of rupture. Endovascular occlusion using stent grafting or embolization is often favorable over high-risk open surgical repair. However, interventional mesenteric angiography may not always be feasible or successful. We present an emergency case of successful occlusion of a large peripancreatic pseudoaneurysm using a single percutaneous injection of thrombin under ultrasound guidance alone after both laparotomy and mesenteric angiography had failed to identify and control bleeding. In this case and review of the current evidence, we propose an effective alternative first-line treatment strategy in these complex patients

Indocyanine green colonic perfusion demonstration following robotic da Vinci X inferior mesenteric artery ligation for the treatment of type II endoleak

Abstract: Background: We describe the technical operative details of the robotic repair of a type II endoleak (T2E) following endovascular abdominal aortic aneurysm repair (EVAR). We demonstrate that indocyanine green (ICG) can be used intra‐operatively to demonstrate perfusion of the colon following ligation of the inferior mesenteric artery (IMA) vessel feeding the aneurysm sac. Methods: A 74‐year old male underwent EVAR for a 5.8 cm infra‐renal abdominal aortic aneurysm using an E‐Tegra, Jotec Device (JOTEC Gmb, Lotzenäcker 23,D‐72379 Hechingen). Surveillance contrast CT (CTA) over the ensuing 30 months confirmed progressive sac expansion. Results: ICG confirmed colonic perfusion via the marginals after IMA ligation. Total operative time 56 min < 50 mls blood loss and 1‐day hospital stay. 3‐month follow‐up: CTA and ultrasound demonstrated complete resolution of T2E and adequately perfused colon. Conclusion: A total robotic approach can be performed safely with intra‐operative ICG used to demonstrate colonic perfusion as an added safety measure

Does One Bad Apple Spoil the Barrel? Carry-Over Effects of Buying Disgusting Products on Consumer Search and Shopping Basket Decisions

Imagine two consumers in a supermarket: X needs to buy trash bags while Y needs to buy sandwich bags. Would you expect these consumers to behave differently during the remainder of the shopping trip? Using transactional data from the field and laboratory experiments we show that products, such as trash bags, that elicit feelings of disgust in consumers can alter how much consumers search among unrelated product categories, how much time they spend in the store as a whole, the types of products they buy, and their evaluations of the shopping experience

Measuring and Mitigating the Costs of Stockouts

There is now an extensive theoretical literature investigating optimal inventory policies for retailers. Yet several recent reviews have recognized that these models are rarely applied in practice. One explanation for the paucity of practical applications is the difficulty of measuring how stockouts affect both current and future demand. In this paper, we report the findings of a large-scale field test that measures the short- and long-run opportunity cost of a stockout. The findings confirm that the adverse impact of a stockout extends to both other items in the current order as well as future orders. We show how the findings can be used to provide input to inventory planning models and illustrate how failing to account for the long-run effects of a stockout will lead to suboptimal inventory decisions. We also demonstrate how the findings can be used in a customer lifetime value model. Finally, the study investigates the effectiveness of different responses that firms can offer to mitigate the cost of stockouts. There is considerable variation in the effectiveness of these responses. Offering discounts to encourage customers to backorder rather than cancel their orders is widely used in practice, but that was the least profitable of the responses that we evaluated. The findings have important implications for retailers considering the use of discounts as a response to stockouts.inventory, long run, stockouts