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The structures, strain fields, and defect distributions in solid materials underlie the mechanical and physical properties across numerous applications. Many modern microstructural microscopy tools characterize crystal grains, domains and defects required to map lattice distortions or deformation, but are limited to studies of the (near) surface. Generally speaking, such tools cannot probe the structural dynamics in a way that is representative of bulk behavior. Synchrotron X-ray diffraction based imaging has long mapped the deeply embedded structural elements, and with enhanced resolution, dark field X-ray microscopy (DFXM) can now map those features with the requisite nm-resolution. However, these techniques still suffer from the required integration times due to limitations from the source and optics. This work extends DFXM to X-ray free electron lasers, showing how the [Formula: see text] photons per pulse available at these sources offer structural characterization down to 100 fs resolution (orders of magnitude faster than current synchrotron images). We introduce the XFEL DFXM setup with simultaneous bright field microscopy to probe density changes within the same volume. This work presents a comprehensive guide to the multi-modal ultrafast high-resolution X-ray microscope that we constructed and tested at two XFELs, and shows initial data demonstrating two timing strategies to study associated reversible or irreversible lattice dynamics.
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An experimental platform for dynamic diamond anvil cell (dDAC) research has been developed at the High Energy Density (HED) Instrument at the European X-ray Free Electron Laser (European XFEL). Advantage was taken of the high repetition rate of the European XFEL (up to 4.5â MHz) to collect pulse-resolved MHz X-ray diffraction data from samples as they are dynamically compressed at intermediate strain rates (≤103â s-1), where up to 352 diffraction images can be collected from a single pulse train. The set-up employs piezo-driven dDACs capable of compressing samples in ≥340â µs, compatible with the maximum length of the pulse train (550â µs). Results from rapid compression experiments on a wide range of sample systems with different X-ray scattering powers are presented. A maximum compression rate of 87â TPaâ s-1 was observed during the fast compression of Au, while a strain rate of â¼1100â s-1 was achieved during the rapid compression of N2 at 23â TPaâ s-1.
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Diamante , Rayos Láser , Difracción de Rayos X , Presión , Rayos XRESUMEN
AIM: To assess the improvements during patient follow-up after implementing a proactive plan for retrieval of inferior vena cava (IVC) filters. MATERIALS AND METHODS: A retrospective study was undertaken including all patients who had a temporary IVC filter inserted over a 10-year period. Patient demographics, insertion dates, retrieval dates, retrieval rates, and complications were recorded. Patients were categorised into three groups as follows: group A, no intervention where retrieval was not suggested; group B, passive intervention where retrieval was suggested but no appointment made; and group C, proactive intervention where a retrieval date was booked by the radiologist. RESULTS: Five hundred and nine patients had a temporary IVC filter inserted at Royal Liverpool University Hospital over the study period. One per cent of patients in group C were lost to follow-up compared to 41% and 29% in groups A and B respectively (p<0.001). The number of patients who had an IVC retrieval attempt also increased to 80% in group C compared to 53% and 64% in groups A and B (p<0.001). CONCLUSION: Incorporation of a proactive retrieval booking system has significantly reduced the number of patients lost to follow-up to 1%, leading to an increased number of IVC filter retrieval attempts.
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Filtros de Vena Cava , Remoción de Dispositivos , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares , Filtros de Vena Cava/efectos adversos , Vena Cava Inferior/diagnóstico por imagenRESUMEN
Collateralisation around stenotic or occlusive arterial disease is a commonly observed adaptation for maintenance of arterial perfusion. It occurs through pathways of well-understood embryological origin. Examples include Winslow's pathway (internal thoracic artery to iliac artery via the epigastric arteries) and the arc of Riolan (between superior and inferior mesenteric arteries). In this article, we describe a pathway of collateralisation around stenotic disease of the coeliac and superior mesenteric arteries in a 76-year-old man with an abdominal aortic aneurysm. The collateral pathway was identified on computed tomography angiography between the left internal thoracic artery in the thorax and the coeliac artery in the abdomen via the left inferior phrenic artery. This has implications for routine cardiac surgery, such that left internal thoracic artery harvest during coronary artery bypass surgery would likely result in acute ischaemia of the abdominal viscera.
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Arteria Celíaca , Arterias Mamarias , Anciano , Arteria Celíaca/diagnóstico por imagen , Arteria Celíaca/cirugía , Circulación Colateral , Constricción Patológica , Humanos , Arteria Ilíaca/cirugía , Masculino , Arterias Mamarias/diagnóstico por imagen , Arterias Mamarias/cirugía , TóraxRESUMEN
INTRODUCTION: A long dwell time is associated with higher inferior vena cava (IVC) filter retrieval complication rates. Manufacturers advise that "excessive force should not be used" during filter retrieval; however, the term "excessive" is subjective and is likely to lead to variability amongst operators. The aims of this study were to 1) ascertain what interventional radiologists consider to be excessive force during filter retrieval and 2) to understand the variability in interventional radiologists' perception of force. METHODS: The authors recruited interventional radiologists to perform a benchtop simulated filter retrieval. Participants were invited to pull on a modified force tester attached to a Gunther Tulip filter retrieval set (GTRS). The participants were asked to pull as if they were retrieving an IVC filter and stop when they felt it was clinically unsafe to apply greater force. They were then asked to replicate forces of 10N and 50N, respectively. Each of the three tasks was completed three times. Data were obtained on the clinical experience of the participants with specific questions focusing on their filter retrieval practices. RESULTS: The range of maximum forces applied during filter retrieval varied between 0.8 and 79.8N. When asked to replicate 10N and 50N, for attempt-1, the median forces produced were 23.5N and 38.1N, respectively. A trend analysis showed that those who overestimate 10N are more likely to apply a greater overall maximum force (rs = 0.622; P < 0.001). CONCLUSION: There is wide variation in what interventional radiologists consider to be the maximum safe force to apply during IVC filter retrieval. IMPLICATIONS FOR PRACTICE: Manufacturers and operators should consider methods in which only a safe range of forces can be applied during an IVC filter retrieval. Operators may wish to undertake 'personal' force calibration as part of training in interventional radiology.
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Filtros de Vena Cava , Vena Cava Inferior , Remoción de Dispositivos/métodos , Humanos , Percepción , Radiólogos , Vena Cava Inferior/cirugíaRESUMEN
The high-precision X-ray diffraction setup for work with diamond anvil cells (DACs) in interaction chamber 2 (IC2) of the High Energy Density instrument of the European X-ray Free-Electron Laser is described. This includes beamline optics, sample positioning and detector systems located in the multipurpose vacuum chamber. Concepts for pump-probe X-ray diffraction experiments in the DAC are described and their implementation demonstrated during the First User Community Assisted Commissioning experiment. X-ray heating and diffraction of Bi under pressure, obtained using 20â fs X-ray pulses at 17.8â keV and 2.2â MHz repetition, is illustrated through splitting of diffraction peaks, and interpreted employing finite element modeling of the sample chamber in the DAC.
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Superconductivity near room temperature in the sulfur-hydrogen system arises from a sequence of reactions at high pressures, with X-ray diffraction experiments playing a central role in understanding these chemical-structural transformations and the corresponding S:H stoichiometry. Here we document X-ray irradiation acting as both a probe and as a driver of chemical reaction in this dense hydride system. We observe a reaction between molecular hydrogen (H2) and elemental sulfur (S8) under high pressure, induced directly by X-ray illumination, at photon energies of 12 keV using a free electron laser. The rapid synthesis of hydrogen sulfide (H2S) at 0.3 GPa was confirmed by optical observations, spectroscopic measurements, and microstructural changes detected by X-ray diffraction. These results document X-ray induced chemical synthesis of superconductor-forming dense hydrides, revealing an alternative production strategy and confirming the disruptive nature of X-ray exposure in studies on high-pressure hydrogen chalcogenides, from water to high-temperature superconductors.
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The insulator-to-metal transition in dense fluid hydrogen is an essential phenomenon in the study of gas giant planetary interiors and the physical and chemical behavior of highly compressed condensed matter. Using direct fast laser spectroscopy techniques to probe hydrogen and deuterium precompressed in a diamond anvil cell and laser heated on microsecond timescales, an onset of metal-like reflectance is observed in the visible spectral range at P >150 GPa and T ≥ 3000 K. The reflectance increases rapidly with decreasing photon energy indicating free-electron metallic behavior with a plasma edge in the visible spectral range at high temperatures. The reflectance spectra also suggest much longer electronic collision time (≥1 fs) than previously inferred, implying that metallic hydrogen at the conditions studied is not in the regime of saturated conductivity (Mott-Ioffe-Regel limit). The results confirm the existence of a semiconducting intermediate fluid hydrogen state en route to metallization.
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Ultrafast x-ray diffraction at the LCLS x-ray free electron laser has been used to resolve the structural behavior of antimony under shock compression to 59 GPa. Antimony is seen to transform to the incommensurate, host-guest phase Sb-II at â¼11 GPa, which forms on nanosecond timescales with ordered guest-atom chains. The high-pressure bcc phase Sb-III is observed above â¼15 GPa, some 8 GPa lower than in static compression studies, and mixed Sb-III/liquid diffraction are obtained between 38 and 59 GPa. An additional phase which does not exist under static compression, Sb-I^{'}, is also observed between 8 and 12 GPa, beyond the normal stability field of Sb-I, and resembles Sb-I with a resolved Peierls distortion. The incommensurate Sb-II high-pressure phase can be recovered metastably on release to ambient pressure, where it is stable for more than 10 ns.
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In their comment, Desjarlais et al claim that a small temperature drop occurs after isentropic compression of fluid deuterium through the first-order insulator-metal transition. We show that their calculations do not correspond to the experimental thermodynamic path, and that thermodynamic integrations with parameters from first-principles calculations produce results in agreement with our original estimate of the temperature drop.
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Metales , Deuterio , Presión , Temperatura , TermodinámicaRESUMEN
Bismuth has long been a prototypical system for investigating phase transformations and melting at high pressure. Despite decades of experimental study, however, the lattice-level response of Bi to rapid (shock) compression and the relationship between structures occurring dynamically and those observed during slow (static) compression, are still not clearly understood. We have determined the structural response of shock-compressed Bi to 68 GPa using femtosecond X-ray diffraction, thereby revealing the phase transition sequence and equation-of-state in unprecedented detail for the first time. We show that shocked-Bi exhibits a marked departure from equilibrium behavior - the incommensurate Bi-III phase is not observed, but rather a new metastable phase, and the Bi-V phase is formed at significantly lower pressures compared to static compression studies. We also directly measure structural changes in a shocked liquid for the first time. These observations reveal new behaviour in the solid and liquid phases of a shocked material and give important insights into the validity of comparing static and dynamic datasets.
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Dense fluid metallic hydrogen occupies the interiors of Jupiter, Saturn, and many extrasolar planets, where pressures reach millions of atmospheres. Planetary structure models must describe accurately the transition from the outer molecular envelopes to the interior metallic regions. We report optical measurements of dynamically compressed fluid deuterium to 600 gigapascals (GPa) that reveal an increasing refractive index, the onset of absorption of visible light near 150 GPa, and a transition to metal-like reflectivity (exceeding 30%) near 200 GPa, all at temperatures below 2000 kelvin. Our measurements and analysis address existing discrepancies between static and dynamic experiments for the insulator-metal transition in dense fluid hydrogen isotopes. They also provide new benchmarks for the theoretical calculations used to construct planetary models.
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Diatomic nitrogen is an archetypal molecular system known for its exceptional stability and complex behavior at high pressures and temperatures, including rich solid polymorphism, formation of energetic states, and an insulator-to-metal transformation coupled to a change in chemical bonding. However, the thermobaric conditions of the fluid molecular-polymer phase boundary and associated metallization have not been experimentally established. Here, by applying dynamic laser heating of compressed nitrogen and using fast optical spectroscopy to study electronic properties, we observe a transformation from insulating (molecular) to conducting dense fluid nitrogen at temperatures that decrease with pressure and establish that metallization, and presumably fluid polymerization, occurs above 125 GPa at 2500 K. Our observations create a better understanding of the interplay between molecular dissociation, melting, and metallization revealing features that are common in simple molecular systems.
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Endovascular sealing is a new technique for the repair of abdominal aortic aneurysms. Commercially available in Europe since 2013, it takes a revolutionary approach to aneurysm repair through minimally invasive techniques. Although aneurysm sealing may be thought as more stable than conventional endovascular stent graft repairs, post-implantation movement of the endoprosthesis has been described, potentially leading to late complications. The paper presents for the first time a model, which explains the nature of forces, in static and dynamic regimes, acting on sealed abdominal aortic aneurysms, with references to real case studies. It is shown that elastic deformation of the aorta and of the endoprosthesis induced by static forces and vibrations during daily activities can potentially promote undesired movements of the endovascular sealing structure.
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Aneurisma de la Aorta Abdominal/fisiopatología , Aneurisma de la Aorta Abdominal/cirugía , Procedimientos Endovasculares/métodos , Prótesis Vascular , Implantación de Prótesis Vascular/métodos , Simulación por Computador , Modelos Teóricos , Diseño de Prótesis , Stents , Resultado del TratamientoRESUMEN
INTRODUCTION: Planning of endovascular sealing of abdominal aortic aneurysms requires measurement of the aortic lumen volume. The aim of this study was to investigate mathematically the effect of intra- and inter-observer variability error, as well as cardiac cycle-related variability, on these measurements. METHODS: Mean (±2SD) intra- and inter-observer error in lumen measurements and mean (+2SD) cardiac cycle-related variability were obtained from published literature and added to the measurement of the flow lumen volume of a 57 mm abdominal aortic aneurysm to calculate average and extreme error possibilities. RESULTS: The aneurysm volume was measured at 165 ml. The calculated possible mean measurement error due to cardiac cycle variation, intra- and inter-observer variability was +11.0%, resulting in a potential measurement of 183.1 ml. The calculated extreme errors were +24.3% (if 2SD of all errors were added to the mean) and +3.5% (if 2SD of all errors, except cardiac cycle, were subtracted from the mean), resulting in potential measurements of 170.8 ml and 205.1 ml, respectively. When considering the errors combined, the proportion of patients who may have volume measurement errors of up to ±2.5 ml, ±2.6 to ±5.0 ml and ±5.1 to ±7.5 ml were 18%, 17% and 15%, respectively. CONCLUSION: Measurement of CT-based aortic lumen volumes in abdominal aortic aneurysms is imprecise. This has practical implications for the planning and the performance of complex endovascular therapies.
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Aorta Abdominal/anatomía & histología , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/cirugía , Errores Diagnósticos , Procedimientos Endovasculares , Planificación de Atención al Paciente , Tomografía Computarizada por Rayos X/métodos , Humanos , Variaciones Dependientes del Observador , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes. METHODS: This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed. Comparison between outcomes of less complex grafts (fewer than 3 fenestrations) and more complex grafts (3 or 4 fenestrations) was undertaken. RESULTS: Some 173 patients underwent FEVAR; median age was 76 (i.q.r. 70-79) years and 90·2 per cent were men. Median aneurysm diameter was 63 (59-71) mm and median follow-up was 34 (16-50) months. The adjusted primary technical operative success rate was 95·4 per cent. The in-hospital mortality rate was 5·2 per cent; there was no known aneurysm-related death during follow-up. Median survival was 7·1 (95 per cent c.i. 5·2 to 8·1) years and overall survival was 60·1 per cent (104 of 173). There was a trend towards an increasing number of fenestrations in the graft design over time. In-hospital mortality appeared higher when more complex stent-grafts were used (8 versus 2 per cent for stent-grafts with 3-4 versus fewer than 3 fenestrations; P = 0·059). Graft-related endoleaks were more common following deployment of stent-grafts with three or four fenestrations (12 of 90 versus 6 of 83; P < 0·001). CONCLUSION: Fenestrated endovascular aneurysm repair for juxtarenal aneurysm is associated with few aneurysm-related deaths in the long term. Significant numbers of secondary interventions are required, but the majority of these can be performed using an endovascular approach.
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Aneurisma de la Aorta Abdominal/cirugía , Procedimientos Endovasculares/métodos , Stents/tendencias , Cuidados Posteriores , Anciano , Aneurisma de la Aorta Abdominal/mortalidad , Prótesis Vascular/tendencias , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/mortalidad , Tiempo de Internación , Masculino , Tempo Operativo , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidad , Diseño de Prótesis/mortalidad , Diseño de Prótesis/tendencias , Estudios Retrospectivos , Dehiscencia de la Herida Operatoria/etiología , Dehiscencia de la Herida Operatoria/metabolismo , Análisis de SupervivenciaRESUMEN
True aneurysm of the tibial arteries is a rare clinical condition. We report the case of a 67-year-old man who presented with a gradual onset of right calf swelling and pain. Imaging revealed large aneurysms arising from the proximal peroneal arteries bilaterally, measuring 7.4cm and 4cm on the right and left respectively. A detailed medical history, clinical examination and laboratory investigations did not identify evidence of an underlying cause. A surgical reconstruction with an interposition vein graft was successfully performed. To our knowledge, this is the first reported case of primary aneurysm of the peroneal artery in the English literature. We undertook a systematic literature review to identify all reported cases of primary aneurysms of the tibial arteries. The clinical presentation, modes of investigation and interventional treatments are discussed.
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Aneurisma/diagnóstico por imagen , Pierna/irrigación sanguínea , Arterias Tibiales/diagnóstico por imagen , Anciano , Anastomosis Quirúrgica , Aneurisma/cirugía , Humanos , Masculino , Arterias Tibiales/cirugía , Tomografía Computarizada por Rayos X , Procedimientos Quirúrgicos VascularesRESUMEN
Using x-ray diffraction at the Linac Coherent Light Source x-ray free-electron laser, we have determined simultaneously and self-consistently the phase transitions and equation of state (EOS) of the lightest transition metal, scandium, under shock compression. On compression scandium undergoes a structural phase transition between 32 and 35 GPa to the same bcc structure seen at high temperatures at ambient pressures, and then a further transition at 46 GPa to the incommensurate host-guest polymorph found above 21 GPa in static compression at room temperature. Shock melting of the host-guest phase is observed between 53 and 72 GPa with the disappearance of Bragg scattering and the growth of a broad asymmetric diffraction peak from the high-density liquid.
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This corrects the article DOI: 10.1103/PhysRevLett.108.065701.
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OBJECTIVE: Despite technical advances of fenestrated and branched endografts, endovascular exclusion of aneurysms involving renal, visceral, and/or supra-aortic branches remains a challenge. In situ fenestration (ISF) of standard endografts represents another endovascular means to maintain perfusion to such branches. This study aimed to review current indications, technical descriptions, and results of ISF. METHOD: A review of the English language literature was performed in Medline databases, Cochrane Database, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Sixty-seven relevant papers were selected. Thirty-three papers were excluded, leaving 34 articles as the basis of the present review. RESULTS: Most experimental papers evaluated ISF feasibility and assessed the consequences of ISF on graft fabric. Regarding clinical papers, 73 ISF procedures have been attempted in 58 patients, including 26 (45%) emergent and three (5%) bailout cases. Sixty-five (89%) ISF were located at the level of the arch, and eight (11%) in the abdominal aorta. Graft perforation was performed by physical, mechanical, or unspecified means in 33 (45%), 38 (52%), and two vessels (3%), respectively. ISF was technically successful in 68/73 (93%) arteries. At 30 days, two (3.4%) patients died in the setting of an aorto-bronchial fistula and an aorto-oesophageal fistula, respectively. No post-operative death, major complication, or endoleak was described as secondary to the ISF procedure. With follow-up between 0 and 72 months, four (6.9%) late deaths were noted, unrelated to the aorta. One (1.7%) LSA stent was stenosed without symptoms. CONCLUSIONS: Although there may be publication bias, multiple techniques were described to perform ISF with satisfactory short-term results. Long-term data remain scarce. Aortic endograft ISF is an off-label procedure that should not be used outside emergent bailout techniques or investigational studies. A comparison with alternative techniques of preserving aortic side branches is needed.