The NBCA-based vein sealing system is a fast and effective treatment option for the management of incompetent saphenous veins that does not involve tumescent anesthesia, compression stockings, paresthesia, burn marks, or pigmentation. Further large-scale studies with long-term outcomes are required to identify the optimal treatment modalities for patients with saphenous vein insufficiency.

Objectives The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is still a popular technique. Although this procedure is considered to be fast and simple, side effects such as headaches, vomiting, and urinary retention could occur. These side effects make the recovery period difficult for the patient. The patient’s age, gender, and procedural risk factors such as needle sizes and types are important parameters that affect the occurrence and rate of undesirable outcomes. This retrospective study aims to evaluate the endovenous thermal ablation method for the management of incompetent great saphenous veins under spinal anesthesia. Methods A total of 128 patients with incompetent varicose veins who were treated with an endovenous thermal ablation method under spinal anesthesia were retrospectively investigated between January 2016 and January 2019. The pre-, intra-, post-procedural, and follow-up data of the patients were collected and retrospectively compared. Results A total of 128 patients (69 males, 59 females; mean age 45.8 ± 11.8 years; range 21–71 years) were included in the study. The average preprocedural great saphenous vein diameters were 7.41 ± 18.8 mm (range: 5.5–13.0). The average ablated vein length was 25.3 ± 3.4 (range: 15–35) cm. The average tumescent anesthesia use was 300.9 ± 52.6 (range: 150–500) mL. The average procedure time was 18.2 ± 1.8 (range: 11–25) min. The venous clinical severity scores and the chronic venous insufficiency quality of life questionnaire scores declined significantly ( p for venous clinical severity scores: 0.001, p for chronic venous insufficiency quality of life questionnaire scores: 0.001). There was no postoperative paresis or paresthesia. There was one case of deep venous thrombosis and three cases of bruising. The total of three months’ occlusion rates was 96.9% (124/128). The overall post-dural puncture headache ratio was 18%. Women significantly suffered from more headaches than men (27% vs. 10%, p = 0.013). The extreme age intervals (pertaining to ages between 18 and 30 or 50+) were almost significantly less affected by headaches in comparison to the group with the age interval between 31 and 50 (11.3%, 24.2%, p: 0.056). A percentage of 12.5 patients suffered from vomiting. It was recorded that female patients suffered from vomiting more so than the males (20.3%, 5.8%, p: 0.013). Pertaining to vomiting, there was no significant difference between the two age interval groups ( p: 0.14). Urinary retention was observed in 6.3% of the patients. The female gender had a higher ratio of urinary retention, but the difference was insignificant. (8.5%, 4.3%, p: 0.46). There was no significant difference between the age interval groups in terms of urinary retention. Conclusions The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is a fast and effective treatment option for the management of incompetent saphenous veins. However, side effects such as headaches, vomiting, and urinary retention that are affected by gender types, age-intervals, and procedural characteristics should be kept in mind.

Background We aimed to investigate the short‐term outcomes of heart transplant patients who underwent SherpaPak™ donor organ preservation. Method We prospectively collected the data of patients who underwent heart transplantation using SherpaPak™ system for donor organ transportation from February 2020 to March 2021. Donor and recipient demographic data, preoperative and postoperative echocardiographic and hemodynamic parameters, total ischemic time and SherpaPak temperatures, vasoactive inotropic scores (VIS), primary graft dysfunction (PGD) status, intensive care unit stay, complications, and mortality during follow‐up were assessed. Results A total of 39 consecutive heart transplant patients with SherpaPak system were included in the study. The mean donor age was 32.2 ± 6.7 (range: 16–46). The mean recipient age was 57.5 ± 12 (range: 19–73). The mean preoperative ejection fraction (EF) was 23.7 ± 15.4 (range: 5–75). All recipients underwent a standard bicaval technique for orthotopic heart implantation. The mean total ischemic time was 230.1 ± 41 (range: 149–342) min. The mean Sherpa temperature was 5.6 ± 0.8°C (range: 3.7–7.5). The mean VIS was 10.2 ± 6.5 (range: 2–32). The number of mild PGD was 5 (14.7%), and moderate PGD was 4 (11.8%). There was no severe PGD. The postoperative EF was 64.3 ± 5.5 (range: 50–78). Mean intubation time was 47.4 ± 64 (range: 8–312, median: 22) h. The mean time of intensive care unit stay was 6.3 ± 5 (range: 2–31, median: 5) days. Two patients required chest revision (5.8%), two patients had lung infection (5.8%). Two patients had a stroke (5.8%). There was no mortality. Conclusion Using the SherpaPak system during heart transplantation is safe and not associated with significant recipient morbidity. None of the recipients experienced significant PGD and mortality.

Introduction The present study aimed to compare the clinical outcomes of heart transplant patients whose donor hearts were preserved with the SherpaPak controlled cold organ system versus the conventional ice storage technique. Methods All patients undergoing heart transplantation at our center between January 2019 and April 2021 were divided into two groups according to the technique used during donor heart preservation and transport. The first group consisted of 34 SherpaPak controlled temperature preservation patients, and the second group consisted of 47 patients where the conventional three bags and ice technique was utilized during organ transportation. The two groups were compared based on demographics, operative details, and postoperative outcomes. Results There were no significant differences between the groups regarding Vasoactive Inotropic Score (VIS), Primary Graft Dysfunction (PGD), and the need for a transient pacer. However, the VIS, PGD, and pacing trends were lower in the SherpaPak patients even though the total ischemic and cardiopulmonary bypass times were significantly longer. Furthermore, SherpaPak patients exhibited a shorter stay in the ICU with no severe PGD and mortality. Conclusion The SherpaPak donor heart preservation provides safe outcomes in heart transplant patients. Further research is needed to utilize this method for longer durations of ischemic time and expand travel distances for organ transportation.

Concomitant treatment with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella may improve outcomes in patients with cardiogenic shock compared with VA-ECMO alone. Here, we explain a new method to introduce Impella and ECMO through the same arterial access site and jugular venous cannulation to accomplish a mobile patient concept.