Editor's Choice - Treatment of Aortic Prosthesis Infections by Graft Removal and In Situ Replacement with Autologous Femoral Veins and Fascial Strengthening

Introduction: Aortic prosthetic graft infection (AGI) is a major challenge in vascular surgery. Eradicating the. infection requires prosthetic material removal, debridement, and lower limb revascularization. For the past 15 years, we have used femoral veins for aorto-iliac reconstruction and tensor fascia lata to strengthen the upper anastomosis. Objective: The purpose of this single institution retrospective study is to present results regarding in situ replacement of infected aortic grafts with autologous femoral veins (FVs). Methods: From October 2000 to March 2013, patients treated for AGI with graft removal and autologous FV reconstruction at Helsinki University Hospital were included. Primary outcome measures were 30 day mortality, long-term treatment related mortality, and re-infection rate. Secondary outcome measures were long-term all cause mortality and event free survival (graft rupture, re-intervention, major amputation). Results: During a 13 year period 55 patients (42 male, 13 female) were operated on using a venous neo-aorto-iliac system for AGI. The mean follow up was 32 months (1-157 months). The 30 day mortality rate was 9% (5) and overall treatment related mortality 18% (10). All cause mortality during follow up was 22 (40%) and overall Kaplan-Meier survival was 90.7% at 30 days, 81.5% at 1 year, and 59.3% at 5 years. Graft rupture occurred in three (5%) cases, two of which were caused by graft re-infection. (4%). Four patients required major amputation, one of them on arrival and three (5%) during the post-operative period. Nine (16%) patients needed interventions for the vein graft, and two graft limbs occluded during follow up. Conclusion: In situ reconstruction for aortic graft infection with autologous FV presents acceptable rates of morbidity and mortality, and remains the treatment of choice for AGI at Helsinki University Hospital. (C) 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Efficiency of thermal outgassing for tritium retention measurement and removal in ITER

Proceedings of the 22nd International Conference on Plasma Surface Interactions 2016, 22nd PSIAs a licensed nuclear facility, ITER must limit the in-vessel tritium (T) retention to reduce the risks of potential release during accidents, the inventory limit being set at 1kg. Simulations and extrapolations from existing experiments indicate that T-retention in ITER will mainly be driven by co-deposition with beryllium (Be) eroded from the first wall, with co-deposits forming mainly in the divertor region but also possibly on the first wall itself. A pulsed Laser-Induced Desorption (LID) system, called Tritium Monitor, is being designed to locally measure the T-retention in co-deposits forming on the inner divertor baffle of ITER. Regarding tritium removal, the baseline strategy is to perform baking of the plasma-facing components, at 513K for the FW and 623K for the divertor. Both baking and laser desorption rely on the thermal desorption of tritium from the surface, the efficiency of which remains unclear for thick (and possibly impure) co-deposits. This contribution reports on the results of TMAP7 studies of this efficiency for ITER-relevant deposits.Peer reviewe

Long-term fuel retention and release in JET ITER-Like Wall at ITER-relevant baking temperatures

The fuel outgassing efficiency from plasma-facing components exposed in JET-ILW has been studied at ITER-relevant baking temperatures. Samples retrieved from the W divertor and Be main chamber were annealed at 350 and 240 degrees C, respectively. Annealing was performed with thermal desoprtion spectrometry (TDS) for 0, 5 and 15 h to study the deuterium removal effectiveness at the nominal baking temperatures. The remained fraction was determined by emptying the samples fully of deuterium by heating W and Be samples up to 1000 and 775 degrees C, respectively. Results showed the deposits in the divertor having an increasing effect to the remaining retention at temperatures above baking. Highest remaining fractions 54 and 87% were observed with deposit thicknesses of 10 and 40 mu m, respectively. Substantially high fractions were obtained in the main chamber samples from the deposit-free erosion zone of the limiter midplane, in which the dominant fuel retention mechanism is via implantation: 15 h annealing resulted in retained deuterium higher than 90%. TDS results from the divertor were simulated with TMAP7 calculations. The spectra were modelled with three deuterium activation energies resulting in good agreement with the experiments.Peer reviewe

Thermal desorption spectrometry of beryllium plasma facing tiles exposed in the JET tokamak

Corrigendum: 10.1016/j.fusengdes.2018.08.007.The phenomena of retention and de-trapping of deuterium (D) and tritium (T) in plasma facing components (PFC) and supporting structures must be understood in order to limit or control total T inventory in larger future fusion devices such as ITER, DEMO and commercial machines. The goal of this paper is to present details of the thermal desorption spectrometry (TDS) system applied in total fuel retention assessment of PFC at the Joint European Torus (JET). Examples of TDS results from beryllium (Be) wall tile samples exposed to JET plasma in PFC configuration mirroring the planned ITER PFC is shown for the first time. The method for quantifying D by comparison of results from a sample of known D content was confirmed acceptable. The D inventory calculations obtained from Ion Beam Analysis (IBA) and TDS agree well within an error associated with the extrapolation from very few data points to a large surface area.Peer reviewe

Investigation of deuterium trapping and release in the JET ITER-like wall divertor using TDS and TMAP

Selected set of samples from JET ITER-Like Wall (JET-ILW) divertor tiles exposed both in 2013–2014 and 2011–2014 has been analysed using Thermal Desorption Spectrometry (TDS). The deuterium (D) amounts obtained with TDS were compared with Ion Beam Analysis (IBA) and Secondary Ion Mass Spectrometry (SIMS) data. The highest amount of D was found on the top part of inner divertor which has regions with the thickest deposited layers. This area resides deep in the scrape-off layer. Changes in plasma configurations between the first (2011–2012) and the second (2013–2014) JET-ILW campaign altered the material migration towards the inner and the outer divertor corner increasing the amount of deposition in the shadowed areas of the divertor base tiles. D retention on the outer divertor tiles is clearly smaller than on the inner divertor tiles. Experimental TDS spectra for samples from the top part of inner divertor and from the outer strike point region were modelled using TMAP program. Experimental deuterium profiles obtained with SIMS have been used and the detrapping and the activation energies have been adjusted. Analysis of the results of the TMAP simulations enabled to determine the nature of traps in different samples.Peer reviewe

Beryllium melting and erosion on the upper dump plates in JET during three ITER-like wall campaigns

Data on erosion and melting of beryllium upper limiter tiles, so-called dump plates (DP), are presented for all three campaigns in the JET tokamak with the ITER-like wall. High-resolution images of the upper wall of JET show clear signs of flash melting on the ridge of the roofshaped tiles. The melt layers move in the poloidal direction from the inboard to the outboard tile, ending on the last DP tile with an upward going waterfall-like melt structure. Melting was caused mainly by unmitigated plasma disruptions. During three ILW campaigns, around 15% of all 12376 plasma pulses were catalogued as disruptions. Thermocouple data from the upper dump plates tiles showed a reduction in energy delivered by disruptions with fewer extreme events in the third campaign, ILW-3, in comparison to ILW-1 and ILW-2. The total Be erosion assessed via precision weighing of tiles retrieved from JET during shutdowns indicated the increasing mass loss across campaigns of up to 0.6 g from a single tile. The mass of splashed melted Be on the upper walls was also estimated using the high-resolution images of wall components taken after each campaign. The results agree with the total material loss estimated by tile weighing (similar to 130 g). Morphological and structural analysis performed on Be melt layers revealed a multilayer structure of re-solidified material composed mainly of Be and BeO with some heavy metal impurities Ni, Fe, W. IBA analysis performed across the affected tile ridge in both poloidal and toroidal direction revealed a low D concentration, in the range 1-4 x 10(17) D atoms cm(-2).Peer reviewe

Comparative study of deuterium retention and vacancy content of self-ion irradiated tungsten

Self-ion irradiation of pure tungsten with 2 MeV W ions provides a way of simulating microstructures generated by neutron irradiation in tungsten components of a fusion reactor. Transmission electron microscopy (TEM) has been used to characterize defects formed in tungsten samples by ion irradiation. It was found that tungsten irradiated to 0.85 dpa at relatively low temperatures develops a characteristic microstructure dominated by dislocation loops and black dots. The density and size distribution of these defects were estimated. Some of the samples exposed to self-ion irradiation were then implanted with deuterium. Thermal Desorption Spectrometry (TDS) analysis was performed to estimate the deuterium inventory as a function of irradiation damage and deuterium release as a function of temperature. Increase of inventory with increasing irradiation dose followed by slight decrease above 0.1 dpa was found. Application of Positron Annihilation Spectroscopy (PAS) to self-irradiated but not deuterium implanted samples enabled an assessment of the density of irradiation defects as a function of exposure to highenergy ions. The PAS results show that the density of defects saturates at doses in the interval from 0.085 to 0.425 displacements per atom (dpa). These results are discussed in the context of recent theoretical simulations exhibiting the saturation of defect microstructure in the high irradiation exposure limit. The saturation of damage found in PAS agrees with the simulation data described in the paper. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )Peer reviewe

Investigation of deuterium trapping and release in the JET divertor during the third ILW campaign using TDS

Selected set of samples from JET ITER-Like Wall (JET-ILW) divertor tiles exposed in 2015-2016 has been analysed using Thermal Desorption Spectrometry (TDS). The deuterium (D) amounts obtained with TDS were compared with Nuclear Reaction Analysis (NRA). The highest amount of D was found on the top part of inner divertor which has regions with the thickest deposited layers as for divertor tiles removed in 2014. This area resides deep in the scrape-off layer and plasma configurations for the second (ILW-2, 2013-2014) and the third (ILW-3, 2015-2016) JET-ILW campaigns were similar. Agreement between TDS and NRA is good on the apron of Tile 1 and on the upper vertical region whereas on the lower vertical region of Tile 1 the NRA results are clearly smaller than the TDS results. Inner divertor Tile 3 has somewhat less D than Tiles 0 and 1, and the D amount decreases towards the lower part of the tile. The D retention at the divertor inner and outer corner regions is not symmetric as there is more D retention poloidally at the inner than at the outer divertor corner. In most cases the TDS spectra for the ILW-3 samples are different from the corresponding ILW-2 spectra because HD and D-2 release occurs at higher temperatures than from the ILW-2 samples indicating that the low energy traps have been emptied during the plasma operations and that D is either in the energetically deep traps or located deeper in the sample.Peer reviewe

Gyrokinetic analysis and simulation of pedestals to identify the culprits for energy losses using 'fingerprints'

Fusion performance in tokamaks hinges critically on the efficacy of the edge transport barrier (ETB) in suppressing energy losses. The new concept of 'fingerprints' is introduced to identify the instabilities that cause transport losses in the ETBs of many of today's experiments, from among widely posited candidates. Analysis of the gyrokinetic-Maxwell equations and gyrokinetic simulations of experiments reveals that each mode type produces characteristic ratios of transport in the various channels: density, heat, and impurities. This, together with experimental observations of transport in some channel or of the relative size of the driving sources of channels, can identify or determine the dominant modes causing energy transport. In multiple H-mode cases with edge-localized modes that are examined, these fingerprints indicate that magnetohydrodynamic (MHD)-like modes are apparently not the dominant agent of energy transport; rather, this role is played by micro-tearing modes (MTMs) and electron temperature gradient (ETG) modes, and in addition, possibly by ion temperature gradient/ trapped electron modes (ITG/TEM) on JET (Joint European 'Torus). MHD-like modes may dominate the electron particle losses. Fluctuation frequency can also be an important means of identification, and is often closely related to the transport fingerprint. The analytical arguments unify and explain previously disparate experimental observations on multiple devices, including DIII-D, JET, and ASDEX-U. Detailed simulations of two DIII-D ETBs also demonstrate and corroborate this.Peer reviewe