Percutaneous proximal axillary artery versus femoral artery access for endovascular interventions.

OBJECTIVE: The primary objective of this study is to describe and illustrate the technique of ultrasound-guided percutaneous proximal axillary artery (PAA) access, and secondarily to evaluate the versatility and safety of this approach in peripheral, visceral, and aortic endovascular interventions. METHODS: This is a single-center retrospective review of all peripheral, visceral, and aortic endovascular cases using percutaneous PAA access from February 2019 to March 2021 compared with a sample of an equivalent number of consecutive cases completed via percutaneous common femoral artery (CFA) access during the same time period. Access entry success, minor and major access site complications within 30 days, major adverse events within 30 days, demographics, and procedural details were analyzed using standard statistical analyses. RESULTS: A total of 115 accesses-59 PAA and 56 CFA-were reviewed during the study period. Group demographics were not significantly different. Access entry success was achieved in 58 (98.3%) and 56 (100%) of PAA and CFA accesses, respectively, with no statistically significant difference. There were no significant differences in minor access-site complications (13.6% vs 5.4%; P = .21) major access site complications (3.4% vs 7.1%; P = .43), or major adverse events (6.8% vs 5.4%). between the PAA and CFA groups. With respect to versatility, PAA cases had a significantly greater mean number of vessels intervened on per procedure compared with CFA access (2.59 ± 1.31 vs 1.95 ± 0.98; P < .01). A wide range of target vessels were intervened on in both groups. PAA cases had significantly more bilateral lower leg interventions (28.8% vs 12.5%; P = .04). PAA access had a significantly longer mean procedure time (103.2 minutes vs 58.63 minutes; P < .001) and fluoroscopy time (18.21 minutes vs 12.87 minutes; P = .02). CONCLUSIONS: The PAA is a feasible, versatile, and safe percutaneous access option for endovascular intervention. The in-line trajectory from this site facilitates visceral, renal, aortic, and bilateral lower extremity interventions with ease. Outcomes, complications, and major adverse events are similar to those of conventional CFA access in the short term.

Musical trends and predictability of success in contemporary songs in and out of the top charts.

We analyse more than 500 000 songs released in the UK between 1985 and 2015 to understand the dynamics of success (defined as 'making it' into the top charts), correlate success with acoustic features and explore the predictability of success. Several multi-decadal trends have been uncovered. For example, there is a clear downward trend in 'happiness' and 'brightness', as well as a slight upward trend in 'sadness'. Furthermore, songs are becoming less 'male'. Interestingly, successful songs exhibit their own distinct dynamics. In particular, they tend to be 'happier', more 'party-like', less 'relaxed' and more 'female' than most. The difference between successful and average songs is not straightforward. In the context of some features, successful songs pre-empt the dynamics of all songs, and in others they tend to reflect the past. We used random forests to predict the success of songs, first based on their acoustic features, and then adding the 'superstar' variable (informing us whether the song's artist had appeared in the top charts in the near past). This allowed quantification of the contribution of purely musical characteristics in the songs' success, and suggested the time scale of fashion dynamics in popular music.