Fenestrated Aortic Aneurysm Repair in Patients Treated Inside Versus Outside of Instructions for Use

Objectives: The aim of this study was to compare outcomes of patients treated with the Cook Zenith Fenestrated (ZFEN) device for juxtarenal aortic aneurysms inside versus outside the IFU. Methods: We retrospectively reviewed our institutional ZFEN database for cases performed between 2012 and 2018, with analysis performed in 2020 in order to report midterm outcomes. The cohort was stratified based on treatment inside (IFU group) and outside (non-IFU group) the IFU for criteria involving the proximal neck: neck length 4 to 14 mm, neck diameter 19 to 31 mm, and neck angulation ≤45°. Patients with thoracoabdominal aneurysms or concurrent chimney grafting were excluded. The primary outcomes in question were mortality, type 1a endoleak, and reintervention. Univariate and multivariate analyses were performed to determine associations between adherence to IFU criteria and outcomes. Results: We identified 100 consecutive patients (19% female, mean age 73.6 years) for inclusion in this analysis. Mean follow-up was 21.6 months. Fifty-four patients (54%) were treated outside the IFU because of inadequate neck length (n=48), enlarged neck diameter (n=10), and/or excessive angulation (n=16). Eighteen patients were outside IFU for two criteria, and one patient was outside IFU for all three. Non-IFU patients were exposed to higher radiation doses (3652 vs 5445 mGy, p=0.008) and contrast volume (76 vs 95 mL, p=0.004). No difference was noted between IFU and non-IFU groups for 30-day mortality (0% vs 3.7%, p=0.18), or type 1a endoleak (0% vs 1.9%, p=0.41). Reintervention was also similar between cohorts (13% vs 27.8%, p=0.13). Being outside IFU for neck diameter or length was each borderline significant for higher reintervention on univariate analysis (p=0.05), but this was not significant on multivariate Cox proportional hazard modeling (HR 1.82 [0.53–6.25]; 2.03 [0.68–7.89]), respectively. No individual IFU deviations were associated with the primary outcomes on multivariate analysis, nor being outside IFU for multiple criteria. Conclusions: Patients with juxtarenal aortic aneurysms may be treated with the ZFEN device with moderate deviations from the IFU. While no differences were seen in mortality or proximal endoleak, larger studies are needed to examine the potential association between IFU nonadherence and reinterventions and close follow-up is warranted for all patients undergoing such repair.

Keragaman Fenotipe Kualitatif dan Kuantitatif Itik Sikumbang Jonti sebagai Plasma Nutfah di Sumatera Barat

This research was aimed to identifiaty qualitative and quantitative phenotypic polymorphism of Sikumbang Jonti Duck in Kecamatan Payakumbuh Timur Kota Payakumbuh Sumatera Barat. This research used 206 Sikumbang Jonti duck that were sexual maturity (22-48 weeks), divided of 50 males and 156 females. The qualitative traits observeted were head color, neck color, breaks color, back color, primary wings color, tail color, thigh color, bill color, and shank color. The quantitative traits observed were body weight (kg), beak width (cm), beak length (cm), neck length (cm), wing length (cm), femur length (cm), tibia length (cm), shank length (cm), back length (cm), number of primary wing feathers (strands), number of secondary wing feathers (strands), pelvic width (cm), and chest circumference (cm). The result showed that color of Sikumbang Jonti duck was dominated by white. Male Sikumbang Jonti duck had color head was white-black, and female had color head was white. In addition, the Sikumbang Jonti duck had green primary wing feathers like a beetle. The coefficient of diversity of the Sikumbang Jonti duck was low for beak width, tibia length (female), number of primary wing feathers, and number of secondary wing feathers, moderate value for body weight, beak length, neck length, wing length, femur length (female), length tibia (male), shank length, back length, perlvis width (females), and chest circumference (males), and high value for femur length (males). Keywords: Duck morphometric; Germplasm; Pattern color; Payakumbuh; Sumatera barat Abstrak Penelitian ini bertujuan untuk mengindentifikasi keragaman fenotipe kualitatif dan kuantitatif itik Sikumbang Jonti di Kecamatan Payakumbuh Timur Kota Payakumbuh Provinsi Sumatera Barat. Penelitian ini menggunakan 206 ekor itik Sikumbang Jonti yang sudah dewasa kelamin (22 – 48 minggu), terdiri dari 50 ekor jantan dan 156 ekor betina. Sifat kualitatif yang diamati adalah warna bulu head, warna bulu neck, warna bulu breaks, warna back, warna primary wings, warna tail, warna thigh, warna bill, dan warna shank. Sifat kuantitatif yang diamati adalah bobot badan (kg), lebar paruh (cm), panjang paruh (cm), panjang leher (cm), panjang sayap (cm), panjang femur (cm), panjang tibia (cm), panjang shank (cm), panjang punggung (cm), jumlah bulu sayap primer (helai), jumlah bulu sayap sekunder(helai), lebar pelvis (cm), dan lingkar dada (cm). Hasil menunjukkan warna bulu itik Sikumbang Jonti didominasi dengan warna bulu putih. Warna bulu kepala itik Sikumbang Jonti jantan berwarna putih-hitam, sedangkan itik Sikumbang Jonti betina berwarna putih. Selain itu, itik Sikumbang Jonti memiliki warna bulu sayap primer berwarna hijau seperti kumbang. Koefisien keragaman itik Sikumbang Jonti bernilai rendah untuk lebar paruh, panjang tibia (betina), jumlah bulu sayap primer, dan jumlah bulu sayap sekunder, bernilai sedang untuk bobot badan, panjang paruh, panjang leher, panjang sayap, panajng femur (betina), panjang tibia (jantan), panjang shank, panjang punggung, lebar perlvis (betina), dan lingkar dada (jantan), dan bernilai tinggi untuk panjang femur (jantan). Keragaman fenotipe kualitatif dan kuantitatif pada itik Sikumbang Jonti relatif seragam, kecuali pada fenotipe kuantitatif panjang femur pada itik Sikumbang Jonti jantan memiliki keragaman tinggi. Kata kunci: Morfometrik itik; Payakumbuh; Plasma nutfah; Sumatera barat; Warna bulu

Karakteristik Morfometrik dan Produksi Telur Itik di Sentra Peternakan Itik Kabupaten Tolitoli

This research aimed to identify the morphometrics characteristic and egg production of duck in the center farming area in Tolitoli Regency. There are four districts chosen as the research sample location, which are Dampal Selatan, Lampasio, Galang, and Dako Pemean. In each district, 250 female ducks were used. Parameters was observed is body weight, body length, pubis width, shank length, chest circumference, wings length, neck length, and egg production based on Hand Day Production. The correlation between morphometrics and HDP analyzed by IBM Statistic 25 software. The results showed that pubis width have a strong positive correlation with egg production (r value 0.37 – 0.45). The body weight have negative correlation with HDP (-0.31 to -0.22), chest circumference (-0.13 to -0.05), body length (-0.01 to 0.03), wing length (-0.12 to 0.03), neck length (-0.03 to 0.02), and shank length (0.02 to 0.03). The morphometrics characteristic and egg production in duck center farming area are uniform with an HDP at 63%. Keywords: Correlation; Duck; Egg; Morphometrics; Production Abstrak Penelitian ini bertujuan untuk mengetahui karakteristik morfometrik dan produksi telur itik di sentra peternakan itik Kabupaten Tolitoli. Terdapat empat kecamatan yang dijadikan lokasi sampel pada penelitian ini yaitu Kecamatan Dampal Selatan, Lampasio, Galang, dan Dako Pemean dijadikan sampel penelitian. Masing-masing 250 itik betina yang digunakan. Parameter yang diamati yaitu bobot badan, panjang badan, lebar pubis, panjang shank, lingkar dada, panjang sayap, dan panjang leher serta produksi telur berdasarkan Hen Day Production (HDP). Hubungan morfometrik dengan produksi telur dianalisis menggunakan analisis korelasi menggunakan IBM Statistic 25. Hasil penelitian menunjukkan bahwa lebar pubis memiliki korelasi yang positif dan cukup kuat dengan HDP dengan nilai korelasi antara 0,37–0,45. Bobot badan berkorelasi negative dengan HDP (-0,31 sampai -0,22), lingkar dada (-0,13 sampai -0,05), panjang badan (-0,01 sampai 0,03), panjang sayap (-0,12 sampai 0,03), panjang leher (-0,03 sampai 0,02), dan panjang shank (0,02 sampai 0,03). Karakteristik morfometrik dan produksi telur itik pada sentra peternakan yang diteliti seragam dengan nilai HDP sebesar 63%. Kata kunci: Itik; Korelasi; Morfometrik; Produksi; Telur

Emergency endovascular treatment using a Viabahn stent graft for upper and lower extremity arterial bleeding: a retrospective study

Background A Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB). Methods Consecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, rebleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. Results EVT using the Viabahn SG was performed in 22 patients (mean age, 72.0 ± 13.0 years; 11 men) and 23 arteries (upper, 6; lower, 17). The indications for EVT were pseudoaneurysm (n = 13, 59.1%), extravasation (n = 9, 39.1%), and inadvertent arterial cannulation (n = 1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 ± 2.2 and 8.9 ± 2.3 mm, respectively. The mean neck length was 20.4 ± 11.3 mm. No endoleaks or rebleeding occurred during the follow-up period (mean, 169 ± 177 days). Two SG occlusions without limb ischemia occurred in the external iliac and brachial arteries after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively. Conclusions Emergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.

Phenotypic characterization of four indigenous naked neck chicken ecotypes in Pakistan

A study was conducted to characterize four phenotypes (black, white with black tips, light brown and dark brown) of naked neck chickens [n=320; 80(40♂, 40♀)] for qualitative and quantitative traits at 20 weeks of age. Qualitative phenotypic characterization was based on head appearance, comb type, wattle size, plumage pattern, shank color, spurs prevalence and number of toes. Quantitative phenotypic characterization was based on neck length, keel length, shank length, drum stick length, body length, wing span and circumference. Males and females of all phenotype had plain head and single comb. Plain feather pattern was predominantly most frequent on breast, wing bow, wing bar, wing bay, saddle and tail followed by stippled, penciled and laced. Males had most frequent yellow shanks followed by grey, off-white and green. White black, light and dark brown phenotypes expressed maximum yellow shank coloration whereas grey shanks were most frequent in black birds. Morpho-metric measurements were significantly higher in males than females. Light and dark brown phenotypes had higher values of quantitative traits than those of black and white black. All males and females of naked neck phenotypes possessed four toes, normal spurs and tuft feathers on the ventral portion of the neck above crop. The phenotypic variation observed in indigenous naked neck chickens could provide valuable basic information to develop effective utilization and conservation programs.

Emergency endovascular treatment using a Viabahn stent graft for upper and lower extremity arterial bleeding: a retrospective study

BackgroundA Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB).MethodsConsecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated.ResultsEVT using Viabahn SG was performed in 22 patients (mean age: 72.0 years; 11 males) and 23 arteries (upper: 6, lower: 17). The indications for EVT were pseudoaneurysm (n=13, 59.1%), extravasation (n=9, 39.1%), and inadvertent arterial cannulation (n=1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 and 8.9 mm, respectively. The mean neck length was 20.4 mm. No endoleaks or re-bleeding occurred during the follow-up period (mean: 169 days). Two SG occlusions without limb ischemia occurred in the external iliac artery and brachial artery after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively.ConclusionsEmergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.

Anatomical Features of Abdominal Aortic Aneurysm on CT Angiography: A Comparison Study

Background: There is little information about the anatomical characteristics and relationship between ruptured and unruptured abdominal aortic aneurysm (AAA). Objective: The present study was to determine the anatomical differences between the two groups as assessed with multi-detector computed tomographic angiography (CTA). Materials and Methods: A retrospective review of all the patients diagnosed with AAA that underwent CTA before aortic repair were performed with matching between ruptured and unruptured groups for age and gender. Patient characteristics, and morphological data of aneurysmal and non-aneurysmal parts on CTA images were reviewed. Results: Ninety-six patients in each group were matched. The ruptured group had significantly lower systolic blood pressure (p=0.027), and higher blood creatinine (p=0.006). In the aneurysm part, maximal aneurysmal diameter was significantly larger in the ruptured group at 7.8 cm versus 6 cm (p<0.001), as well as the larger lumen diameter (p=0.006), longer aneurysmal length (p=0.005), shorter aneurysmal neck length (p=0.009), and thicker maximal thrombus thickness (p<0.001). In the non-aneurysmal part, the aortic diameter of the ruptured group was significantly larger in every location. Multivariate analysis indicated that maximal aneurysmal diameter, non-aneurysmal part of the infrarenal aortic diameter, aneurysmal neck length, and current smoking status remained significant variables for ruptured AAAs. Conclusion: Ruptured AAAs had shorter aneurysmal neck length and larger diameter of both aneurysmal and non-aneurysmal parts of AAA than unruptured group. Keywords: Abdominal aortic aneurysm; CT angiography

Endovascular treatment with Viabahn stent-grafts for arterial injury and bleeding at the visceral arteries: initial and midterm results

Purpose The purpose of the study is to evaluate the initial and midterm efficacy and safety of endovascular treatment (EVT) using Viabahn stent-graft (SG) for arterial injury and bleeding (AIB) at the visceral arteries. Materials and methods Consecutive patients with visceral AIB who underwent EVT using Viabahn between January 2017 and February 2021 were retrospectively reviewed. Technical success, clinical success, peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, 30-day mortality, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. Results EVT using Viabahn was performed in 14 patients (mean age: 68.6 years; 12 males) and 15 arteries. The technical and clinical success rates were 100%. The rates of peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, and 30-day mortality were all 0%. The mean neck length was 9.9 mm. No endoleaks or re-bleeding occurred during the follow-up (mean: 732 days). The SG patency was confirmed after 1, 3, 6, and 12 months in 78.6%, 78.6%, 78.6%, and 56.1% of the patients, respectively. Conclusion EVT using Viabahn for AIB at the visceral arteries was safe and effective. SG occlusions without ischemia often occurred after 12 months.

Two new and two known species of the genus Paraoxydirus Jairajpuri and Ahmad, 1978 (Nematoda: Dorylaimida) from Western Ghats of India

Summary Two new and two known species of the genus Paraoxydirus Jairajpuri and Ahmad, 1978 are described and illustrated from Western Ghats of India. P. vulvalpapillatus n. sp. is characterized by having large sized body (L = 4.6 – 4.8 mm); lip region continuous with completely amalgamated lips; amphidial fovea cup – shaped; 5 – 6 μm long odontostyle; 11 – 13 μm long odontophore; pharyngeal expansion about 28 – 36 % of neck length; transverse vulva; vulval papillae conspicuous; males with 46 – 54 μm long spicules; 11 – 14 continuous ventromedian supplements and long filiform tail similar in both sexes. P. indicus n. sp. is characterized by having large sized body (L = 4.0 – 4.8 mm); lip region poorly offset with amalgamated lips; amphidial fovea cup-shaped; 7 – 8 μm long, robust odontostyle; 17 – 18 μm long odontophore; pharyngeal expansion about 32 – 40 % of neck length; 21 – 26 μm long cardia; longitudinal vulva; 748 – 894 μm long filiform tail; males with 45 – 54 μm long spicules and 12 – 15 continuous ventromedian supplements. P. gigas Jairajpuri, 1964 and P. novus Jairajpuri, 1965 are redescribed based on specimens collected from several localities. A diagnostic Key and compendium to the identification of its eight valid species is provided.