Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma as a Bridge to Liver Transplantation: A Retrospective Study

Background. Transcatheter arterial lipiodol chemoembolization (TACE) can be used in cirrhotic patients with hepatocellular carcinoma to avoid tumor progression before transplantation. Objective. To evaluate the efficacy and safety of TACE used as a bridge to liver transplantation. Methods. TACE was performed in 30 cirrhotic patients with hepatocellular carcinoma. Milan criteria were used to select patients for transplant. Patients had a good or moderately impaired liver function, no arterioportal fistulae, and a good portal perfusion. Results. 48 TACE were performed in 30 patients. Before transplantation, 4 patients were dropped off the list due to tumor extension or liver failure. Complete necrosis of the tumor was observed in 11 patients and partial necrosis in 15 patients. After transplantation, 6 patients died and tumor recurrence was observed in 5 patients with a tumor beyond Milan criteria or no response to TACE. Conclusion. TACE is useful as a bridge to liver transplantation in a selected group of cirrhotic patients with hepatocellular carcinoma. A combined therapeutic approach before surgery might improve the prognosis in these patients

Femtosecond laser inscription of depressed cladding single-mode mid-infrared waveguides in sapphire

Mid-infrared optical waveguides were inscribed in sapphire with femtosecond pulses at 515 nm. We show that such pulses induce a smooth negative refractive index change allowing for the inscription of a depressed cladding waveguide by closely overlapping the corresponding type I modification traces. The resulting structure consists of a highly symmetrical, uniform, and homogeneous waveguide. The size and numerical aperture of the waveguides were tailored to achieve efficient transmission in the mid-infrared. Single mode operation at a wavelength of 2850 nm and propagation loss of <0.37  dB/cm are reported for a 33 mm long depressed cladding waveguide. Thermal annealing was performed, and the refractive index contrast was still preserved to 50% (i.e., Δ=∼2.5×10−3) up to 1400°C

Direct inscription of on-surface waveguides in polymers using a mid-ir fiber laser

A detailed study of photo-inscribed optical waveguides in PMMA and polycarbonate using a mid-IR laser is presented. The wavelength of the laser is tuned near the absorption peaks of stretching C-H molecular bonds and the focused beam is scanned onto the surface of planar polymer samples. For the first time, we report the formation of optical waveguides in both polymers through resonant absorption of the laser beam. The optical properties of the waveguides were thoroughly assessed. An elliptic Gaussian mode is guided at the surface of both polymers. Insertion losses of 3.1 dB for a 30 mm long on-surface waveguide inscribed in PMMA were recorded. Such waveguides can interact with the external medium through evanescent coupling. As a proof of concept, the surface waveguides are used as highly sensitive refractometric sensors. An attenuation dynamical range of 35 dB was obtained for a liquid that matches the index of the PMMA substrate. Our results pave the way for large scale manufacturing of low cost biocompatible photonic devices

Nonlinear increase, invisibility, and sign inversion of a localized fs-laser-induced refractive index change in crystals and glasses

Multiphoton absorption via ultrafast laser focusing is the only technology that allows a three-dimensional structural modification of transparent materials. However, the magnitude of the refractive index change is rather limited, preventing the technology from being a tool of choice for the manufacture of compact photonic integrated circuits. We propose to address this issue by employing a femtosecond-laser-induced electronic band-gap shift (FLIBGS), which has an exponential impact on the refractive index change for propagating wavelengths approaching the material electronic resonance, as predicted by the Kramers–Kronig relations. Supported by theoretical calculations, based on a modified Sellmeier equation, the Tauc law, and waveguide bend loss calculations, we experimentally show that several applications could take advantage of this phenomenon. First, we demonstrate waveguide bends down to a submillimeter radius, which is of great interest for higher-density integration of fs-laser-written quantum and photonic circuits. We also demonstrate that the refractive index contrast can be switched from negative to positive, allowing direct waveguide inscription in crystals. Finally, the effect of the FLIBGS can compensate for the fs-laser-induced negative refractive index change, resulting in a zero refractive index change at specific wavelengths, paving the way for new invisibility applications

Treatment of mycotic superior mesenteric vein pseudoaneurysm via placement of covered endovascular stent

Vascular pseudoaneurysms are a rare yet life-threatening complication of untreated pancreatic pseudocysts related to their high risk of rupture and bleeding. Several studies and reports have established endovascular approaches as a successful first-line therapy in the management of arterial pancreatic pseudoaneurysms. However, no reports have been published describing endovascular repair of a venous pseudoaneurysm that developed after infection of a chronically stable pancreatic pseudocyst, most likely due to its rare occurrence. We report in this technical note the treatment of a superior mesenteric vein pseudoaneurysm that developed as a result of an infected small pancreatic pseudocyst, by radiologic placement of a covered endovascular stent

Enhancing Evanescent Wave Coupling of Near-Surface Waveguides with Plasmonic Nanoparticles

Evanescent field excitation is a powerful means to achieve a high surface-to-bulk signal ratio for bioimaging and sensing applications. However, standard evanescent wave techniques such as TIRF and SNOM require complex microscopy setups. Additionally, the precise positioning of the source relative to the analytes of interest is required, as the evanescent wave is critically distance-dependent. In this work, we present a detailed investigation of evanescent field excitation of near-surface waveguides written using femtosecond laser in glass. We studied the waveguide-to-surface distance and refractive index change to attain a high coupling efficiency between evanescent waves and organic fluorophores. First, our study demonstrated a reduction in sensing efficiency for waveguides written at their minimum distance to the surface without ablation as the refractive index contrast of the waveguide increased. While this result was anticipated, it had not been previously demonstrated in the literature. Moreover, we found that fluorescence excitation by waveguides can be enhanced using plasmonic silver nanoparticles. The nanoparticles were also organized in linear assemblies, perpendicular to the waveguide, with a wrinkled PDMS stamp technique, which resulted in an excitation enhancement of over 20 times compared to the setup without nanoparticles

Modified astigmatic beam technique for laser writing

International audienceThe ultrafast laser writing of optical waveguides and devices is increasingly ubiquitous among the photonics community, mostly for its flexibility and three-dimensional fabrication capability. The well-known astigmatic beam technique is the simplest method to inscribe near-circular cross-section waveguides. In this paper, we report on a significant enhancement to the widely used astigmatic beam technique that makes it more flexible and yields a more circular waveguide cross section. By simply superposing a long-focus lens before the laser inscription objective lens, we demonstrate that the normalized squared radial deviation from a perfectly circular waveguide cross section can be reduced to 0.1 typically obtained using the standard astigmatic beam technique, or > 0.7 with a Gaussian beam. The modified technique also makes it easy to use the full power delivered by the laser, which is not usually the case with the standard technique. A technique to optimize the waveguide shape prior to the inscription by in situ laser-induced plasma emission imaging is also discussed