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Medical University of Vienna

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32 articles published in JoVE

Behavior

The Innovation Arena: A Method for Comparing Innovative Problem-Solving Across Groups Theresa Rössler^1,3, Berenika Mioduszewska^1,4, Mark O’Hara^1,2, Ludwig Huber¹, Dewi M. Prawiradilaga², Alice M. I. Auersperg¹ ¹Comparative Cognition, Messerli Research Institute, University of Veterinary Medicine Vienna, University of Vienna, Medical University of Vienna, ²Research Center for Biology, National Research and Innovation Agency (BRIN), ³Department of Cognitive Biology, University of Vienna, ⁴Max Planck Institute for Ornithology The Innovation Arena is a novel comparative method for studying technical innovation rate per time unit in animals. It is composed of 20 different problem-solving tasks, which are presented simultaneously. Innovations can be carried out freely and the setup is robust with regard to predispositions on an individual, population or species level.
Bioengineering

Automated Two-dimensional Spatiotemporal Analysis of Mobile Single-molecule FRET Probes Lukas Schrangl¹, Janett Göhring², Florian Kellner², Johannes B. Huppa², Gerhard J. Schütz¹ ¹Institute of Applied Physics, TU Wien, ²Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna This article presents a method for spatiotemporal analysis of mobile, single-molecule Förster resonance energy transfer (smFRET)-based probes using widefield fluorescence microscopy. The newly developed software toolkit allows the determination of smFRET time traces of moving probes, including the correct FRET efficiency and the molecular positions, as functions of time.
Medicine

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers Agnes Sturma^1,2, Laura A. Hruby^1,3, Anna Boesendorfer¹, Clemens Gstoettner¹, Dario Farina², Oskar C. Aszmann^1,4 ¹Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, ²Bioengineering Department, Imperial College London, ³Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, ⁴Department of Plastic and Reconstructive Surgery, Medical University of Vienna This work presents a protocol to enhance prosthetic function after selective nerve transfer surgery. Rehabilitation interventions include patient information and selection, support of wound healing, cortical re-activation of sensory-motor areas of the upper limb, training of selective muscle activation, prosthetic handling in daily life, and regular follow-up assessments.
Developmental Biology

Rapid Isolation of Single Cells from Mouse and Human Teeth Jan Krivanek¹, Josef Lavicky¹, Thibault Bouderlique², Igor Adameyko^2,3 ¹Department of Histology and Embryology, Faculty of Medicine, Masaryk University, ²Department of Molecular Neuroimmunology, Centre for Brain Research, Medical University of Vienna, ³Department of Physiology and Pharmacology, Karolinska Institute The current protocol presents a fast, efficient, and gentle method for isolating single cells suitable for single-cell RNA-seq analysis from a continuously growing mouse incisor, mouse molar, and human teeth.
Cancer Research

A Data Integration Workflow to Identify Drug Combinations Targeting Synthetic Lethal Interactions Maximilian Marhold¹, Andreas Heinzel², Almas Merchant¹, Paul Perco³, Michael Krainer¹ ¹Department of Internal Medicine I - Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, ²Department of Nephrology, Medical University of Vienna, ³Department of Internal Medicine IV, Medical University Innsbruck Large genetic screens in model organisms have led to the identification of negative genetic interactions. Here, we describe a data integration workflow using data from genetic screens in model organisms to delineate drug combinations targeting synthetic lethal interactions in cancer.
Biology

Confocal Laser Scanning Microscopy of Calcium Dynamics in Acute Mouse Pancreatic Tissue Slices Andraž Stožer¹, Jurij Dolenšek^1,2, Lidija Križančić Bombek¹, Viljem Pohorec¹, Marjan Slak Rupnik^1,3, Maša Skelin Klemen¹ ¹Institute of Physiology, Faculty of Medicine, University of Maribor, ²Faculty of Natural Sciences and Mathematics, University of Maribor, ³Center for Physiology and Pharmacology, Medical University of Vienna We present the preparation of acute pancreatic tissue slices and their use in confocal laser scanning microscopy to study calcium dynamics simultaneously in a large number of live cells, over long time periods, and with high spatiotemporal resolution.
Medicine

The Intra-Aortic Balloon Pump Ganesh Gajanan¹, Emmanouil S. Brilakis², Jolanta M. Siller-Matula^3,4,5, Ronald L. Zolty¹, Poonam Velagapudi¹ ¹Division of Cardiovascular Medicine, University of Nebraska Medical Center, ²Minneapolis Heart Institute, ³Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, ⁴Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Center for Preclinical Research and Technology CEPT, ⁵Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna We describe the steps for the percutaneous implantation of the intra-aortic balloon pump (IABP), a mechanical circulatory support device. It acts by counterpulsation, inflating at the onset of diastole, augmenting diastolic aortic pressure and improving coronary blood flow and systemic perfusion, and deflating before systole, reducing left ventricular afterload.
Medicine

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy Thomas Reiberger^1,2, Philipp Schwabl^1,2, Michael Trauner^1,2, Markus Peck-Radosavljevic^2,3, Mattias Mandorfer^1,2 ¹Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, ²Vienna Hepatic Hemodynamic Lab, Medical University of Vienna, ³Department of Internal Medicine and Gastroenterology (IMuG), Klinikum Klagenfurt am Woerthersee Here, we present a protocol for measurement of hepatic venous pressure gradient (HVPG),the gold standard to diagnose clinically significant portal hypertension. Moreover, we describe how to perform a transjugular liver biopsy within the same session.
Medicine

Semi-Minimal Invasive Method to Induce Myocardial Infarction in Rats and the Assessment of Cardiac Function by an Isolated Working Heart System Patrick M. Pilz¹, Miriam Lang¹, Ouafa Hamza¹, Petra L. Szabo¹, Milat Inci¹, Anne M. Kramer¹, Michael Koch², Johann Huber³, Bruno K. Podesser¹, Attila Kiss¹ ¹Ludwig-Boltzmann-Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, ²Concept & Ideation, Electrical Sector/EMEA/Power Distribution Division, Eaton Industries (Austria) GmbH, ³Vetfarm and Clinical Unit for Herd Health Management in Ruminants, Clinic for Ruminants, Vetmeduni Vienna This article presents an efficient method to perform myocardial ischemia and subsequent chronic reperfusion in rats using a minimally invasive approach. In addition, left ventricular hemodynamic function of rats is assessed by echocardiography and isolated working heart methods.
Biochemistry

An Electrochemiluminescence-Based Assay for MeCP2 Protein Variants Hannes Steinkellner¹, Alexander V. Beribisky¹, Philip Mausberg¹, John Christodoulou², Barbara Scheiber-Mojdehkar³, Anna Huber¹, Victoria Sarne¹, Franco Laccone¹ ¹Institute of Medical Genetics, Center for Pathobiochemistry and Genetics, Medical University of Vienna (MUV), ²Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Discipline of Child & Adolescent Health, Sydney Medical School, ³Department of Medical Chemistry and Pathobiochemistry, Medical University of Vienna The electrochemiluminescence immunoassay (ECLIA) is a novel approach for quantitative detection of endogenous and exogenously applied MeCP2 protein variants, which produces highly quantitative, accurate and reproducible measurements with low intra- and inter-assay error over a wide working range. Here, the protocol for the MeCP2-ECLIA in a 96-well format is described.
Medicine

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm Fiona I. Jäger*¹, Kirsten Platho-Elwischger*², Gerald Wiest¹ ¹Department of Neurology, Medical University Vienna, Austria, ²Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria The perception of gravity is commonly determined by the subjective visual vertical in the head upright position. The additional assessment at head tilts of ± 15° and ± 30° in the roll plane ensures increased information content for the detection of impaired graviceptive perception.
Neuroscience

Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction Laura A. Hruby^1,2, Agnes Sturma^1,3, Oskar C. Aszmann^1,4 ¹Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, ²Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, ³Department of Bioengineering, Imperial College London, ⁴Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna Optimal functional outcomes after bionic reconstruction in patients with global brachial plexus injury depend on a structured rehabilitation protocol. Surface electromyographic guided training may improve the amplitude, separation and consistency of EMG signals, which - after elective amputation of a functionless hand - control and drive a prosthetic hand.
Medicine

Structured Motor Rehabilitation After Selective Nerve Transfers Agnes Sturma^1,2,3, Laura A. Hruby^1,4, Dario Farina², Oskar C. Aszmann^1,5 ¹Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, ²Bioengineering Department, Imperial College London, ³Master's Degree Program Health Assisting Engineering, University of Applied Sciences FH Campus Wien, ⁴Department of Orthopedics and Trauma Surgery, Medical University of Vienna, ⁵Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna Here, we present a protocol for the motor rehabilitation of patients with severe nerve injuries and selective nerve transfer surgery. It aims at restoring the motor function proposing several stages in patient education, early-stage therapy after surgery and interventions for rehabilitation after successful re-innervation of the nerve’s target.
Biochemistry

Enrichment of Native Lipoprotein Particles with microRNA and Subsequent Determination of Their Absolute/Relative microRNA Content and Their Cellular Transfer Rate Markus Axmann¹, Andreas Karner², Sabine M. Meier¹, Herbert Stangl¹, Birgit Plochberger² ¹Center for Pathobiochemistry and Genetics, Institute of Medical Chemistry and Pathobiochemistry, Medical University Vienna, ²School of Medical Engineering and Applied Social Sciences, University of Applied Sciences Upper Austria Here, a quantitative real-time polymerase chain reaction-based protocol is presented for the determination of the native micro-RNA content (absolute/relative) of lipoprotein particles. In addition, a method for increasing the micro-RNA level, as well as a method for determining the cellular uptake rate of lipoprotein particles, is demonstrated.
Genetics

Isolation of Papillary and Reticular Fibroblasts from Human Skin by Fluorescence-activated Cell Sorting Ana Korosec*¹, Sophie Frech*¹, Beate M. Lichtenberger¹ ¹Skin, Endothelium Research Division, Department of Dermatology, Medical University of Vienna This manuscript describes a FACS-based protocol for isolation of papillary and reticular fibroblasts from human skin. It circumvents in vitro culture which was inevitable with the commonly used isolation protocol via explant cultures. The emanating fibroblast subsets are functionally distinct and display differential gene expression and localization within the dermis.
Chemistry

Technical Aspect of the Automated Synthesis and Real-Time Kinetic Evaluation of [¹¹C]SNAP-7941 Chrysoula Vraka¹, Verena Pichler¹, Sarah Pfaff¹, Theresa Balber^1,2, Marcus Hacker¹, Markus Mitterhauser^1,3, Wolfgang Wadsak^1,4, Cecile Philippe¹ ¹Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, ²Department for Pharmaceutical Technology and Biopharmaceutics, Faculty of Life Sciences, University of Vienna, ³Ludwig Boltzmann Institute Applied Diagnostics, ⁴CBmed GmbH - Center for Biomarker Research in Medicine Here, we represent a protocol for the fully automated radiolabelling of [¹¹C]SNAP-7941 and the analysis of the real-time kinetics of this PET-tracer on P-gp expressing and non-expressing cells.
Cancer Research

Orthotopic Transplantation of Syngeneic Lung Adenocarcinoma Cells to Study PD-L1 Expression Herwig P. Moll¹, Julian Mohrherr², Kristina Breitenecker², Marcel Haber², Viktor Voronin², Emilio Casanova^1,2 ¹Department of Physiology, Center of Physiology and Pharmacology & Comprehensive Cancer Center (CCC), Medical University of Vienna, ²Ludwig Boltzmann Institute for Cancer Research (LBI-CR) Here we describe a minimally invasive syngeneic orthotopic transplantation model of mouse lung adenocarcinoma cells as a time- and cost-reducing model to study non-small cell lung cancer.
Bioengineering

Biological Compatibility Profile on Biomaterials for Bone Regeneration Carina Kampleitner¹, Jessika Obi², Nicola Vassilev², Michelle M. Epstein², Oskar Hoffmann¹ ¹Department of Pharmacology and Toxicology, University of Vienna, ²Laboratory of Experimental Allergy, Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna The number of novel biomaterials engineered for repairing large bone lesions is continuously expanding with the aim to enhance bone healing and overcome the complications associated with bone transplantation. Here, we present a multidisciplinary strategy for pre-clinical biocompatibility testing of biomaterials for bone repair.
Medicine

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats Philipp Königshofer^1,2, Ksenia Brusilovskaya^1,2, Philipp Schwabl^1,2, Bruno K. Podesser³, Michael Trauner¹, Thomas Reiberger^1,2 ¹Div. of Gastroenterology and Hepatology, Dept. of Internal Medicine III, Medical University of Vienna, Vienna, Austria, ²Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria, ³Center of Biomedical Research, Medical University of Vienna, Vienna, Austria Here we describe a detailed protocol for invasive measurements of hemodynamic parameters including portal pressure, splanchnic blood flow, and systemic hemodynamics in order to characterize the portal hypertensive syndrome in rats.
Medicine

Cochlear Implantation in the Guinea Pig Clemens Honeder*¹, Navid Ahmadi*¹, Anne-Margarethe Kramer², Chengjing Zhu¹, Nodir Saidov¹, Christoph Arnoldner¹ ¹Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, ²Department of Biomedical Research, Medical University of Vienna The goal of this protocol is to provide an animal model of cochlear implantation, which can be used to address a multitude of research questions. Potential applications include the evaluation of pharmaceutical interventions or electrical stimulation for beneficial effects on hearing thresholds or electrode impedances.
Medicine

Contractility Measurements of Human Uterine Smooth Muscle to Aid Drug Development Sarah Arrowsmith*¹, Peter Keov², Markus Muttenthaler^3,4, Christian W. Gruber*^2,5 ¹Harris-Wellbeing Preterm Birth Research Centre, Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, ²School of Biomedical Sciences, The University of Queensland, ³Faculty of Chemistry, Institute of Biological Chemistry, University of Vienna, ⁴Institute for Molecular Bioscience, University of Queensland, ⁵Center for Physiology and Pharmacology, Medical University of Vienna This article describes experimental protocols to study ex vivo contractions of human myometrium and their application in drug discovery. This technique is used to improve the understanding of myometrial physiology and pathophysiology as well as to validate pharmacological data from novel research probes or drug leads.
Medicine

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test (OGTT) and Insulin Tolerance Test (ITT) Csörsz Nagy¹, Elisa Einwallner¹ ¹Department of Laboratory Medicine, Medical University of Vienna The current article describes the generation and metabolic characterization of high-fat diet-fed mice as a model of diet-induced insulin resistance and obesity. It further features detailed protocols to perform the oral glucose tolerance test and the insulin tolerance test, monitoring whole-body alterations of glucose metabolism in vivo.
Behavior

The Other End of the Leash: An Experimental Test to Analyze How Owners Interact with Their Pet Dogs Giulia Cimarelli^1,2,3, Borbála Turcsán^1,4, Friederike Range^1,2, Zsófia Virányi^1,2 ¹Comparative Cognition, Messerli Research Institute, University of Veterinary Medicine of Vienna, Medical University of Vienna, University of Vienna, ²Wolf Science Center, Messerli Research Institute, University of Veterinary Medicine of Vienna, Medical University of Vienna, University of Vienna, ³Department of Cognitive Biology, University of Vienna, ⁴Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences This article presents eight different experimental tasks, mirroring the everyday life of dogs and owners, used to analyze how owners interact with their dogs in a standardized way. The tasks included both positive (e.g. play) and negative (potentially stressful) situations (e.g. physical restriction).
Developmental Biology

High-resolution Episcopic Microscopy (HREM) - Simple and Robust Protocols for Processing and Visualizing Organic Materials Stefan H. Geyer¹, Barbara Maurer-Gesek¹, Lukas F. Reissig¹, Wolfgang J. Weninger¹ ¹Division of Anatomy, Center for Anatomy and Cell Biology & MIC, Medical University of Vienna We provide simple and robust protocols for processing biopsy material of various species, embryos of biomedical model organisms and samples of other organic tissues in order to permit digital volume data generation with the high-resolution episcopic microscopy method.
Cancer Research

A Unified Methodological Framework for Vestibular Schwannoma Research Lukas D. Landegger*^1,2,3, Jessica E. Sagers*^1,4, Sonam Dilwali^1,4, Takeshi Fujita^1,2, Mehmet I. Sahin^1,2, Konstantina M. Stankovic^1,2,4 ¹Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, ²Department of Otolaryngology, Harvard Medical School, ³Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna, ⁴Program in Speech and Hearing Bioscience and Technology, Harvard Medical School The goal of this protocol is to outline the collection and processing of human surgical samples for multiple downstream applications in vestibular schwannoma and Schwann cell research.
Medicine

Neonatal Murine Cochlear Explant Technique as an In Vitro Screening Tool in Hearing Research Lukas D. Landegger^1,2,3, Sonam Dilwali^1,4, Konstantina M. Stankovic^1,2,4 ¹Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear, ²Department of Otolaryngology, Harvard Medical School, ³Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna, ⁴Harvard Program in Speech and Hearing Bioscience and Technology The goal of this protocol is to demonstrate the preparation, culture, treatment, and immunostaining of neonatal murine cochlear explants. The technique can be utilized as an in vitro screening tool in hearing research.
Biology

A Rapid Automated Protocol for Muscle Fiber Population Analysis in Rat Muscle Cross Sections Using Myosin Heavy Chain Immunohistochemistry Konstantin D. Bergmeister^1,3, Marion Gröger², Martin Aman¹, Anna Willensdorfer¹, Krisztina Manzano-Szalai¹, Stefan Salminger¹, Oskar C. Aszmann¹ ¹CD Laboratory for the Restoration of Extremity Function, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, ²Core Facility Imaging, Core Facilities, Medical University Vienna, ³Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg Here, we present a protocol for rapid muscle fiber analyses, which allows improved staining quality, and thereby automatic acquisition and quantification of fiber populations using the freely available software ImageJ.
Neuroscience

Immunohistochemical Analysis in the Rat Central Nervous System and Peripheral Lymph Node Tissue Sections Milena Z. Adzemovic^1,2, Manuel Zeitelhofer^1,3, Marianne Leisser², Ulricke Köck², Angela Kury², Tomas Olsson¹ ¹Department of Clinical Neuroscience, Neuroimmunology Unit, Center for Molecular Medicine, Karolinska Institutet, ²Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, ³Department of Medical Biochemistry and Biophysics, Vascular Biology Unit, Karolinska Institutet We here present an optimized, detailed protocol for double immunostaining in formalin-fixed, paraffin-embedded rat central nervous system (CNS) and peripheral lymph node (LN) tissue sections.
Behavior

A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study Aidan Dominic Roche^1,2, Ivan Vujaklija^3,4, Sebastian Amsüss^3,4, Agnes Sturma^1,5, Peter Göbel⁶, Dario Farina^3,4, Oskar C. Aszmann^1,2 ¹Christian Doppler Laboratory for Restoration of Extremity Function, ²Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, ³Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen, ⁴University Medical Center Göttingen, Georg-August University, ⁵University of Applied Sciences FH Campus Wien, ⁶Research & Development, Otto Bock Healthcare Products GmbH As prosthetic development moves towards the goal of natural control, harnessing amputees’ inherent ability to learn new motor skills may enable proficiency. This manuscript describes a structured rehabilitation protocol, which includes imitation, repetition, and reinforcement learning strategies, for improved multifunctional prosthetic control.
Bioengineering

Single Molecule Fluorescence Microscopy on Planar Supported Bilayers Markus Axmann¹, Gerhard J. Schütz¹, Johannes B. Huppa² ¹Institute of Applied Physics - Biophysics, Vienna University of Technology, ²Institute for Hygiene and Applied Immunology, Immune Recognition Unit, Medical University of Vienna Preparation of protein-functionalized planar glass-supported lipid bilayers, determination of protein mobility within and measurement of protein densities is shown here. A roadmap to building a noise-reduced Total Internal Reflection microscope is outlined, which allows visualizing single bilayer-resident fluorochromes with high spatiotemporal resolution.
Bioengineering

Measuring TCR-pMHC Binding In Situ using a FRET-based Microscopy Assay Markus Axmann¹, Gerhard J. Schütz¹, Johannes B. Huppa² ¹Institute for Applied Physics - Biophysics, Vienna University of Technology, ²Institute for Hygiene and Applied Immunology, Medical University of Vienna This manuscript describes how to conduct (single molecule) Förster Resonance Energy Transfer (FRET)- based assays to measure the binding dynamics between T-cell antigen receptor (TCR) and antigenic peptide-loaded MHC molecules as they occur within the immunological synapse of a T-cell in contact with a functionalized planar supported lipid bilayer.
Medicine

Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects Camillo Sherif*^1,2,3, Javier Fandino*^2,4, Salome Erhardt^2,4, Antonio di Ieva⁵, Monika Killer⁶, Guenther Kleinpeter¹, Serge Marbacher^2,4 ¹Department of Neurosurgery, Hospital Rudolfstiftung, ²Department of Neurosurgery, Kantonsspital Aarau, ³Cerebrovascular Research Group, Department of Biomedical Research, Medical University of Vienna, ⁴Cerebrovascular Research Group, Department of Intensive Care Medicine, University of Berne, ⁵Centre for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna, ⁶Department of Neurology, Paracelsus University Salzburg An optimized technique for the microsurgical creation of arterial bifurcation aneurysms mimicking bifurcation human cerebral aneurysms is described. A venous pouch is sutured into an artificially created true bifurcation of both common carotid arteries. Facilitated microsurgical techniques and aggressive postoperative anticoagulation and analgesia lead to minimized morbidity rates and high aneurysm patency rates.

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