The effectiveness of an extra-curricular lecture for STI prevention and sexual education.

While the incidence of infections with the human immunodeficiency virus largely remained unchanged in Germany, an increase of other sexually transmitted infections (STIs) was observed. The aim was to analyse the effectiveness of our sexual education lecture for students in improving the awareness, knowledge and prevention of STIs. We conducted a cross-sectional survey after students had attended our extra-curricular lecture at the Department of Dermatology of the Ludwig-Maximilians-University of Munich, Germany (LMU). We compared the data with a previously performed study in which the same survey was carried out before the lecture had started. A total of 5866 questionnaires were included in the analysis. After attending the lecture significantly more students were aware of STIs (syphilis: 36.8% (before) vs. 63.5% (after); chlamydia: 30.5% vs. 49.3%; gonorrhoea: 22.4% vs. 38.2%; human papillomaviruses (HPV): 17.7% vs. 30.2%), the transmission pathways of STIs (oral: 36.6% vs. 82.6%; vaginal: 81.8% vs. 97.3%; anal: 42.8% vs. 94.0%; penile: 68.7% vs. 92.1%), knew that the HPV vaccination is directed against a virus (36.8% vs. 56.9%) and were interested in receiving a vaccination (57.7% vs. 78.8%). This study demonstrates the positive educative effects of our lecture for awareness and improved knowledge of STIs. To satisfy the need for a comprehensive sexual education, a combination of school and health facility-based programmes should be implemented as one single lecture cannot convey the entire information about STIs.

First ex vivo cultivation of human Demodex mites and evaluation of different drugs on mite proliferation.

BACKGROUND: Demodex spp. mites are the most complex resident of the human skin microbiome. Although they are considered commensals, they can be pathophysiologically relevant in inflammatory skin diseases like rosacea. Until now, there is no culture system available for these mites except for using live vertebrate hosts. OBJECTIVES: Our aim was to establish an ex vivo culture of human Demodex mites and to characterize the sebogenesis-dependent mite density. METHODS: Demodex mites were cultivated in pilosebaceous units of human skin explants, called human organotypic skin explant culture (hOSEC). Furthermore, different sebogenesis-modifying additives were evaluated. Mites and mite survival were evaluated using light and fluorescence microscopy. RESULTS: After 90 days of incubation, living Demodex mites - including eggs, larvae and nymphs - were detected in the dissected skin samples. Incubation for 30 days with anabolic steroids (testosterone and trenbolone) as well as retinol and retinoic acid (isotretinoin) yielded a reduced mite density. CONCLUSIONS: With this technique, mites can be cultivated ex vivo for the first time, thereby establishing new ways to investigate Demodex spp. The sebostatic effect of isotretinoin might explain the mechanism of action in the off-label treatment of rosacea. We anticipate our findings to be the basis of an accelerated research on our most complex commensal, its life, biology and physiology.

Unique robotic vascular surgery procedures.

INTRODUCTION: Based on their experience with robot-assisted vascular surgery, the authors present some unique types of procedures they have performed in this area. METHODS: From November 2005 to February 2022, a total of 560 robotic vascular procedures were performed, of which 70 were orphan operations, corresponding to 12.5%. The most common was robotic decompression of the coeliac trunk (18 times) in Dunbar syndrome, followed by robotic repair of type II endoleak after stent graft implantation (15 times) and robotic repair of splenic artery aneurysm (11 times). Less common were isolated pelvic artery aneurysm surgery (8 times), aortic thromboenderectomy and abdominal aortic patch repair (8 times) and hybrid surgery (6 times). Completely unique are renal artery reconstruction (2 times), operation of internal mammary artery aneurysm (1 time) in a patient with Marfan syndrome and paracaval biopsy (1 time) in a cancer patient. RESULTS: In 3 cases (4.2%) the operation had to be converted to open surgery. Twice in the management of splenic artery aneurysm due to flat adhesions in the abdominal cavity and once in the endoleak operation, when due to the very fragile wall of the dilated and pulsating abdominal aortic aneurysm sac, we considered manipulation with robotic instruments to be highly risky. There was zero mortality in this cohort; one patient had to undergo laparoscopic diaphragm repair for diaphragmatic hernia at another institution after deliberation of the coeliac trunk and in one case open surgery was needed for persistent endoleak. CONCLUSION: The use of the robotic system can be beneficial also in less frequent procedures, offering the patients all the advantages of robotic surgery. However, the need of extensive experience in robotic surgery should be emphasized because these operations are rare and perfect anatomical knowledge of the area is necessary.

Surgical treatment of thoracoabdominal aortic pathology - retrospective study of 300 patients.

INTRODUCTION: Thoracoabdominal aortic surgery is a technically demanding and extensive treatment that has its place in the era of endovascular techniques. To ensure the best possible outcomes, it requires a well-coordinated team of surgeons, anaesthetists, intensive care physicians and other medical staff. METHODS: The authors present a series of 300 patients operated on between 1 January 2003 and 15 March 2022. Although the group included sporadic cases of severe obliterating involvement of the visceral aorta, patients with thoracoabdominal aortic aneurysms (TAAA) constituted the vast majority. All known organ preservation procedures were used during the operations. The thoraco-phreno-retroperitoneal approach was chosen in almost all TAAA cases; the thoraco-phreno-transperitoneal approach was used only in two reoperations. RESULTS: In this cohort, type II thoracoabdominal aneurysm according to Crawford classification was most common (33%). This was followed by type IV (32%), type III (15.3%), type I (8.7%), type V (6.7%) and other thoracoabdominal aortic procedures (4.3%). Thirty-day mortality rate was 9.6% (2019 - 6%, 2020 - 9.5%, 2021 - 3.8%) in this group; surgical postoperative complications occurred in 36 patients (12%). Neurological complications were reported in 16 cases (5.3%), of which postoperative paraplegia was noted 6 times (2%). Temporary postoperative dialysis due to renal insufficiency was performed in 19 patients (6.3%) and 4 patients (1.3%) have entered the chronic dialysis programme. In 67 patients (23.3%), temporary tracheostomy was done postoperatively due to prolonged withdrawal from the lung ventilator. CONCLUSION: Surgical treatment of the thoracoabdominal aorta is one of the most extensive procedures in vascular surgery and the mortality and morbidity rates still remain relatively high. A multidisciplinary approach, sufficient experience and a dedicated team are essential for a successful outcome of these highly specialised operations.

Abdominal aortic aneurysm as an IgG4-related disease.

The objectives of this study were to evaluate patients with aortic abdominal aneurysm (AAA) with regard to immunoglobulin (Ig)G4-related disease (IgG4-RD). IgG4-RD represents a recently defined condition comprised of a collection of disorders characterized by IgG4 hypergammaglobulinemia, the presence of IgG4-positive plasma cells in organs affected with fibrotic or sclerotizing changes and typical histopathological features. It was identified as a possible cause of vasculitis in large vessels. Studies have been published on a possible association between inflammatory aortic or cardiovascular disease and IgG4-RD. We examined 114 patients with AAA requiring surgery in order to identify findings which are characteristic of IgG4-RD. Aneurysm samples from seven patients showed histopathological features consistent with IgG4-RD and the presence of IgG4+ plasma cells. Only two of these seven patients showed elevated IgG4 serum levels higher 1·35 g/l. In five of the patients, the concentration of serum IgG4 was lower than 1·20 g/l, with the number of IgG4+ plasma cells being higher than 50/high-power field. These findings were consistent with AAA being a heterogeneous group of inflammatory diseases with different pathogenesis.

Tracing the evolution of the heterotrimeric G protein α subunit in Metazoa.

BACKGROUND: Heterotrimeric G proteins are fundamental signaling proteins composed of three subunits, Gα and a Gßγ dimer. The role of Gα as a molecular switch is critical for transmitting and amplifying intracellular signaling cascades initiated by an activated G protein Coupled Receptor (GPCR). Despite their biochemical and therapeutic importance, the study of G protein evolution has been limited to the scope of a few model organisms. Furthermore, of the five primary Gα subfamilies, the underlying gene structure of only two families has been thoroughly investigated outside of Mammalia evolution. Therefore our understanding of Gα emergence and evolution across phylogeny remains incomplete. RESULTS: We have computationally identified the presence and absence of every Gα gene (GNA-) across all major branches of Deuterostomia and evaluated the conservation of the underlying exon-intron structures across these phylogenetic groups. We provide evidence of mutually exclusive exon inclusion through alternative splicing in specific lineages. Variations of splice site conservation and isoforms were found for several paralogs which coincide with conserved, putative motifs of DNA-/RNA-binding proteins. In addition to our curated gene annotations, within Primates, we identified 15 retrotranspositions, many of which have undergone pseudogenization. Most importantly, we find numerous deviations from previous findings regarding the presence and absence of individual GNA- genes, nuanced differences in phyla-specific gene copy numbers, novel paralog duplications and subsequent intron gain and loss events. CONCLUSIONS: Our curated annotations allow us to draw more accurate inferences regarding the emergence of all Gα family members across Metazoa and to present a new, updated theory of Gα evolution. Leveraging this, our results are critical for gaining new insights into the co-evolution of the Gα subunit and its many protein binding partners, especially therapeutically relevant G protein - GPCR signaling pathways which radiated in Vertebrata evolution.

[The da Vinci robot in the field of vascular surgery]. / Uplatnení robotického systému da Vinci v cévní chirurgii.

INTRODUCTION: The aim of this study was to evaluate the clinical experience with 379 robot-assisted vascular procedures performed from November 2005 to December 2016 at our institution. METHODS: A total of 366 cases (96.6%) were successfully completed using the robotic surgical systems da Vinci Standard and da Vinci Xi. RESULTS: Conversion was necessary in 13 patients (3.4%). The 30-day mortality was 0.26% and 2 (0.5%) late prosthetic infections occurred. CONCLUSIONS: From a practical point of view, the greatest advantage of robot-assisted procedures has been the speed and relative simplicity of vascular anastomosis construction. Our experience with robot-assisted surgery has demonstrated the safety and feasibility of this technique in different areas of vascular surgery.Key words: robotic vascular surgery aortic and non-aortic surgery.

Ground-State Cooling of a Mechanical Oscillator by Interference in Andreev Reflection.

We study the ground-state cooling of a mechanical oscillator linearly coupled to the charge of a quantum dot inserted between a normal metal and a superconducting contact. Such a system can be realized, e.g., by a suspended carbon nanotube quantum dot with a capacitive coupling to a gate contact. Focusing on the subgap transport regime, we analyze the inelastic Andreev reflections which drive the resonator to a nonequilibrium state. For small coupling, we obtain that vibration-assisted reflections can occur through two distinct interference paths. The interference determines the ratio between the rates of absorption and emission of vibrational energy quanta. We show that ground-state cooling of the mechanical oscillator can be achieved for many of the oscillator's modes simultaneously or for single modes selectively, depending on the experimentally tunable coupling to the superconductor.

Robot assisted Aortic and Non-aortic Vascular Operations.

BACKGROUND: The aim of this study was to evaluate the clinical experience with 310 robot assisted vascular procedures. The da Vinci system has been used by a variety of disciplines for laparoscopic procedures but the use of robots in vascular surgery is still relatively uncommon. METHODS: From November 2005 to May 2014, 310 robot assisted vascular operations were performed. Two hundred and twenty four patients were prospectively evaluated for occlusive disease, 61 patients for abdominal aortic aneurysm, four for a common iliac artery aneurysm, four for a splenic artery aneurysm, one for a internal mammary artery aneurysm, and after the unsuccessful endovascular treatment five for hybrid procedures, two patients for median arcuate ligament release and nine for endoleak II treatment post EVAR. Among these patients, 224 underwent robotic occlusive disease treatment (Group I), 65 robotic aorto-iliac aneurysm surgery (Group II) and 21 other robotic procedures (Group III). RESULTS: A total of 298 cases (96.1%) were successfully completed robotically. In 10 patients (3.2%) conversion was necessary. The 30 day mortality was 0.3%, and two (0.6%) late prosthetic infections were seen. Targeted Group I and Group II patients were compared. Robotic ilio-femoral bypass, aorto-femoral bypass, or aorto-iliac thrombo-endarterectomy with prosthetic patch (Group I) required an operative time of 194 (range, 127-315) minutes and robotic aorto-iliac aneurysm surgery (Group II), 253 (range, 185-360) minutes. The mean aortic cross clamping time was 37 minutes in Group I and 93 minutes in Group II. The mean blood loss was more significant in Group II (1,210 mL) than in Group I (320 mL). CONCLUSION: From a practical point of view, the greatest advantage of the robot assisted procedure has been the speed and relative simplicity of construction of the vascular anastomosis. This experience with robot assisted laparoscopic surgery has demonstrated the feasibility of this technique in different areas of vascular surgery.

Ground-state cooling of a carbon nanomechanical resonator by spin-polarized current.

We study the nonequilibrium steady state of a mechanical resonator in the quantum regime realized by a suspended carbon nanotube quantum dot in contact with two ferromagnets. Because of the spin-orbit interaction and/or an external magnetic field gradient, the spin on the dot couples directly to the flexural eigenmodes. Accordingly, the nanomechanical motion induces inelastic spin flips of the tunneling electrons. A spin-polarized current at finite bias voltage causes either heating or active cooling of the mechanical modes. We show that maximal cooling is achieved at resonant transport when the energy splitting between two dot levels of opposite spin equals the vibrational frequency. Even for weak electron-resonator coupling and moderate polarizations we can achieve ground-state cooling with a temperature of the leads, for instance, of T = 10 ω.

A sensitive and robust method for automated on-line monitoring of enzymatic activities in water and water resources.

The realisation of a novel concept for automated on-line monitoring of enzymatic activities in water was successfully demonstrated by long-term field testing at two remote Austrian ground water resources. The ß-D-glucuronidase (GLUC) activity was selected as a representative enzymatic model parameter for the on-line determination. But the device can be adapted for any enzymatic reaction with diagnostic relevance for microbial water quality monitoring, as demonstrated for the ß-D-galactosidase activity. Automated filtration of volumes up to 5 litres supports sensitive quantification of enzymatic activities. Internet-based data transfer, using internal control parameters for verification and a dynamic determination of the limit of quantification, enabled robust enzymatic on-line monitoring during a 2-year period. A proportion of 5,313 out of 5,506 GLUC activity measurements (96.5%) could be positively verified. Hydrological (discharge, gauge, turbidity, temperature, pH, electric conductivity, spectral absorbance coefficient at 254 nm) as well as microbiological parameters (Escherichia coli, coliforms) were concurrently determined to characterise the investigated ground water resources. The enzymatic on-line measurements closely reflected the different hydrological conditions and contamination patterns of the test sites. Contrary to expectations, GLUC did not qualify as a proxy-parameter for the occurrence of cultivation-based E. coli contamination and warrants further detailed investigations on its indication capacity as a rapid means for microbial faecal pollution detection in such aquatic habitats. Microbial on-line monitoring is likely to become more important in the future, complementing existing surveillance strategies for water safety management. Further perspectives on the application of such analytical on-line technologies, such as their connection with event-triggered sampling and standardised diagnostics, are discussed.

Endovascular treatment of infected aortic aneurysms.

OBJECTIVE: To report on the short- and long-term outcomes of patients with primary infected aortic aneurysm (IAA) treated by stent graft (SG) in two centers. MATERIAL AND METHOD: Over a period of 15 years, 32 patients with IAA underwent endovascular treatment. None had undergone previous aortic surgery. The causal relationship was gastrointestinal infection in 9 patients (28%), endovascular diagnostic/therapeutic procedures/resuscitation in 6 (19%), wound infection after previous surgeries in 5 (16%), urinary infection in 4 (13%), urology or gastroenterology procedures in 3 (9%), pancreatitis in 2 (6%), endocarditis in 1 (3%) and phlebitis in 1 (3%) patient. We implanted 11 bifurcated, 10 tubular thoracic, 4 aorto-uni-iliac, 4 tubular abdominal and 1 iliac SG. Two other surgeries were hybrid procedures. RESULTS: The etiological agent was identified in 28 (88%) patients. Twenty-six (81%) patients survived the 30-day postoperative period. Sixteen (50%) survived to 1-year follow-up and 13 (40.6%) survived to 3-year follow-up. Three patients have survived for less than 1 year and a further 3 for less than 3 years, so far. Among patients with aneurysms situated in central parts of the thoracic and infrarenal aorta there was a better death/survival ratio than among patients with a proximal or distal aneurysm location. CONCLUSION: The implantation of a SG may be an alternative to open surgery in selected groups of patients with primary IAA. Aneurysms of the central part of the thoracic or abdominal aorta have a more favorable prognosis with endovascular treatment.

Current trends in the diagnosis of vascular prosthesis infection.

Early diagnosis of an infected vascular prosthesis, a potentially life-threatening disease, is a precondition of adequate treatment. The most frequently used diagnostic imaging method is computer tomography. Non-acute infections caused by low grade agents may pose a challenge with ambiguous CT-images and other ancillary imaging methods are used for these cases, each offering different levels of diagnostic sensitivity. These methods come from the fields of radiology (magnetic resonance imaging - MRI) and nuclear medicine studies using labelled leukocytes (111In or 99mTc HMPAO), 99mTc labelled antigranulocyte antibodies, 67Ga-citrate or labelled antibiotics (99mTc-ciprofloxacin) or avidin in combination with 111In-biotin. Positron emission tomography (PET) or hybrid PET/CT using 18F-FDG are becoming increasingly popular. The authors of this review article point out the diagnostic potential of the different methods and current trends, including the possibilities of microbiological demonstration of the agent, as well as their potential position in the diagnostic algorithm.

Electric field and grain size dependence of Meyer-Neldel energy in C(60) films.

Meyer-Neldel rule for charge carrier mobility measured in C(60)-based organic field-effect transistors (OFETs) at different applied source drain voltages and at different morphologies of semiconducting fullerene films was systematically studied. A decrease in the Meyer-Neldel energy E(MN) from 36 meV to 32 meV was observed with changing electric field in the channel. Concomitantly a decrease from 34 meV to 21 meV was observed too by increasing the grain size and the crystallinity of the active C(60) layer in the device. These empiric findings are in agreement with the hopping-transport model for the temperature dependent charge carrier mobility in organic semiconductors with a Gaussian density of states (DOS). Experimental results along with theoretical descriptions are presented.

High mobility, low voltage operating C(60) based n-type organic field effect transistors.

We report on C(60) based organic field effect transistors (OFETs) that are well optimized for low voltage operation. By replacing commonly used dielectric layers by thin parylene films or by utilizing different organic materials like divinyltetramethyldisiloxane-bis(benzocyclo-butene) (BCB), low density polyethylene (PE) or adenine in combination with aluminum oxide (AlOx) to form a bilayer gate dielectric, it was possible to significantly increase the capacitance per unit area (up to two orders of magnitude). The assembly of metal-oxide and organic passivation layer combines the properties of the high dielectric constant of the metal oxide and the good organic-organic interface between semiconductor and insulator provided by a thin capping layer on top of the AlOx film. This results in OFETs that operate with voltages lower than 500 mV, while exhibiting field effect mobilities exceeding 3 cm(2) V(-1) s(-1).

[Regenerative therapy for tendon and ligament disorders in horses. Terminology, production, biologic potential and in vitro effects]. / Regenerative Therapie von Sehnen- und Banderkrankungen bei Pferden. Terminologie, Herstellung, biologisches Potenzial und In-vitro-Effekte.

Conventional treatments of equine tendon injuries lead to an unsatisfactory healing process that usually results in a relatively high recurrence rate. Therefore, in recent years so-called regenerative therapeutics were studied scientifically in vitro and in laboratory animals. These include substances that ideally lead to the formation of replacement tissue, which in contrast to the low quality scar, has similar functional properties as the original intact tendon. Currently, a plethora of different substrates is either commercially available or can be produced in practice with the help of kits. The current knowledge on the production and the regenerative potential of nucleated cells like stem cells from bone marrow and fat tissue, of the blood products PRP (platelet rich plasma), ACP (autologous conditioned plasma), ACS (autologous conditioned serum) and of the scaffold substance UBM (urinary bladder matrix) are presented. Finally, the potential of some growth factors and of gene therapy is considered. Currently, it is assumed that the regeneration of tendon tissue is promoted by a complex interaction of scaffolds, growth factors and cells. At present, only very few studies are available which allow a comparison between these substances. Studies on the effect of regenerative substrates on tendons in live horses are presented elsewhere.

[Venous interposition graft in the management of bleeding from distal anastomosis of pedal bypass]. / Zilní interponát pri resení krvácení z distální anastomózy pedálního bypassu.

The authors present a rare complication of limb revascularization using pedal bypass, disruption of the surgical wound resulting from infectious etiology with bleeding from the distal anastomosis. The wound disruption was successfully managed by venous interposition grafting. The bypass patency, as well as full functioning of the extremity, were preserved.

[Simple method of infected vascular prosthesis removal]. / Jednoduchá metoda odstranení infikované cévní protézy.

INTRODUCTION: Removal of infected vascular prosthesis from aortofemoral or femoropopliteal positions may be technically demanding due to their strong fibrous attachment to surrounging tissues. MATERIAL AND METHODS: The authors describe a simple method of vascular prosthesis inversion and removal from the fibrous tissue using instrumentation for tunelization. DISCUSSION: The authors successfully used the method in a patient with firmly attached and thrombotized vascular prosthesis. CONCLUSION: The procedure reduced duration of the procedure and resulted in reduced traumatization of the surrounding tissue.

[Radical operation of infected aortofemoral prosthesis using fresh arterial allograft: our mid-term experience]. / Radikální operace infekce cévní protézy v aortofemorální pozici s pomocí cerstvého tepenného allograftu: nase strednedobé zkusenosti.

INTRODUCTION: The mid-term experience with the use of the fresh arterial allografts in the treatment of aortic or aortofemoral prosthetic infection is presented. MATERIAL AND METHODS: Between 2001-2010 24 patients (23 with the infected graft in aortic or aortofemoral position and one with a mycotic aneurysm of the aortic bifurcation) were operated with the use of the fresh arterial allograft. Male/female ratio was 15/9, average age 65.8 (36-81) years. The gastrointestinal comorbidities dominated this cohort. The total of 70 previous vascular operations (1-9; m. 2.9/patient) were performed with the median of 5.8 years between the first and the last procedure. Seven patients had sepsis (29.2%), aortoeneteric fistula occurred in three. Various technical modifications of the aortobifemoral (13), aortounifemoral (8) bypass, aortic and aortoiliac replacement (3) were performed including the sequential distal reconstructions. The arterial allograft was used within 8-48 hours following harvest (the median cold ischemic time of 20 hours) and all patients were given cyclosporine A perioperatively. RESULTS: In-hospital mortality was 20.8% (5/24), twice caused by postoperative hemorrhage from either the aortic anastomosis or the graft necrosis. The remaining deaths were not related to the allograft itself. Two limbs, preoperatively ischemic, were amputated (8.3%). The median follow-up is 4.6 years (3 m.-8 yrs.). The three-years survival was 68.4% and the known causes of death had no relation to the allograft. The late occlusion of the graft limb occurred twice, stenoses within its course twice and three femoral anastomotic stenoses were disclosed. All were treated either surgically or by PTA/stent and the redo procedures' rate has thus reached 20.5% in the mid-term follow-up interval. One graft has shown a slight diffuse dilatation since requiring but follow-up. CONCLUSIONS: Under the conditions of the ABO compatibility tolerance and ongoing postimplantation immunosuppression the shortly ischemic arterial graft helds its anatomic structure and function and within the hostile setting of the previous infection represents a valuable alternative of the surgical treatment of the vascular prosthetic infection in the aortofemoral position or of the mycotic aneurysm.

[Current trends in the surgical management of thoracoabdominal aortic aneurysms]. / Soucasné trendy v chirurgické lécbe výdute torakoabdominální aorty.

INTRODUCTION: The authors present a group of patients, who underwent standard procedures on thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysms from 01-01-2009 to 15-09-2010. MATERIAL AND METHODS: During the above time period, a total of 29 patients were operated. The authors employed as many known organ protection procedures as possible, including reduced heparinization, mild hypothermia (32-34 degrees C), sequential aortic clamping cerebrospinal drainage, left heart bypass (a biopump) with non-ischemic canylation of the femoral artery, selective visceral blood perfusion (superior mesenteric artery and coeliac trunk) and renal arteries perfusion using cold crystallic solution. For technical reasons, monitoring of somatosensory and motor evoked potentials was used only twice. In the majority of TAAA procedures, the thoracoretroperitoneal approach was used. RESULTS: During the studied period, the overall mortality rate was 24%. In 2009, a total of 16 patients were operated, out of which 14 subjects underwent elective procedures. Two subjects underwent urgent procedures for ruptures and both of them died. In 2009, the mortality rate was 21% for planned procedures. In the following year, from January to September 15, a total of 13 patients underwent surgery, out of whom 11 underwent elective and two urgent procedures. The group's overall mortality rate was 15.4%, the mortality rate in elective surgery patients was 9% . One patient undergoing urgent surgery survived and one exited. Postoperative paraplegia was reported in one subject (3,4%), postoperative dialysis due to postoperative renal insufficiency was used in 6.9% and other postoperative complications occurred in 10,3% of the subjects. CONCLUSION: Mortality and morbidity rates in the surgical management of thoracoabdominal aortic aneurysms remain considerably high, although new procedures of organ protection help to reduce it. These highly specialized procedures require a multispecialty approach and a well- coordinated surgical team, specialized in this problematics.