3-Fr steerable microcatheter system via the upper limb artery in RADPLAT for right maxillary cancer.

BACKGROUND: To evaluate the efficacy of a catheter system using a 3-Fr sheath with a steerable microcatheter through right upper limb artery access for superselective intra-arterial cisplatin infusion and concomitant radiotherapy (RADPLAT) to treat right maxillary sinus squamous cell carcinoma (MS-SCC). MATERIAL AND METHODS: We retrospectively studied 46 sessions in eight patients treated between November 2020 and February 2023 using the catheter system briefly described below. A 3-Fr sheath was inserted into the distal radial, conventional radial, or brachial arteries. A coaxial catheter system with a 2.9-Fr steerable microcatheter and a 1.9-Fr microcatheter was advanced into the brachiocephalic artery. The right common carotid artery was selected by bending the tip of the steerable microcatheter. Coil embolization and intra-arterial cisplatin infusion after selecting each external carotid artery branch were achieved using this catheter system. RESULTS: Cisplatin infusion and coil embolization were successful in all sessions. Arterial occlusion at the sheath insertion sites was found in 29.4% (5/17) of the distal radial arteries and 33.3% (3/9) of the conventional radial arteries. No other major complications were observed during the procedure. CONCLUSION: Using a 3-Fr catheter system with a steerable microcatheter through right upper limb artery access is a feasible method for RADPLAT in treating right MS-SCC.

Suppression of the plasmon-quenching effect on light amplification in 20-µm-diameter plasmonic whispering gallery mode resonators fabricated from bowl-shaped organic/metal thin films.

Bowl-shaped plasmonic whispering gallery mode (WGM) resonators were fabricated from a 10-nm-thick metal (Al, Ag, or Au) plasmonic layer that was covered with a 100-nm-thick 4,4'-bis(N-carbazolyl)-1,1'-biphenyl spacer layer and a 250-nm-thick 2,7-bis[9,9-di(4-methylphenyl)-fluoren-2-yl]-9,9-di(4-methylphenyl)fluorene light-emitting layer; the layer structure was grown on a 20-µm-diameter silica microsphere. When compared with a reference structure without the plasmonic layer, the resonators, which included either Al or Ag, showed almost the same threshold excitation intensities for generation of amplified spontaneous emission (ASE). This result indicates that the ease of light amplification in the plasmonic resonators was comparable to that in the reference structure. Excitons that exist in the vicinity of metal thin films are generally easy to quench because propagating surface plasmon polaritons (SPPs) absorb the exciton energy. Therefore, the observed comparability demonstrates that the plasmonic WGM resonators overcome this quenching effect on ASE via localization of the SPPs in the vicinity of the excitons.

Device parameter to evaluate exciton energy transfer in organic whispering-gallery-mode microresonators and its dependence on the amplified spontaneous emission threshold.

Exciton energy transfer in organic whispering-gallery-mode (WGM) resonators and its effect on the amplified spontaneous emission (ASE) threshold have been investigated using the stilbene-based energy donor 4,4'-bis[(N-carbazole)styryl]biphenyl (BSB-Cz) and the coumarin-based energy acceptor 2,3,6,7-tetrahydro-1,1,7,7,-tetramethyl-1H,5H,11H-10-(2-benzothiazolyl)quinolizino[9,9a,1gh]coumarin (C545T). Using the stacked-layer structure of BSB-Cz/C545T/BSB-Cz, we fabricated bowl-shaped microresonators on silica microspheres with a total thickness of 250 nm fixing the thickness of the C545T layer to 1 nm. The ASE threshold depended on the thicknesses of the top and bottom BSB-Cz layers, which affect the magnitude of the energy transfer. To assess the relationship between the ASE threshold and energy transfer, we developed a device parameter to evaluate the magnitude of the energy transfer by formulating the rate equations. We found that ASE easily occurs under the condition that the C545T molecules become unable to accept energy from the BSB-Cz excitons owing to the high exciton density of C545T, and that the ASE threshold decreases with decreasing device parameter. The device parameter is useful for optimizing microresonator structures in multi-component organic WGM resonators that utilize energy transfer.

Nonequilibrium noise as a probe of pair-tunneling transport in the BCS-BEC crossover.

The detection of elementary carriers in transport phenomena is one of the most important keys to understand nontrivial properties of strongly correlated quantum matter. Here, we propose a method to identify the tunneling current carrier in strongly interacting fermions from nonequilibrium noise in the Bardeen-Cooper-Schrieffer to Bose-Einstein condensate crossover. The noise-to-current ratio, the Fano factor, can be a crucial probe for the current carrier. Bringing strongly correlated fermions into contact with a dilute reservoir produces a tunneling current in between. The associated Fano factor increases from one to two as the interaction becomes stronger, reflecting the fact that the dominant conduction channel changes from the quasiparticle tunneling to the pair tunneling.

Impact of Cytoreductive Nephrectomy Following Nivolumab Plus Ipilimumab Therapy for Patients With Advanced Renal Cell Carcinoma.

BACKGROUND/AIM: CheckMate 214 study revealed that nivolumab plus ipilimumab combination therapy showed a strong and durable effect compared to sunitinib for patients with advanced renal cell carcinoma (aRCC). Most of the patients underwent previous nephrectomy before systemic treatment. We retrospectively investigated the clinical outcomes of Japanese patients treated with cytoreductive nephrectomy following nivolumab plus ipilimumab for aRCC. PATIENTS AND METHODS: Seventy-nine patients were treated with systemic therapy for aRCC between October 2018 and August 2021 at the Saitama Medical University International Medical Center. Ten of 61 patients treated with nivolumab plus ipilimumab underwent cytoreductive nephrectomy after the combined immunotherapy. RESULTS: The median overall survival and progression-free survival were 24.3 and 15.9 months, respectively. The objective response rate was 50.8%; 9.8% of patients had a complete response, and the median time to objective response was 3.2 (range=1.3-19.7) months. The estimated percentage of patients who sustained an objective response at 30 months was 73.0%. Twenty-three patients (74%) in the complete or partial response (CR/PR) group, 11 patients (52%) in the stable disease (SD) group, and two patients (22%) in the progressive disease (PD) group had immune-related adverse events of grade 3 or higher, respectively. For all 10 patients, cytoreductive nephrectomy following nivolumab plus ipilimumab treatment were completed safely. Three patients achieved a pathological complete response without viable cancer cells. Only two patients had residual lesions on images after deferred cytoreductive nephrectomy; the remaining patients achieved radiological CR. CONCLUSION: Cytoreductive nephrectomy after nivolumab plus ipilimumab treatment could be useful in a limited number of cases, possibly resulting in curative nephrectomy due to the durable therapeutic effect of immunotherapy.

Elective Endovascular Stent-Graft Implantation for External Iliac Artery Injury after Blunt Pelvic Trauma.

External iliac artery (EIA) injuries caused by blunt trauma are rare. Here, we describe a blunt EIA injury after a motorbike accident suffered by a 16-year-old male. Despite conservative treatment, intermittent claudication persisted. He was successfully treated by elective endovascular stent-graft implantation on day 59 after the injury. Ankle-brachial index (ABI) improved, as did his symptoms. A contrast-enhanced computed tomography scan on postoperative day 90 showed no residual stenosis and favorable peripheral blood flow. This report suggests that elective endovascular stent-graft implantation might be a viable treatment option for blunt EIA injuries.

Endovascular treatment with Viabahn stent-grafts for arterial injury and bleeding at the visceral arteries: initial and midterm results.

PURPOSE: The purpose of the study is to evaluate the initial and midterm efficacy and safety of endovascular treatment (EVT) using Viabahn stent-graft (SG) for arterial injury and bleeding (AIB) at the visceral arteries. MATERIALS AND METHODS: Consecutive patients with visceral AIB who underwent EVT using Viabahn between January 2017 and February 2021 were retrospectively reviewed. Technical success, clinical success, peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, 30-day mortality, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. RESULTS: EVT using Viabahn was performed in 14 patients (mean age: 68.6 years; 12 males) and 15 arteries. The technical and clinical success rates were 100%. The rates of peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, and 30-day mortality were all 0%. The mean neck length was 9.9 mm. No endoleaks or re-bleeding occurred during the follow-up (mean: 732 days). The SG patency was confirmed after 1, 3, 6, and 12 months in 78.6%, 78.6%, 78.6%, and 56.1% of the patients, respectively. CONCLUSION: EVT using Viabahn for AIB at the visceral arteries was safe and effective. SG occlusions without ischemia often occurred after 12 months.

Emergency endovascular treatment using a Viabahn stent graft for upper and lower extremity arterial bleeding: a retrospective study.

BACKGROUND: A Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB). METHODS: Consecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, rebleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. RESULTS: EVT using the Viabahn SG was performed in 22 patients (mean age, 72.0 ± 13.0 years; 11 men) and 23 arteries (upper, 6; lower, 17). The indications for EVT were pseudoaneurysm (n = 13, 59.1%), extravasation (n = 9, 39.1%), and inadvertent arterial cannulation (n = 1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 ± 2.2 and 8.9 ± 2.3 mm, respectively. The mean neck length was 20.4 ± 11.3 mm. No endoleaks or rebleeding occurred during the follow-up period (mean, 169 ± 177 days). Two SG occlusions without limb ischemia occurred in the external iliac and brachial arteries after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively. CONCLUSIONS: Emergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.

A Comparison of Outcomes Based on Vessel Type (Native Artery vs. Bypass Graft) and Artery Location (Below-Knee Artery vs. Non-Below-Knee Artery) Using a Combination of Multiple Endovascular Techniques for Acute Lower Limb Ischemia.

BACKGROUND: To evaluate outcomes of endovascular treatment (EVT) using a combination of multiple endovascular techniques for acute lower limb ischemia (ALLI) and to compare outcomes based on vessel type and artery location. METHODS: A total of 95 consecutive patients with ALLI (mean age, 72.0 years; 65 males; 104 lower limbs) who received emergency EVT using a combination of multiple endovascular techniques including thrombolysis, aspiration thrombectomy, stenting, and balloon angioplasty with or without surgical thromboembolectomy, between January 2005 and December 2017 were included. Vessel type was classified into native artery occlusion (native occlusion) and bypass graft occlusion (graft occlusion), including prosthetic and vein graft. Additionally, native arteries were categorized into below-knee occlusion and non-below-knee occlusion. Technical success, perioperative death (POD), ALLI-related death, amputation, amputation-free survival (AFS), and complications were compared according to vessel type (native occlusion vs. graft occlusion) and artery location (below-knee occlusion vs. non-below-knee occlusion). RESULTS: Of all patients with ALLI, 16.8% underwent a single endovascular technique, whereas 83.2% underwent a combination of multiple endovascular techniques. The technicalsuccess, POD, and ALLI-related death rates in the total number of patients were 94.7%, 11.6%, and 4.2%, respectively. A total of 67 patients (75 limbs) and 28 patients (29 limbs) were classified as having native occlusion and graft occlusion (prosthetic, 24 limbs; vein, 5 limbs), respectively. No significant differences in technical success (native occlusion: 92.5% vs. graft occlusion: 100%), POD (14.9% vs. 3.6%), and ALLI-related death (6.0% vs. 0%) were noted between native occlusion and graft occlusion. However, the 30-day AFS rate of native occlusion was significantly lower than that of graft occlusion (75.2% vs. 96.3%, P=0.01). The amputation rate (P=0.03) and AFS rate (P=0.03) of below-knee occlusion were significantly worse for below-knee occlusion patients than for non-below-knee occlusion patients. CONCLUSIONS: EVT using multiple endovascular techniques for ALLI is effective and safe. A combination of multiple endovascular techniques is crucial for successful treatment. However, native occlusion may have a lower AFS rate than graft occlusion, and below-knee occlusion may have a higher risk of amputation than non-below-knee occlusion.

Late clinical outcomes of manual aspiration thrombectomy for a massive acute pulmonary thromboembolism.

PURPOSE: We investigated the late outcomes of patients who underwent manual aspiration thrombectomy for acute massive pulmonary thromboembolism. MATERIALS AND METHODS: Fifteen patients underwent manual aspiration thrombectomy between December 1995 and June 2002. All patients were discharged after the procedure. Patients' statuses were checked by medical record examinations and telephone interviews. The median follow-up was 162 months (116-208 months). RESULTS: Five patients died during follow-up; two for malignancy, one for septic shock, one for cerebral infarction, and in one patient the cause of death was unknown. There were no pulmonary thromboembolism-related deaths during the period and no recurrence. The 1-year survival rate was 100%, the 5-year survival rate was 75.0 ± 12.5%, and the 10-year survival rate was 75.0 ± 12.5%. CONCLUSION: Patients who undergo manual aspiration thrombectomy for acute massive pulmonary thromboembolism show acceptable outcomes.

Immobilizing a π-Conjugated Catecholato Framework on Surfaces of SiO2 Insulator Films via a One-Atom Anchor of a Platinum Metal Center to Modulate Organic Transistor Performance.

Chemical modification of insulating material surfaces is an important methodology to improve the performance of organic field-effect transistors (OFETs). However, few redox-active self-assembled monolayers (SAMs) have been constructed on gate insulator film surfaces, in contrast to the numerous SAMs formed on many types of conducting electrodes. In this study, we report a new approach to introduce a π-conjugated organic fragment in close proximity to an insulating material surface via a transition metal center acting as a one-atom anchor. On the basis of the reported coordination chemistry of a catecholato complex of Pt(II) in solution, we demonstrate that ligand exchange can occur on an insulating material surface, affording SAMs on the SiO2 surface derived from a newly synthesized Pt(II) complex containing a benzothienobenzothiophene (BTBT) framework in the catecholato ligand. The resultant SAMs were characterized in detail by water contact angle measurements, X-ray photoelectron spectroscopy, atomic force microscopy, and cyclic voltammetry. The SAMs served as good scaffolds of π-conjugated pillars for forming thin films of a well-known organic semiconductor C8-BTBT (2,7-dioctyl[1]benzothieno[3,2-b][1]benzothiophene), accompanied by the engagements of the C8-BTBT molecules with the SAMs containing the common BTBT framework at the first layer on SiO2. OFETs containing the SAMs displayed improved performance in terms of hole mobility and onset voltage, presumably because of the unique interfacial structure between the organic semiconducting and inorganic insulating layers. These findings provide important insight into creating new elaborate interfaces through installing coordination chemistry in solution to solid surfaces, as well as OFET design by considering the compatibility between SAMs and organic semiconductors.

Ferrocene on Insulator: Silane Coupling to a SiO2 Surface and Influence on Electrical Transport at a Buried Interface with an Organic Semiconductor Layer.

A silane coupling-based procedure for decoration of an insulator surface containing abundant hydroxy groups by constructing redox-active self-assembled monolayers (SAMs) is described. A newly synthesized ferrocene (Fc) derivative containing a triethoxysilyl group designated FcSi was immobilized on SiO2/Si by a simple operation that involved immersing the substrate in a toluene solution of the Fc silane coupling reagent and then rinsing the resulting substrate. X-ray photoelectron spectroscopy (XPS) measurements confirmed that the Fc group was immobilized on SiO2/Si in the Fe(II) state. Cyclic voltammetry measurements showed that the Fc groups were electrically insulated from the Si electrode by the SiO2 layer. The FcSi on SiO2/Si structures were found to serve as a good scaffold for formation of organic semiconductor thin films by vacuum thermal evaporation of C8-BTBT (2,7-dioctyl[1]benzothieno[3,2-b][1]benzothiophene), which is well-known as an organic field-effect transistor (OFET) material. The X-ray diffraction profile indicated that the conventional standing-up conformation of the C8-BTBT molecules perpendicular to the substrates was maintained in the thin films formed on FcSi@SiO2/Si. Further vacuum thermal evaporation of Au provided an FcSi-based OFET structure with good transfer characteristics. The FcSi-based OFET showed pronounced source-drain current hysteresis between the forward and backward scans. The degree of this hysteresis was varied reversibly via gate bias manipulation, which was presumably accompanied by trapping and detrapping of hole carriers at the Fc-decorated SiO2 surface. These findings provide new insights into application of redox-active SAMs to nonvolatile OFET memories while also creating new interfaces through junctions with functional thin films, in which the underlying redox-active SAMs play supporting roles.

Late Clinical Outcomes of Hybrid Catheter Intervention for Acute Massive Pulmonary Thromboembolism.

PURPOSE: We aimed to investigate the long-term outcomes of patients undergoing hybrid catheter intervention for acute massive pulmonary thromboembolism. MATERIAL AND METHODS: Twenty-five patients with hemodynamic impairment were treated with mechanical thrombus fragmentation, an intrapulmonary injection of mt-PA, and manual clot aspiration between August 1999 and June 2002. All patients were discharged after the procedure. Patients' statuses were checked by medical record examinations and telephone interviews. The median follow-up was 141 months (115-168 months). RESULTS: Ten patients died during follow-up, five for malignancy, three for septic shock, one for cerebral infarction, and one for heart failure. One patient had recurrence of pulmonary thromboembolism because of drug withdrawal by self-judgment. No chronic pulmonary thromboembolism was observed. The 1-year, 5-year, and 10-year survival rates were 87.5 ±6.8%, 83.3±7.6%, and 74.5±9.0%, respectively. CONCLUSION: Patients who undergo hybrid catheter intervention for acute massive pulmonary thromboembolism show good long-term outcomes.

Long-term outcomes of endovascular aortic aneurysm repair with the Zenith AAA endovascular graft: a single-center study.

PURPOSE: To present long-term results obtained with endovascular abdominal aortic aneurysm (AAA) repair (EVAR) using the Zenith AAA endovascular graft from a single institution. MATERIALS AND METHODS: Between 2007 and 2013, 95 consecutive patients (median age 77 years) underwent EVAR using Zenith. Data were prospectively collected and retrospectively analyzed until 2019. Primary outcomes were overall survival, freedom from AAA rupture, and freedom from AAA-related death. Secondary outcomes were freedom from late (> 30 days) re-intervention and surgical conversion, and freedom from aneurysm sac growth (> 5 mm). RESULTS: The initial technical success rate was 96.8%. There were no deaths or intraoperative conversions. Overall survival at 1, 3, 5, and 10 years was 90.8%, 81.7%. 74.3%, and 57.2%, respectively. AAA rupture occurred in one patient (1.1%). Freedom from AAA-related death was 100% during the follow-up period. Freedom from aneurysm sac growth at 1, 3, 5, and 10 years was 98.8%, 86.4%, 76.9%, 53.0%, respectively. Freedom from late re-intervention and open surgical conversion at 1, 3, 5, and 10 years was 98.9%, 88.9%, 86.7, and 57.9%, respectively. CONCLUSION: EVAR with Zenith endografts represents a safe and durable means of AAA repair, and risk of rupture and aneurysm-related death are low.

Superfluid Phase Transitions and Effects of Thermal Pairing Fluctuations in Asymmetric Nuclear Matter.

We investigate superfluid phase transitions of asymmetric nuclear matter at finite temperature (T) and density (ρ) with a low proton fraction (Yp ≤ 0.2), which is relevant to the inner crust and outer core of neutron stars. A strong-coupling theory developed for two-component atomic Fermi gases is generalized to the four-component case, and is applied to the system of spin-1/2 neutrons and protons. The phase shifts of neutron-neutron (nn), proton-proton (pp) and neutron-proton (np) interactions up to k = 2 fm-1 are described by multi-rank separable potentials. We show that the critical temperature [Formula: see text] of the neutron superfluidity at Yp = 0 agrees well with Monte Carlo data at low densities and takes a maximum value [Formula: see text]= 1.68 MeV at [Formula: see text] with ρ0 = 0.17 fm-3. Also, the critical temperature [Formula: see text] of the proton superconductivity for Yp ≤ 0.2 is substantially suppressed at low densities due to np-pairing fluctuations, and starts to dominate over [Formula: see text] only above [Formula: see text](0.77) for Yp = 0.1(0.2), and (iii) the deuteron condensation temperature [Formula: see text] is suppressed at Yp ≤ 0.2 due to a large mismatch of the two Fermi surfaces.

An Extremely Rare Complication: Abdominal Aortic Aneurysm Rupture Caused by Migration of a Zenith Main Body Years After Repair of the Suprarenal Stent Separation.

PURPOSE: To report an unusual case of an abdominal aortic aneurysm (AAA) rupture caused by migration of a Zenith stent-graft main body years after its separation from the suprarenal stent. CASE REPORT: A 72-year-old man underwent endovascular aneurysm repair with a Zenith stent-graft for an infrarenal AAA in year 2000. At that time, a femorofemoral bypass was performed because the left external iliac and common femoral arteries were dissected during treatment. In 2013, follow-up computed tomography (CT) showed disconnection of the uncovered proximal stent, which led to a type Ia endoleak. An additional Zenith main body and Large Palmaz XL balloon-expandable stent were deployed; the endoleak disappeared. In 2016, the patient had abdominal pain, and emergency CT showed AAA rupture caused by migration of the first main body deployed in 2000 under the distal edge of the contralateral (left) leg of the additional main body from 2013, which led to a type IIIa endoleak between the 2 main bodies. A converter and iliac legs were deployed to successfully seal the type IIIa endoleak. The patient remains well 18 months after the second repair; CT scans document stable stent-grafts and no endoleak. CONCLUSION: Physicians should be aware of the potential risk for AAA rupture caused by late main body migration after treatment for suprarenal stent separation from a Zenith stent-graft.

Orexigenic action of oral zinc: metabolomic analysis in the rat hypothalamus.

We previously reported an orexigenic action of oral zinc administration in male Sprague-Dawley (SD) rats during an early stage of feeding with a zinc-deficient diet, without decreased zinc concentrations in tissues. The overall conclusion was that orally but not intraperitoneally administered zinc stimulates food intake in short-term zinc-deficient-diet fed rats. We here investigate the mechanism of the orexigenic action of zinc using GC-MS/MS-targeted metabolomic analysis in the rat hypothalamus. Four-week-old, male SD/Slc rats were used, and after 2 days of feeding with a zinc-deficient diet, 3 mg of ZnSO4 in 5 mL saline solution were administered to each rat either orally or intraperitoneally. Three hours after administration, the rats were sacrificed and the hypothalamus were excised and analyzed. We found that the oral administration group showed increased concentrations of 3-aminopropanoic acid (ß-alanine), hypotaurine, dopamine, and biotin. In light of metabolomic analysis of these results, we indicate directions for further research.

Multicenter investigation of the incidence of inferior vena cava filter fracture.

PURPOSE: Inferior vena cava filter fracture (FF) may cause life-threatening complications, including cardiac tamponade, although the actual prevalence remains unclear. Therefore, we investigated the incidence of FF. MATERIALS AND METHODS: Data on fracture incidence with filter brands, filter positions [suprarenal (SR) vs. infrarenal (IR)], and follow-up durations were collected from the databases of eight hospitals. RESULTS: Of 532 patients, Günther Tulip (GT), Trap/OptEase (TE/OE), ALN and VenaTech (VT) were implanted in 345, 147, 38 and 2 patients, respectively. Of these, filter retrieval was attempted in 110 (21.7%) patients and was successful in 106 (96.4%). Of the remaining 426 patients, FFs were observed in two (0.7%) of 270 GT filters and 19 (14.1%) of 135 TE/OE filters. Fragment embolization occurred in one patient with a GT filter (50.0%) and three with a TE/OE filter (15.8%) with a total follow-up interval of 718.0 ± 1019.4 days. FF occurred more frequently in TE/OE than in GT filters (p < 0.001). Kaplan-Meier estimates showed significantly higher fracture-free rates for GT than TE/OE (p < 0.001) and IR-TE/OE than SR-TE/OE (p < 0.05). CONCLUSIONS: TE/OE filters are not suitable for permanent implantation due to the relatively early and high fracture rates.

Chopstick Injury: Successful Stent-Graft Therapy for Traumatic Left Subclavian Artery Aneurysm.

Traumatic chopstick injury is very rare, especially in the vascular system. We present an unusual case of a 19-year-old man who presented at the emergency department after being stabbed with a chopstick by his elder brother. Computed tomography revealed a left subclavian artery pseudoaneurysm, which increased from 4 mm to 7 mm in diameter within 47 days. We successfully deployed a Niti-S stent graft for the increasing aneurysm, thereby avoiding a surgical operation. Balloon angioplasty was added for re-stenosis 8 months after the first intervention.

Endovascular Treatment Strategy Using Catheter-Directed Thrombolysis, Percutaneous Aspiration Thromboembolectomy, and Angioplasty for Acute Upper Limb Ischemia.

PURPOSE: To evaluate the usefulness and safety of endovascular treatments for acute upper limb ischemia (AULI) by using multiple techniques, and to compare catheter-directed thrombolysis (CDT) and percutaneous aspiration thromboembolectomy (PAT) as initial procedures. MATERIALS AND METHODS: The study included 18 patients (4 men and 14 women) with AULI, who underwent a total of 20 sessions of endovascular treatment using various endovascular techniques between January 2005 and April 2016. The patients were initially treated with CDT [n = 9, CDT-based group (C-G)], PAT [n = 6, PAT-based group (P-G)], or angioplasty (n = 3). In case of residual emboli, we performed additional endovascular techniques. We assessed technical success, clinical success, and complications. Additionally, we compared the urokinase dosage between the groups. RESULTS: The mean patient age was 74.4 years. Technical and clinical success was obtained in all patients. Among the 18 patients, 1 underwent CDT only, 2 underwent PAT only, 1 underwent angioplasty only, and 14 underwent multiple techniques. Two patients from the C-G experienced major complications (cerebellar hemorrhage 1; pseudo-aneurysm in a branch of the ulnar artery 1). The mean urokinase dosage was lower in the P-G than in the C-G (40,000 vs. 246,667 IU; Mann-Whitney U test, P = 0.004). CONCLUSION: Endovascular treatment is effective and safe for AULI. A combination of multiple endovascular techniques is important for successful treatment. PAT is suggested as an initial procedure among endovascular techniques, in terms of a lower dosage of urokinase and a lower complication rate. LEVEL OF EVIDENCE: IV, Case-control studies.