Residual venous thrombosis is an important risk factor for recurrent thromboembolism and PTS. A greater reduction in thrombus size was associated with lesser clinical events of recurrence and consequently a lesser rate of PTS. However, despite a greater recanalization with enoxaparin, the incidence of PTS was similar between both treatment groups, probably because of the small sample size. Further investigations are needed to clarify the implication of the anticoagulant treatment in the severity of PTS.
The morphometry of the abdominal aortic aneurysms (AAA) has been recognized as one of the main factors that may predispose its rupture. The variation of the AAA morphometry, over time, induces modifications in hemodynamic behavior which, in turn, alters the spatial and temporal distribution of hemodynamic stress on the aneurismatic wall, establishing a bidirectional process that can influence the rupture phenomenon. In order to evaluate potential correlations between the main geometric parameters characterizing the AAA and hemodynamic stresses, 13 unrupture AAA patient-specific models were created. To AAA geometric characterization, 12 indices based on lumen center line were defined and determined. The computing of temporal and spatial distributions of hemodynamic stresses was conducted through Computational Fluid Dynamics. Statistical techniques were used to assess the relationships between the hemodynamic parameters and the different geometrical indices of the AAA. Regression analyses were conducted to obtain linear predictor models for hemodynamic stresses using the different indices defined in this paper as predictor variables. The statistical analysis confirmed that the length L, the asymmetry and the saccular index significantly influenced the hemodynamic stresses. The results obtained show the potential of the use of statistical techniques in predicting the rupture risk of patient-specific AAA.
Missile embolism into the cerebral circulation is a very unusual complication of shotgun wounds to the chest or neck. We report a case of an 11-year-old boy who sustained an air gunshot wound and pellet embolism to the intracranial carotid artery. The cerebral artery pellet embolus resulted in contralateral hemiplegia. The patient was successfully treated by emergency flow reversal and embolectomy. Because this injury is extremely rare, the literature is reviewed, and several principles are suggested to improve the management.
The use of a restrictive postoperative fluid protocol significantly reduces the duration of hospital stay in patients who have undergone major elective abdominal vascular surgery.
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