AVF rupture occurred in 3/17 (18%) cases but did not involve loss of the access circuit. Conclusion The Cleaner XT™ device is a safe, minimally invasive endovascular tool for PMT in thrombosed AVF/AVG, with relatively high success and low complication rates.Objective The treatment for arch aneurysms by endovascular repair is often difficult. This study evaluated the long-term outcomes of thoracic endovascular aortic repair for aortic arch aneurysms treated with the Najuta stent-graft system. Materials and Methods From January 2009 to December 2019, 37 patients underwent treatment for aortic aneurysms with the Najuta stent graft system at two institutes, including our hospital. We retrospectively analyzed the short- and long-term clinical outcomes. Results Of all 37 cases, the technical success rate was 97.3% (36 of 37). The mean proximal neck length was 20.1±5.3 mm. The postoperative results revealed 10 patients with type Ia endoleaks (27.8%), 6 with stroke (16.7%), and one with paraplegia (2.8%). In the chronic phase, the overall survival rates and the rates of freedom from aorta-related events at 7 years were 71.3% and 50.7%, respectively. Between two groups divided based on the proximal neck diameter of 20 mm, the less then 20-mm group had significantly higher rates of aorta-related events in terms of freedom from aortic events (P=0.046). Conclusion The fenestrated stent graft can be a less invasive option for the treatment of high-risk patients with aortic aneurysms.Objective Endovascular treatment (EVT) for lower-limb peripheral artery disease patients reduces blood pressure (BP) and improves prognosis. https://www.selleckchem.com/products/ltx-315.html This study retrospectively examined hemodynamics during EVT to clarify the mechanism. Materials and Methods Systemic vascular resistance (SVR) was measured using a noninvasive continuous cardiac output monitoring system during EVT. Furthermore, ankle brachial index was measured before and after EVT. Results The study included 88 lesions of 56 patients (hypertension in 98%). SVR significantly decreased from 2409.1±746.8 dynes·s·cm-5 to 2033.7±635.0 dynes·s·cm-5 (p less then 0.0001). The difference in SVR before and after EVT was significantly greater in the Fontaine IV group than in the Fontaine IIa group (554.7±406.6 dynes·s·cm-5 vs. 312.9±245.7 dynes·s·cm-5, p=0.0151). The change in SVR was correlated with a change in mean BP in the upper limb (p=0.0026). When the change in pressure gradient between the upper limb and the diseased lower limb was large, mean BP of the upper limb significantly decreased (p=0.0022). Conclusion EVT can reduce SVR and BP by canceling the pressure gradient between central BP and diseased lower-limb BP.Objective This study aims to evaluate the efficacy and safety of direct oral anticoagulants (DOACs) after unfractionated heparin (UFH) bolus for the treatment of intermediate-high-risk pulmonary embolism. Materials and Methods On the basis of initial treatment, 81 patients were divided into two groups DOAC after UFH bolus infusion group (group D; n=32) and conventional therapy group (group C; n=49). The frequency of recurrence of venous thromboembolism (VTE) and bleeding within 6 months were compared. In addition, hospitalization length and thrombus reduction rate in the pulmonary artery on computed tomography (CT) at the chronic phase were assessed. Results Recurrence of VTE was found in one (3.1%) and three patients (6.1%) (P=1.00) in groups D and C, respectively, whereas no bleeding events was found in group D and 8.2% of patients in group C (P=0.15). Group D showed shorter hospitalization (7.2±2.3 days) than group C (15.7±9.9 days; P less then 0.001). In the subset of patients with serial CT assessment (group D, n=20; group C, n=38), almost all thrombus of pulmonary artery were disappeared and the thrombus reduction rates were similar between the two groups (group D, 99.5%; group C, 97.1%; P=0.59). Conclusion DOAC administration immediately after UFH bolus treatment has the same efficacy and safety, whereas hospitalization days were significantly shorter than the conventional treatment group.Objective The objective of this study is to share our experience of early surgical excision of highly vascular carotid body tumor (CBT) and to correlate it with current literature. Materials and Methods Data of all consecutive patients diagnosed with CBT from September 2011 to September 2018, who underwent surgical excision, was analyzed. Results Of the 22 cases with mean age of 42±standard deviation (SD) 6 years and female to male ratio of 1.2  1, 68.1% (n=15) of the tumors were on the right side. There were 13.6% (n=3) Shamblin I, 77.2% (n=17) Shamblin II, and 9% (n=2) Shamblin III tumors. Complete excision without vascular reconstruction was achieved in 63.6% (n=14), while patch plasty with Dacron graft was noted in 29.4% (n=5) and interposition Dacron grafting 13.6% (n=3). Peroperative vascular shunt was deployed in 13.6% (n=3) of cases. Transient neuropraxia of the hypoglossal nerve was noted in 13.6% (n=3) of cases, while permanent drooping of the lower lip was noted in 4.5% (n=1). There was no ischemic stroke. The mortality rate was zero, and no recurrence was recorded in mean follow-up of 24±SD 3 months. Conclusion Complete surgical excision of CBT at an early stage, regardless of size, is associated with the best outcome.Klippel-Trenaunay syndrome (KTS) is a rare slow-flow combined vascular malformation characterized by capillary-lymphatic-venous lesions with soft tissue overgrowth of the limbs. We report the case of a 37-year-old female KTS patient with a deep femoral arterial aneurysm. We finally diagnosed that the aneurysm had resulted from a fundamental defect in the arterial wall structure. We discuss whether the use of "aneurysm associated with KTS" is accurate and how to better classify this type of capillary-venous lesion in 17 reported KTS patients with arterial aneurysms. In this review, we describe nosological problems of arterial aneurysms associated with KTS.Strain AS-1 was isolated from laboratory-scale activated sludge collected in Japan. This strain not only grows on rich medium, including R2A medium, but also forms colonies on medium lacking organic matter other than agar (water agar), indicating it could be used as a eurytrophic recombinant host in material production processes. Here, we present a draft genome sequence of Enterobacter sp. AS-1, which consists of a total of 24 contigs containing 5,207,146 bp, with a GC content of 55.64%, and comprising 4,921 predicted coding sequences. Based on 16S rRNA gene sequence analysis, strain AS-1 was designated as Enterobacter sp. AS-1.