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Objectives: To review our experience of stentgraft deployment for vascular aneurysm or pseudoaneurysm of the brachiocephalic or subclavian artery. Methods: Participants comprised 7 patients (4 men, 3 women; mean age, 61 years; range, 47 - 76 years) who underwent endovascular repair of brachiocephalic or subclavian arterial vascular lesions between July 2001 and November 2008. Causes of vascular lesions were: traffic accident, n = 4; infection, n = 2; and post-irradiation state of esophageal cancer, n = 1. Safety, technical success, and clinical follow-up were evaluated. Results: Stentgraft deployment was successful in all cases. No complications related to stent fracture were encountered during follow-up (up to 2308 days). One male patient with esophageal cancer died of rebleeding from the tracheostomy hole 13 days after treatment with size mismatch between the stentgraft and brachiocephalic artery. Conclusion: Stentgraft deployment represents acceptable treatment for the injured brachiocephalic artery or proximal side of the subclavian artery.
The vaccination of one person may prevent another from becoming
infected, either because the vaccine may prevent the first person from
acquiring the infection and thereby reduce the probability of transmission to
the second, or because, if the first person is infected, the vaccine may impair
the ability of the infectious agent to initiate new infections. The former
mechanism is referred as a contagion effect and the latter is referred as an
infectiousness effect. By applying a principal stratification approach, the
conditional infectiousness effect has been defined, but the contagion effect is
not defined using this approach. Recently, new definitions of unconditional
infectiousness and contagion effects were provided by applying a mediation
analysis approach. In addition, a simple relationship between conditional and
unconditional infectiousness effects was found under a number of assumptions.
These two infectiousness effects can be assessed by very simple estimation and
sensitivity analysis methods under the assumptions. Nevertheless, such simple
methods to assess the contagion effect have not been discussed. In this paper,
we review the methods of assessing infectiousness effects, and apply them to
the inference of the contagion effect. The methods provided here are
illustrated with hypothetical vaccine trial data.