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People of all ages enjoy chocolate, and its popularity is attributed to its pleasant taste and aroma, as well as its associated health benefits. Produced through both artisanal and industrial processes, which involve harvesting, selecting, fermenting, roasting and grinding cocoa beans, chocolate has a diverse chemical composition. It contains stimulants for the central nervous system, including caffeine and theobromine, and antioxidants and flavonoids, some of which are associated with promoting cardiovascular health, circulatory function, alertness, and attention. This study aimed to use NIR spectroscopy to determine whether this technique can effectively quantify the percentage of cocoa present in commercial chocolates. In the exploratory analysis of the NIR spectra, conducted in the range of 900-1600 nm, it was observed that the cocoa percentage in the samples correlated most strongly with chemical groups exhibiting absorbance in the range of 900-1400 nm. Principal Component Analysis (PCA) exhibited good discriminatory ability between samples with different cocoa percentages. Kohonen neural networks have also been proven effective in processing high-dimensional nonlinear data and complementing PCA analysis in pattern recognition. Additionally, Principal Component Regression (PCR) was performed to evaluate the predictive capability of cocoa percentage based on NIR spectra, yielding an R 2 value of 0.84. The study demonstrates that integrating the NIR spectra with PCA/PCR and KNN enables cocoa percentage identification, making it a valuable tool for chocolate quality control and authenticity assurance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

Research Background: There is a growing interest in foods with added nutritional value and extended shelf life. This study investigates the use of infrared technology in the drying of banana slices to improve their stability and quality by minimizing moisture content and water activity., Experimental Approach: The drying experiments were carried out at a temperature of 70 °C, using the following pretreatments: ultrasound-assisted (UA) immersion in water for 20 and 30 min, osmotic dehydration (OD) and ultrasound-assisted osmotic dehydration (UAOD) for 20, 30 and 40 min. The osmotic process consisted of immersing the samples in the isomaltulose solution (40.0 g/100 g deionized water) for 60 min., Results and Conclusions: All mathematical models used to describe the drying process showed a good fit with high R 2 values (>0.98) and low value of the relative mean error E (%), the sum of squared error and the root mean squared error. The Fick's diffusion coefficient ( D eff ) was higher for the samples previously treated with ultrasound for 20 and 30 min. The ultrasonic treatment resulted in shorter drying times with a reduction in average time of up to 29 %. OD was not efficient in reducing drying time, resulting in samples with lower drying rates. The samples treated with ultrasound showed less isotropic shrinkage and better color parameters. The osmotic process resulted in samples with greater rehydration capacity., Novelty and Scientific Contribution: The impregnation of a carbohydrate with low glycemic index in banana slices was achieved by the osmotic pretreatment, resulting in a new food product with attractive nutritional properties. This advancement represents not only a significant step in the development of functional foods, but also a major innovation in terms of processing technologies. The OD was combined with infrared drying, a method known for its superior drying rates, high heat transfer coefficient and energy efficiency. The synergy of these promising techniques not only shortens the processing times but also ensures more uniform dehydration of food products, resulting in end products that not only maintain but also optimize their nutritional value. These advances offer innovative solutions to improve food quality and also minimize environmental impact through low-energy technologies such as ultrasound and infrared treatment., Competing Interests: CONFLICT OF INTEREST The authors declare no conflict of interest., (Authors.)

The yacon roots are rich in fructooligosaccharides (FOS) and highly perishable. Drying is crucial for food quality and extending shelf life. However, preserving thermosensitive compounds, such as FOS, poses a challenge in conventional drying methods. In this regard, microwave drying and ethanol pretreatment (ET) have emerged as promising solutions for maintaining nutrients and reducing drying time (DT). The objective of this study was to assess how ET and sample temperature affect quality and process parameters during intermittent microwave drying of yacon. Drying at 52°C treated with ethanol was the one that stood out for presenting the highest fructan retention (64.1%), low DT, lower energy consumption (EC) (364.00 ± 5.03 kWh kg water -1 ), higher retention of antioxidant capacity (73.9%) and total phenolic content (77.5%), and slight variation in color parameters. Therefore, microwave drying with a controlled temperature of yacon pretreated with ethanol effectively reduces DT and EC by maintaining quality parameters., (© 2024 Institute of Food Technologists.)

The acerola seed is an agro-industrial waste. It is a high moisture content product, rich in bioactive compounds. Drying is an alternative to make this waste available in a safe condition. The use of ethanol as a pretreatment could improve the drying process besides reducing the operation time. This study aimed to investigate the influence of ethanol pretreatment (ET) on the content of bioactive compounds, cell wall thickness, and color. The drying kinetics was studied, and the influence of external and internal resistance was discussed. The samples were immersed in ethanol for 2 min with subsequent convective drying (40 °C and 60 °C; 1 m s -1 ) until they reached the equilibrium condition. The ET reduced the drying time up to 36.36 %. The external and mixed control of mass transfer were identified as the governing regimes for drying this material, depending on the use of ethanol. ET led to an increase in effective diffusivity, a reduction in cell wall thickness, and preservation of the color of the dried waste. The ET positively impacted the conservation of ascorbic acid compared to untreated dried samples but was not relevant to phenolic compounds, carotenoids, and antioxidant activity. The drying process increased the bioactivity of the anthocyanins. The best condition was drying at 60 °C, pretreated with ethanol., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Yacon is a highly perishable tuberous root, rich in fructooligosaccharides (FOS). Convective drying preceded by ethanol treatment (ET) is an alternative for increasing shelf life in a shorter process. The aim of this study was to investigate the impact of ET and temperature (50 °C and 70 °C) on quality parameters (fructan retention, total phenolic content, antioxidant capacity, shrinkage, color and microstructural parameters) and process parameters (drying time, drying kinetics, and energy consumption) in the convective drying of yacon slices. The ET induced structural alterations in the tissues and cells that aids in the reduction of drying time up to 28.00 %. ET resulted in an increase in effective diffusivity and leaded to noteworthy reduction in energy consumption (up to 22.72 %). The quality parameters such as color, shrinkage, and total phenolic content showed no significant differences among the treatments. The use of ethanol promoted highest preservation of antioxidant activity; however, it caused degradation of FOS. The ethanol pretreated drying at 50 °C was the better condition for lower consumption and preservation of quality parameters as total phenolic content, antioxidant capacity and fructan retention, but the samples dried at 50 °C were the ones with the highest fructan retention (55.11 ± 2.19 %)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The Brazilian Society of Angiology and Vascular Surgery, through the Guidelines Project, presents new Abdominal Aortic Aneurysm Guidelines, on the subject of care for abdominal aortic aneurysm patients. Its development prioritized descriptive guidelines, using the EMBASE, LILACS, and PubMed databases. References include randomized controlled trials, systematic reviews, meta-analyses, and cohort studies. Quality of evidence was evaluated by a pair of coordinators, aided by the RoB 2 Cochrane tool and the Newcastle Ottawa Scale forms. The subjects include juxtarenal aneurysms, infected aneurysms, and new therapeutic techniques, especially endovascular procedures. The current version of the guidelines include important recommendations for the primary topics involving diagnosis, treatment, and follow-up for abdominal aortic aneurysm patients, providing an objective guide for medical practice, based on scientific evidence and widely available throughout Brazil., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article., (Copyright© 2023 The authors.)

Purpose: To report the 60-month safety and effectiveness results of a multicenter, prospective, randomized controlled trial comparing the ZILVER PTX paclitaxel-eluting stent to prosthetic above-the-knee bypass for the treatment of symptomatic TransAtlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions., Materials and Methods: Patients were enrolled between October 2013 and July 2017. One of the secondary outcomes was primary patency at 60 months, defined as no evidence of binary restenosis or occlusion within the target lesion or bypass graft based on a duplex ultrasound peak systolic velocity ratio < 2.4 and no clinically-driven target lesion revascularization (TLR) in endovascular cases or reintervention to restore flow in the bypass at 60 months. Survival rates after 5 years were also analyzed., Results: 220 patients (mean age 68.6 ± 10.5 years; 159 men) were included and randomized to ZILVER PTX (n = 113, 51.40%) or BYPASS group (n = 107, 48.60%). The 60-month primary patency rate was 49.3% for the ZILVER PTX group versus 40.7% for the bypass group (p = 0.6915). Freedom from TLR was 63.8% for the ZILVER PTX group versus 52.8% for the bypass group (p = 0.2637). At 5 years, no significant difference in survival rate could be seen between the ZILVER PTX and the bypass group (69.1% vs. 71% respectively, p = 0.5503)., Conclusion: Even at 5 years, non-inferior safety and effectiveness results of the ZILVER PTX could be seen. These findings confirmed that the use of ZILVER PTX stents can be considered as a valid alternative for bypass surgery when treating long and complex femoropopliteal lesions., (© 2023. The Author(s).)

Objectives: The Iliac Sandwich is an off-label technique that uses parallel stent grafts to treat aortoiliac aneurysms. The purpose of this experimental study is to evaluate the conformability and juxtaposition of stent grafts combinations used in this technique through in-vitro mechanical evaluation, computed tomography (CT) analyses, and a controlled pulsatile flow system., Methods: The combinations of two Viabahn® ("V-V") or Viabahn® and Excluder® iliac extension ("V-E") were analysed using CT imaging with measurement of the gutter area by two independent analysts before and after balloon angioplasty. In a second phase, the parallel stent combinations were also evaluated using CT imaging after being implanted in the aortic aneurysm model with a pulsatile flow system with controlled temperature, viscosity, and density., Results: The "V-E" group had a better conformability when compared to the "V-V" group, ensuring smaller gutter areas (0.0064 cm 2  ± 0.01 vs. 0.0228 cm 2  ± 0.03, p < 0.001). Post dilatation with two non-compliant balloons resulted in enlargement of the gutter area (Area A, p 0.065; Area B, p 0.071). Conversely, post dilatation with a non-compliant balloon for the internal iliac component and a compliant balloon for the external iliac device reduced the gutter area (Area A, p 0.008; Area B, p 0.010)., Conclusion: The combination of Viabahn® and Excluder® iliac extension device ("V-E") had a smaller gutter area compared to two Viabahn® parallel stents for the Iliac Sandwich Technique. Post dilatation using a non-compliant balloon for the internal iliac device and a compliant balloon for the external iliac provided superior conformability and juxtaposition., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)

Background: There are several ways to treat varicose veins of the lower limbs, among which use of 1470nm diode lasers stands out. This technique can be used to treat patients in outpatient settings, with early return to work, good esthetic results, and low rates of complications. However, variables such as the laser wavelength, the power administered in each area, the type of fiber, and the linear intravenous energy density (LEED) are still extensively discussed., Objectives: To analyze the results of superficial venous insufficiency treatment with a 1470nm diode laser., Methods: Retrospective study conducted at a private clinic in a private hospital in Florianopolis, based on a database collected prospectively. The sample comprised 287 patients who underwent surgery to treat superficial venous insufficiency with 1470nm diode laser, from January 2016 to December 2018, totaling 358 great saphenous veins (GSVs) and 84 small saphenous veins (SSVs) treated., Results: The total occlusion rates after 12 months of surgery were 94.4% in the GSVs, with an average LEED of 45.90 J/cm, and 96.4% in the SSVs, with an average LEED of 44.07 J/cm., Conclusions: During the follow-up period, the 1470nm diode laser proved to be a safe treatment, with great efficacy and low rates of complications (pain, edema, bruising, deep vein thrombosis, and endothermal heat-induced thrombosis - EHIT)., Competing Interests: No conflicts of interest declared concerning the publication of this article., (Copyright© 2021 The authors.)

Second-generation stent-grafts (SGs) have addressed many of the mechanical problems reported for first-generation endoprostheses, such as graft tear and stent rupture; however, suture wear and detachment due to pulsatile fatigue remains an issue. Numerical studies on the mechanical behavior of these endoprostheses usually model the attachment between stents and graft as a continuous ''tie'' constraint, which does not provide information on the mechanical loads acting on individual sutures. This paper presents a suitable approach for Finite Element (FE) simulations of SGs which allows for a qualitative evaluation of the loads acting on sutures. Attachment between stents and graft is modeled as rigid beams at discrete locations of the endoprostheses, and the reaction forces on the beams are analyzed. This modeling strategy is employed for four different SG models (two Z-stented commercial models and two circular-stented models) subjected to a severe 180° U-bend, followed by intraluminal pressurization. Results show that, for all models, the majority of sutures is experiencing fluctuating forces within a cardiac cycle (between 80 and 120 mmHg), which points to pulsatile fatigue as potential failure mode. In addition, the highest loads are concentrated in kinks and, for Z-stented models, at the apexes of stents. Moreover, suture loads for circular-stented models are lower than for Z-stented models, indicating better resistance to suture detachment. All these observations are in line with experimental results published in the literature, and, therefore, the procedure herein proposed may serve as a valuable tool in the development of new SG models with better suture resistance to pulsatile wear and fatigue., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: To report the 12-month results of a multicenter, prospective, randomized controlled trial to determine if the ZILVER PTX paclitaxel-eluting stent was noninferior in terms of safety and efficacy compared with surgical bypass. Materials and Methods: This is a study in symptomatic TransAtlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions comparing endovascular ZILVER PTX stenting vs surgical bypass surgery using a prosthetic graft ( ClinicalTrials.gov identifier NCT01952457). Between October 2013 and July 2017, 220 patients (mean age 68.6±10.5 years; 159 men) were enrolled and randomized to the ZILVER PTX treatment group (113, 51.4%) or the bypass treatment group (107, 48.6%). Most of the lesions were occlusions (208, 94.5%); the mean lesion length was 247.1±69.3 mm. The primary outcome measure was primary patency at 12 months, defined as no evidence of binary restenosis or occlusion within the target lesion or bypass graft based on a duplex-derived peak systolic velocity ratio <2.4 and no clinically-driven target lesion revascularization (TLR) in endovascular cases or reintervention to restore flow in the bypass. Results: The estimated 12-month primary patency rate was 74.5% (95% CI 66.3% to 82.7%) for the ZILVER PTX group vs 72.5% (95% CI 63.7% to 81.3%) for the bypass arm (p=0.998). Freedom from TLR at 12 months was 80.9% (95% CI 73.3% to 88.5%) for the ZILVER PTX group vs 76.2% (95% CI 68.0% to 84.4%) for the bypass group (p=0.471). The 30-day complication rate was significantly lower in the ZILVER PTX group (4.4% vs 11.3%, p=0.004). Also, procedure time and hospital stay were significantly shorter in the ZILVER PTX group (p<0.001 for both). Conclusion: With noninferior patency results, a lower complication rate, and shorter procedures and hospital stays, paclitaxel-eluting stenting might become a recommended treatment for long TASC C and D femoropopliteal lesions.

Objective: This study reports the technical aspects and 30-day outcomes of the prospective, multicenter early feasibility study designed to evaluate the GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis (TAMBE; W. L. Gore & Associates, Flagstaff, Ariz)., Methods: Thirteen patients with pararenal or extent IV thoracoabdominal aortic aneurysms were prospectively enrolled at five U.S sites and one non-U.S. site from 2014 to 2016. The TAMBE included four portals with either retrograde or antegrade renal portal configuration and used GORE VIABAHN Balloon-Expandable Endoprosthesis (W. L. Gore & Associates) for stenting of the renal and mesenteric arteries. The primary end point was procedural safety at 30 days, defined by absence of major adverse events, including any-cause mortality, myocardial infarction, stroke, paraplegia, bowel ischemia, respiratory failure, severe acute kidney injury (>50% decline in estimated glomerular filtration rate), dialysis, and procedural blood loss >1000 mL., Results: There were 11 male and two female patients with a mean age of 69 ± 8 years. Mean aneurysm diameter was 61 ± 13 mm. A total of 52 renal and mesenteric arteries were incorporated (4 vessels/patient). Technical success was achieved in 12 patients (92%). One patient had inadvertent occlusion of a right renal artery due to dissection. There was no mortality, aneurysm rupture, conversion to open repair, dialysis, or spinal cord injury. Mean length of hospital stay was 5 ± 3 days. At 30 days, four patients (31%) had major adverse events, all due to procedural blood loss >1000 mL. One patient had a type I endoleak at the distal renal branch, which was successfully treated by placement of an additional renal stent before dismissal. Computed tomography angiography at 30 days showed patent target vessels and no type I or type III endoleak., Conclusions: This study confirms the early feasibility of the TAMBE for treatment of pararenal and extent IV thoracoabdominal aortic aneurysms. The high technical success, no mortality, and low morbidity rate support continuation of clinical investigation in a larger population of patients., (Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Background: The Octopus technique is an off-label and off-the-shelf strategy used as an option in the management of some specific and selected cases of thoracoabdominal aortic aneurysms (TAAA). We sought to compare 2 different methods of measurements on computed tomography (CT) slices and to evaluate the accommodation and conformability, before and after ballooning, of the components used in the Octopus technique., Methods: The CT gutter analysis between the 3 stent grafts within the short docking limb of the Excluder(®) was made using Viabahns(®) of 8, 7, and 6 mm in diameter. Each of the 10 possible combinations underwent a CT established protocol. The best axial image of the docking limb was submitted for an evaluation by 2 independent analysts, using 2 different methods. We also performed a postballooning evaluation, and the same CT protocol was used., Results: There was no significant difference between the formats of measurement type "A" and type "B." Furthermore, there was no significant difference between the measurements made by the independent analysts. The tomography analyses demonstrated that the combination of stent grafts (Viabahn) of 8 and 7 mm diameter, inside the short docking limb of the bifurcated endoprosthesis, had the best possible relationship between the diameters used. These combinations showed better conformability and juxtaposition, with smaller areas of gutters and theoretically less possibility of endoleak. In addition, we found that postimplant balloon dilatation impaired the conformability and juxtaposition of the stent grafts (Viabahn) in the optimum combinations., Conclusions: In this analysis, we demonstrated a feasible, reliable, and reproducible form of CT measurement of the gutters in the Octopus technique for endovascular repair of TAAAs. Based on these measurements, there is a preferable combination of Viabahn sizes to be used in the Octopus technique and that postdilatation impairs the conformability and juxtaposition., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Pulmonary embolism is an important cause of cardiovascular death. Inferior vena cava filters have been shown to be effective for prevention of this condition., Objectives: To determine the safety, performance and efficacy of a new inferior vena cava filter in an ovine model., Methods: BKone1 filters are self-centering with over-the-wire deployment, have three filtering regions and are made from nickel-titanium alloy. Eight of these filters were implanted in 8 sheep. The sheep were divided into 4 groups of two animals (A and B) and the number of clots injected differed by group. Two clots were injected in group 2, four in group 3, eight in group 4 and zero clots in group 1. A animals underwent euthanasia soon after the procedure and B animals were observed for 30 days and then euthanized after a control cavography. All inferior vena cavas were processed for histological examination. Clots were prepared in a metal mold, sectioned and then radiopaque markers were inserted. Clot capture was analyzed by identifying the radiopaque marker on fluoroscopy., Results: No clot migration was observed during follow-up. Control cavographies showed patent inferior vena cavas. Pathological examination indicated little inflammatory tissue response. All clots were captured in the condition with 2 clots, only one clot was missed in the group injected with 4 clots and in the condition of 8 clots, they were partly captured., Conclusions: The filters were deployed safely. There was a reduction in efficacy as the number of blood clots increased., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Background: The Global Registry for Endovascular Aortic Treatment (GREAT) is a prospective observational multicenter cohort registry that was initiated in November 2011. The aim of the GREAT is to collect contemporary real-world data on the performance of all Gore aortic endografts in the treatment of multiple aortic pathologies. The primary and secondary objectives, design, and future directions of the GREAT are described., Methods: The GREAT aims to enroll 5000 consecutive patients with Gore thoracic and abdominal aortic endografts from multiple centers throughout the world. The GREAT has broad inclusion criteria with minimal exclusion criteria to reflect real-world practice such as including off-label use, nonstandard indications and devices deployed outside instruction for use. Follow-up will extend to 10 years providing major insights into the long-term durability and behavior of Gore aortic endografts. Primary end points include the incidence and timing of (1) endoleak of any type, (2) endograft migration and/or stent fracture, (3) endograft explantation, and (4) aortic rupture. Secondary end points include the following: (1) incidence of serious device events by pathology, (2) incidence of serious device events by aortic segment (ascending aorta, arch of aorta, descending thoracic aorta, abdominal aorta), (3) long-term survival by pathology, and (4) aorta-related mortality by pathology., Results: As of June 2015, 2960 patients have been enrolled into the GREAT from 78 centers in Europe, the United States, Australia, New Zealand, and Brazil. The majority of patients and centers are from Europe and the United States. Completion of enrollment is anticipated to be in 2017 with interim results planned to be published during enrollment and on follow-up., Conclusions: Upon completion, the GREAT will be among the largest clinical registry to date of abdominal and thoracic aortic devices manufactured by a single sponsor. It will provide valuable real-world data on the use and durability of Gore aortic endografts in the treatment of a variety of aortic pathologies and devices deployed within and outside instruction for use., (Copyright © 2016 Elsevier Inc. All rights reserved.)

A ruptured abdominal aortic aneurysm (RAAA), complicated by an aortocaval fistula (ACF), is usually associated with high morbidity and mortality during open operative repair. We report a case of endovascular treatment of an RAAA with ACF. After accessing both common femoral arteries, a bifurcated aortic stent graft was placed. Subsequently, we accessed the fistula from the right femoral vein and a cava vein angiography showed a persistent massive flow from the cava to the excluded aneurysm sac. We proceeded by covering the fistula with an Excluder aortic stent-graft cuff to prevent pressurization of the aneurysm sac and secondary endoleaks. This procedure is feasible and may reduce the chances of posterior endoleaks., (Copyright © 2014 Elsevier Inc. All rights reserved.)

We describe a case of Kommerell's diverticulum involving the distal portion of a right-sided aortic arch and the origin of an aberrant left subclavian artery (LSA). The patient underwent a total endovascular repair with the use of a modified Valiant endograft (Medtronic, Minneapolis, Minn) to which a branch was attached to keep LSA patency. Postoperative computed tomography showed complete exclusion of the lesion, without endoleaks. The use of "customized off-label" devices to treat special conditions was feasible in this case, keeping patency of the LSA without risk of arm claudication or the requirement for a complementary surgical bypass., (Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)

Aim: The Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE) is a long-term 1200-patient multicenter prospective study initiated to augment the knowledge base (poolable and comparable) about endovascular aortic repair (EVAR) in a real-world population implanted with a single latest-generation stent graft system (Endurant). With enrollment ongoing at 80 high-volume sites, the registry has limited inclusion/exclusion criteria or procedural specification. Technical and clinical data will be reported through 5 years., Methods: An interim analysis was performed on investigator-reported data for the first 180 patients enrolled. These patients were asymptomatic elderly males (92.1%) with considerable comorbidities. For 47.3% of the patients, the American Society of Anesthesiologists risk class was either III or IV. The Endurant stent graft was successfully deployed in 99.4% of patients for elective treatment of abdominal aortic aneurysm., Results: Through 30 days, the rate of all-cause mortality was 1.7% (N=3), with all 3 deaths classified as procedure-related but not device-related. The rate of secondary endovascular procedures was 1.1%, and the rate of conversion to open repair was 0.6%. At postprocedure and at 30-day follow-up, there were no type I or type III endoleaks and no instances of stent graft kinking, thrombosis, or occlusion. ENGAGE represents the largest real-world registry for any single EVAR stent graft., Conclusion: The interim results through 30 days of the first 180 patients enrolled are promising. Longer-term follow-up for more patients will be reported.

The development of a homemade device for in vivo human determination of the open circuit potential (OCP) of Nitinol is described. Pseudo-reference electrodes (316L stainless steel and Pt) were initially tested and validated in vitro using simulated body fluids. As judged from the excellent electrochemical responses in terms of both accuracy and precision, the most ideal system comprised the combination of sterilized Pt (pseudo-reference) and Nitinol (working) needle-shaped electrodes. The average in vivo human OCP determined from independent measurements on six human patients with indication of direct arterial surgery was -0.334 +/- 0.030 V/SCE. This value was in good agreement with data recorded in vitro using simulated body fluids (-0.313 +/- 0.003 V/SCE in AFNOR S90-701 artificial saliva; -0.334 +/- 0.001 V/SCE in artificial urine; -0.239 +/- 0.007 V/SCE in Ringer's solution). The thin surface film protecting the bulk NiTi alloy is therefore not susceptible to active dissolution at rest as long as the break down potentials (>>0.0 V/SCE) so far reported are well above OCP measured in this study. These results highlight the importance of evaluating the corrosion resistance of Nitinol under realistic conditions (mechanical loads, wear and fatigue) in order to establish multifaceted mechanisms that might lead to accelerated dissolution and failure of implanted stents., (Copyright 2008 Wiley Periodicals, Inc.)

Purpose: To establish a correlation between intrasac pressure measurements of a pressure sensor and an angiographic catheter placed in the same aneurysm sac before and after its exclusion by an endoprosthesis., Methods: Patients who underwent endovascular abdominal aortic aneurysm repair and received an EndoSure wireless pressure sensor implant between March 19 and December 11, 2004 were enrolled in the study. Simultaneous readings of systolic, diastolic, mean, and pulse pressure within the aneurysm sac were obtained from the catheter and the sensor, both before and after sac exclusion by the endoprosthesis (Readings 1 and 2, respectively). Intrasac pressure measurements were compared using Pearson's correlation and Student's t test. Statistical significance was set at p<0.05., Results: Twenty-five patients had the pressure sensor implanted, with simultaneous readings (i.e., recorded by both devices) obtained in 19 patients for Reading 1 and in 10 patients for Reading 2. There was a statistically significant correlation for all pressure variables during both readings, with p<0.01 for all except the pulse pressure in Reading 1 (p<0.05). Statistical significance of pressure variations before and after abdominal aortic aneurysm exclusion was coincident between the sensor and catheter for diastolic (p>0.05), mean (p>0.05), and pulse (p<0.01) pressures; the sole disagreement was observed for systolic pressure, which varied, on average, 31.23 mmHg by the catheter (p<0.05) and 22 mmHg (p>0.05) by the sensor., Conclusion: The excellent agreement between intrasac pressure readings recorded by the catheter and the sensor justifies use of the latter for detection of post-exclusion abdominal aortic aneurysm pressurization.

Objective: Complete exclusion and depressurization of the aneurysm sac is the prime goal of endovascular repair (EVAR) of abdominal aortic aneurysms. Thus, any EVAR that results in a type I or III endoleak has been classified as a technical failure. The current method to detect endoleaks uses intraoperative aortography. However, aortography is limited by its subjective nature, inability to quantify the significance of the endoleak, and artifacts such as bowel gas that may mimic an endoleak. In addition, repetitive contrast injection may impair renal function. To increase the efficacy and safety of intraoperative endoleak detection, a wireless pressure-monitoring system has been developed and tested in the clinical setting., Methods: The APEX trial (Acute Pressure Measurement to Confirm Aneurysm Sac EXclusion) is a prospective, multicenter/international trial sponsored by CardioMEMS to evaluate the safety and efficacy of the EndoSure wireless pressure sensor for EVAR. The 30 x 5 x 1.5-mm sensor contains no battery and is powered externally with radiofrequency energy. The sensors are extremely stable, operate over the full physiologic range of pressures, and have a resolution of 1 mm Hg. A total of 90 patients were enrolled at 12 sites, 76 of whom were eligible for analysis. The sensor was implanted via the contralateral femoral artery at the time of EVAR. The sac pulse pressure was measured with both an angiographic catheter and the sensor after deployment of the main endograft but before the deployment of the contralateral limb (type I endoleak equivalent). Sac pressure was again measured with the sensor after deployment of the contralateral limb and completion of the EVAR. Data were collected in a prospective manner., Results: In all of the eligible patients (n = 76), the initial sensor pressure measurement agreed closely with the angiographic catheter pressure measurement of the type I endoleak equivalent. At the completion of the procedure, there was agreement between the sensor measurement and angiography regarding the presence or absence of a type I or III endoleak in 92.1% (n = 70) of the measurements. Overall, the sensitivity was 0.94 and the specificity was 0.80 for detecting type I or III endoleaks. Final pulse pressures decreased significantly compared with baseline measurements., Conclusions: Implantation of the wireless pressure sensor is safe, and remote aneurysm sac pressure sensing is feasible. It was a valuable guide in evaluating the completeness of the EVAR procedure. Long-term study will be needed to prove its efficacy for postoperative surveillance.

Twenty patients with complications of drug addiction were admitted to the Department of Vascular Surgery of the Santa Catarina University Hospital, from January 1986 to September 1990. Most of these patients were male, aged between 20 and 35 years. The most common drug used was propoxiphene, followed by cocaine. Swelling, ulcers and pain in the inferior extremities were the most common signs and symptoms. Six patients presented deep venous thrombosis, four had acute lymphangitis, all of them in the lower limbs. Five patients had acute arterial occlusions, one presented common femoral artery mycotic aneurysm and another had a false aneurysm of the superficial femoral artery. Venous and lymphatic complications were clinically treated with antibiotics, heparin and local care. Six patients were submitted to surgical procedures. One was treated by aneurysmectomy and vascular reconstruction, another with aneurysmectomy and arterial ligation. On one patient forearm fasciotomy was performed. Two amputations and one drainage of abscess were carried out.