Idiopathic True Radial Artery Aneurysm: A Rare Case Report.

Idiopathic true aneurysm of the distal radial artery is a rare disease with only few reported cases. Most patients were treated surgically with proximal and distal arterial ligatures, while there are reports of only 7 cases where revascularization procedures were performed. We present a case of a 66-year-old man with a pulsatile mass in the right forearm at the location of the radial artery. Six months preceding the presentation, the patient had first noticed a pulsatile tumefaction which gradually increased in size, with a sudden increase during the last month. The patient worked as a waiter and was a non-smoker with no significant comorbidities. There was no history of trauma, recent infection, hospitalization, recurrent injury, or peripheral venous cannulation. After CDT diagnosis, we performed resection of aneurysm and reconstruction with cephalic autovenous graft. One month afterwards, at the follow-up visit, the patient denied having symptoms of hand ischemia and duplex ultrasound examination showed adequate patency of the radial artery. This paper presents a rare case of a true idiopathic radial artery aneurysm that was treated surgically by complete resection and interposition with a reverse cephalic vein autovenous graft. Detailed anamnesis and clinical examination are necessary for the appropriate surgical treatment of the disease.

Correlation between climatic and biochemical parameters in etiopathogenesis of unprovoked deep vein thrombosis of the lower limbs.

AIM: Beside the intention of early detection and optimal treatment of deep venous thrombosis (DVT), the aim of this study was to investigate the influence of chronobiological rhythms on the etiopathogenesis of unprovoked deep vein thrombosis of the lower limbs with monitoring of seasonal variations in biochemical parameters. PATIENTS AND METHODOLOGY: The prospective clinical trial included all consecutive hospitalized patients and outpatients diagnosed with DVT at the Vascular Surgery Clinic of the Clinical Center in Nis, starting from January 2013 to December 2014. RESULTS: There was no statistically significant difference in correlation between the distribution of the incidence of DVT of the lower limbs (p = 0.582), sex (p = 0.350), age (p = 0.385) and localization (p = 0.886) and the seasons. Creatinine levels were significantly higher in patients who developed DVT in spring than in those who developed DVT in winter (p < 0.05), while LDL cholesterol levels were significantly higher in patients diagnosed with DVT in winter than in those diagnosed with DVT in autumn (p < 0.05). CONCLUSION: According to the results of the study, it can be concluded that in the territory of South Serbia, the seasons are not significantly related to the incidence, sex, age and localization of unprovoked DVT of the lower limbs. Creatinine levels were significantly higher in patients who developed DVT in spring than in those who developed DVT in winter, while LDL cholesterol levels were significantly higher in patients during winter than during autumn.

Methodology for determining ecological benefits of advanced tolling systems.

Toll plazas are places on the road network where increased emissions of exhaust gases occur due to changes in vehicle driving regime in their corresponding impact areas. Therefore, they provide a great potential in terms of the ability to significantly reduce the emission of pollutants by using advanced technologies. In light of this, this paper aims at getting the most accurate quantification of pollutant emission (CO, CO2, HC and NOx) for the various vehicle categories which use Manuel System (MS), Electronic toll collection (ETC) with mechanical barriers and Multi Lane Free Flow (MLFF) system, for determining ecological benefits that can be achieved using advanced tolling systems. The measurement of the emission of harmful gases was carried out in real field conditions for the five most common classes of passenger cars, light truck and semi-trailer-truck. Vehicle speed, fuel consumption and emission of pollutants were recorded every second, in various driving processes in the impact areas of toll plazas, as well as in numerous scenarios that involve a different number of vehicles in a queue. The obtained results show that the use of the MLFF system, compared to the MS, can achieve a reduction in CO2 in the range of 25%-45% and the reduction in NOx in the range of 32%-98%, depending on the type of vehicle and the considered scenario. The case study of the tolling system in the Republic of Serbia, on a sample of 77,408,112 vehicles, has shown that moving from the existing to an advanced MLFF tolling system allows for annual ecological benefits ranging from 1,349,862 € to 1,491,391 €.

Computer methods for follow-up study of hemodynamic and disease progression in the stented coronary artery by fusing IVUS and X-ray angiography.

Despite a lot of progress in the fields of medical imaging and modeling, problem of estimating the risk of in-stent restenosis and monitoring the progress of the therapy following stenting still remains. The principal aim of this paper was to propose architecture and implementation details of state of the art of computer methods for a follow-up study of disease progression in coronary arteries stented with bare-metal stents. The 3D reconstruction of coronary arteries was performed by fusing X-ray angiography and intravascular ultrasound (IVUS) as the most dominant modalities in interventional cardiology. The finite element simulation of plaque progression was performed by coupling the flow equations with the reaction-diffusion equation applying realistic boundary conditions at the wall. The alignment of baseline and follow-up data was performed automatically by temporal alignment of IVUS electrocardiogram-gated frames. The assessment was performed using three six-month follow-ups of right coronary artery. Simulation results were compared with the ground truth data measured by clinicians. In all three data sets, simulation results indicated the right places as critical. With the obtained difference of 5.89 ± ~4.5% between the clinical measurements and the results of computer simulations, we showed that presented framework is suitable for tracking the progress of coronary disease, especially for comparing face-to-face results and data of the same artery from distinct time periods.