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Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening. In our case report, we present a 59-year-old patient, smoker, affected by hypertension, dyslipidemia, chronic renal failure, and morbid obesity who came at our attention for a 6-cm abdominal aorta aneurysm, treated with an aorto-aortic graft. Within 24 hours from surgery, the patient presented acute ischemia of the right lower limb due to thrombosis of the common iliac artery and underwent the positioning of a kissing stent at the aortic bifurcation. In the immediate postoperative period, a relevant increase in serum creatinine, creatine phosphokinase, and myoglobin value was recorded, associated with clinical presentation of swelling in the right buttock with intense pain. The diagnosis of gluteal CS was confirmed by the measurement of the gluteal compartment pressure, which resulted of 110 mm Hg. The treatment of the CS consisted in gluteal dermofasciotomy, surgical debridement of the buttock, and positioning of negative pressure medication, associated with infusive therapy, avoiding hemodialysis. Because of the epidural anesthesia only later on it was possible to observe a persistent plegia of the right lower limb, which was solved within 1 month of neurological and physical therapy. With our experience, we can state that the CS is an extremely severe complication that can occur in vascular surgeries and it should therefore be kept in mind in the short-term postoperative period in order to guarantee a precocious diagnosis and immediate treatment.

There is increasing evidence in the literature that endovascular aneurysm repair is the first-line approach for most of abdominal aortic aneurysms (AAAs). Furthermore aortouniiliac stent graft placement is, in high risk patients or during emergency setting, a safe procedure over the mid- and long-term period and compares well with the results of bifurcated stent grafts. We present a case of a 66 -year-old gentleman, with pneumothorax after therapeutic thoracentesis and a giant AAA, successfully treated with an aortomonoiliac stent grafting and femoro-femoral crossover bypass.

International audience; The Horizon 2020 Project EuPRAXIA ('European Plasma Research Accelerator with eXcellence In Applications') aims at producing a design report of a highly compact and cost-effective European facility with multi-GeV electron beams using plasma as the acceleration medium. The accelerator facility will be based on a laser and/or a beam driven plasma acceleration approach and will be used for photon science, high-energy physics (HEP) detector tests, and other applications such as compact X-ray sources for medical imaging or material processing. EuPRAXIA started in November 2015 and will deliver the design report in October 2019. EuPRAXIA aims to be included on the ESFRI roadmap in 2020.

The Horizon 2020 Project EuPRAXIA ("European Plasma Research Accelerator with eXcellence In Applications") is preparing a conceptual design report of a highly compact and cost-effective European facility with multi-GeV electron beams using plasma as the acceleration medium. The accelerator facility will be based on a laser and/or a beam driven plasma acceleration approach and will be used for photon science, high-energy physics (HEP) detector tests, and other applications such as compact X-ray sources for medical imaging or material processing. EuPRAXIA started in November 2015 and will deliver the design report in October 2019. EuPRAXIA aims to be included on the ESFRI roadmap in 2020. © Published under licence by IOP Publishing Ltd.

The Horizon 2020 Project EuPRAXIA ("European Plasma Research Accelerator with eXcellence In Applications") is preparing a conceptual design report of a highly compact and cost-effective European facility with multi-GeV electron beams using plasma as the acceleration medium. The accelerator facility will be based on a laser and/or a beam driven plasma acceleration approach and will be used for photon science, high-energy physics (HEP) detector tests, and other applications such as compact X-ray sources for medical imaging or material processing. EuPRAXIA started in November 2015 and will deliver the design report in October 2019. EuPRAXIA aims to be included on the ESFRI roadmap in 2020.

The technique for producing and measuring few tens of femtosecond electron beams, and the consequent generation of few tens femtoseconds single spike FEL radiation pulses at SPARC_LAB is presented. The undulator has been used in the double role of radiation source and diagnostic tool for the characterization of the electron beam. The connection between the electron bunch length and the radiation bandwidth is analyzed.

The active plasma lens represents a compact and affordable tool with radially symmetric focusing and field gradients up to several kT/m. In order to be used as a focusing device, its effects on the particle beam distribution must be well characterized. Here, we present the experimental results obtained by focusing an high-brightness electron beam by means of a 3 cm-long discharge-capillary pre-filled with Hydrogen gas. We achieved minimum spot sizes of 24 μ m (rms) showing that, during plasma lensing, the beam emittance increases due to nonlinearities in the focusing field. The results have been cross-checked with numerical simulations, showing an excellent agreement.

We report on the experimental characterization of the effect that a passive plasma lens in the overdense regime has on high-brightness bunch quality by means of 6D phase-space analysis. The passive lens is generated by confining hydrogen gas with a capillary tube pre-ionized with a high-voltage discharge. We observed that the optimum condition is retrieved at the end of the overdense regime with almost no effect on bunch brightness. The presence of gas jets, leaking from the hollow capillary end-points, extends the lens effects also outside of the capillary, resulting in longer focusing channels. Experimental results are supported with numerical simulations of the complete accelerator line together with the plasma channel section.

A high brightness electron LINAC is being built in the Compton Gamma Source at the ELI Nuclear Physics facility in Romania. To achieve the design luminosity, a train of 32 bunches, 16 ns spaced, with a nominal charge of 250 pC will collide with the laser beam in the interaction point at two electron beam energies, namely 280 MeV and 720 MeV. Electron beam spot size is measured with optical transition radiation (OTR) profile monitors. The paper deals with the possibility of using the OTR monitors to measure also beam energy along the machine; such measurements may help monitoring the accelerating sections performances, especially when the whole bunch train is being accelerated. We discuss the measurement principle, the expected accuracy and the main characteristic of the optical line to retrieve the angular distribution of the emitted radiation., Proceedings of the 6th Int. Beam Instrumentation Conf., IBIC2017, Grand Rapids, MI, USA

INTRODUCTION: Severe dialysis-associated steal syndrome (DASS) is an uncommon and severe complication after arteriovenous fistula (AVF) creation that can lead to finger gangrene and amputation. As the number of patients on hemodialysis increases in western countries the number of patients at risk for DASS will continue to rise. METHODS: We retrospectively reviewed all patients who underwent a surgical intervention for the management of DASS with finger gangrene from January 2004 to July 2013. Demographic data, pre-operative work-up, procedure details and outcomes were collected. A literature search using MEDLINE's Medical Subject Heading terms was used to identify recent articles. Cross-references from these articles were also used. RESULTS: A total of nine patients were identified. Mean age was 53 years, 67% were women. All patients presented with finger tissue loss or gangrene. Surgical procedures included AVF closure/ligation (5), distal artery ligation (DRAL) (2), distal revascularization with interval ligation (DRIL) (1), banding (1). All patients had improvement of symptoms during follow-up. No major amputation occurred. CONCLUSIONS: Surgical interventions to correct DASS in patients with finger gangrene are mandatory while conservative management is not recommended. The decision for which type of procedure is made individually, according to clinical symptoms, technical findings, and patients' general state of health.

There is increasing evidence in the literature that endovascular aneurysm repair is the first-line approach for most of abdominal aortic aneurysms (AAAs). Furthermore aortouniiliac stent graft placement is, in high risk patients or during emergency setting, a safe procedure over the mid- and long-term period and compares well with the results of bifurcated stent grafts. We present a case of a 66 -year-old gentleman, with pneumothorax after therapeutic thoracentesis and a giant AAA, successfully treated with an aortomonoiliac stent grafting and femoro-femoral crossover bypass.

Port-a-cath is widely used as a route for administration of drugs in hematology and oncology patients and, recently, has been adapted also for hemodialysis patients. Major complications include infection, thrombosis, arrhythmia, and embolization. The Pinch-off-syndrome (POS) means the clavicle and the first rib compress the long-term central venous catheter. The reported incidence rate ranges from 1.4% to 4.1%. This syndrome can be recognized on chest radiography by observing a thinning of the catheter lumen through the passage between the clavicle and the first rib. Catheter fracture is a rare but potentially life-threatening complication that must be recognized and treated promptly. Management of dislodged ports includes percutaneous transcatheter retrieval, open thoracotomy retrieval and oral anticoagulant therapy. Among these techniques, percutaneous transcatheter retrieval is an easy, safe and efficient method. We report the successful percutaneous endovascular retrieval of dislodged intracardiac catheter, separated from its port, in a 58 year-old male patient who presented with chest pain.

Plasma-based laser amplification is considered as a possible way to overcome the technological limits of\ud present day laser systems and achieve exawatt laser pulses. Efficient amplification of a picosecond laser\ud pulse by stimulated Brillouin scattering (SBS) of a pump pulse in a plasma requires to reach the self-similar\ud regime of the strongly coupled (SC) SBS. In this Letter, we report on the first observation of the signatures\ud of the transition from linear to self-similar regimes of SC-SBS, so far only predicted by theory and\ud simulations. With a new fully head-on collision geometry, subpicosecond pulses are amplified by a factor\ud of 5 with energy transfers of few tens of mJ. We observe pulse shortening, frequency spectrum broadening,\ud and down-shifting for increasing gain, signatures of SC-SBS amplification entering the self-similar regime.\ud This is also confirmed by the power law dependence of the gain on the amplification length: doubling the\ud interaction length increases the gain by a factor 1.4. Pump backward Raman scattering (BRS) on SC-SBS\ud amplification has been measured for the first time, showing a strong decrease of the BRS amplitude and\ud frequency bandwidth when SBS seed amplification occurs.\ud

The generation of ultra-short electron bunches with ultra-low timing-jitter relative to the photo-cathode (PC) laser has been experimentally proved for the first time at the SPARC_LAB test-facility (INFN-LNF, Frascati) exploiting a two-stage hybrid compression scheme. The first stage employs RF-based compression (velocity-bunching), which shortens the bunch and imprints an energy chirp on it. The second stage is performed in a non-isochronous dogleg line, where the compression is completed resulting in a final bunch duration below 90 fs (rms). At the same time, the beam arrival timing-jitter with respect to the PC laser has been measured to be lower than 20 fs (rms). The reported results have been validated with numerical simulations.

The ELI-NP Gamma Beam System is an advanced gamma ray source based on the Compton back-scattering effect with unprecedented specifications of brilliance ( >10²¹), monochromaticity (0.5%) and energy tunability (0.2 - 19.5 MeV), presently under construction in Magurele-Bucharest (RO). Here the head-on collision is foreseen between an intense high power laser beam and a high brightness high quality electron beam with a maximum kinetic energy of 740 MeV. The electron beam dynamics analysis and control for the ELI-NP GBS Linac in the single and multi bunch mode have been investigated and are here illustrated., Proceedings of the 7th Int. Particle Accelerator Conf., IPAC2016, Busan, Korea

New generation of particle accelerators is based on the excitation of large amplitude plasma waves driven by either electron or laser beams, named as Plasma Wakefield Accelerator (PWFA) and Laser Wakefield Accelerator (LWFA), respectively. Future experiments scheduled at the SPARC_LAB test facility aim to demonstrate the acceleration of externally injected high brightness electron beams through both schemes. In particular, in the so-called resonant PWFA a train of more than two driver electron bunches generated with the laser comb technique resonantly excites wakefields into the plasma, the last bunch (witness) is injected at the proper accelerating phase gaining energy from the wake. The quality of the accelerated beam depends strongly on plasma density and its distribution along the acceleration length. The desired density can be achieved with a correct shaping of the capillary in which plasma is formed. The measurements of plasma density, as well as other plasma characteristics, can be performed with spectroscopic measurements of the plasma self emitted light. The measurement of density distribution for hydrogen filled capillaries is here reported., Proceedings of the 7th Int. Particle Accelerator Conf., IPAC2016, Busan, Korea

The ELI-NP Gamma Beam Source (GBS) is now under construction in Magurele–Bucharest (RO). Here an advanced source of gamma photons with unprecedented specifications of brilliance ( > 10 21 ), monochromaticity (0.5%) and energy tunability (0.2–19.5 MeV) is being built, based on Inverse Compton Scattering in the head-on configuration between an electron beam of maximum energy 750 MeV and a high quality high power ps laser beam. These requirements make the ELI-NP GBS an advanced and challenging gamma ray source. The electron beam dynamics analysis and control regarding the machine sensitivity to the possible jitter and misalignments are presented. The effects on the beam quality are illustrated providing the basis for the alignment procedure and jitter tolerances.

International audience; The ELI-NP GBS is a high intensity and monochromatic gamma source under construction in Magurele (Romania). The design and construction of the Gamma Beam System complex as well as the integration of the technical plants and the commissioning of the overall facility, was awarded to the Eurogammas Consortium in March 2014. The delivery of the facility has been planned in for 4 stages and the first one was fulfilled in October 31st 2015. The engineering aspects related to the delivery stage 1 are presented.

The SPARC_LAB Thomson source is a compact X-ray source based on the Thomson backscattering process presently under its second phase of commissioning at the LNF. The electron beam energy ranges between 30 and 150 MeV, the electrons collide head-on with the Ti:Sapphire FLAME laser pulse the energy of which ranges between 1 and 5 J with pulse lengths in the 25 fs–10 ps range, this provides an X-ray energy tunability in the range of 20–500 keV, with the further capability to generate strongly non-linear phenomena and to drive diffusion processes due to multiple and plural scattering effects. The experimental results of the obtained X-ray radiation are presented.

A systematic study of the polarization of x-gamma rays produced in Thomson and Compton scattering is presented, in both classical and quantum schemes. Numerical results and analytical considerations let us to establish the polarization level as a function of acceptance, bandwidth and energy. Few sources have been considered: the SPARC_LAB Thomson device, as an example of a x-ray Thomson source, ELI-NP, operating in the gamma range. Then, the typical parameters of a beam produced by a plasma accelerator has been analyzed. In the first case, with bandwidths up to 10%, a contained reduction ($l10%$) in the average polarization occurs. In the last case, for the nominal ELI-NP relative bandwidth of $5\ifmmode\times\else\texttimes\fi{}1{0}^{\ensuremath{-}3}$, the polarization is always close to 1. For applications requiring larger bandwidth, however, a degradation of the polarization up to 30% must be taken into account. In addition, an all optical gamma source based on a plasma accelerated electron beam cannot guarantee narrow bandwidth and high polarization operational conditions required in nuclear photonics experiments.

Sub-picosecond, high-brightness electron bunch trains are routinely produced at SPARC-LAB via the velocity bunching technique. Such bunch trains can be used to drive multi-color Free Electron Lasers (FELs) and plasma wake field accelerators. In this paper we present recent results at SPARC-LAB on the generation of such beams, highlighting the key points of our scheme. We will discuss also the on-going machine upgrades to allow driving FELs with plasma accelerated beams or with short electron pulses at an increased energy.

Pemetrexed and Carboplatin are two well-known chemioterapic agents used for the treatment of many tumors, especially for lung cancer and mesothelioma. Peripheral ischemic events related to Pemetrexed and Carboplatin are rarely reported. We herein report a case of lower limb acute ischemia related to combined treatment of Pemetrexed and Carboplatin. A 68-year-old woman was given the chemiotherapic treatment with combination of Pemetrexed and Carboplatin after pleural resection for a malignant pleural mesothelioma. Immediately after the second cycle of treatment, the patient experienced sudden acute left lower limb ischemia. Symptoms resolved after an intra-operative thrombolytic and spasmolytic therapy.Il Pemetrexed ed il carboplatino sono farmaci chemioterapici di uso corrente nel trattamento di molti tumori, in particolar modo del cancro del polmone e del mesothelioma pleurico. In letteratura sono raramente riportate complicanze ischemiche periferiche relative all’uso del pemetrexed e del carboplatino. Scopo di questo lavoro è descrivere un caso di ischemia acuta d’arto dopo trattamento con pemetrexed e carboplatino. Una donna di 68 anni fu sottoposta a ciclo chemioterapico con pemetrexed e carboplatino dopo decorticazione pleurica per un mesotelioma pleurico maligno. Alla conclusione del secondo ciclo di trattamento, la paziente sviluppò improvvisa ischemia acuta all’arto inferiore sinistro. Trasportata d’urgenza presso il nostro Istituto, fu sottoposta ad esame arteriografico e successivo trattamento trombolitico e spasmolitico trans-catetere che portarono alla completa risoluzione del quadro clinico.

We present the experimental evidence of the generation of coherent and statistically stable Free-Electron Laser (FEL) two color radiation obtained by seeding an electron double peaked beam in time and energy with a single peaked laser pulse. The FEL radiation presents two neat spectral lines, with time delay, frequency separation and relative intensity that can be accurately controlled. The analysis of the emission shows a temporal coherence and regularity in frequency significantly enhanced with respect to the Self Amplified Spontaneous Emission (SASE). © 2015 SPIE.

The purpose of this paper is to report a salvage maneuver for accidental coverage of both renal arteries during endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA). A 72-year-old female with a 6 cm infrarenal abdominal aortic aneurysm was treated by endovascular means with a standard bifurcated graft. Upon completing an angiogram, both renal arteries were found to be accidentally occluded. Through a left percutaneous brachial approach, the right renal artery was catheterized and a chimney stent was deployed; however this was not possible for the left renal artery. A retroperitoneal surgical approach was therefore carried out with a retrograde chimney stent implanted to restore blood flow. After three months, both renal arteries were patent and renal function was not different from the baseline. Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

The FEL-SPARC operation with two bunches at different energies has been characterized using different tools. The effect of the e-beam matching on the SASE operation has been explored by controlling the transport with an ad hoc developed control system, allowing either the transport in matching conditions and in different configurations. Since the two bunches have, at the entrance of the undulator, different phase space characteristics we used this effect as a knob to enhance or suppress one or the other FEL mode. We investigated the effect of seeding on both frequencies and observed beating waves, furthermore we observed effects of intra-bunch seeding when only one of the modes is seeded.

We describe the case of a 72-year-old man with massive hemorrhage and shock resulting from rupture of the left common femoral artery as a complication of radiotherapy in the groin for cancer of the scrotum. This complication is extremely rare, presents dramatically, and is usually fatal. The patient was successfully treated with a stent graft deployment in order to achieve immediate hemostasis maintaining blood flow to the leg. Open surgery is not ideal in those cases especially when there is extensive tumor involvement of the groin causing altered anatomy and increasing the risk of re-bleeding.