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All sourcesNASA NTRSDOE OSTI
NASA NTRS1978

Influence of systematic radiation differences on the dynamics of a model atmosphere

Numerical experiments were run on the Goddard Laboratory for Atmospheric Sciences (GLAS) nine-level GCM using two different long-wave radiation routines - the Hogan routine and the Wu-Kaplan routine - to determine whether systematic radiation difference is important in the modeling of the general circulation of the atmosphere. The climatologies produced from GCM runs using the different radiation routines were compared for both winter and summer. Systematic differences were found in the mean zonal temperatures, in the location and shape of the zonal west wind maximum, in the strength of the Hadley and Ferrel cells, in the cloud and precipitation distributions, and in the mass distributions. On the basis of comparisons with observations, it was found that the Wu-Kaplan routine had a positive impact or at least made improvements in the right direction in most respects.

Wu, M.-L. C.↗
DOE OSTI2019

In Situ Characterization of Turbine Hydraulic Environment to Support Development of Fish-Friendly Hydropower Guidelines in the Lower Mekong River Region

The Mekong River is one of the most biodiverse rivers on the planet. As a result, many communities located near the river and its tributaries rely on fisheries for sustenance as well as economic viability. Along the Mekong River mainstem, there are plans for 11 new hydropower projects with potentially several hundred smaller hydropower projects along the tributaries. Currently, there is little information to guide construction of fish-friendly hydropower systems. Preliminary guidelines for construction on the mainstem Mekong call for safe upstream and downstream fish passage for 95% of target species. To understand the hydraulic conditions at existing dams in the region, Sensor Fish, a small neutrally buoyant autonomous sensor package capable of measuring and collecting in situ motion and force data, were deployed at Nam Ngum Dam in Lao PDR. The Sensor Fish were released through two turbine units—Unit 1, which contains an older 17.5-MW Francis turbine, and Unit 4, which contains a slightly newer 40-MW Francis turbine. Comparisons were made between the results from the two turbine units at Nam Ngum Dam to results for four hydroelectric dams in the U.S. Pacific Northwest for which live fish survival studies had been conducted. Three of the U.S. dams have Francis-turbine units and the other has a fish-friendly Kaplan turbine. Based on the occurrence of severe acceleration events, the survival rate of juvenile salmonids at a dam like Nam Ngum Dam would be expected to between the 11.1% to 54.1% survival rates experienced at the U.S. with Francis turbines and the 97.0% survival rate at the U.S. dam equipped with fish-friendly Kaplan turbines. Between the newer and older turbine units tested at Nam Ngum Dam, the newer Unit 4 had a higher median nadir pressure of 126 kPaA compared to 99 kPaA for Unit 1. Based on a dose-response relationship for juvenile Chinook salmon, these nadir pressures predict probabilities of mortal injury of 5% for Unit 4 and 12% for Unit 1. With respect to both pressure and acceleration, the older 17.5-MW Francis turbine had more severe hydraulic conditions than the newer 40-MW Francis turbine. Francis turbines, like the ones involved in this study, are the most common type of hydropower turbines in the throughout the world. The results from this study can be used to guide the construction of new hydropower structures and make design and operational changes to existing hydropower structures that will improve fish passage conditions.

Francis turbine, Mekong River, sustainable hydropo↗
DOE OSTI2019

Tumor Volume Is Better Than Diameter for Predicting the Prognosis of Patients with Early-Stage Non-small Cell Lung Cancer

Background: This study aimed to investigate whether tumor volume (TV) is better than diameter for predicting the prognosis of patients with early-stage non-small cell lung cancer (NSCLC) after complete resection. Methods: This study retrospectively reviewed the clinicopathologic characteristics of 274 patients with early-stage NSCLC who had received pretreatment computed tomography (CT) scans and complete resection. TV was semi-automatically measured from CT scans using an imaging software program. The optimal cutoff of TV was determined by X-tile software. Disease-free survival (DFS) and overall survival (OS) were assessed by the Kaplan–Meier method. The prognostic significance of TV and other variables was assessed by Cox proportional hazards regression analysis. Results: Using 3.046 cm{sup 3} and 8.078 cm{sup 3} as optimal cutoff values of TV, the patients were separated into three groups. A larger TV was significantly associated with poor DFS and OS in the multivariable analysis. Kaplan–Meier curves of DFS and OS showed significant differences on the basis of TV among patients with stage 1a disease, greatest tumor diameter (GTD) of 2 cm or smaller, and GTD of 2–3 cm, respectively. Using two TV cutoff points, three categories of TV were created. In 54 cases (19.7%), patients migrated from the GTD categories of 2 cm or smaller, 2–3 cm, and larger than 3 cm into the TV categories of 3.046 cm{sup 3} or smaller, 3.046–8.078 cm{sup 3}, and larger than 8.078 cm{sup 3}. Conclusion: TV is an independent prognostic factor of DFS and OS for early-stage NSCLC. The findings show that TV is better than GTD for predicting the prognosis of patients with early-stage NSCLC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2024

Full Scale HEPA Filter Encapsulation in Ultra-High-Performance Grout - Proof of Concept

The Hanford Tank Waste Treatment and Immobilization Plant (WTP) currently being constructed to treat radioactive waste, includes vitrification facilities for both the high-level waste (HLW) and low activity waste (LAW) fractions. Operation of the WTP will produce contaminated high-efficiency particulate air filters (HEPA), as part of the solid secondary waste (SSW) stream. The HEPA filters receive off-gas from the vessel vent header and primary off-gas treatment system in LAW Facility and remove particulate contaminants including 99 Tc and 129 I salts. The current disposal method for HEPA filters is encapsulation in metal containers using cementitious material (CM) and disposal in the Integrated Disposal Facility (IDF). Results from the 2017 IDF Performance Assessment (PA) WRPS (2018) demonstrated that while compliance is maintained for the 1000 year compliance period mandated by DOE O 435.1 and its accompanying manual, release of constituents from the HEPA filters result in exceedance of the performance objective imposed as the groundwater regulatory limit at later times. For example, at about 1500 years post-closure, solid secondary waste (SSW), including HEPA filters is predicted to become a dominant contributor to 99 Tc release and over the 10,000-year sensitivity analysis period, SSW is the dominant contributor of 129 I release to the groundwater. The estimated release could potentially be reduced if the HEPA filters are not compacted and waste containers could be distributed throughout a large space, thereby diluting the contaminant release. Additionally, a better cementitious material could be used to encapsulate the HEPA filters. One alternative method for disposal of contaminated HEPA filters is encapsulation of the filters in ultra high-performance grout (UHPG). UHPG is a variation of ultra-high-performance concrete (UHPC) is commonly used in the prestressed concrete industry for large structural members. Recent studies of UHPG show it has excellent properties for containing radionuclides such as 99 Tc and 129 I Nichols and Kaplan (2021). This report presents the results of the first attempt to encapsulate a clean, full-size HEPA filter in UHPG and evaluate the effectiveness of the immobilization process and final waste form. A full-scale proof-of-concept simulated waste form was prepared by encapsulating a HEPA filter in a 110-gallon stainless steel (SS) drum using UHPG. A change from Type I/II PC to Type 1L PLC was made after American Rock Products informed the team that they would no longer be using Type I/II by the end of 2024 and the northwest was phasing out Type I/II PC overall. Type I/II PC used in previous studies of UHPG for encapsulation (Nichols and Kaplan 2021). After the UHPG was cured both the scaled mockup and the full-scale simulated waste forms were sectioned for visual examination. UHPG completely encapsulated the filters and bonded to the external surfaces of materials comprising the filters. No cracks were observed in the sectioned waste forms.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
NASA NTRS1990

Corrections regarding the Lellouch et al. (1989) analysis of Mars atmospheric C-12O and C-13O spectra

Lellouch et al. (1989) obtained atmospheric CO mixing ratios from Martian C-12O and C-13O microwave spectra that were 3-5 times greater than the Kaplan et al. (1969) IR measurememts; they also inferred a factor-of-2 increase in atmospheric CO abundance between September, 1986 and January, 1987. A reanalysis has been conducted of the Lellouch material, and more detailed treatment of the radiative transfer analysis indicates that its observations are consistent with the Kaplan CO volume mixing ratio determination. It is also ascertained that the Lellouch atmospheric temperature profiles are in error, with no evidence being found for the extreme temperature inversions inferred for the lowest 5 km of the Martian atmosphere.

Clancy, R. Todd↗
DOE OSTI2023

Experimental Limit on Nonlinear State-Dependent Terms in Quantum Theory

Linear time evolution is one of the fundamental postulates of quantum theory. Past theoretical attempts to introduce nonlinearity into quantum evolution have violated causality. However, a recent theory has introduced nonlinear state-dependent terms in quantum field theory, preserving causality [D. E. Kaplan and S. Rajendran, Phys. Rev. D 105, 055002 (2022)]. We report the results of an experiment that searches for such terms. Our approach, inspired by the Everett many-worlds interpretation of quantum theory, correlates a binary macroscopic classical voltage with the outcome of a projective measurement of a quantum bit, prepared in a coherent superposition state. Measurement results are recorded in a bit string, which is used to control a voltage switch. Presence of a nonzero voltage reading in cases of no applied voltage is the experimental signature of a nonlinear state-dependent shift of the electromagnetic field operator. We implement blinded measurement and data analysis with three control bit strings. Control of systematic effects is realized by producing one of the control bit strings with a classical random-bit generator. The other two bit strings are generated by measurements performed on a superconducting qubit in an IBM Quantum processor and on a N 15 nuclear spin in a nitrogen-vacancy center in diamond. Our measurements find no evidence for electromagnetic quantum state-dependent nonlinearity. We set a bound on the parameter that quantifies this nonlinearity | ε γ | < 4.7 × 10 - 11 , at 90% confidence level.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2025

Velocity- and pressure-based metrics for estimating strike injuries during fish passage through hydro turbines

Hydropower is a crucial source of clean and reliable energy worldwide, and its importance will continue to grow. To enhance the environmental sustainability of hydropower development and operations, it is essential to predict the strike injury rates of fish passing through turbines accurately and cost-effectively. However, conventional experiments involving a large number of live fish are still commonly conducted in practice, and previous attempts mainly focused on the dose-response relationships at an individual level or relative comparisons of biological characterization between different conditions. Thus, this study proposes two novel strike metrics based on velocity and pressure (M V and M P ) measured by the cutting-edge Sensor Fish (SF) technology, designed to quantify the biological effects of strikes and collisions between fish and rigid hydraulic structures. SF measurements and 48-hour survival rates of live fish from a study conducted at the Ice Harbor Dam on the Snake River were used to establish thresholds for the two proposed metrics. These metrics and thresholds were then applied to three additional SF studies conducted at hydropower facilities featuring Kaplan turbines within the Columbia River basin. Results from the application of the strike metrics indicate that the estimated survival rates derived from both metrics agree well with previously reported live fish survival rates. Furthermore, the study identified specific passage regions with elevated risks of fish mortality due to strikes and collisions. Overall, the proposed strike metrics present a reliable and cost-effective approach to reducing reliance on live fish and lowering costs in fish passage studies.

Biological characterization↗
DOE OSTI2024

Unconventional Error Cancellation Explains the Success of Hartree–Fock Density Functional Theory for Barrier Heights

Energy barriers, which control the rates of chemical reactions, are seriously underestimated by computationally efficient semilocal approximations for the exchange-correlation energy. The accuracy of a semilocal density functional approximation is strongly boosted for reaction barrier heights by evaluating that approximation non-self-consistently on Hartree–Fock electron densities, which has been known for ~30 years. Here, the conventional explanation is that the Hartree–Fock theory yields the more accurate density. This work presents a benchmark Kohn–Sham inversion of accurate coupled-cluster densities for the reaction H 2 + F → HHF → H + HF and finds a strong, understandable cancellation between positive (excessively overcorrected) density-driven and large negative functional-driven errors (expected from stretched radical bonds in the transition state) within this Hartree–Fock density functional theory. This confirms earlier conclusions (Kaplan, A. D., et al. J. Chem. Theory Comput. 2023, 19, 532–543) based on 76 barrier heights and three less reliable, but less expensive, fully nonlocal density functional proxies for the exact density.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2020

Convergence of nuclear effective field theory with perturbative pions

The classic paper by Fleming, Mehen, and Stewart (FMS) cast doubts on the convergence of spin-triplet nucleon-nucleon partial wave scattering amplitudes when following the proposal of Kaplan, Savage, and Wise to construct nuclear effective field theory (EFT) around the unitary fermion limit with perturbative pion exchange. FMS identified the subclass of iterated one-pion exchange potential graphs as the cause of this poor convergence, which they showed persisted in the chiral limit. Theoretical tools are developed in this work to compute these Feynman graphs analytically to high order in all angular momentum channels simultaneously, examining the amplitudes computed to seven loops in the $\textit{L = J}$ channels and three loops in the coupled $\textit{L = J}$ ± 1 channels. One finds that there is nothing pathological about the perturbative expansion of a 1/$r^3$ potential in general and that the expansion converges satisfactorily in all partial waves except those with the lowest angular momentum, particularly the $^3P_0$ and the coupled $^3S_1 - ^3D_1$ channels. The results corroborate work by Birse, which suggests possible avenues to explore for improving the range of validity of the EFT expansion.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2021

Uranium Immobility in Tims Branch Wetland

The objective of this study was to address an item identified by the Low-Level Waste Disposal Facility Federal Review Group (LFRG) panel during their review of the Savannah River Site’s Composite Analysis. Their concern was that the Tims Branch wetland, which has elevated levels of uranium (U) originating from site operations between 1952 to 1985, may be a secondary source term, posing a human health risk. This report briefly describes three studies dealing with: 1) quantifying the mass of U remaining in the wetland, 2) quantifying the tendency of U to release from Tims Branch sediment, and 3) describing the distribution of U in aqueous and suspended solids in Tims Branch water during episodic storm events. The Tims Branch wetland has been extremely effective for the last 50 years at immobilizing U released to the system. A detailed map including 270,000 gamma spectra of the U distribution in the wetland indicated that 84% of the initial 43,500 kg U introduced in the system remain there after 50 years (Kaplan et al., 2020). The effectiveness of immobilizing U is supported by stream water measurements collected over the last several decades indicating that U concentrations have been consistently below drinking water regulatory limits (i.e., the EPA Maximum Contaminant Level, 30 pg/L (SRNS, 2019)). Furthermore, using contaminated Tims Branch sediments, in situ desorption Kd values (ratio of U sediment/U Water) were extremely high, ranging from 104to 106 L/kg, suggesting the U is strongly bound to these wetland sediments. Finally, a detailed study of Tims Branch stream water properties during episodic rain events indicated that essentially all the U transported in this stream was associated with suspended solids (Batson et al., 1996). Together these findings indicate that the Tims Branch wetland is extremely effective in its present state at immobilizing U and that the small masses of U released downstream will be predominantly in association with suspended solids.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2025

Self-Lubricating Bushing Testing for John Day Dam Ka plan Turbine Replacement

The goal of this testing program is to find suitable self-lubricated alternatives to replace the in use oil lubricated grooved-bronze bushing in Kaplan runner hubs that are currently being utilized at John Day Dam operated by the U.S. Army Corps of Engineers (USACE). Scaled bushing testing utilizing a Pacific Northwest National Laboratory designed, fabricated, and operated Bushing Test Stand under the direction and funding from USACE determined that self-lubricated bushings tested appear capable of outperforming the current oil-lubricated bronze bushings. Performance tests are focused on durability which includes cyclic load bearing properties and articulations under various loading scenarios. This testing was performed at nominally 1/5 th scale. A scaling sensitivity analysis determined that scaled testing results apply to prototypic size. This report shows the direct comparison between the current baseline bronze bushing to self-lubricated bushings from various manufacturers. Bushing data like coefficient of friction and bushing material loss (associated with bushing wear) was determined. Self-lubricated bushings tested include products manufactured specifically for hydropower applications by the following companies: Trelleborg, Kamatics, Anonymous, and Tenneco/Deva.

42 ENGINEERING↗
NASA NTRS1983

A nested-grid limited-area model for short term weather forecasting

The present investigation is concerned with a mesoscale atmospheric simulation system (MASS), incorporating the sigma-coordinate primitive equations. The present version of this model (MASS 3.0) has 14 vertical layers, with the upper boundary at 100 mb. There are 128 x 96 grid points in each layer. The earlier version of this model (MASS 2.0) has been described by Kaplan et al. (1982). The current investigation provides a summary of major revisions to that version and a description of the parameterization schemes which are presently included in the model. The planetary boundary layer (PBL) is considered, taking into account aspects of generalized similarity theory and free convection, the surface energy budget, the surface moisture budget, and prognostic equations for the depth h of the PBL. A cloud model is discussed, giving attention to stable precipitation, and cumulus convection.

Wong, V. C.↗
DOE OSTI2022

Prognostic importance of the preoperative New‐Naples prognostic score for patients with gastric cancer

Abstract Background The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New‐NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis. Methods This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t‐ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan–Meier method and log‐rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C‐index), and decision curve. Results A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New‐NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA ( P = 0.026), Borrmann type ( P = 0.001), pTNM ( P < 0.001), New‐NPS ( P < 0.001), and nerve infiltration ( P = 0.035) were independent risk factors for prognosis. Conclusion The New‐NPS based on the cutoff values of NLR, LMR, Alb, and TC is not only suitable for predicting prognosis but can also be combined with clinicopathological characteristics to construct a nomogram model for GC patients.

Wang, Hao↗
DOE OSTI2023

The Association Between Baseline Hepatic or Renal Function and Clinical Outcomes for Patients With Non–Small Cell Lung Cancer Treated With a PD –1/PD– L1 Blocking Antibody Using Real–World and Trial Data

Clinical trials have demonstrated the benefit of PD-1/PD-L1 blocking antibodies for the treatment of patients with advanced non-small cell lung cancer (NSCLC) in defined patient populations that often exclude patients with moderate or severe hepatic or renal impairment. We assessed the association between overall survival (OS) and baseline organ function in patients with advanced NSCLC treated with PD-1/PD-L1 blocking antibodies in real-world data (RWD; patient-level data from electronic health records) and pooled clinical trial data submitted to the US Food and Drug Administration (FDA). The Kaplan–Meier estimator was used to estimate OS in different subgroups based on organ function. Unadjusted and adjusted Cox proportional hazards models were used to estimate the association between OS and organ function. In this hypothesis-generating study, baseline renal impairment did not appear to be associated with OS, while patients with baseline liver impairment had shorter OS. RWD provided information on a broader range of renal and hepatic function than was evaluated in clinical trials and hold promise to complement trial data in better understanding populations not represented in clinical trials.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Safe passage of American Eels through a novel hydropower turbine

Abstract Objective Study the effects of downstream passage through a novel turbine designed for fish safety, the Restoration Hydro Turbine (RHT), on American Eels Anguilla rostrata in a recirculating turbine test facility. Methods A 55‐cm‐diameter RHT was operated under 10 m of hydraulic head and 667 revolutions/min. In total, 131 eels were passed through the turbine and 43 eels were used as experimental controls (length = 33.9–65.5 cm). High‐speed video of passage through the runner region was captured for 89% of turbine‐passed eels, and injury and behavioral effects were recorded immediately before and after passage, as well as after a 48‐h holding period. A subset of 37 eels was additionally examined with X‐ray imaging for internal injuries. Result The 48‐h survival rate for both treatment and control groups was 100%, with no major internal or external injuries present after the holding period. Conclusion This is a substantial improvement over eel survival rates through conventional Kaplan and Francis turbines, which may range from 40% to 95%, and suggests that hydropower turbines designed for safe downstream fish passage could be implemented without major impacts to eels.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas

Purpose: To evaluate the effect of size and central location of the tumor on safety and efficacy of percutaneous CEUS- and CT-guided MWA in biopsy-proven renal cell carcinomas (RCCs). Materials and methods: In this IRB-approved retrospective study, 69 biopsy-proven renal tumors in 56 patients, who underwent MWA in our institution from January 2013 to March 2017, were evaluated. Data collection included demographics, tumor characteristics, procedural protocols, and follow-up visits within 6 months post procedure. Primary outcomes were assessed by technical success (TS), local tumor progression (LTP), and complications. The Kaplan–Meier analysis was used for survival rate. Results: Overall technical success was achieved for all 69 lesions (92.8% primary TS, 100% overall). Median nephrometry score was 8 (4–11) and median tumor size was 2.5 cm (0.8–7). Five lesions which required second ablation had significantly higher median tumor size 4 cm (P = 0.039) with the same nephrometry score. Renal function remained stable with no significant change in eGFR before or after ablation. The LTP rate was 5.8%. The most recurrent tumors were clear cell (50%) followed by papillary tumors (25%). The complication rate was 5.8% with minor complications (hematoma and pain) and no major issues. There was no significant association between nephrometry score and technical success, recurrence, or complication rates. Overall and tumor-specific survival rates were 96.7% and 100% at 11.9 months. Conclusions: Image-guided MWA appears to be a safe and effective treatment regardless of nephrometry score and tumor location with high technical success, low recurrence, and complication rates.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Correlation between SACE (Subjective Angiographic Chemoembolization Endpoint) score and tumor response and its impact on survival after DEB-TACE in patients with hepatocellular carcinoma

Purpose: To asses angiographic and computed tomographic success criteria during and after transcatheter arterial drug-eluting bead chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC) and its impact on progression-free survival (PFS) and overall survival (OS). Methods: In this retrospective single-center study, 50 patients with unresectable HCC having undergone DEB-TACE from January 2010 to July 2015 were assessed. The angiographic endpoint was classified by Subjective Angiographic Chemoembolization Endpoint (SACE) scale. Relative tumor density in arterial (D{sub Art}) and portal venous phase (D{sub PV}) computed tomography post- versus pre-DEB-TACE were calculated, respectively. Tumor response according to modified Response Criteria in Solid Tumors (mRECIST) was assessed. Univariate Kaplan–Meier and Cox regression analysis were carried out. Results: SACE scores I, II, III, and IV were found in 1 (2%), 20 (40%), 15 (30%), and 14 (28%) patients, respectively. Median OS and PFS were 14.2 and 5.5 months, respectively. Death rates at 6 months, 1 year and 2 years were 24%, 38%, and 52%, respectively. SACE score during DEB-TACE significantly correlated with local and overall mRECIST results (local: p < 0.001, r = 0.49, overall: p = 0.042, r = 0.29) and inversely correlated with D{sub PV} (p = 0.005, r = − 0.40). In univariate analysis, progressive disease (PD) according to mRECIST and increase of D{sub Art} and D{sub PV} were associated with significantly shorter PFS. Modified RECIST independently predicted OS (hazard ratio for complete remission vs. PD = 0.15, 95% confidence interval 0.03–0.68, p = 0.014). Conclusions: A direct impact of SACE on PFS or OS could not be shown. However, SACE significantly correlated with local and overall mRECIST tumor response that again significantly predicted OS. We therefore postulate an indirect impact of SACE on OS. Consequently, complete embolization should be attempted.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Endovascular Recanalization of Thromboangiitis Obliterans (Buerger’s Disease) in Twenty-Eight Consecutive Patients and Combined Antegrade–Retrograde Intervention in Eight Patients

Purpose: The aim of the study was to evaluate the technical success of the procedure and the clinical efficacy of treatment in patients with thromboangiitis obliterans (TAO) (Buerger’s disease) based on a change in the Rutherford classification. Materials and Methods: A total of 28 consecutive patients (26 males, 2 females, mean age 43.3 ± 5.32 years) underwent endovascular recanalization with a diagnosis of TAO, between April 2015 and July 2018. After unsuccessful attempts using the antegrade approach, retrograde approaches were used in 8 patients under ultrasound guidance. Clinical follow-up was routinely performed at 1-month, 3-month, 6-month, and 1-year intervals. Results: A total of 28 TAO patients underwent 40 procedures in 32 limbs. Technical success was achieved in 28 of the 32 limbs (87.5%). In total, 45 of 59 (76.2%) below the knee arteries were treated successfully. One major amputation was performed, providing a 96.8% rate for limb salvage both at 12 and 24 months. Amputation-free survival estimated by Kaplan–Meier analysis was 84% at 12 and 24 months. Primary patency rates at 12, 24, and 36 months were 84%, 78%, and 75%, respectively. Secondary patency rates were 87.5% both at 12 and 24 months. Conclusion: Endovascular treatment is a technically feasible and potentially effective treatment modality for Buerger’s disease. Combined antegrade and retrograde interventions in TAO patients may improve technical success and clinical recovery, especially in cases where the antegrade approach has failed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗