Virtual ABI: A computationally derived ABI index for noninvasive assessment of femoro-popliteal bypass surgery outcome.

BACKGROUND AND OBJECTIVE: Peripheral arterial disease of the lower limbs, which affects 12-14% of the population, is often treated by bypassing a blocked portion of the vessel. Due to the limited ability of clinicians to predict the outcome of a selected bypass strategy, the five-year graft occlusion ranges from 50% to 90%, with a 20% risk of amputation in the first 5 years after the surgery. The aim of this study was to develop a computational procedure that could enable surgeons to reduce negative effects by assessing patient-specific response to the available surgical strategies. METHODS: The Virtual ABI assumes patient-specific finite element modeling of patients' hemodynamics from routinely acquired medical scans of lower limbs. The key contribution of this study is a novel approach for prescribing boundary conditions, which combines noninvasive preoperative measurements and results of numerical simulations. RESULTS: The validation performed on six follow-up cases indicated high reliability of the Virtual ABI, since the correlation with the experimentally measured values of ankle-brachial index was R² = 0.9485. CONCLUSION: The initial validation showed that the proposed Virtual ABI is a noninvasive procedure that could assist clinicians to find an optimal strategy for treating a particular patient by varying bypass length, choosing adequate diameter, position and shape.

Multi-elemental Analysis, Pattern Recognition Techniques of Wild and Cultivated Rosehips from Serbia, and Nutritional Aspect.

Twenty-six major and trace elements, in the seed and the mesocarp of wild and cultivated rosehips from different locations in Serbia, were quantified by means of inductively coupled plasma-atomic emission spectroscopy (ICP-AES). The cultivated rosehip was investigated for the first time. In both wild and cultivated rosehips, the most abundant elements were K and Ca. Among trace elements, Mn (in both seed and mesocarp); Fe (in seeds); and B, Ba, and Sr (in mesocarp) were quantified in the highest concentrations. The higher content of Cu, K, Mn, P, and S in the seed of cultivated rosehip, as well as Ca, Mg, and Sr in the mesocarp of wild rosehip, was observed, both significant at p < 0.05. Additionally, differences between the seed and the mesocarp of studied rosehip were noticed in the content of B, Cu, Fe, K, Ni, P, S, Sr, and Ti (p < 0.05). Nutritional assessment revealed that both wild and cultivated rosehips are a valuable source of essential elements (Ca, Cu, K, Mg, Mn, and P). The absence of toxic and potentially toxic elements additionally contributes to the quality of studied Serbian rosehip. A high impact of factors such as variety, location, as well as their interaction on the content of elements in cultivated rosehip mesocarp and seed was observed. Pattern recognition techniques, principal component analysis (PCA), and hierarchical cluster analysis (HCA) were applied in order to provide insight into similarities among the analyzed samples.

Endovascular treatment of the subclavian artery aneurysm in high-risk patient - a single-center experience.

We present our first experience with endovascular treatment of 6 subclavian artery aneurysms (SAA) occurring in five male and one female patient. All patients, in our studies, according to ASA classification were high risk for open repair of SAA. The etiology of the all aneurysms was atherosclerosis degeneration of the artery. Two aneurysms were of intrathoracic location, then the other were extrathoracic. Symptoms related to subclavian artery aneurysms were present in two patients, compression and chest pain in one, and hemorrhage shock in second, while the remaining patients were asymptomatic. We preferred the Viabhan endoprosthesis for endovascular repair in 5 cases. In one patient with ruptured of subclavian artery aneurysm who was high-risk for open repair we made combined endovascular procedure. First at all, we covered the origin of left subclavian artery with thoracic stent graft and after that we put two coils in proximal part of subclavian artery. There was no operative mortality, and the early patency rate was 100%. The follow-up period was from 3 months to 3 years. During this period, one patient died of heart failure and one patient required endovascular reoperation due to endoleak type I. Endovascular treatment is recommended for all patients with subclavian artery aneurysm whenever this is possible due to anatomical reasons especially in high-risk patient with intrathoracic localization of aneurysm, to prevent potential complications.