Peritoneal Dialysis (PD) is the most common modality of renal replacement therapy in children with acute kidney injury (AKI). Various open and laparoscopic techniques for the placement of peritoneal dialysis (PD) catheter, with or without intra-abdominal fixation, have been described. The incidence of catheter migration after PD is 0–19
The Orbital Atherectomy System (OAS) has demonstrated high procedural success, with excellent stent deliverability and low complication rates. The effects of orbital atherectomy (OA) and its impact on calcified coronary plaques are not yet fully understood, highlighting the need for a larger and more comprehensive study. Calcium Reduction by Orbital Atherectomy in Western Europe (CROWN) is an ongoing study that aims to evaluate the effects of OA in treating de novo, severely calcified coronary lesions before stent placement using optical coherence tomography (OCT), and to assess stent expansion by measuring the OCT-derived minimum stent area (MSA). The CROWN study is a prospective, multicenter, international, single-arm observational study. We will enroll 100 patients with severely calcified coronary lesions undergoing OCT-guided orbital atherectomy and stent placement. All patients will undergo peri-procedural OCT imaging, with assessments conducted before and after OA, as well as following stent placement. Patients will be enrolled at a maximum of 6 sites in the Netherlands, Germany, and Italy. The primary endpoint is to assess the proportion of patients achieving stent expansion, defined as an OCT-derived MSA ≥ 5.5 mm2. The CROWN study will evaluate the impact of OA on calcified plaques, potentially refine operator practices, and provide additional insights on device selection for treating severely calcified lesions (clinicaltrials.gov NCT06035783).
Temporary mechanical circulatory support (t-MCS) is increasingly used in fulminant myocarditis (FM), yet long-term outcomes and risk factors remain poorly defined. From the FULLMOON international cohort (419 adults with suspected FM across 36 centers in 15 countries), 295 patients treated with venoarterial extracorporeal membrane oxygenation (V-A ECMO) and/or Impella were analyzed. The primary endpoint was mortality at 1 year, heart transplantation (HTx), or left-ventricular assist device (LVAD). Multivariate Cox regression identified predictors of adverse outcomes. A propensity score-weighted analysis assessed outcomes based on timing of endomyocardial biopsy (EMB): early (≤ 2 days), delayed (> 2 days), or none. The median age was 39 years (IQR 28–60), and 55
Abstract Introduction Pulmonary papillary adenoma (PPA) is an extremely rare benign lung tumor arising from type II pneumocytes, with fewer than 50 cases reported. Because of its rarity and nonspecific radiologic features, PPA often poses a diagnostic dilemma, mimicking low-grade adenocarcinoma or carcinoid tumor. We present a case with mild FDG avidity, highlighting the diagnostic pitfalls and the importance of histologic confirmation. Case A 66-year-old man with a smoking history was followed for a right upper lobe lung nodule first noted incidentally in 2007. Over time, he developed chronic cough and intermittent wheezing, which were attributed to his underlying COPD. Serial imaging demonstrated slow interval growth of the nodule from 1.4 cm to 2.7 cm. A PET/CT performed in August 2024 revealed mild FDG uptake, raising concern for low-grade malignancy. The patient elected to proceed with video-assisted thoracoscopic surgery (VATS) wedge resection and mediastinal lymph node sampling.Gross examination showed a 2.5-cm well-circumscribed papillary lesion. Histopathology demonstrated papillary fronds lined by bland cuboidal pneumocytes without necrosis or mitotic activity. Immunohistochemistry showed positivity for TTF-1, KRTAE1/AE3, and EMA, and absence of a round-cell component, ruling out sclerosing pneumocytoma. Margins and all lymph nodes were negative for tumor.Postoperatively, the patient’s chronic cough and wheezing completely resolved, and he remains asymptomatic and doing well. Discussion This case highlights unique aspects of pulmonary papillary adenoma. The 17-year radiologic course represents one of the longest documented natural histories of this tumor, underscoring its indolent and benign behavior. Despite slow growth, the lesion showed mild FDG avidity, raising concern for malignancy. This reinforces that low-level PET uptake does not exclude benign pathology, as chronic pneumocyte hyperplasia or focal inflammation can yield false positives. Histologically, PPA can closely mimic sclerosing pneumocytoma or papillary adenocarcinoma, requiring immunohistochemical confirmation. Notably, the patient’s chronic respiratory symptoms resolved after tumor excision, suggesting a local inflammatory effect of the lesion. This case also emphasizes the role of shared decision-making in managing indeterminate pulmonary nodules, where growth and metabolic activity warranted resection, leading to both diagnosis and symptom resolution. Conclusion PPA is a benign lesion that can mimic malignancy radiographically and metabolically. Awareness of its indolent growth pattern, potential for mild FDG uptake, and overlapping histology with malignant papillary neoplasms is essential for accurate diagnosis and appropriate management. Complete surgical excision is curative, and long-term prognosis is excellent. This abstract is funded by: none
