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Objective: The aim of this article is to determine the predictive value of the leukocyte-glycemic index in the long-term evolution of diabetic patients with peripheral arterial disease following endovascular treatment.

The current paper presents an examination of the emerging role of deep learning-based simulation software in enhancing preprocedural planning for intracranial aneurysm treatment using flow diverters. Intracranial aneurysms pose significant risk due to their potential rupture leading to life-threatening subarachnoid hemorrhage. Innovative endovascular treatment options like flow diverters, which redirect blood flow and promote healing, are gaining attention. The role of simulation software in optimizing these procedures is becoming increasingly crucial.

Background and aims. The conventional computed tomography (CT) appearance of ovarian cystic masses is often insufficient to adequately differentiate between benign and malignant entities. This study aims to investigate whether texture analysis of the fluid component can augment the CT diagnosis of ovarian cystic tumors. Methods. Eighty-four patients with adnexal cystic lesions who underwent CT examinations were retrospectively included. All patients had a final diagnosis that was established by histological analysis in forty four cases. The texture features of the lesions content were extracted using dedicated software and further used for comparing benign and malignant lesions, primary tumors and metastases, malignant and borderline lesions, and benign and borderline lesions. Texture features' discriminatory ability was evaluated through univariate and receiver operating characteristics analysis and also by the use of the k-nearest-neighbor classifier. Results. The univariate analysis showed statistically significant results when comparing benign and malignant lesions (the Difference Variance parameter, p=0.0074) and malignant and borderline tumors (the Correlation parameter, p=0.488). The highest accuracy (83.33%) was achieved by the classifier when discriminating primary tumors from ovarian metastases. Conclusion. Texture parameters were able to successfully discriminate between different types of ovarian cystic lesions based on their content, but it is not entirely clear whether these differences are a result of the physical properties of the fluids or their appartenance to a particular histopathological group. If further validated, radiomics can offer a rapid and non-invasive alternative in the diagnosis of ovarian cystic tumors. [ABSTRACT FROM AUTHOR]

Carotid artery stenosis is usually a consequence of thromboembolism or atheroembolism, or it can be secondary to a low-velocity status in the carotid circulation. This disease can also represent an important cause of stroke, being responsible for 7% of all stroke cases. Endovascular techniques were recently proposed as alternative interventions for patients with high risk for endarterectomy. We present the case of a 70-year-old patient, accusing headache, vertigo, and fatigue. Angiography indicated bilateral carotid artery stenosis. Interventional surgery and angioplasty were performed, crossing the stenotic lesions of the left internal carotid artery, followed by the implantation of a Carotid WALLSTENT endoprosthesis. Evolution of the patient was favorable after the endovascular intervention, with significant improvement of the symptoms caused by bilateral carotid stenosis. As a conclusion, decision-making must be modulated in each patient, according to the patient’s anatomy and comorbidities, and the experience of the team performing the procedure.

Introduction: Renal cell carcinoma has a propensity to propagate into the renal vein and inferior vena cava. A small percentage has distant metastasis at presentation. Pulmonary, hepatic, cerebral and bone metastases are common, but skeletal muscle involvement is rare.

Critical limb ischemia is a vascular emergency defined as a sudden decrease in limb perfusion associated with a risk of loss of viability of the affected extremity. It has two treatment possibilities: surgical treatment or catheter-based treatment. In our opinion, mechanical thrombectomy (MT) is superior to thrombolysis in the treatment of limb ischemia in some cases. In rare cases, a clavicle fracture can cause arterial compression, releasing a limb ischemia. We describe the case of a 50-year-old male patient with critical ischemia of the right upper limb. He had a history of untreated right clavicle fracture in the childhood which had caused an extrinsic compression of the subclavian artery releasing occlusion. A thromboembolectomy combined with endovascular therapy of the subclavian, brachial and distal arteries was performed, mechanical thrombembolecomy proved to be more effective in this case. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a common medical condition where the blood flow of the brain is suddenly stopped, leading to different neurological deficits. It mostly affects individuals aged 55 or above, but it can occur at any age. The stroke can come as an ischemic stroke, hemorrhagic stroke or even transient ischemic stroke. The most common type is the ischemic stroke, which can further come as large artery atherosclerosis, cardioembolic, small vessel disease, or other forms. Case Report: We present the case of a 37-year-old male patient who suffered an ischemic stroke. The patient underwent a comprehensive treatment protocol, including endovascular thrombectomy, following the identification of an obstruction of the internal carotid artery. Prior to the intervention, the patient underwent radiological and imaging investigations at the radiology department, where several CT scans were performed. The patient was referred to our clinic after a thorough neurological examination, with tandem stroke, trough simultaneous occlusion of the cervical segment of the internal carotid artery, and middle cerebral artery. Initially, aspiration thrombectomy was attempted using an aspiration catheter, yielding only partial success. Eventually, combined thrombectomy was performed, where an aspiration catheter alongside a stent retriever was deployed, to capture the thrombus. The procedure was complicated by the thrombus fragmentation and migration into the upper trunk of the middle cerebral artery. After numerous attempts, successful recanalization was obtained, with the ischemic stroke attributed to an embolic thrombus originating from the heart, associated with the patient's atrial fibrillation. Discussions : The presented case highlights the complexity often encountered in managing ischemic strokes, particularly in younger patients. The use of a comprehensive treatment approach, including endovascular thrombectomy, highlights the evolving landscape of stroke management, where timely intervention is crucial to mitigate potential long-term neurological deficits. The tandem occlusion of the cervical segment of the internal carotid artery and middle cerebral artery poses an incredible challenge, employing innovative strategies such as combined thrombectomy to address the obstruction effectively. Conclusions: In conclusion, this case highlights the challenges and complexities in managing ischemic strokes, particularly when tandem arterial occlusions occur with embolic origin. Despite procedural difficulties, successful recanalization was achieved, emphasizing the importance of strategizing, adaptability and perseverance in stroke interventions. [ABSTRACT FROM AUTHOR]

Introduction: Carotid angioplasty is a minimally invasive treatment procedure for atherosclerosis of the carotid arteries. Carotid angioplasty is necessary in the treatment of high-grade stenosis, as an alternative to surgical procedures (carotid endarterectomy). The intervention restores optimal blood circulation to the brain, thus preventing a transient ischemic attack or ischemic stroke. Carotid angioplasty is performed percutaneously, through a puncture in the skin, without the need for incisions. As a result, recovery is rapid and risks are minimal. Case Report: We present a case of carotid artery stenosis in a 73-year-old male patient. He underwent radiological and imaging investigations at the radiology department, where several CT scans were performed. The results indicated the presence of a carotid artery with an abnormally narrow diameter, significantly restricting blood flow to the brain. For treatment, it was decided to perform an endovascular percutaneus angioplasty, during which doctors dilated the narrowed area using a catheter and a small-sized expandable balloon, under the protection of a filter. Additionally, a stent was placed to maintain vessel patency. Despite the initial success of the intervention, migration of a thrombus formed on the stent was observed, obstructing the upper and lower branches of the middle cerebral artery, with consequences on blood circulation to the brain. After several aspiration thrombectomies, blood flow was restored and the normal diameter of the carotid artery was regained. Discussions : One of the most feared complications when approaching the supra-aortic vessels are formation of blood clots, and their intracerebral migration. Whether the angioplasty is performed under open surgery or through an endovascular approach, protection of the intracerebral vessels in mandatory. Even though the operating team used a filter placed in the petrous segment of the internal carotid artery, migration of a thrombus occurred after the filter was removed. Having a qualified operating team, with access to specialized equipment for thrombectomy is a second layer of prevention. In the presented case, the patient had an excellent outcome, with no neurological deficit, and improvement of the symptoms. Conclusions: In conclusion, despite the initial success of the endovascular percutaneous angioplasty procedure for carotid artery stenosis, the migration of a thrombus posed a significant challenge to blood circulation to the brain. However, timely intervention through aspiration thrombectomies ultimately led to the restoration of blood flow and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Uterine fibroid (leiomyoma) is known as the most common benign uterine tumor of reproductive period affecting millions of women across the world. According to the specialized literature 20-50% of the existing fibroids will become symptomatic. Uterine artery embolization (UAE) is a minimally invasive procedure performed to treat fibroids by suppressing their blood supply. Objective: The purpose of this report is to summarize the technique, results and case particularity of a UAE in management of a symptomatic uterine fibroid following failed medical therapy. Material and methods: We will debate the case of a 43 years old woman accusing menorrhagia, lower abdominal pain and urinary problems, caused by the presence of a uterine leiomyoma, diagnosed by the gynecologist and treated by hormonal therapy, with no results. After the pre-procedural evaluation was carried out, an UAE has been proven to be the most appropriate treatment. This procedure is performed under local anesthesia and is based on the approach of the uterine arteries through the brachial artery followed by delivering of thousands Polyvinyl alcohol particles via the catheter in order to block the blood flow towards the fibroid. The entire procedure was fluoroscopically assisted. Results: After intervention a control angiography was performed in order to confirm the successful occlusion of peri-fibroid vessels. Patient complained moderate pain, nausea and cramps which were released by analgesics and anti-inflammatory during five days. She was discharged two days after the intervention and resumed her usual activities. Conclusions: UAE should be seen as an alternative therapy of uterine fibroids considering the shorter recovery time and hospitalization, the relieving of symptoms and the lower rate of major complications accompanied by minimal physical and psychological stress for the patient. [ABSTRACT FROM AUTHOR]