Computational Exploration of Fluorocyclopentenyl-purines and-pyrimidines Derivatives as Potential Inhibitors of Epidermal Growth Factor Receptor (EGFR) for the Treatment of Breast Cancer.

The Epidermal Growth Factor Receptor (EGFR) is an important therapeutic target for the treatment of a variety of epithelial malignancies, including breast cancer, in which EGFR is aberrantly expressed.The fluorocyclopentenyl-purine-pyrimidines derivatives, which have previously been described as powerful compounds against breast cancer, were selected to investigate their potential against EGFR using computational tools in an effort to obtain potent inhibitors with fewer adverse effects. The molecule's chemical reactivity and stability were assessed by determining the HOMO-LUMO energy gap using density functional theory (DFT) calculations. Among all the selected compounds, PU4 displayed a HOMO-LUMO gap of 0.191 eV. Additionally, molecular docking analysis was performed to assess the binding affinities of PU4 within the active pocket of EGFR-TK. The compound PU4 showed potent interactions with EGFR exhibiting -32.3 kJ/mol binding energy which was found best as compared to gefitinib i. e., -27.4 kJ/mol which was further validated by molecular dynamics simulations and ADMET analysis. The results of these analyses indicate that the top hits obtained from the virtual screening possess the ability to act as effective EGFR inhibitor. Therefore, it is recommended to further investigate the inhibitory potential of these identified compounds using in vitro and in vivo approaches.

Evaluation of mechanical features and antibacterial potential of fluoroquinolone against ß-ketoacyl-ACP synthases (FabB, FabF & FabH) via computational approaches.

The synthesis of fatty acids, which are essential for the growth and survival of bacterial cells, is catalyzed by beta-keto acyl-ACP synthase I-III. Due to the significant differences between the bacterial ACP synthase enzyme and the mammalian enzyme, it may serve as a viable target for the development of potent anti-bacterial medications. In this study, a sophisticated molecular docking strategy was employed to target all three KAS enzymes. Initially, 1000 fluoroquinolone derivatives were obtained from PubChem database, along with the commonly used ciprofloxacin, and subjected to virtual screening against FabH, FabB, and FabF, respectively. Subsequently, molecular dynamics (MD) simulations were conducted to confirm the stability and reliability of the generated conformations. The compounds 155813629, 142486676, and 155567217 were found to exhibit potential molecular interactions against FabH, FabB, and FabF, respectively, with docking scores of -9.9, -8.9, and -9.9 kcal/mol. These scores outperformed the docking score of standard ciprofloxacin. Furthermore, MD simulations were used to assess the dynamic nature of molecular interactions in both physiological and dynamic settings. Throughout the simulated trajectory, all three complexes displayed favorable stability patterns. The findings of this investigation suggest that fluoroquinolone derivatives may serve as highly effective and selective inhibitors of the KAS enzyme.

STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery.

INTRODUCTION: Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines. METHODS: A STROCSS 2021 steering group was formed to come up with proposals to update STROCSS 2019 guidelines. An expert panel of researchers assessed these proposals and judged whether they should become part of STROCSS 2021 guidelines or not, through a Delphi consensus exercise. RESULTS: 42 people (89%) completed the DELPHI survey and hence participated in the development of STROCSS 2021 guidelines. All items received a score between 7 and 9 by greater than 70% of the participants, indicating a high level of agreement among the DELPHI group members with the proposed changes to all the items. CONCLUSION: We present updated STROCSS 2021 guidelines to ensure ongoing good reporting quality among observational studies in surgery.

Ultra-wideband, wide angle, asymmetric transmission based chiral metasurface for C and X band applications.

A multi-layered chiral device manifesting asymmetric transmission (AT) facilitating one-way channeling of electromagnetic (EM) waves, based on the inherent polarization is presented. The designed metasurface depicts a high transmission contrast with an efficiency above 80% for an ultra-wide operational range of 6.3-12.3 GHz, constituting a fractional bandwidth of 64%. As an additional feature, the reported metasurface yields robustness against oblique incidences up to 45[Formula: see text] while maintaining high transmission efficiency. This report also introduces a unique analogy of the AT based communication system with logic-gates by formulating its truth-table and logic circuit. Furthermore, new insights of AT magnitude's dependence to oblique incidences are presented on the account of surface impedance mismatch due to TE and TM polarization with varying incidence angle. Moreover, avoidance of grating lobes and the associated transmission deterioration through utilization of electrically small periodic metasurface is presented. The results have been numerically and practically validated yielding state-of-the-art features. Operating within C and X band, the reported work is an ideal candidate for practical AT applications.

Oral health status and risk determinants in adult Syrian refugees in Jordan.

OBJECTIVES: Lack of data regarding the oral health of Syrian refugees represents a crucial gap in the literature. This study aimed to investigate the oral health status of Syrian refugees and related socio and behavioral factors. BASIC RESEARCH DESIGN: Cross-sectional study from June to September 2019 at Zaatari refugee camp, Jordan. METHODS: An experienced, calibrated field investigator performed an oral clinical examination of 505 Syrian refugees (18-60 years) using the WHO criteria. DMFT, SiC, oral health indices and socio-demographic variables were recorded. RESULTS: A total of 264 males and 241 females were included. The prevalence of caries was 96.0%, of which 76.0% had 4-17 carious lesions. The mean number of decayed, missing and filled teeth was 5.76, 2.55 and 1.88 respectively. The mean DMFT score was 10.19 (100% had DMFT⟩0), SiC was 17.09, and the mean simplified Oral hygiene index score was 2.18. The most common chief complaint was pain (92.7%). Nearly half of the participants were smokers (45.7%). There was a negative association between level of education and oral health (P=0.011). Most participants did not brush their teeth regularly (87.5%). Females had better oral hygiene practices than males (P=0.015). CONCLUSIONS: Syrian refugees had a high prevalence of caries, high unmet dental treatment needs and poor oral hygiene practices. Preventive programs and focused interventions may reduce the burden of disease in this underprivileged population, on funding agencies and host countries as well.

Cryptochrome mediated magnetic sensitivity in Arabidopsis occurs independently of light-induced electron transfer to the flavin.

Cryptochromes are highly conserved blue light-absorbing flavoproteins which function as photoreceptors during plant development and in the entrainment of the circadian clock in animals. They have been linked to perception of electromagnetic fields in many organisms including plants, flies, and humans. The mechanism of magnetic field perception by cryptochromes is suggested to occur by the so-called radical pair mechanism, whereby the electron spins of radical pairs formed in the course of cryptochrome activation can be manipulated by external magnetic fields. However, the identity of the magnetosensitive step and of the magnetically sensitive radical pairs remains a matter of debate. Here we investigate the effect of a static magnetic field of 500 µT (10× earth's magnetic field) which was applied in the course of a series of iterated 5 min blue light/10 min dark pulses. Under the identical pulsed light conditions, cryptochrome responses were enhanced by a magnetic field even when exposure was provided exclusively in the 10 min dark intervals. However, when the magnetic stimulus was given exclusively during the 5 min light interval, no magnetic sensitivity could be detected. This result eliminates the possibility that magnetic field sensitivity could occur during forward electron transfer to the flavin in the course of the cryptochrome photocycle. By contrast, radical pair formation during cryptochrome flavin reoxidation would occur independently of light, and continue for minutes after the cessation of illumination. Our results therefore provide evidence that a magnetically sensitive reaction is entwined with dark-state processes following the cryptochrome photoreduction step.

Pile-up correction algorithm for high count rate gamma ray spectroscopy.

In nuclear applications related to radiation energy measurement, digital pulse processing for fast sampling facility has great advantages compared to the traditional analog pulse processing. A distortion in energy spectrum and degradation in timing resolution take place when pulse pile-up occurs. This in turn leads to degradations of the signals used in applications such as nuclear medicine. Pile-up pulses are commonly removed in most algorithms if they are detected, but in this case, getting a clean spectrum becomes a challenge due to data loss. A proposed pile-up detection and recovery algorithm based on fitting the preamplifier data and signal extrapolation is presented. The extrapolated pulse is used for recovering (extracting) the piled-up pulse to estimate its parameters. A smoothed first derivative algorithm is used for peak tracking inside the detected events. To evaluate the proposed pile-up recovery algorithm theoretically and experimentally, it is applied on both simulated input signals generated with different time displacements between the piled-up events, and experimental preamplifier radiation signals. The obtained results prove that the proposed algorithm achieves better utilization of power and can be used for high count rate (high activity elements) spectroscopy systems.

Oral Candidal carriage and associated risk indicators among adults in Sakaka, Saudi Arabia.

BACKGROUND: Candida is a ubiquitous organism in nature which inhabits the oral cavity as part of the normal microbial flora. The oral carriage of Candida is perpetuated by several predisposing factors. METHODS: This cross-sectional study was designed to investigate the carriage rate of Candida among 104 voluntary adults at the college of medicine - Jouf University. The concentrated oral rinse technique using Sabouraud Dextrose agar medium supplemented with 0.05% Chloramphenicol was used to isolate Candida. The relative factors affecting the colonization of Candida and the concentration of each type were also determined. RESULTS: Candida species were isolated from the oral cavity of 45 (43.4%) subjects. Of these 55.6% were identifies as C. albicans as determined by the Vitek 2 compact system. Other Candida species were represented by C. glabrata (11.1%), C. krusei (11.1%), C. dubliniensis (8.9%), C. parapsilosis (6.7%), C. tropicalis (4.4%), and C. famata (2.2%). Subjects with very poor plaque status, severe gingivitis and diabetes had significantly (P = 0.001) high concentration of Candida spp. CONCLUSION: Plague, severe gingivitis, and diabetes were found to be significantly associated with higher Candida colonization.

Efficacy of Aortic Valve Replacement through Full Sternotomy and Minimal Invasion (Ministernotomy).

Background: new minimally invasive sternotomy (mini-sternotomy) procedures have improved the treatment outcome and reduced the incidence of perioperative complications leading to improved patient satisfaction and a reduced cost of aortic valve replacement in comparison to the conventional median sternotomy (full sternotomy). The aim of this study is to compare and gain new insights into operative and early postoperative outcomes, long-term postoperative results, and 5-year survival rates after aortic valve replacement through a ministernotomy and full sternotomy. Methods: This is a retrospective study of patients who underwent an isolated replacement of the aortic valve via a full sternotomy or ministernotomy from 2011 to 2016. From 2011 to 2016, 426 cardiac interventions were performed, 70 of which (16.4%) were of the ministernotomy and 356 (83.6%) of the full sternotomy. Through propensity score matching, 70 patients who underwent the ministernotomy (ministernotomy group) were compared with 70 patients who underwent the full sternotomy (control group). Results: in the propensity matching cohort, no statistical difference in operative time was noted (p = 0.856). The ministernotomy had longer cross clamp (88.7 ± 20.7 vs. 80.3 ± 24.6 min, p = 0.007) and bypass (144.0 ± 29.9 vs. 132.9 ± 44.9 min, p = 0.049) times, less ventilation time (9.7 ± 1.7 vs. 11.7 ± 1.4 h, p < 0.001), shorter hospital stay (18.3 ± 1.9 vs. 21.9 ± 1.9 days, p = 0.012), less 24-h chest tube drainage (256.2 ± 28.6 vs. 407.3 ± 40.37 mL, p < 0.001), fewer corrections of coagulopathy (p < 0.001), fewer patients receiving catecholamine (5.71 vs. 30.0%, p < 0.001) and better cosmetic results (p < 0.001). Moreover, the number of patients without complaints at 1 year after the operation was significantly greater in the ministernotomy group (p = 0.002), and no significant differences in the 5-year survival between the groups were observed. In the overall cohort, the ministernotomy had longer cross clamp times (88.7 ± 20.7 vs. 79.9 ± 24.8 min, p < 0.001), longer operative times (263.5 ± 62.0 vs. 246.7 ± 74.2 min, p = 0.037) and bypass times (144.0 ± 29.9 vs. 132.7 ± 44.5 min, p = 0.026), lower incidence of 30-day mortality (1(1.4) vs. 13(3.7), p = 0.022), shorter hospital stays post-surgery p = 0.025, less 24-h chest tube drainage, p < 0.001, and fewer corrections of coagulopathy (p < 0.001). Conclusions: the ministernotomy has a number of advantages compared with the full sternotomy and thus could be a better approach for aortic valve replacement.

A wearable sensor based multi-criteria-decision-system for real-time seizure detection.

This paper presents a wireless, low power and low cost two part wearable for real-time epileptic seizure detection. Using parameters of Electro-cardiograph (ECG), Electro-dermal Activity (EDA), body motion and breathing rate (BR), a novel multi-criteria-decision-system (MCDS) is proposed that reduces false alarms and true negatives. The combination of a chest and hand worn wearable continuously senses these parameters transmitting the data to a smart phone application via BLE 4.0 where long-short-term-memory (LSTM) based anomaly detection algorithms and logistic classifiers decide on the occurrence of the seizure in real time. A 96% precision and 90% recall is achieved through testing on synthetic data.

Comparison between different disease activity scores in rheumatoid arthritis: an Egyptian multicenter study.

The aim of our work was to assess the performance of different Disease Activity Score (DAS) other than DAS-ESR in daily clinical practice in our Egyptian outpatient clinics and also to evaluate the accuracy of European League Against Rheumatism Classification (EULAR) proposed cutoffs for these scores to stratify Egyptian patients into different categories of disease activity. This study is a cross-sectional Egyptian multicenter study. It included 130 rheumatoid arthritis (RA) patients who visited our Rheumatology and Rehabilitation outpatient and inpatient clinics; 80 patients from Cairo University Hospitals and 50 patients from Zagazig University Hospitals. The patients fulfilled the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism Classification criteria for rheumatoid arthritis. Disease Activity Score 28-ESR (DAS28-ESR), DAS28-CRP, Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) were calculated. A significant positive correlation was found between all three scores and morning stiffness, ESR, Modified Health Assessment Questionnaire (MHAQ), and DAS-ESR. Also, there was a significant negative correlation between DAS-CRP and hemoglobin and a significant positive correlation with CRP. Also, there was a highly significant moderate agreement between DAS-ESR and DAS-CRP using Fleischmann et al. thresholds and also between DAS-ESR and SDAI. While a highly significant fair agreement was found between DAS-ESR and DAS-CRP using DAS-ESR thresholds and between DAS-ESR and CDAI. We conclude that DAS-CRP, SDAI, and CDAI are very useful in representing disease activity in RA patients in our outpatient clinics being well correlated with many markers of disease activity. We recommend huge multicenter studies in Egypt and in different populations to define new cutoff values to optimize their use in clinical setting.

In vitro and in vivo evaluation of the antiangiogenic activities of Trigonella foenum-graecum extracts

Objective: To assess the antiangiogenic activity of fenugreek. Methods: Different fractions of fenugreek crude extracts were prepared and their anti-angiogenic properties were assessed using the ex vivo rat aortic ring assay and in vivo chicken embryo chorioallantoic membrane (CAM) assay. They were investigated for their direct cytotoxic activity in the MCF7 cells using the MTT assay. Results: The ethanol extract showed 100％ inhibition of blood vessel outgrowth from primary tissue explants in the rat aortic ring assay at a concentration of 100μg/mL while the other extracts did not show significant antiangiogenic activity. The ethanol extract was therefore investigated at varying concentrations and exhibited a significant dose dependent effect. The CAM assay coincided with the results of the aortic ring assay as ethanol extract showed a significant inhibition of formation of new blood vessels. The extracts only showed anti-proliferative activity at the highest concentration of 400μg/mL towards MCF7 breast cancer cell lines in the MTT assay. Conclusions: Findings of the both assays confirmed that the ethanol extract inhibited vascularization significantly. Further studies on the ethanol extract would be beneficial in isolating the active ingredient responsible for the inhibition.

Disposable, Paper-Based, Inkjet-Printed Humidity and H2S Gas Sensor for Passive Sensing Applications.

An inkjet-printed, fully passive sensor capable of either humidity or gas sensing is presented herein. The sensor is composed of an interdigitated electrode, a customized printable gas sensitive ink and a specialized dipole antenna for wireless sensing. The interdigitated electrode printed on a paper substrate provides the base conductivity that varies during the sensing process. Aided by the porous nature of the substrate, a change in relative humidity from 18% to 88% decreases the electrode resistance from a few Mega-ohms to the kilo-ohm range. For gas sensing, an additional copper acetate-based customized ink is printed on top of the electrode, which, upon reaction with hydrogen sulphide gas (H2S) changes, both the optical and the electrical properties of the electrode. A fast response time of 3 min is achieved at room temperature for a H2S concentration of 10 ppm at a relative humidity (RH) of 45%. The passive wireless sensing is enabled through an antenna in which the inner loop takes care of conductivity changes in the 4-5 GHz band, whereas the outer-dipole arm is used for chipless identification in the 2-3 GHz band.

A meta-analysis examining the independent association between thyroid nodule size and malignancy.

BACKGROUND: Tumor size is recognized as an important predictor of malignancy in many types of cancers. However, there is no clear line of characterization when it comes to the association between thyroid nodule size and malignancy risk prediction; and the current data remains inconsistent across different studies. The aim of our study is to examine the association between nodule size and malignancy using meta-analysis of the current literature. METHODS: Data sources were gathered through systemic search of PubMed, Embase and other scientific databases for articles published between January 1, 1996 and June 1, 2013. A reference group with nodule sizes <3 cm was set as a control group. Two other nodule size categories were established and these included nodules from 3-5.9 cm and nodules ≥6 cm in size. Primary outcome was a histologically proven malignancy per nodule size category. The effect sizes of clinicopathologic parameters, which are the quantitative measures of association strength between two variables, were calculated by the means of odds ratios (OR). The effect sizes were then combined using a random-effects model. RESULTS: Seven studies met our inclusion criteria with 10,817 thyroid nodules evaluated. Malignancy was identified in 2,206 (20.4%) nodules. After adjusting for patient age and gender, nodules that measured 3-5.9 cm had a 26% greater malignancy risk compared to those measuring <3 cm [OR, 1.26; 95% confidence interval (CI): 1.13-1.39]. However, nodules 6 cm or larger had a 16% lower risk of malignancy compared to those measuring <3 cm (OR, 0.84; 95% CI: 0.73-0.98). CONCLUSIONS: Thyroid nodule size predicts cancer risk. However, a threshold effect of thyroid nodule size 6 cm or greater is significantly associated with a more benign disease.

Possible risk factors associated with greater damage in systemic lupus erythematosus patients: an Egyptian multicenter study.

OBJECTIVES: Systemic lupus erythematosus (SLE) is a prototypic multisystem autoimmune disorder. The total damage in a patient with SLE may result from SLE itself or from any other pathologic process. The aim of this study was to assess risk factors of greater damage in a sample of Egyptian SLE patients. METHODS: This Egyptian multicenter retrospective study included 100 SLE patients: 64 patients from Cairo University Hospitals and 36 patients from Zagazig University Hospitals. The Systemic Lupus International Collaborative Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (ACR-DI) was used to document the damage in each patient. RESULTS: The total SLICC/ACR-DI score ranged from 0 to 8. A higher DI score was found in hypertensive patients, compared to normotensive patients; and among those with positive anti-phospholipid antibodies, compared to those with negative anti-phospholipid antibodies. This difference was statistically significant (p < 0.01). Also, a higher DI score was found in cyclophosphamide users, compared to non-users; and in those with proteinuria and seizures, compared to those without; and the difference was statistically significant (p < 0.05). There was a significant positive correlation between the DI and patient age (p < 0.05). CONCLUSIONS: Damage in SLE cannot be prevented completely, as SLE disease is considered an aggressive disease treated by aggressive medications, but rheumatologists should try to minimize damage as much as possible to maintain the patients' health, functioning and general wellbeing.

Medical undergraduates' contributions to publication output of world's top universities in 2013.

BACKGROUND: Medical undergraduates' (UGs) involvement in research activities is thought to be mutually beneficial to students, their mentors and the scholarly productivity of their universities. However, most evidence in favor of such assumption relies on subjective measures such as the self-reported gains in skills or knowledge rather than robust objective estimates for assessing impact. AIM: We aimed to objectively track and describe publications with UG co-authors-their proportion to the total publication output of world's top universities, their characteristics and their potential impact on biomedical literature. METHODS: We contacted the corresponding authors of the 2013's Medline-indexed publications affiliated to world's top 10 universities to investigate if any of their co-authors was an UG. Articles with UG co-authors were further assessed to determine, along with other variables: the type of study design, field of the article, publishing journal and its impact factor (IF), and number of received citations. RESULTS: Out of 25 152 publications, 2537 articles (10.1%) contained at least one UG co-author who was the first author in 635 papers (25%). Articles with UG co-authors were published in 1114 journals with a median IF of 3.661. Most UGs' co-authored publications (82.7%, n = 2098) were cited at least once within 1 year, for a median of three citations per article. CONCLUSION: UGs contributed to one in every 10 publications affiliated to top universities. Their papers were published in journals with good IFs and received a fair number of citations, which would reflect the relatively good quality and impact of these articles.

Stem cell intervention ameliorates epigallocatechin-3-gallate/lipopolysaccharide-induced hepatotoxicity in mice.

Stem cells are identified as a novel cell therapy for regenerative medicine because of their ability to differentiate into many functional cell types. We have shown earlier a new model of hepatotoxicity in mice by administering (1500 mg/kg) epigallocatechin-3-gallate (EGCG) intragastric (IG) for 5 days after a single intraperitoneal dose (6 mg/kg) of lipopolysaccharide (LPS). In this study, we aimed to study the effect of intrahepatic (IH) injection of mouse embryonic stem cells (MESCs) on the hepatotoxicity induced by EGCG/LPS in mice. Mice were administered EGCG/LPS and rested for 3 days. MESCs were obtained from American Type Culture Collection and cultured in vitro for 4 days. Stem cells were injected IH. Seven days later, a single dose of LPS (6 mg/kg) followed by daily doses of IG administration of EGCG were re-administered for 5 days. At the end of the experiment, blood samples were collected for analysis of biochemical parameters associated with liver. Results showed that the group of mice that were administered MESCs prior to EGCG/LPS showed lower levels of alanine amino transferase, alkaline phosphatase, and bilirubin, higher albumin/globulin ratio, and less remarkable histopathological lesions. Also, that group of mice showed less expression of oxidative stress biomarkers (oxidized low-density lipoprotein Ox.LDL and chemokine CXCL16), less expression of nuclear protein receptors (retinoic acid receptor and retinoid X receptor), and less expression of inflammatory biomarkers (tumor necrosis factor α and transforming growth factor ß1) compared with other groups of mice that were not given MESCs. In conclusion, MESCs can ameliorate EGCG/LPS-induced hepatotoxicity in mice.

Intraperitoneal marsupialization of a giant para-pelvic renal cyst: A case report.

Simple renal cysts are among the most common cystic lesions of the kidney. Renal cysts most often remain asymptomatic, but rarely these cysts may become huge in size and result in significant symptoms. Giant renal cysts present a technical challenge in terms of surgical management. Although laparoscopic procedures have been performed successfully at experienced centres, intraperitoneal marsupialization via open approach may be a feasible option at less experienced centres. We report a case of a young female with a giant (24 × 18 cm) renal cyst of Bosniak type-II variety. De-roofing and intraperitoneal marsupialization of the cyst was performed. At the 1-year follow-up, she was asymptomatic, with no residual cyst.

Endovascular treatment of hemodialysis access pseudoaneurysms.

OBJECTIVE: Pseudoaneurysm (PSA) formation is a complication of hemodialysis access. Open repair requires PSA resection, interposition graft placement, and insertion of a catheter as a bridge. Endovascular stent graft repair is an alternative that permits immediate use of the access site. The objective of this study was to determine the efficacy of stent grafts for repair of arteriovenous fistula and arteriovenous graft PSA. METHODS: A retrospective review of medical records from October 2007 to March 2011 revealed 24 patients with a PSA who underwent endovascular repair using a stent graft. Indications for repair included PSA with symptoms (n = 11), PSA with skin erosion (n = 8), PSA with failed hemodialysis (n = 3), and PSA after balloon angioplasty of a stenosis (n = 2). Outcome measures were technical success, 30-day and 180-day patency, secondary interventions, and complications. All the statistical analyses were conducted by using software SAS 9.1 (SAS, SAS Institute, Gary, NC). RESULTS: Twenty-seven self-expanding stent grafts (Viabahn, W. L. Gore, n = 25; Fluency, Bard, n = 2) were used to treat hemodialysis access (arteriovenous graft, n = 13; arteriovenous fistula, n = 11) PSA in 24 patients (16 females; mean age, 55.7 years; mean body mass index, 28.4; mean PSA diameter, 19.5 mm). Comorbidities included hypertension (n = 22; 91.7%), diabetes mellitus (n = 8; 33.3%), and coronary artery disease (n = 4; 16.67%). The median time from access creation to repair was 455 days. The technical success rate was 100%. Balloon angioplasty of an outflow stenosis was performed in 56% of stent grafts. The 30- and 180-day patency rate was 100% and 69.2%, respectively. Three secondary interventions were performed for treatment of unrelated stenosis. Treatment failure occurred in five (18.5%) stent grafts due to infection (n = 3) and thrombosis (n = 2). Treatment of PSA with skin erosion was associated with failure due to infection (odds ratio, 5.0; 95% confidence interval, .38, 66.01). The remaining 22 (81.5%) stent grafts remain patent. The mean follow-up time was 268.9 days (median, 97.5). CONCLUSIONS: Endovascular therapy is an effective and durable treatment option for patients with dialysis access PSAs. This technique permits immediate use of the hemodialysis access site as well as identification and treatment of associated stenosis. It may be considered as an alternative to open repair in patients who are anatomically suitable candidates.