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INTRODUCTION Some studies suggest celiac artery coverage during elective endovascular thoracoabdominal aortic aneurysm (TAAA) repair is safe given sufficient collateralization of visceral organ perfusion from the superior mesenteric artery. However, there is concern that celiac artery coverage may lead to increased risk of foregut or spinal cord ischemia with an attendant increased risk of mortality. We sought to investigate rates of bowel ischemia, spinal cord ischemia and 30-day mortality associated with celiac artery coverage during TEVAR and complex EVAR. METHODS The Society for Vascular Surgery Vascular Quality Initiative (VQI) database was queried for TEVAR and complex EVAR cases from 2012 to 2018. Inclusion criteria included TAAA pathology and endograft extension to aortic zone 6. Patients with aortic rupture, trauma, prior thoracic aortic surgery, known preoperative occlusion of the left subclavian superior mesenteric, or celiac arteries were excluded. Cases with intraoperative celiac artery occlusion4%), P=.039. The composite endpoint occurred at a significantly greater proportion for those who had CAO (10 of 44, 23%) compared to CAP (53 of 584, 9%, P=.008), driven by higher rates of 30-day mortality and bowel ischemia (9% vs. 2%, P=.026). By multivariate analysis, CAO was predictive of 30-day mortality (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 1.1 – 13.8, P=.04) and the composite endpoint (OR=3.0, 95% CI=1.1 – 8.5, P=.03). Increasing procedure time was also associated with 30-day mortality (OR=1.4, 95% CI=1.1 – 1.7, P less then .001) and the composite endpoint (OR=1.4, 95% CI=1.1 – 1.6, P less then .001). CONCLUSION For those treated for TAAAs, CAO was independently predictive of increased 30-day mortality and a composite endpoint of perioperative mortality, spinal cord ischemia, and bowel ischemia. When treating patients with extensive aortic aneurysmal disease, physicians should attempt to preserve the celiac artery, by revascularization or avoiding ostium coverage, whenever feasible. BACKGROUND To evaluate systematic duplex ultrasound (DUS) surveillance of patients treated with in situ great saphenous vein bypass (ISSVB) due to critical limb-threatening ischemia (CLTI) we performed a retrospective analysis of prospectively entered registry data. METHODS Single-center study including consecutive patients undergoing elective ISSVB surgery due to CLTI between 2011 and 2015. Postoperative graft surveillance program included clinical examination, ankle-brachial indices (ABIs), and DUS at 6 weeks and 3 and 12 months. All DUS scans were performed by trained nurse sonographers. Patient data were extracted from the Danish Vascular Registry, electronic medical records and Picture Archiving and Communication System (PACS). Primary outcomes were reintervention rate, patency, and survival. Sodium ascorbate RESULTS In total, 363 consecutive and treatment-naive CLTI patients were revascularized with ISSVB and included in the study. Of those, 310 patients had minimum one follow-up visit and in total 1,199 DUS examinations. During the study period, 84 (23%) patients received 125 graft preserving reinterventions of which 20 were indicated solely on routine DUS without concurrent ischemic symptoms and/or significant (>15%) decrease in ABI. Hence, to find one asymptomatic graft stenosis requiring reintervention, we needed to scan 60 patients. After 1, 2, and 3 years, assisted primary patency was (Kaplan-Meier estimate) 79.4% (95% CI 74.4, 83.5), 76.3% (95% CI 70.7, 81.0), and 73.6% (95% CI 66.9, 79.2), respectively. Survival rates were 82.6% (95% CI 78.1, 86.3), 64.2% (95% CI 57.8, 69.9) and 47.7% (95% CI 40.6, 54.4) at 1, 2, and 3 years, respectively. CONCLUSIONS In this study, one in four patients received a graft preserving intervention, but very few were driven by routine DUS and most graft lesions were detected on clinical findings. These findings suggest that development of a more individualized surveillance program differentiating between high- and low-risk infrainguinal bypass patients may increase cost-effectiveness. PURPOSE The optimal timing of decompression surgery following thrombolysis in patients with primary upper extremity deep vein thrombosis (UEDVT) is still a matter of debate. This systematic review compares the safety and efficacy of early intervention versus postponed intervention in patients with primary UEDVT. METHODS A structured PUBMED, EMBASE and COCHRANE search was performed for studies reporting on the timing of surgical intervention for primary UEDVT. Studies reporting on timing of decompression surgery in combination with recurrent thrombosis, bleeding complications and symptom free survival were included. Two treatment groups were defined; group A received surgical decompression within two weeks following thrombolysis and group B after two weeks or more. All endpoints were assessed in accordance with the reported outcomes in the included articles. Mean percentages were calculated using descriptive statistics. RESULTS Six articles (126 patients) were included 87 patients in group A versus 39 in group B. In group A, bleeding complications occurred in 7% of patients versus 5% in group B. Two-third of the bleeding complications in group A occurred in patients receiving surgical decompression within 24 hours after thrombolysis while kept on intravenous heparin both pre- and postoperatively. Reported preoperative recurrent thrombosis was 7% in group A versus 11% in group B, another 13% had postoperative recurrent thrombosis versus 21% in group B. The effectiveness of both treatment strategies was comparable with a total of 89% of patients in group A with minimal or no symptoms at final follow-up compared to 90% in group B. The mean follow-up in group A was 35 months (1-168 months) and 28 months (1-168 months) in group B. CONCLUSION Based on the limited available data presented in this review, early decompression surgery within two weeks after CDT seems as safe and effective as postponed surgical intervention in patients with primary UEDVT. The present study evaluates the effect of several pharmaceutical plasticizers on the thermo-physical and physicochemical properties of partially hydrolyzed poly(vinyl alcohol) (PVA) used in fusion-based pharmaceutical formulation processes. Specifically, the effect of mannitol (MAN), sorbitol (SOR), sucrose (SUC), anhydrous citric acid (CA), triethyl citrate (TEC) and low-molecular weight polyethylene glycol (PEG400) on PVA’s melting properties, physical state and thermal degradation was evaluated via differential scanning calorimetry (DSC), powder X-ray diffractometry (pXRD) and thermo-gravimetric analysis (TGA). Results showed that the use of MAN, SOR, SUC and PEG400 led to the reduction of PVA’s melting onset temperature, while MAN, SUC, CA and SOR were amorphously dispersed within PVA’s matrix, and the addition of SUC and CA resulted in significant reduction of PVA’s crystallinity. TGA results showed the formation of thermally highly unstable PVA mixtures in the cases of CA and TEC (degradation started from ~150 °C and ~125 °C, respectively), while significant molecular interactions were identified by FTIR in the cases of PVA-MAN, PVA-SOR and PVA-SUC.