Nellix endovascular aortic sealing endoprosthesis late explantation for concomitant type I endoleak and stent frames proximal caudal migration

Endovascular aneurysm sealing (EVAS) using the Nellix™ System was introduced in clinical practice with the aim of reducing the incidence of complications such as migration, endoleaks, and reinterventions after conventional endovascular aneurysm repair (EVAR). Although, initial efficacy data on this device have been encouraging, EVAS has also demonstrated to undergo adverse events. Herein, we report a case of Nellix graft explant due to endobags shrinkage after air bubble reabsorption leading to proximal type I A endoleak and stent migration. The focus of this article is on the importance of a more assiduous surveillance of this new device, in particular in those cases with air into the endobags immediately after the procedure; this surveillance should be aimed to timely identify complications which can otherwise lead to consequences that require open conversion

Recovery of baseline renal function after treatment for prolonged in-stent artery thrombosis, in a COVID-19 positive patient: a case report

Objective: Acute renal in-stent thrombosis is common, especially after complex endovascular treatments, or in case of risk factors such as Covid-19 infection. Irreversible renal damage occurred when the renal artery was occluded for more than 3 hours. In this case, we present a case of renal function recovery after thromboaspiration of a renal stent thrombosis for more than 72 hours. Case presentation: A 88-year-old man who tested positive for COVID-19 presented to the emergency room with dyspnea and anuria. He referred a previous complex endovascular intervention with the triple chimney technique (ChEVAR). More than 72 hours passed between the onset of symptoms to the diagnosis of acute renal intra-stent thrombosis. He underwent urgent thromboaspiration with neurovascular devices returning to his baseline renal function. Conclusion: Despite the prolonged ischemia, renal revascularization with thromboaspiration restored renal function and rescued the remaining renal parenchym

PIV measurements over a double bladed Darrieus-type vertical axis wind turbine: A validation benchmark

Vertical axis wind turbines (VAWTs) are very attractive for in-home power generation since they can be adopted even at low wind speeds and highly variable wind direction. Even if significant experimental research activity has been carried out to improve VAWTs performance, the ability to accurately reproduce flow field characteristics around turbine blades by CFD (computational fluid dynamics) techniques represents a powerful approach to further enhance wind turbines performance. Thanks to CFD, in fact, it is possible to reproduce flow characteristics with a detail level impossible to achieve by experiments. Nevertheless, in order to appropriately analyze the flow structure by CFD application, an accurate validation is essential, and high-quality measurements of some main flow characteristics are required. In recent publications the authors investigated, both experimentally and numerically, the performance of an innovative double bladed Darrieus-type VAWT, with the aim to define an optimal configuration also focusing on self-starting ability of the prototype by employing CFD technique. Nevertheless, comparison between experiments and numerical results was made only in terms of power and torque coefficient. To overcome such limitation, in this paper the authors propose an experimental benchmark case for CFD results validation, describing detailed flow field in correspondence of one pair of blades of the innovative Darrieus-type VAWT in static conditions. Measurements were performed employing Particle Image Velocimetry (PIV) technique on a scaled model of the turbine blades realized by 3D printing. An uncertainty analysis was also performed which showed a high accuracy of the obtained experimental results. The measurements of the main flow characteristics (bi-dimensional velocity components) were then used for a test case CFD validation of two different turbulence model

Can New Ultrasound Imaging Techniques Improve Breast Lesion Characterization? Prospective Comparison between Ultrasound BI-RADS and Semi-Automatic Software “SmartBreast”, Strain Elastography, and Shear Wave Elastography

Background: Ultrasound plays a crucial role in early diagnosis of breast cancer. The aim of this research is to evaluate the diagnostic performance of BI-RADS classification in comparison with new semi-automatic software Resona R9, Mindray, “SmartBreast” and strain elastography (SE), point shear wave (pSWE), and 2D shear wave (2D SWE) Elastography for breast lesion differentiation. Methods: Ninety-two breast nodules classified according to BI-RADS lexicon by an expert radiologist were evaluated by a second investigator with B-mode ultrasound, color Doppler, “SmartBreast”, and elastography. Histopathology was considered the gold standard. Results: The agreement between software and investigator was excellent in the identification of the posterior features of breast masses (Cohen’s k = 0.94), good for shape and vascular signal (Cohen’s k, respectively, of 0.6 and 0.65), poor for orientation, margins, and echo pattern (Cohen’s k, respectively, of 0.28, 0.33 and 0.48), moderate for dimensions (Lin’s correlation coefficient of 0.90, p = 0.07). SE showed a greater area under curve (AUC) than pSWE and 2D SWE (0.84, 0.64, and 0.61, respectively), with a greater specificity and a comparable sensitivity to pSWE (respectively, of 0.86 and 0.55, 0.81 and 0.84). Conclusions: SE improved the diagnostic performance of BI-RADS classification more than pSWE and 2D SWE; “SmartBreast” showed good agreement only for shape and vascularization but not for the other ultrasound features of breast lesions

Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture

First-line therapy of acute ischemic stroke is intravenous thrombolysis (IVT) irrespective of etiology. We report on a patient with acute ischemic stroke secondary to carotid plaque rupture who experienced plaque thrombosis and marked clinical worsening despite IVT. While the latter is the gold standard therapy optimal platelets inhibition should be guaranteed to allow a safe as possible carotid intervention. Hereby we discuss all available strategies to be considered in order to better individualized treatment decision-making

Internal carotid stenosis associated with compression by hyoid bone

Atherosclerotic plaques concomitantly with the hyoid bone protrusion into the internal carotid artery (ICA) are rarely reported in the literature. These plaques can be considered as arising from the turbulent flow and the shear stress caused by the close contact between the hyoid bone and the arterial wall carotid artery. The carotid stenosis was greater than 70%. We report a patient with a transient ischemic attack and a right significant carotid artery stenosis presumably due to a compression of an elongated ICA by the hyoid bone. The patient was submitted to open surgery to remove the plaque and correct the anomalous course of ICA combined with the lysis of the arterial adhesions with the right greater horn of the hyoid bone. The hyoid bone is a remote cause of injury and subsequent atherosclerotic lesions of carotid vessels. Elongation of the carotid artery can alter its course and can favor the mechanical interference with the hyoid bone and the subsequent arterial wall damage. When an external compression of the carotid artery is viewed, the endovascular treatment of the carotid artery stenosis is not advisable and open surgery is mandatory