Midterm Outcomes of Primary and Secondary Use of an Endoanchor System for Thoracic and Abdominal Aortic Endovascular Aortic Repair.

PURPOSE: To assess the safety, technical success, and midterm outcomes of endoanchor (Heli-FX, Medtronic, Santa Rosa, California) deployment in thoracic endovascular aortic repair (TEVAR) or abdominal endovascular aortic repair (EVAR). MATERIALS AND METHODS: This single-institution, retrospective study of all endoanchor procedures was performed from February 1, 2017 to March 30, 2021. All procedures were performed percutaneously by interventional radiologists. Clinical information and outcome data were retrieved from electronic medical records. Fifty patients (14% females, n = 7; 86% males, n = 43; median age, 79 years [range, 56-93 years]) underwent Endoanchor procedures, with 349 Endoanchors implanted; 33 procedures were primary deployments (at initial stent deployment) and 17 were secondary deployments (previous stent deployment). For the primary group (4 TEVARs and 29 EVARs), indications were prophylactic (n = 30), hostile neck (n = 28), hostile distal landing zone (n = 2), and intraprocedural type 1a endoleaks (n = 3). For the secondary group (4 TEVARs and 13 EVARs), indications were graft migration (n = 8), seal zone expansion without proven endoleak (n = 7) (proximal [n = 4] or distal seal [n = 3]), and proven type 1a endoleak (n = 2). RESULTS: Median number of endoanchors deployed per procedure was 7 (range, 3-10). Median time to deploy endoanchors was 22 minutes (range, 8-46 minutes). The technical success rate of Endoanchor was 99.7% (348/349). The 30-day mortality rate was 0%. The overall adverse event rate was 6% (n = 3). Reinterventions were performed in 12% of patients (n = 6). Median follow-up was 38 months (range, 2-71 months). Overall survival at 1 and 3 years was 95% and 85%, respectively. Overall freedom from type 1a endoleak at 1 and 3 years was 96% and 93%, respectively. CONCLUSIONS: Endoanchor procedures are safe with excellent technical success rate and good midterm clinical outcomes.

A de novo-designed antimicrobial peptide with activity against multiresistant Staphylococcus aureus acting on RsbW kinase.

Antimicrobial peptides are a promising complement to common antibiotics, development of resistance to which is a growing problem. Here we present a de novo-designed peptide, SP1-1 (RKKRLKLLKRLL-NH2), with antimicrobial activity against multiresistant Staphylococcus aureus (minimal inhibitory concentration: 6.25 µM). Elucidation of the mode of action of this peptide revealed a strong interaction with RsbW kinase (Kd: 6.01±2.73 nM), a serine kinase negatively regulating the activity of the transcription factor σB (SigB). SP1-1 binding and functional modulation of RsbW were shown in vitro by a combination of biochemical, molecular, and biophysical methods, which were further genetically evidenced in vivo by analysis of S. aureus ΔsigB deletion mutants. Intracellular localization of the peptide was demonstrated using nanometer-scaled secondary ion mass spectrometry. Moreover, microarray analysis revealed that transcription of numerous genes, involved in cell wall and amino acid metabolism, transport mechanisms, virulence, and pigmentation, is affected. Interestingly, several WalR binding motif containing genes are induced by SP1-1. In sum, the designed peptide SP1-1 seems to have multiple modes of action, including inhibition of a kinase, and therefore might contribute to the development of new antibacterial compounds, giving bacterial kinase inhibition a closer inspection.

Endovascular repair of de novo post-stenotic aortic coarctation aneurysms with complex collateral supply: two cases with long and medium term follow-up.

PURPOSE: To report the technical details and outcomes of the endovascular repair of two cases of de novo post-stenotic aortic coarctation aneurysms complicated by complex collateral supply. CASE PRESENTATIONS: Two patients with thoracic aortic aneurysms complicated by complex aneurysm sac collaterals distal to a previously untreated thoracic aortic coarctation have been treated at our institution. Open surgical intervention was deemed to carry a high risk of haemorrhage due to the degree and complexity of arterial collateralisation. In the first case, selective embolisation of collateral vasculature was performed prior to successful exclusion of the aneurysm with a thoracic endovascular stent-graft and then balloon-expandable stent dilatation of the coarctation stenosis. In the second case, the additional technique of using a jailed sheath within the aneurysm sac allowed for selective embolisation of previously inconspicuous collaterals after deployment of the stent-graft and stent combination. RESULTS: Technical success was achieved in both patients with successful occlusion of the aneurysm, with no recorded complications or aneurysm sac perfusion in the long and medium term follow up periods respectively. CONCLUSION: De novo post stenotic aortic coarctation aneurysms are rare. Endovascular repair is a safe and durable technique that provides a less invasive alternative to open surgical repair. The use of a jailed sheath allows for complete selective embolisation of complex collaterals avoiding a type II aneurysm endoleak.

From the ORFeome concept to highly comprehensive, full-genome screening libraries.

Recombination-based cloning techniques have in recent times facilitated the establishment of genome-scale single-gene ORFeome repositories. Their further handling and downstream application in systematic fashion is, however, practically impeded because of logistical plus economic challenges. At this juncture, simultaneously transferring entire gene collections in compiled pool format could represent an advanced compromise between systematic ORFeome (an organism's entire set of protein-encoding open reading frames) projects and traditional random library approaches, but has not yet been considered in great detail. In our endeavor to merge the comprehensiveness of ORFeomes with a basically simple, streamlined, and easily executable single-tube design, we have here produced five different pooled screening-ready libraries for both Staphylococcus aureus and Homo sapiens. By evaluating the parallel transfer efficiencies of differentially sized genes from initial polymerase chain reaction (PCR) product amplification to entry and final destination library construction via quantitative real-time PCR, we found that the complexity of the gene population is fairly stably maintained once an entry resource has been successfully established, and that no apparent size-selection bias loss of large inserts takes place. Recombinational transfer processes are hence robust enough for straightforwardly achieving such pooled screening libraries.