Emergent endovascular treatment of thoraco-abdominal aortic rupture in Behcet's disease

Background: Aortic rupture in Behcet’s disease is associated with high mortality rates. Endo- vascular approach with parallel graft technique can be a valid solution in emergency setting for the treatment of thoraco-abdominal aorta involvement in Behcet’s disease. Methods: We describe the clinical case of a 41-year-old man, urgently hospitalized for a rupture of thoraco-abdominal aorta with occlusion of the celiac trunk and involvement of superior mesenteric artery. The patient also presented a massive right hemothorax and a massive left pulmonary thromboembolism. An aortic endoprosthesis was deployed from the third bottom of the thoracic aorta to the origin of the renal arteries. Parallel stent-graft technique was used to preserve the patency of the superior mesenteric artery. The procedure was performed with local anaesthesia due to the critical conditions of the patient. The patient was discharged in good clin- ical conditions. Results: The angio-computed tomography performed 6 months after surgery showed good deployment of the endoprosthesis and patency of the superior mesenteric artery. Conclusion: In high risk for surgery patients, endovascular treatment with parallel stent graft of thoraco-abdominal aorta rupture is safe and feasible

Chronic venous disorders: Correlation between visible signs, symptoms, and presence of functional disease

none5siBackground: The aim of this study was to investigate the frequency of chronic venous disorders (CVD) in different demographic groups in Italy and to provide correlations between patterns of valve incompetence and clinical feature of disease severity. Methods: Advertisements in television and newspapers in 53 Italian cities were used to solicit 16,251 subjects (13,826 women, mean age 50.4 years; 2,425 men, mean age 59.1 years). They underwent a clinical examination of the lower limbs, including presence and severity of visible signs (CEAP classification), and assessment of functional disease by color-coded duplex ultrasound imaging. Results: Varicose veins and telangiectases were the most common objective signs in both men and women. Older people were more severely affected. Telangiectases were more frequent in women, and men had a higher incidence of trunk varices, trophic changes, and venous reflux. Frequency of both visible and functional venous disease increased with family history and body mass index. Presence of reflux correlated positively with increasing CEAP grade of visible disease (P for trend < .0001 for all superficial venous segments). A large number of subjects, especially women, complained of subjective symptoms in the legs, and the presence of symptoms correlated almost always positively with both worsening of visible findings (P for trend < .001) and presence of hemodynamic change in both genders. Conclusions: The frequency of reflux increased with the severity of visible signs of disease as described by the CEAP classification. In men, the occurrence of subjective symptoms was mostly correlated with functional disorders. © 2007 The Society for Vascular Surgery.Chiesa, R.; Marone, E.M.; Limoni, C.; Volontè, M.; Petrini, O.Chiesa, R.; Marone, ENRICO MARIA; Limoni, C.; Volontè, M.; Petrini, O

Aorto-iliac aneurysm associated with congenital pelvic kidney: A short series of successful open repairs under hypothermic selective renal perfusion

The occurrence of congenital pelvic kidney (cPK) during aorto-iliac aneurysm repair is an extremely unusual finding. We report a series of four patients with aorto-iliac aneurysm and associated cPK who underwent aorto-iliac repair at our institution over the last 10 years. Aorto-iliac aneurysm repair under cPK selective hypothermic perfusion was successfully accomplished in all cases. All the cPK arteries were spared and were selectively reimplanted when required. No major complications or death were reported at long-term follow-up. Open surgical repair of aorto-iliac aneurysm in patients with cPK is safe and effective and, in our short series, we observed no worsening of the renal function; besides, we reported a persistent improvement of the renal function in two out of the four cases

TCT-734 Percutaneous Implantation of Stent Grafts in the Management of Vascular Complications in Transfemoral Transcatheter Aortic Valve Implantation

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Aortoenteric fistula as a late complication of thrombolysis and bare metal stenting for perioperative occlusion of aortofemoral bypass

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Diagnostic laparoscopy for early detection of acute mesenteric ischaemia in patients with aortic dissection

Introduction: Recognition of acute mesenteric ischaemia (AMesI) in patients with aortic dissection (AoD) may be a challenge and exploratory laparotomy is often performed. Methods: We retrospectively analysed our experience with the use of diagnostic laparoscopy (DL) for the early detection of AMesI in patients with AoD, either undergoing medical treatment or after open/endovascular interventions. Results: Between 2004 and 2011, 202 consecutive AoDs were treated in our centre (71 acute type A AoD; 131 acute and chronic type B AoD). Among the 17 (8.4%) patients in which AMesI was suspected, nine (52.9%) were selected for DL. Three DLs were performed during medical treatment of patients with acute type B AoD, six after treatment of AoD (both surgical and endovascular). Three second-look DLs were also performed. Eight DLs were negative, three showed AMesI and the patients underwent successful emergent revascularisation. One DL was not conclusive and laparotomy was required. Among the eight patients not submitted to DL, one case of bowel infarction was recorded. Conclusions: In our series DL was feasible and safe. The low invasiveness and repeatability were the main advantages. Although additional experience is mandatory, DL seems a promising technique for the detection of AMesI in patients with AoD. © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Enhancing chestnut coppices: silvicultural management and socio-economic context.

 Castanea sativa is one of the most important species for timber production in Italy but, both management system, ownership type and wood chain structure, aren’t able to  enhance enough the market value of wood assortments. Although the high demand of quality timber, the internal production is heavily  reduced, mainly as far as timber quality is concerned and because of the lack of suitable timber sizes. In this context, experimental trials  have been approached to identify and verify which silvicultural methods are best suited to reach high yields depending to the investments  needed and the local socio-economical condition. Two technical approaches were evaluated: stand silviculture and single-tree oriented silviculture. As for the socio-economical aspects, a few demographic indexes have been examined and the first-phase processing enterprises  acting in the concerned area were analyzed. The goals of this paper are to evaluate the biological response to the applied silviculture, to  analyze the problems arisen and to estimate the applicability of the proposed methods in relation to the different socio-economic contexts. The research has been carried out in Tuscany in two important forest areas - Monte Amiata and Colline Metallifere - in young chestnut  coppices characterized by an homogeneous stand density and a good site index. The two examined districts showed some similarities  but they have mainly highlighted important differences about the social structure and concerns and enterprises characteristics. The area of Monte Amiata is typified by a higher residents density then the Colline Metallifere but only 1/3 of the population is employed in the agro-forest sector. In addition, in the Monte Amiata district most concerns are sized less than 2 hectares and chestnut is the main forest  species. On the contrary, in the Colline Metallifere the agro-forest sector (57% of workers) is one of the main sources of income for the  local communities and medium-sized concerns are noteworthy present. Chestnut stands have here a marginal role, oaks are dominant  and the prevailing assortment is firewood. From a silvicultural viewpoint, both the studied areas showed a quite good potentiality, suitabl

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio