Имитационное моделирование технологии управления процессом производства

Предложено использование комплекса имитационного моделирования для получения информации при контроле функционирования и управлении технологическим процессом производства.Запропоновано використання комплексу імітаційного моделювання для одержання інформації при контролюванні функціонування та управління технологічним процесом виробництва.Complex of simulation modeling for obtaining information when checking an operation and control of technological process of production is offered to use

Bare metal stents for treatment of extracranial internal carotid artery aneurysms : Long-term results

Purpose: To examine the long-term outcomes of bare metal stent placement for exclusion of extracranial internal carotid artery (ICA) aneurysms. Methods: From 2006 to 2011, 7 consecutive symptomatic patients (4 men; mean age 52 years) with surgically inaccessible extracranial ICA aneurysms were treated with a bare stent at a single center. Patients received clopidogrel for 3 months after the procedure and aspirin for life. Clinical follow-up with duplex ultrasound and/or computed tomographic angiography was performed at 3, 6, and 12 months and yearly thereafter. Results: All procedures were technically successful; no neurological complications occurred. After 6 months, there was complete thrombosis of the aneurysm in all except one case. In this asymptomatic patient, the residual active flow was successfully obliterated by additional coil embolization. Over a mean follow-up of 57±22 months, all patients were alive and free of local or central neurological symptoms. All stents were patent, and thrombosis of the aneurysms was complete. Conclusion: In this small series, treatment of extracranial ICA aneurysms with a bare stent seems technically feasible and safe. All treated extracranial ICA aneurysms were excluded by primary intervention or secondary coil embolization

Aneurysm characteristics.

<p>Aneurysm characteristics.</p

Histology of control sample: fibrous cap atheroma.

<p>Histology of control sample. Sample taken just distal from the bifurcation. Elastin-van Giesson (EvG) stain. In black the elastic fibers are clearly present and well organized. Atherosclerotic changes, atheroma with a lipid core. E, Elastin; Lip, Lipid core; Lum ext., lumen of the external carotid artery; Lum int., lumen of the internal carotid artery.</p

In vivo aneurysm.

<p>Aneurysm of a left saccular carotid artery visible between the internal carotid artery (ICA) and the external carotid artery (ECA) and originating from a dorsal loop in the ICA. The common carotid artery is ligatured in red, the ECA is identified with transparent ligatures. A, aneurysm of the ICA; BIF, carotid bifurcation; H, nervus hypoglossus; S, suture; VL, vessel loop.</p

Histology of carotid aneurysms.

<p>A-D, dissection; E and F, degeneration. A, overview of aneurysm due to dissection. Elastin-van Giesson (EvG) stain. Bar = 1.5 mm. B, higher magnification of the same staining as A. Arrow indicates the disrupted internal elastic lamina. Bar = 500 μm. C, Hematoxylin and eosin staining of the same panel as B. m, media; t, organized thrombus that replaces the absent media. Bar = 500 μm. D, CD34 immunostain showing endothelial coverage of the thrombus (in brown). Bar = 250 μm. E, overview of an aneurysm due to degeneration. Elastin-van Giesson (EvG) stain. Bar = 4 mm. F, higher magnification of the same staining as E. In black remnants of the elastic fibers of the media. Bar = 1 mm.</p

Patient characteristics.

<p>Patient characteristics.</p

Rationale and design of the extracranial Carotid artery Aneurysm Registry (CAR)

Background: Aneurysms of the extracranial carotid artery (ECAA) are rare. Although most ECAA are identified in asymptomatic patients, serious neurological complications may occur. Current literature on treatment outcome contains mainly case reports and small case series with incomplete data and lack of long-term follow-up. There is clear lack on natural follow-up data, and there is no clear treatment algorithm. An international web-based registry to collect data on patients with ECAAis designed to provide clinical guidance on this scarce pathology. Methods: The Carotid Aneurysm Registry (CAR) is open for inclusion of all patients with a fusiform or saccular ECAA. Patients with primary or secondary ECAA can be enrolled in CAR independent of the type of treatment (conservative or invasive). CAR participation does not interfere with the local physician's treatment policy. Follow-up and imaging can also be scheduled according to local clinical practice. The primary endpoint of the CAR in conservative patients is occurrence of symptoms related to the aneurysm at 30 days, one, three, and five years. The primary endpoint in invasively treated patients is freedom from symptoms of the aneurysm at 30 days, one, three, and five years. Results: Analyses will relate outcome to etiology, imaging characteristics, ECAA growth patterns, and (if applicable) revascularization technique applied. The aim of the registry is to prospectively collect follow-up data on patients with an ECAA, being either treated conservatively or by invasive aneurysm exclusion strategies. The CAR database will be used to address diagnostic and therapeutic research questions. Conclusions: Collecting and analyzing the data gained from the registry could be the first step towards development of treatment guidelines and expert consensus for the management of ECAA