The cellular consequences of particulate matter pollutants in plants: Safeguarding the harmonious integration of structure and function

Particulate matter (PM) pollution is one of the pressing environmental concerns confronting human civilization in the face of the Anthropocene era. Plants are continuously exposed to an accelerating PM, threatening their growth and productivity. Although plants and plant-based infrastructures can potentially reduce ambient air pollutants, PM still affects them morphologically, anatomically, and physiologically. This review comprehensively summarizes an up-to-date review of plant-PM interaction among different functional plant groups, PM deposition and penetration through aboveground and belowground plant parts, and plants' cellular strategies. Upon exposure, PM represses lipid desaturases, eventually leading to modification of cell wall and membrane and altering cell fluidity; consequently, plants can sense the pollutants and, thus, adapt different cellular strategies. The PM also causes a reduction in the photosynthetically active radiation. The study demonstrated that plants reduce stomatal density to avoid PM uptake and increase stomatal index to compensate for decreased gaseous exchange efficiency and transpiration rates. Furthermore, genes and gene sets associated with photosynthesis, glycolysis, gluconeogenesis, and the TCA cycle were dramatically lowered by PM stress. Several transcription factors, including MYB, C2H2, C3H, G2-like, and WRKY were induced, and metabolites such as proline and soluble sugar were accumulated to increase resistance against stressors. In addition, enzymatic and non-enzymatic antioxidants were also accumulated to scavenge the PM-induced reactive oxygen species (ROS). Taken together, this review provides an insight into plants' underlying cellular mechanisms and gene regulatory networks in response to the PM to determine strategies to preserve their structural and functional blend in the face of particulate pollution. The study concludes by recommending that future research should precisely focus on plants' response to short- and long-term PM exposure.

Is there a downside to plant ecological services in the city? Influences of particulate matter on the two-spotted spider mite (Tetranychus urticae) foraging on the small-leaved lime in urban conditions

The aim of this research was to examine how particulate matter (PM) pollution affects the life history of the two-spotted spider mite (TSSM), Tetranychus urticae (Trombidiformes: Tetranychidae), in modelled urban conditions. For this purpose, experimental populations of TSSM were cultured on the foliage of small-leaved lime (Tilia cordata) contaminated with PM at intensities corresponding to differing city zones such as a park, a busy road and an industrial area. The control samples in the study were washed, unpolluted leaves. The spider mite was selected as a model organism due to its cosmopolitan distribution, broad host spectrum, resistance to a variety of pesticides and food-intake mode involving cell-content sucking, while T. cordata is widely planted in cities and has demonstrated a considerable capability for PM capture. Data on the longevity and mortality of particular instars and on female fecundity at different pollution levels were collected and statistically evaluated. Concentrations of PM typical for roads and industrial city zones significantly reduced total female fecundity (avg. 53.9 and 55.9 eggs/female, respectively, vs 79.2 in control), which entailed a slower population increase, while the survival rate of particular developmental instars (P = 0.52) and fertility curves (P = 0.19) remained unchanged. The presence of PM caused physiological effects in the mites, despite the lack of direct consumption of the pollutant by adult and juvenile instars. Considering the incomparable resilience of TSSM to unfavourable environmental factors, it is predicted that the detrimental influence of PM on other representatives of urban arthropods may be even more severe. The results suggest that there is a need for further investigations into the ecological ramifications of air purification provided by urban green spaces.

Species-specific influence of powdery mildew mycelium on the efficiency of PM accumulation by urban greenery

Particulate matter (PM) is one of the most important air pollutants, especially in urban areas. The efficiency of PM biofiltration by plants depends on the morphological features of the foliage. More PM is deposited on complex leaves, covered with thick wax layer, trichomes, epidermal glands, and convex venation. Very few literature reports suggest that also the presence of mycelium of nonparasitic and saprophytic fungi positively affects the accumulation of PM on the leaves. In this work, to our best knowledge, for the first time the effect of the mycelium of the parasitic powdery mildew on the efficiency of PM accumulation by urban greenery was studied. Uninfested and fungus-infested leaves of Acer negundo L., Malus domestica Borkh Quercus robur L., and Berberis vulgaris L. were harvested in July in the center of Warsaw city. The effect of powdery mildew infection on PM accumulation was species-specific. A higher amount of PM on leaves not infected with powdery mildew was found in M. domestica and Q. robur, while in A. negundo and B. vulgaris more PM was accumulated on leaves infected with fungus. All species (except A. negundo) accumulated more of the PM of 0.2-2.5-μm and 2.5-10-μm size fractions on leaves not infected with powdery mildew. One of the greatest consequences of the presence of powdery mildew mycelium on the foliage is most probably reduction of the direct involvement of waxes in PM accumulation and retention processes.

Interactive relations between plants, phyllosphere microbial community, and particulate matter pollution

Particulate matter (PM) pollution poses a significant risk to many ecosystems; as sessile organisms, plants are at particular risk from PM pollution since they cannot move away from it. Microorganisms are essential components of ecosystems that can help macro-organisms to cope with pollutants (such as PM). In the phyllosphere (the aerial/above-ground parts of plants colonized by microbial communities), plant-microbe associations have been found to promote plant development while also increasing host resilience to biotic and abiotic stressors. This review discusses how plant-microbe symbiosis in the phyllosphere potentially affects host survivability and efficiency in the face of pollution and factors such as climate change. Evidence is presented that plant-microbe associations can be beneficial, such as by degrading pollutants, yet also bring disadvantages, such as causing the loss of symbiotic organisms and/or inducing disease. It is suggested that plant genetics is a fundamental driver of the phyllosphere microbiome assembly, connecting phyllosphere microbiota to plant health management in adverse conditions. Finally, potential ways that essential community ecological processes might influence plant-microbe partnerships in the face of Anthropocene-linked changes and what this might mean for environmental management are discussed.

Breathing Fresh Air in the City: Implementing Avenue Trees as a Sustainable Solution to Reduce Particulate Pollution in Urban Agglomerations

The issue of air pollution from particulate matter (PM) is getting worse as more and more people move into urban areas around the globe. Due to the complexity and diversity of pollution sources, it has long been hard to rely on source control techniques to manage this issue. Due to the fact that urban trees may provide a variety of ecosystem services, there is an urgent need to investigate alternative strategies for dramatically improving air quality. PM has always been a significant concern due to its adverse effects on humans and the entire ecosystem. The severity of this issue has risen in the current global environmental context. Numerous studies on respiratory and other human disorders have revealed a statistical relationship between human exposure to outdoor levels of particles or dust and harmful health effects. These risks are undeniably close to industrial areas where these airborne, inhalable particles are produced. The combined and individual effects of the particle and gaseous contaminants on plants' general physiology can be detrimental. According to research, plant leaves, the primary receptors of PM pollution, can function as biological filters to remove significant amounts of particles from the atmosphere of urban areas. This study showed that vegetation could provide a promising green infrastructure (GI) for better air quality through the canopy and leaf-level processes, going beyond its traditional role as a passive target and sink for air pollutants. Opportunities exist for urban GI as a natural remedy for urban pollution caused by PMs.

Accumulation of Plastics and Trace Elements in the Mangrove Forests of Bima City Bay, Indonesia

Pollution with microplastics (MPs), nanoplastics (NPs) and trace elements (TEs) remains a considerable threat for mangrove biomes due to their capability to capture pollutants suspended in the water. This study investigated the abundance and composition of plastics and TEs contained in the soil and pneumatophores of Avicennia alba sampled in experimental areas (hotel, market, river mouth, port, and rural areas) differentiated in anthropopressure, located in Bima Bay, Indonesia. Polymers were extracted and analyzed with the use of a modified sediment isolation method and Fourier transform infrared spectroscopy. Trace elements were detected by inductively coupled plasma optical emission spectrometry. The lowest and highest quantities of MPs in soil were recorded in rural and hotel areas, respectively. The rural site was characterized by distinct MP composition. The amounts of sediment-trapped MPs in the tested localities should be considered as high, and the recognized polymers partly corresponded with local human activity. Concentrations of seven plastic types found in plant tissues did not entirely reflect sediment pollution with nine types, suggesting a selective accumulation (particularly of polyamides and vinylidene chloride) and substance migration from other areas. Very low concentrations of non-biogenic TEs were observed, both in sediments and pneumatophores. The results highlight the relevance of environmental contamination with plastics.

Phyto-cleaning of particulate matter from polluted air by woody plant species in the near-desert city of Jodhpur (India) and the role of heme oxygenase in their response to PM stress conditions

Particulate matter (PM) is one of the most dangerous pollutants in the air. Urban vegetation, especially trees and shrubs, accumulates PM and reduces its concentration in ambient air. The aim of this study was to examine 10 tree and shrub species common for the Indian city of Jodhpur (Rajasthan) located on the edge of the Thar Desert and determine (1) the accumulation of surface and in-wax PM (both in three different size fractions), (2) the amount of epicuticular waxes on foliage, (3) the concentrations of heavy metals (Cd and Cu) on/in the leaves of the examined species, and (4) the level of heme oxygenase enzyme in leaves that accumulate PM and heavy metals. Among the investigated species, Ficus religiosa L. and Cordia myxa L. accumulated the greatest amount of total PM. F. religiosa is a tall tree with a lush, large crown and leaves with wavy edge, convex veins, and long petioles, while C. myxa have hairy leaves with convex veins. The lowest PM accumulation was recorded for drought-resistant Salvadora persica L. and Azadirachta indica A. Juss., which is probably due to their adaptation to growing conditions. Heavy metals (Cu and Cd) were found in the leaves of almost every examined species. The accumulation of heavy metals (especially Cu) was positively correlated with the amount of PM deposited on the foliage. A new finding of this study indicated a potentially important role of HO in the plants' response to PM-induced stress. The correlation between HO and PM was stronger than that between HO and HMs. The results obtained in this study emphasise the role of plants in cleaning polluted air in conditions where there are very high concentrations of PM.

Where trees cannot grow - Particulate matter accumulation by urban meadows

It has already been proven that trees and shrubs, can efficiently remove particulate matter (PM) from air. However, almost nothing is known about PM accumulation by herbaceous plants (grasses and forbs) found in urban meadows. Meadows, unlike trees and shrubs, can be located close to roads, one of the main sources of PM in cites. The aim of this study was to investigate the tolerance to urban condition and PM accumulation in the immediate roads vicinity of selected plants species in urban meadows. PM accumulation of annual and perennial meadows was compared with that of lawns. Results were interpreted in the context of species composition, biomass production, soil conditions and ambient PM concentrations. Of the species grown in annual meadows, the highest PM accumulation was found in Achillea millefolium L., Chenopodium album L. and Echium vulgare L., while Centaurea scabiosa L., Echium vulgare L. and Convolvulus arvensis L. accumulated the largest amounts of PM in perennial meadows. PM deposition on plants was positively correlated with a feathery leaf shape. For species in the annual meadows, a positive correlation was also found between PM accumulation and the wax content on plants. The presence of hairs on leaves, leaf size and plant growth pattern had no effect on PM deposition on plants. PM accumulation in one square metre of urban meadow was on average greater than that of lawn, regardless of meadow species' composition, age and location. The greatest accumulation of PM was found in a perennial meadow with low biodiversity but the greatest biomass. It would appear that the biomass produced by meadows and canopy structure has a crucial impact on the amount of PM accumulated by meadow plants. The results obtained indicate that meadows could be an important element of nature-based solutions for mitigating air pollution in urbanised areas.

Exogenous hemin improves Cd2+ tolerance and remediation potential in Vigna radiata by intensifying the HO-1 mediated antioxidant defence system

The present study evaluated the effects of exogenous hemin on cadmium toxicity in terms of metal accretion and stress resilience in Vigna radiata L. (Wilczek). One-week-old seedlings were treated with CdCl₂ (50 μM) alone and in combination with hemin (0.5 mM) in half-strength Hoagland medium for 96 h. The optimum concentrations of Cd and hemin were determined on the basis of haem oxygenase-1 activity. The results demonstrated that under Cd stress, plants accumulated a considerable amount of metal in their tissues, and the accumulation was higher in roots than in leaves, which significantly reduced the plant biomass and chlorophyll content by increasing the oxidative stress (MDA and H₂O₂ content). However, hemin supplementation under Cd,-stress improved plant growth by enhancing the harvestable biomass and photosynthetic pigments, increasing antioxidant activities (SOD, APX, POD, HO-1 and proline), lowering oxidative damage and increasing Cd tolerance in plants. Furthermore, the application of hemin enhances the removal efficiency of Cd in V. radiata by increasing the uptake of Cd via roots and its translocation from roots to foliar tissues. Thus, the study suggests that hemin has the potential to improve the stress tolerance and phytoremediation ability of heavy metal-tolerant plants so that they can be used instead of hyperaccumulators for remediation of Cd-contaminated environments.

Particulate matter on foliage of Betula pendula, Quercus robur, and Tilia cordata: deposition and ecophysiology

Trees in urban and industrial areas significantly help to limit the amount of particulate matter (PM) suspended in the air, but PM has a negative impact on their life. The amount of PM gathered on leaves depends on quantity, size, and morphology of leaves and can also be increased by the presence of epicuticular waxes, in which PM can become stuck or immersed. In this study, we determined the ability of PM to accumulate on leaves in relation to the species of tree and PM source. We tested saplings of three common European tree species (Betula pendula, Quercus robur, and Tilia cordata) by experimentally polluting them with PM from different sources (cement, construction, and roadside PM), and then assessing the effects of PM on plant growth and ecophysiology. In all studied species, we have found two types of PM accumulation: a layer on the leaf surface and an in-wax layer. Results showed that the studied species accumulate PM on their leaf blade, reducing the efficiency of its photosynthetic apparatus, which in a broader sense can be considered a reduction in the plants' normal functioning. Saplings of Q. robur suffered the least, whereas B. pendula (especially photosynthetic rate and conductivity) and T. cordata (especially increase in leader shoot length) exhibited greater negative effects. The foliage of B. pendula collected the most PM, followed by Q. robur, and then T. cordata, regardless of the dust's source. All tested species showed a tendency for higher wax production when growing under PM pollution stress. We believe that, potentially, B. pendula best enhances the quality of the PM-contaminated environment; however, faster leaf fall, reduced productivity, and worse quality of wood should be considered in urban forest management.

Impact of particulate matter accumulation on the photosynthetic apparatus of roadside woody plants growing in the urban conditions

Particulate matter (PM) is one of the most harmful inhaled pollutants. When pollutants are emitted into the atmosphere, the only possible method for cleaning the air is through phytoremediation, where plants act as biological filters for pollutants. However, PM also has negative impacts on plants, although knowledge concerning the effects of PM on vegetation remains limited. In this work, an attempt was therefore made to define the amount of PM and waxes on foliage, and to evaluate the efficiency of the photosynthetic apparatus in seven plant species (three trees, three shrubs and one climber) grown in two locations (centre and suburbs of Warsaw) that differed in their level of PM pollution in the air. More PM and waxes accumulated on the foliage of plants grown in the highly polluted location. These plants also exhibited a lowered efficiency of their photosynthetic apparatus, manifested by a lower photosynthesis rate that corresponded with an increased stomatal resistance. Plants grown in the more polluted environment also showed decreased values of F_v/F_m parameter and no statistically significant trend to increase total chlorophyll content. Among the tested species, Betula pendula Roth accumulated the greatest amount of PM and Physocarpus opulifolius L. showed no weakening of its parameters of photosynthesis in a more contaminated environment.

Particulate matter on two Prunus spp. decreases survival and performance of the folivorous beetle Gonioctena quinquepunctata

Woody plants growing along streets and construction sites play an important role in removing harmful particulate matter (PM). Researchers rarely consider the impact of different types and size fractions of PM deposited on the leaves on insect folivores. We determined differences in the accumulation of cement and roadside PM on the leaves of two Prunus species (P. padus and P. serotina) with different leaf surface structures. We also determined the effect of PM on the beetle Gonioctena quinquepunctata, the main pest of these plants. Saplings were artificially dusted in greenhouses and leaves were utilised for larval and adult insect stages feeding in laboratory conditions. Road PM accumulated in greater amounts than did cement PM, regardless of plant species. For both PM sources, P. padus accumulated twofold more than did P. serotina. Insect survival was negatively affected by PM pollution; however, neither Prunus species nor PM source variant significantly affected masses of larvae and pupae, duration of larval and pupal development or relative growth rates. The experiment showed strong negative influences of PM were noted only for adult insects, due to the grazing period being longer than that in larvae. The mass of adult insects and the efficiency of conversion of ingested food (ECI) were lower for insects exposed to PM than those for control insects. Insects compensated for lower ECI by eating a greater total amount of food (TFE). Adult insects gained significantly higher mass when fed with P. serotina than with P. padus. The effect of PM on analysed plant metabolites was insignificant. Only Prunus sp. and date of collection affected the level of condensed tannins and total phenols. Our results indicate that, when investigating the effect of the host plant on folivore performance, the accumulation of PM, as well as its type and quantity, should be taken into account.

Accumulation of particulate matter, heavy metals, and polycyclic aromatic hydrocarbons on the leaves of Tilia cordata Mill. in five Polish cities with different levels of air pollution

Urbanized areas are struggling with the problem of air pollution and as the number of people living in cities is increasing, the situation is likely to deteriorate. One of the most harmful pollutants is particulate matter (PM). Increased levels of PM in the atmosphere are likely to have a negative impact on human health. Phytoremediation technology could be a solution. It involves plants acting as bio-filters by accumulating particles on, and in the leaves, thus removing the particles from the atmosphere. This study investigates the accumulation of PM including heavy metals (HMs) and polycyclic aromatic hydrocarbons (PAHs), on the foliage of small-leaved lime (Tilia cordata Mill.) in five Polish cities. There were significantly different PM amounts found in the trees between the cities which related to the different quantities of PM in the atmosphere at these cities. Significant differences were found between cities for the amounts of the different particulate size fractions, and the HMs and PAHs in leaves. Strong winds reduced the amount of PM on leaves, especially the smallest fractions, but no relationship with precipitation was found. The results suggest that T. cordata improves the air quality in cities and can be used as an effective bioindicator for PM air pollution.

The Role of Plant-Microbe Interactions and Their Exploitation for Phytoremediation of Air Pollutants

Since air pollution has been linked to a plethora of human health problems, strategies to improve air quality are indispensable. Despite the complexity in composition of air pollution, phytoremediation was shown to be effective in cleaning air. Plants are known to scavenge significant amounts of air pollutants on their aboveground plant parts. Leaf fall and runoff lead to transfer of (part of) the adsorbed pollutants to the soil and rhizosphere below. After uptake in the roots and leaves, plants can metabolize, sequestrate and/or excrete air pollutants. In addition, plant-associated microorganisms play an important role by degrading, detoxifying or sequestrating the pollutants and by promoting plant growth. In this review, an overview of the available knowledge about the role and potential of plant-microbe interactions to improve indoor and outdoor air quality is provided. Most importantly, common air pollutants (particulate matter, volatile organic compounds and inorganic air pollutants) and their toxicity are described. For each of these pollutant types, a concise overview of the specific contributions of the plant and its microbiome is presented. To conclude, the state of the art and its related future challenges are presented.

Particulate Matter deposition on Quercus ilex leaves in an industrial city of central Italy

A number of studies have focused on urban trees to understand their mitigation capacity of air pollution. In this study particulate matter (PM) deposition on Quercus ilex leaves was quantitatively analyzed in four districts of the City of Terni (Italy) for three periods of the year. Fine (between 0.2 and 2.5 μm) and Large (between 2.5 and 10 μm) PM fractions were analyzed. Mean PM deposition value on Quercus ilex leaves was 20.6 μg cm(-2). Variations in PM deposition correlated with distance to main roads and downwind position relatively to industrial area. Epicuticular waxes were measured and related to accumulated PM. For Fine PM deposited in waxes we observed a higher value (40% of total Fine PM) than Large PM (4% of total Large PM). Results from this study allow to increase our understanding about air pollution interactions with urban vegetation and could be hopefully taken into account when guidelines for local urban green management are realized.

The Level of Particulate Matter on Foliage Depends on the Distance from the Source of Emission

One of the most dangerous inhaled pollutants is particulate matter (PM). PM in inhaled air have a negative impact on human wellbeing and health, and may even cause deaths. Where pollutants have been emitted into the outdoor atmosphere, the only possible method for cleaning the air is through phytoremediation, a form of environmental biotechnology, where plants act as biological filters for pollutants. This study compared PM levels on the leaves of Tilia cordata Mill. trees growing in locations at increasing distances from the source of the PM emission. Significant differences between individual trees growing at a distance of between 3 m and 500 m from the road edge were found in: (i) the mass of PM that accumulated on leaves (total, surface, in-wax and the three determined size fractions) and (ii) the amount of waxes deposited on leaves.

Particulate matter on foliage of 13 woody species: deposition on surfaces and phytostabilisation in waxes--a 3-year study

Particulate matter (PM) as an air pollutant can be harmful for human health through allergic, mutagenic and carcinogenic effects. Although the main focus is on decreasing air pollution, after PM has been emitted to the atmosphere, one ofthe realistic options to decrease it's concentrations in urbanized area will be phytoremediation. This study compared the capacity to capture PM from air of seven tree species commonly cultivated in Poland (Catalpa bignonioides Walter, Corylus colurna L., Fraxinus pennsylvanica Marsh., Ginkgo biloba L., Platanus x hispanica Mill. ex Muenchh., Quercus rubra L., Tilia tomentosa Moench 'Brabant') and six shrub species (Acer tataricum subsp, ginnala (Maxim.) Wesm., Sambucus nigra L., Sorbaria sorbifolia (L) A.Br., Spiraea japonica L.f., Syringe meyeri C.K. Schneid. 'Palibin', Viburnum lantana L.). Significant differences were found between species in mass of total PM accumulation for two PM categories and three size fractions determined and in amount of waxes. A positive correlation was found between in-wax PM of diameter 2.5-10 microm and amount of waxes, but not between amount of waxes and amount of total PM or of any size fraction.

Plant species differences in particulate matter accumulation on leaf surfaces

Particulate matter (PM) accumulation on leaves of 22 trees and 25 shrubs was examined in test fields in Norway and Poland. Leaf PM in different particle size fractions (PM(10), PM(2.5), PM(0.2)) differed among the species, by 10- to 15-folds at both test sites. Pinus mugo and Pinus sylvestris, Taxus media and Taxus baccata, Stephanandra incisa and Betula pendula were efficient species in capturing PM. Less efficient species were Acer platanoides, Prunus avium and Tilia cordata. Differences among species within the same genus were also observed. Important traits for PM accumulation were leaf properties such as hair and wax cover. The ranking presented in terms of capturing PM can be used to select species for air pollution removal in urban areas. Efficient plant species and planting designs that can shield vulnerable areas in urban settings from polluting traffic etc. can be used to decrease human exposure to anthropogenic pollutants.

Deposition of particulate matter of different size fractions on leaf surfaces and in waxes of urban forest species

Particulate matter (PM) is an air contaminant in urban and industrial areas that often exceeds limit values, creating serious problems due to its harmful effects on health. Planting trees and shrubs as air filters is a way to improve air quality in these areas. However,further knowledge on species effectiveness in air purification is essential This study compared four species of tree (Acer campestre L, Fraxinus excelsior L, Platanus x hispanica Mill. ex Muenchh. 'Acerifolia', Tilia cordata Mill.), three species of shrub (Forsythia x intermedia Zabel, Physocarpus opulifolius (L.) Maxim., Spiraea japonica L.), and one climber species (Hedera helix L) that are commonly cultivated along streets in Poland to capture fine, coarse and larger particles from air. Separate gravimetric analyses were performed to quantify PM deposited on surfaces and trapped in waxes. Significant differences were found between the plant species tested. The distribution of different particle size fractions differed between and within species and also between leaf surfaces and in waxes.

Fascia Suturing of Large Access Sites After Endovascular Treatment of Aortic Aneurysms and Dissections

PURPOSE

To evaluate a technique for closure of a femoral artery access in which the cribriform fascia covering the common femoral artery is sutured.

METHODS

A consecutive series of 127 patients (103 men; median age 74 years, range 45- 89) underwent endovascular aortic aneurysm repair between August 2001 and September 2004. Twelve patients underwent a secondary intervention for a total of 139 procedures in the group. Sixty-one (43.9%) of the 139 operations were acute. Among the 257 femoral arteries used for access, a fascia suturing technique was performed in 131 (51.0%). Data were collected for analysis of access site complications, bleeding, thrombosis, pseudoaneurysm, and stenosis. A subgroup of 72 patients had ankle-brachial indexes (ABI) recorded; another subgroup of 50 patients were also investigated by duplex ultrasonography.

RESULTS

Complications occurred in 18 (13.7%) of the 131 sutured cases. The majority (n = 16) arose within 24 hours: 8 cases of perioperative bleeding or thrombosis required open surgery and 8 cases were reoperated within 24 hours for bleeding (n = 4), thrombosis (n = 3), and 1 intimal dissection. The acute failure rate was 12.2%. Two patients had late complications: 1 case of neuralgia and 1 pseudoaneurysm that required acute surgery 28 months postoperatively. The ABI did not change significantly from pre- to postoperatively in the 72 patients examined. Five patients with stenoses did not have a reduction in ABI. In the 66 sites examined with ultrasound in 50 patients, 3 minor pseudoaneurysms were detected.

CONCLUSION

The fascia suturing technique for closure of a femoral artery access during endovascular repair of aortic diseases is feasible, even in acute situations. Failures can be managed easily. Late complications requiring additional procedures are rare.

Radiation exposure in stent-grafting of abdominal aortic aneurysms

In recent years, endovascular stent-grafting of abdominal aortic aneurysms has become more and more common. The radiation dose associated with these procedures is not well documented however. The aim of the present study was to estimate the radiation exposure and to simulate the effects of a switch from C-arm radiographic equipment to a dedicated angiographic suite. Dose-area product (DAP) was recorded for 24 aortic stent-grafting procedures. Based on these data, entrance surface dose (ESD) and effective dose were calculated. A simulation of doses at various settings was also performed using a humanoid Alderson phantom. The image quality was evaluated with a CDRAD contrast-detail phantom. The mean DAP was 72.3 Gy cm(2) at 28 min fluoroscopy time with a mean ESD of 0.39 Gy and a mean effective dose of 10.5 mSv. If the procedures had been performed in an angiographic suite, all dose values would be much higher with a mean ESD of 2.9 Gy with 16 patients exceeding 2 Gy, which is considered to be a threshold for possible skin injury. The image quality for fluoroscopy was superior for the C-arm whilst the angiographic unit gave better acquisition images. Using a C-arm unit resulted in doses similar to percutaneous coronary intervention (PCI). If the same patients had been treated using dedicated angiographic equipment, the risk of skin injury would be much higher. It is thus important to be aware of the dose output of the equipment that is used.