The purpose of this postmarket surveillance registry was to document the efficacy of a vascular prosthesis coated with metallic silver in high-risk patients undergoing vascular reconstructions. Patency (primary endpoint) and freedom from graft infection (secondary endpoint) data were assessed at a minimum of 12 months in patients with significant co-morbidity and/or confirmed graft infections or infected native vessels. Between November 2006 and December 2009, 230 patients with high-risk factors underwent aortic, peripheral and/or extra-anatomic reconstructions with Silver Graft^® (SG) in six German, one French and one Polish vascular center. All participating centers used the metallic silver-coated polyester graft (SG) in various diameters and lengths including tubular and bifurcate vascular grafts. Doppler ultrasound follow-ups to determine graft patency were planned at 12 months or done at an earlier time in case the patient became symptomatic. A total of 230 patients were studied. Ten of these 230 patients had graft infections at baseline whereas the remaining 220 subjects had significant risk factors such as coronary artery disease (62.7%, 138/220), vascular access in scar tissue (27.3%, 60/220), Fontaine III/IV (38.2%, 84/220), chronic renal insufficiency (26.8%, 59/220) and diabetes (21.0%, 46/220). The long-term follow-up at 15.5 ± 8.3 months revealed a secondary patency rate of 93.2% (205/220) and an ‘all cause’ mortality rate of 18.6% (41/220). There was a freedom from de novo graft infection rate of 95.9% (211/220) in the high-risk group without graft infections at baseline. One regraft infection occurred distal of the revisional reconstruction in the 10 patients with graft infection at baseline. The presence of perigraft fluid at follow-up and Fontaine III/IV at baseline were found to be predictors for graft patency whereas perigraft fluid presence was the only predictor for de novo graft infections. This registry revealed favorable patency and freedom from de novo infections rates in a ‘high-risk’ population with significant co-morbidities.

Cel pracy: Zbadano związek stylu radzenia sobie ze stresem i motywacji do spożycia alkoholu w kontekście ryzyka uzależnienia od alkoholu u studentów kierunków medycznych.Metoda: Badaniem objęto 268 studentów kierunków medycznych W badaniach wykorzystano Test AUDIT (Alcohol Use Disorders Identyfication Test), Kwestionariusz Radzenia Sobie w Sytuacjach Stresowych (CISS), oraz autorską ankietę badającą poza danymi demograficznymi także motywację do picia alkoholu i sytuacje, w jakich badani sięgają po alkohol.Wyniki: W badanej grupie 94% osób spożywało alkohol w okresie ostatnich dwunastu miesięcy. W badanej grupie 16% studentów kierunku medycznego i 20% studentów stomatologii pije w sposób ryzykowny lub szkodliwy. W 2% przypadków zaobserwowano duże ryzyko uzależnienia od alkoholu Ponad połowa respondentów sięga po alkohol w celu radzenia sobie ze stresem. Dane dotyczące stylu radzenia sobie ze stresem nie wykazują różnic istotnych statystycznie w zakresie głównego stylu radzenia sobie ze stresem: skoncentrowanego na zadaniu, skoncentrowanego na emocjach, skoncentrowanego na unikaniu. Studenci kierunku lekarskiego istotnie częściej niż studenci stomatologii radzili sobie ze stresem w sposób unikowy (poszukiwanie kontaktów towarzyskich). Nie wykazano istotnego związku między stylem radzenia sobie ze stresem, motywacją do picia i ryzykiem uzależniania od alkoholu.Wnioski: Brak związków między badanymi zmiennymi może wskazywać na stosowanie przez badanych innych czynności niż sięganie po alkohol w radzeniu sobie ze stresem. Ważna jest profilaktyka i stworzenie warunków sprzyjających rozwojowi strategii radzenia sobie ze stresem w grupie studentów kierunków medycznych.

Background: Peripheral artery disease (PAD) remains a major issue in modern societies and affects more than 200 million people around the world. Endovascular methods have been evaluated to be safe and effective in limb salvage. The Supera is able to withstand increased compression, biomechanical stress and to have higher radial force. The objective of this study is to evaluate performance, durability and 3-year patency of Supera stent implantation in severe femoropopliteal disease. Methods: A retrospective real-world analysis was performed with consideration of 77 patients that had a Supera stent implanted with femoropopliteal atherosclerotic disease at a single center. Among the 77 individuals, 92 Supera stents were implanted. Analysis of patients’ demographics, lesions characteristics, reintervention rates and patency rates was performed. Results: The median follow-up was 33 months and ranged from 0 to 84 months. Chronic limb-threatening ischemia was observed among 43 patients. Mean lesion length was 152.8 ± 94.6 mm. Chronic total occlusions were observed in a majority of lesions. Overall, primary patency rates at 6, 12, 24 and 36 months were 85.0%, 73.6%, 59.2% and 53.2%, respectively. Conclusions: The Supera stent is effective in the management of long and complex lesions. The results of patency rates were evaluated to be worse among lesions extending to the popliteal artery.

An important negative factor of EVAR is the radiation acquired during long-lasting procedures. The aim of the study was to document the radiation doses of EVAR and to discuss potential reasons for prolongation of radiological procedures. Dose-area product (DAP) (Gy cm2) and air kerma (AK) (Gy) obtained during EVAR from 92 patients were analyzed retrospectively in regards to body mass index (BMI), angulations of aneurysm neck, length of aneurysm neck and occurrence of tortuosity of iliac arteries. Total AK for fluoroscopy differed significantly between normal BMI (373 mGy) and BMI 25–29.9 (1125 mGy) or BMI >30 (1085 mGy). Iliac artery tortuosities >45° and short aneurysm necks caused higher doses of total AK (1097 mGy and 1228 mGy, respectively) than iliac artery tortuosities 25, tortuosity of iliac arteries >45° and short aneurysm necks.