Contribution to a better understanding of different behaviour patterns observed with organic coatings evaluated by electrochemical impedance spectroscopy

In the present paper, three different coatings (epoxy, alkyd, polyurethane paints) were characterized by electrochemical impedance measurements, permeability tests, free-standing film impedance and local impedance measurements. The increase in resistance with immersion time of alkyd paint was linked to the nature of the polymeric network and not to phenomena occurring at the metal/paint interface. For polyurethane paint, local impedance was not able to detect defects in the paint, which was attributed to the fact that the defects are smaller than those observed in alkyd paint and also that they are less active and homogeneously distributed through the coating. Although electrochemical impedance methods (global and local) are excellent tools to monitor the behaviour of organic coatings, these techniques alone are not sufficient to screen different paints

Aorto-left ventricular tunnel : a rare cause of heart failure in the newborn

Aorto-left ventricular tunnel is a rare congenital cardiac anomaly, consisting of a short abnormal pathway, usually from a sinus of Valsalva into the left ventricular cavity. It is usually diagnosed with echocardiography. We report a case of a newborn presenting with heart murmur and rapid progression to heart failure and left ventricular enlargement due to an aorto-left ventricular tunnel. Despite successful closure of the tunnel, the patient required a Ross procedure due to progressive aortic disease.peer-reviewe

“Mechanical thrombectomy beyond 6 hours for acute ischemic strokes due to M2 occlusions”

Publisher Copyright: © 2024 The Author(s)Background: The time frame for mechanical thrombectomy (MT) in acute ischemic stroke (AIS) is enlarging. Guidelines recommend MT until 6 h of symptom onset in M2 segment occlusions (grade IIB). In practice, it is frequently performed later. Aims: To assess the functional prognosis of AIS patients subjected to M2 segment's MT beyond 6 h, compared to standard intervention. Methods: Retrospective cohort study including all consecutive AIS patients subjected to MT of M2 occlusions between 1st January 2018 and 31st December 2020 in St Joseph's Local Health Unit, Lisbon, Portugal. Allocation to standard or extended groups was done according to the symptom-to-puncture time, whether within or beyond 6 h after symptom onset, respectively. The primary outcome was the modified Rankin Scale (mRS) at three months. Secondary outcomes were symptomatic intracranial hemorrhage (sICH) at 24 h and three-month mortality. Results: We included 155 patients, 51.0 % men, median age 76.0 years (P25:69.0;P75:86.0), baseline mRS “0-2” in 84.5 %, mean NIHSS 13.6(6.5). Initial Computed Tomography showed early ischemic changes in 27.1 %. Most patients belonged to the standard group (71.0 %). Groups had similar baseline features. The standard group underwent more frequent (68.2 % vs 44.4 %, p = 0.006) and earlier (2 h02 min, 3 h02 min, p < 0.001) fibrinolysis. Symptom-to-puncture times were 7 h13 min (extended) and 4h01 min (standard), p < 0.001. Outcomes were similar between groups (three months’ mRS [p = 0.578]; sICH [p = 0.720]; three-month mortality [p = 0.422]). Conclusions: Our study suggests similar outcomes in M2 occlusions performing MT before and beyond 6 h of symptom onset, consistent with previous studies. Patients might benefit from widening inclusion criteria for MT in AIS.publishersversionpublishe

Initial Experience of a TAVI Program: Analysis of the Anesthetic Decision and its Evolution

Introduction: Transcatheter aortic valve implantation is a less invasive option for aortic valve replacement. The number of transcatheter aortic valve implantations under local anesthesia with sedation has been increasing as the team’s experience increases and less invasive accesses are used. The aim of this study is to describe the evolution of the anesthetic technique in patients undergoing transcatheter aortic valve implantation at our center over the years, as which was compared. Material and Methods: Retrospective study in 149 consecutive patients undergoing transcatheter aortic valve implantation in Hospital Santa Marta (January 2010 to December 2016). Data was collected from the periprocedural records of patients. Patients were stratified according to anesthetic technique. Results: From our patients’ sample, 57.0% were female, with median age 82 [58 - 95] years. Most patients underwent general anesthesia (68.5%). In the local anesthesia with sedation group there was a shorter duration of the procedure (120; [60 - 285] vs 155 [30 - 360]) and a lower number of patients requiring administration of vasopressors (61.8% vs 28.3%) – p 0.05. There was an increasing number of transcatheter aortic valve implantations performed under local anesthesia with sedation over the years. Discussion: The choice of anesthetic technique depends on the patient’s characteristics, experience and preference of the team. Conclusion: Local anesthesia with sedation seems to be associated with similar results as general anesthesia. The increase in the number of transcatheter aortic valve implantations under local anesthesia with sedation seems to follow the trend of lower invasiveness of the procedure

EnDovascular therapy plus best medical treatment (BMT) versus BMT alone for medIum distal veSsel occlusion sTroke (DISTAL): An international, multicentre, randomized-controlled, two-arm, assessor-blinded trial

Ischemic stroke; Distal vessel occlusion; Endovascular therapyIctus isquèmic; Oclusió del vas distal; Teràpia endovascularIctus isquémico; Oclusión del vaso distal; Terapia endovascularRationale: Whether endovascular therapy (EVT) in addition to best medical treatment (BMT) in people with acute ischemic stroke (AIS) due to a medium distal vessel occlusion (MDVO) is beneficial remains unclear. Aim: To determine if people experiencing an AIS due to an isolated MDVO (defined as the co- or non-dominant M2 segment, the M3 or M4 segment of the middle cerebral artery, the A1, A2, or A3 segment of the anterior cerebral artery or the P1, P2 or P3 segment of the posterior cerebral artery) will have superior outcome if treated with EVT in addition to BMT compared to BMT alone. Sample size: To randomize 526 participants 1:1 to EVT plus BMT or BMT alone. Methods and design: A multicentre, international, prospective, randomized, open-label, blinded-endpoint (PROBE) superiority trial. Outcomes: The primary efficacy endpoint is the distribution of disability levels on the modified Rankin Scale at 90 days. Secondary clinical efficacy outcomes include normalized change in National Institutes of Health Stroke Scale score from baseline to day 1, cognitive outcome at 90 days, and health-related quality of life at 90 days. Safety outcomes include all serious adverse events, symptomatic intracranial hemorrhage within 24 h, and all-cause mortality up to 90 days. Secondary imaging outcomes include successful reperfusion at end of EVT procedure and recanalization of target artery at 24 h. Discussion: DISTAL will inform physicians whether EVT in addition to BMT in people with AIS due to a MDVO is more efficacious than BMT alone.The trial is supported by public grants from the Swiss National Science Foundation (SNSF grant number 33IC30_198783) and the Gottfried und Julia Bangerter-Rhyner-Stiftung (Basel, Switzerland) as well as through unrestricted grants from Stryker Neurovascular Inc., Medtronic Inc., Phenox GmbH, Rapid Medical Inc., and Penumbra Inc

Usefulness of TNFR1 as biomarker of intracranial aneurysm in patients with spontaneous subarachnoid hemorrhage

To determine the utility of TNF-α receptor (TNFR1) as a biomarker for the presence of aneurysms in patients with acute subarachnoid hemorrhage (SAH). This is a prospective study in patients with acute spontaneous SAH. Arterial blood from catheter near aneurysm and peripheral venous blood samples are collected. TNFR1 levels were analyzed in patients with and without aneurysm. 80 patients were included, 58 were analyzed. 41 patients (70.7%) had an aneurysm. Venous TNFR1 levels >1658 pg/ml had 46.3% sensitivity and 94.1% specificity for aneurysms presence. TNFR1 >1658 pg/ml was also an independent predictor for its presence (odds ratio = 12.03 [1.13–128.16]; p = 0.039). High levels of TNFR1 in peripheral venous blood are associated with the presence of aneurysm in patients with acute SAH. Subarachnoid hemorrhage (SAH) is a neurological emergency, in many cases caused by the rupture of a cerebral aneurysm. Usually aneurysms are detected in imaging tests, but sometimes they can be very small and go unnoticed. TNF-α is an inflammatory biomarker related to the presence and rupture of intracranial aneurysms and its receptor, TNFR1, could be detected in peripheral blood. This study demonstrates that elevated peripheral blood TNFR1 values are related to the presence of intracranial aneurysms in patients with acute subarachnoid hemorrhage. Following further research, it could become a useful tool for detecting small aneurysms in addition to conventional imaging tests

Examining gender bias across different training access routes in Europe

Publisher Copyright: © The Author(s) 2025.Background/purpose: Gender bias in academic medicine has been widely described. In Europe, training and career pathways in neurointervention (NI) are heterogeneous. We hypothesize that the access route to neuroradiology specialty and NI subspecialty may correlate with the proportion of women in the field and with their career progression. Methods: An online survey consisting of 18 questions was distributed through European professional societies and several online social platforms. A total of 422 responses from 54 different countries were collected and statistically evaluated. Results: Access routes to specialty and subspecialty did not correlate with the number of women practicing NI. However, men were significantly more likely to have children, to occupy leading positions, to have more clinical experience and higher weekly workload both in diagnostic and interventional neuroradiology. Female gender significantly affected career progression. Conclusion: This study reflects a positive change in European reality concerning gender bias. Distinct training access routes do not seem to affect the proportion of female neurointerventionalists. However, gender differences still negatively impact women NI careers, leading to lower workload, having less children, and a limited access to leading positions in NI.publishersversioninpres

Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery : A systematic review and meta-analysis

Background and purpose Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study-level meta-analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke. Methods We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0-2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH). Results Twelve studies with a total of 679 patients were included in the meta-analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83-70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35-55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30-20.93) and 12.3% (95% CI 8.64-17.33). sICH occurred in 4.2% (95% CI 2.47-7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75-5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences. Conclusions Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.Peer reviewe