Valve Migration Into the Left Ventricular Outflow Tract Managed by Coaxial Double-Valve Alignment

The efficacy and overall safety of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis at high risk for conventional surgery is validated. Nevertheless, infrequent, but severe, intraprocedural complications, often necessitating intraoperative bailout maneuvers, are reported. Among these, valve migration into the left ventricle is particularly dismal and requires conversion to an emergent surgical procedure with a reported disproportionally high mortality rate. We report herein a case in which valve migration into the left ventricular outflow tract (LVOT) was successfully managed by repositioning a second prosthesis, thus avoiding emergent surgery

Patient-specific computational fluid dynamics of femoro-popliteal stent-graft thrombosis

Intra-stent thrombosis is one of the major failure modes of popliteal aneurysm endovascular repair, especially when the diseased arterial segment is long and requires overlapping stent-grafts having different nominal diameters in order to accommodate the native arterial tapering. However, the interplay between stent sizing, post-operative arterial tortuosity, luminal diameter, local hemodynamics, and thrombosis onset is not elucidated, yet. In the present study, a popliteal aneurysm was treated with endovascular deployment of two overlapped stent-grafts, showing intra-stent thrombosis at one-year follow-up examination. Patient-specific computational fluid-dynamics analyses including straight- and bent-leg position were performed. The computational fluid-dynamics analysis showed that the overlapping of the stent-grafts induces a severe discontinuity of lumen, dividing the stented artery in two regions: the proximal part, affected by thrombosis, is characterized by larger diameter, low tortuosity, low flow velocity, low helicity, and low wall shear stress; the distal part presents higher tortuosity and smaller lumen diameter promoting higher flow velocity, higher helicity, and higher wall shear stress. Moreover, leg bending induces an overall increase of arterial tortuosity and reduces flow velocity promoting furtherly the luminal area exposed to low wall shear stress

Peptide-modified liposomes for selective targeting of bombesin receptors overexpressed by cancer cells: a potential theranostic agent.

OBJECTIVES: Drug delivery systems consisting of liposomes displaying a cell surface receptor-targeting peptide are being developed to specifically deliver chemotherapeutic drugs to tumors overexpressing a target receptor. This study addresses novel liposome composition approaches to specifically target tissues overexpressing bombesin (BN) receptors. METHODS: A new amphiphilic peptide derivative (MonY-BN) containing the BN(7-14) peptide, the DTPA (diethylenetriaminepentaacetate) chelating agent, a hydrophobic moiety with two C(18) alkyl chains, and polyethylene glycol spacers, has been synthesized by solid-phase methods. Liposomes have been generated by co-aggregation of MonY-BN with 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC). The structural and biological properties of these new target-selective drug-delivery systems have been characterized. RESULTS: Liposomes with a DSPC/MonY-BN (97/3 molar ratio) composition showed a diameter of 145.5 ± 31.5 nm and a polydispersity index of 0.20 ± 0.05. High doxorubicin (Dox) loading was obtained with the remote pH gradient method using citrate as the inner buffer. Specific binding to PC-3 cells of DSPC/MonY-BN liposomes was obtained (2.7% ± 0.3%, at 37°C), compared with peptide-free DSPC liposomes (1.4% ± 0.2% at 37°C). Incubation of cells with DSPC/ MonY-BN/Dox showed significantly lower cell survival compared with DSPC/Dox-treated cells, in the presence of 100 ng/mL and 300 ng/mL drug amounts, in cytotoxicity experiments. Intravenous treatment of PC-3 xenograft-bearing mice with DSPC/MonY-BN/Dox at 10 mg/kg Dox dose produced higher tumour growth inhibition (60%) compared with nonspecific DSPC/ Dox liposomes (36%) relative to control animals. CONCLUSION: The structural and loading properties of DSPC/MonY-BN liposomes along with the observed in-vitro and in-vivo activity are encouraging for further development of this approach for target-specific cancer chemotherapy

ENDOVASCULAR DEVICE FOR DYSFUNCTIONAL FISTULAS

https://patentscope.wipo.int/search/en/detail.jsf?docId=WO2020152600&tab=PCTBIBLIO&_cid=P11-KDMV3V-84227-

A nearly missed catastrophic aortic injury after reduction of a thoracic spine fracture managed by prompt endovascular treatment

Thoracic aorta injuries resulting from spinal procedures are rare. Delayed diagnosis and the clinical complexity may result in a catastrophic outcome. Moreover, in such circumstances a conventional surgical approach might be impeded by the need to keep the patient in a supine position to avoid spinal injuries..

The \u201cNever-Ending Coil\u201d: Embolization Procedure Complicated by an Unraveled Coil

Coil unraveling is a rare but challenging complication that has been described mostly during intracerebral arterial embolization. Treatment options include snare retrieval, which may be difficult because of the length of the component filament. Here we describe successful endovascular treatment of an unraveled coil following its partial deployment for treatment of a type I endoleak after endovascular repair of an infrarenal abdominal aortic aneurysm

What is the Best Revascularization Strategy for Acute Occlusive Arterial Mesenteric Ischemia: Systematic Review and Meta-analysis

Purpose: Acute mesenteric ischemia (AMI) is a life-threatening disease that leads to bowel infarction and death. The optimal management of AMI remains controversial. The present meta-analysis aimed to estimate the prognostic impact of surgical (SG) versus endovascular or hybrid intervention (EV) as the first-line treatment for acute arterial occlusive mesenteric ischemia and to assess whether endovascular strategy was actually effective in reducing bowel resection. Methods: MEDLINE, Scopus and the Cochrane Library databases were searched. There have been no randomized controlled trials comparing SG versus EV for the treatment of AMI. We undertook this systematic review and meta-analysis according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines, assessing the included study quality with the Newcastle\ue2\u80\u93Ottawa scale. Results: Seven studies comparing EV versus SG as first strategy for the treatment of AMI were selected for the analyses, reporting of 3020 patients. EV was associated with a reduced risk of in-hospital mortality (RR 0.68; 95% CI 0.59\ue2\u80\u930.79; fixed-effects analysis; p\uc2&nbsp