Stent fracture, an incidental finding or a significant marker of clinical in-stent restenosis?

BACKGROUND: The predictors and clinical significance for stent fracture (SF) in drug-eluting stents (DES) remain unknown. We identified procedural factors leading to SF and its clinical consequences in DES. METHODS: Percutaneous coronary interventions were performed on 3,920 patients with DES over 12 months. In-stent restenosis (ISR) of DES was observed in 188 cases with 121 cases (64.4%) receiving a sirolimus-eluting stent (SES) and 67 (35.6%) a paclitaxol-eluting stent (PES). RESULTS: SF was identified in 35 (18.6%) of the 188 cases. The 35 cases were then compared with 153 cases of ISR without angiographic evidence of SF. SF was identified in 29 (23.9%) SES compared with 6 (9.0%) in PES (P \u3c 0.05). With univariate analysis, additional factors associated with SF included longer mean stented segment length, male gender, overlapping stents, vessel segment angulation \u3e75 degrees , and more stents (all P \u3c 0.05). With multivariate adjustment, three factors, i.e., stenting on a bend \u3e75 degrees (OR = 13.8, 95%CI 3.7 to 51; P \u3c 0.001), SES (OR = 4.1, 95%CI 1.3 to 13.4; P \u3c 0.018) and overlapping stented segments (OR = 3.9, 95%CI 1.1 to 14.1; P \u3c 0.041) were statistically significant independent predictors of SF while larger stent diameter was protective (OR = 0.14, 95%CI 0.04 to 0.70; P \u3c 0.017). CONCLUSION: SF proved to be associated with angiographically-documented clinical ISR. Although the exact mechanism is unknown, factors that appear to play a negative role in SF include vessel tortuosity, use of SES and overlapping stents. Larger stent diameter was protective. Further studies are needed to better define the factors important in the mechanism of SF

Endovascular intervention of aortoiliac occlusive disease in high-risk patients using the kissing stents technique: long-term results

Endovascular intervention deploying a kissing stents (KS) technique has been used as an alternative to surgical intervention in treating symptomatic aortoiliac occlusive disease. However, the long-term results on high-risk patients are unknown. We retrospectively analyzed data on high-risk patients who underwent endovascular intervention using the KS technique at our institution. Fifty high-risk patients aged 62 +/- 6.4 years with severe aortoiliac stenosis underwent stent-supported angioplasty using the KS technique. Thirty percent of the patients had total occlusion of the distal aorta and/or the iliac arteries. Twelve patients received thrombolytics prior to stenting. The procedure was successful in all 50 patients. There was a 4% acute complication rate (distal embolization). However, there were no vascular complications, myocardial infarction, or perioperative death. Primary patency during follow-up of 20 +/- 12.3 months was 92%, while secondary patency rate was 100%. Amputation-free survival was 100%. Ninety-two percent remained free of lifestyle-limiting claudication

Green Communication in IoT Networks Using a Hybrid Optimization Algorithm

There has been a huge surge in the Internet of Things (IoT) applications in recent years. The sensor nodes in the IoT network generate data continuously that directly affects the longevity of the network. Even though the potential of IoT applications are immense, there are numerous challenges like security, privacy, load balancing, storage, heterogeneity of devices, and energy optimization that have to be addressed. Of those, the energy utilization of the network is of importance and has to be optimized. Several factors like residual energy, temperature, the load of Cluster Head (CH), number of alive nodes, and cost function affect the energy consumption of sensor nodes. In this paper, a hybrid Whale Optimization Algorithm-Moth Flame Optimization (MFO) is designed to select optimal CH, which in turn optimizes the aforementioned factors. The performance of the proposed work is then evaluated with existing algorithms with respect to the energy-specific factors. The results obtained prove that the proposed method outperforms existing approaches

A Novel PCA-Firefly Based XGBoost Classification Model for Intrusion Detection in Networks Using GPU

The enormous popularity of the internet across all spheres of human life has introduced various risks of malicious attacks in the network. The activities performed over the network could be effortlessly proliferated, which has led to the emergence of intrusion detection systems. The patterns of the attacks are also dynamic, which necessitates efficient classification and prediction of cyber attacks. In this paper we propose a hybrid principal component analysis (PCA)-firefly based machine learning model to classify intrusion detection system (IDS) datasets. The dataset used in the study is collected from Kaggle. The model first performs One-Hot encoding for the transformation of the IDS datasets. The hybrid PCA-firefly algorithm is then used for dimensionality reduction. The XGBoost algorithm is implemented on the reduced dataset for classification. A comprehensive evaluation of the model is conducted with the state of the art machine learning approaches to justify the superiority of our proposed approach. The experimental results confirm the fact that the proposed model performs better than the existing machine learning models

Effect of electrical stimulation on arteriogenesis and angiogenesis after bilateral femoral artery excision in the rabbit hind-limb ischemia model

The effects of electrical stimulation (ES) on arteriogenesis (the opening of preexisting collaterals) and angiogenesis (formation of new capillaries) were studied after acute bilateral hind limb ischemia was induced via bilateral femoral artery excision in a rabbit model. The study evaluated the rabbit hind limbs\u27 normal response to acute ischemia and to application of ES by calculating changes in arterial and capillary densities. Comparisons were made with our prior study, in which the femoral artery was unilaterally excised, as we attempted to expand on the topics of arteriogenesis and angiogenesis. Twelve adult New Zealand white rabbits were randomly assigned to 1 of 2 series. In Series 1, the control group, both femoral arteries were excised and no ES was applied. In Series 2, both femoral arteries were excised and ES was applied to the left limb. One lead was implanted into the left adductor muscle near the site of the excised left femoral artery (Series 2), and a stimulator (Thera, Medtronic, Inc, Minneapolis, MN) was implanted in a separate pocket. ES was applied at a rate of 3 V, 30 contractions per minute, beginning immediately after surgery and continuously for 1 month. Angiography was performed in all 12 rabbits 1 month after surgery to establish the anatomy of the collateral vessels and to demonstrate that the femoral artery stump continued to be an end artery. Contrast-opacified arteries (COAs) that crossed the grid\u27s midline, and the total number of grid lines intersected by COAs, were tallied according to an established method. Capillary density was calculated as the number of capillaries per square millimeter of muscle. In Series 1, after 1 month, the number of COAs crossing the grid\u27s midline was 4.5 +/-1.5 on the left and 4.8 +/-1.2 on the right side. In Series 2, the number of COAs crossing the grid\u27s midline was 7.9 +/-1.8 on the left side (