Search Results (934)

The evaluation of stents in coronary computed tomography angiography (CCTA) is still a major topic in cardiovascular imaging. Using Photon-Counting Detector CT (PCCT) may improve the assessment of coronary stents and make on-site CT-FFR analysis feasible for ruling out in-stent restenosis (ISR). In this study, patients with previous coronary stent implantation who underwent CCTA using PCCT and subsequent invasive catheter angiography (ICA) were included. Stent characteristics such as location and length were reported. CT-FFR measurements were taken 1.8 cm before and after the stent, with a value of ≤0.80 defined as hemodynamically significant under respecting the diagnostic accuracy drop in the gray zone between 0.76 and 0.80. Delta CT-FFR with a cut-off value of ≥0.06, indicating hemodynamic significance, was determined. Any ISR and interventional treatment during the following ICA was recorded. Diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated for post-stent CT-FFR and Delta CT-FFR in detecting ISR. Patients were followed up to evaluate the rate of major adverse cardiovascular events (MACE) 6 months after CCTA. A total of 19 patients (5 female, 14 male, median age 69 years) were enrolled in this study. In most cases, coronary stents were located in the proximal LAD with a median stent length of 70.2 mm. Pathological CT-FFR < 0.76 distal to the stent was detected in 6 cases (31.6%), while pathological Delta CT-FFR ≥ 0.06 occurred in 14 cases (73.7%). ICA was performed in three of these patients, with ISR confirmed in two cases. These findings yield sensitivity and NPV of 100% for both post-stent CT-FFR and Delta CT-FFR for excluding ISR with a superior specificity (76.5% vs. 29.4%) and overall diagnostic accuracy (78.9% vs. 36.8%) for post-stent CT-FFR. Two patients reported a myocardial infarction in follow-up; however, neither of them was located in the territory of the stented coronary artery. This study outlines the feasibility of on-site CT-FFR analysis using PCCT in excluding ISR in coronary stents with a high diagnostic accuracy. These findings highlight the need to extend the benefits of CT-FFR analysis for non-invasive assessment of possible ISR regarding personalized risk stratification and therapy planning. Full article

Coronary in-stent restenosis (ISR) remains a major contributor to repeat revascularisation despite advances in drug-eluting stent (DES) technology. Its persistence reflects a complex and heterogeneous interplay among mechanical, biological, and procedural factors, and understanding the dominant mechanism in each case is fundamental to effective treatment selection. This narrative review provides a contemporary, mechanism-guided approach to the practical management of coronary ISR. We summarise the definition, incidence, and classification of ISR—including the Mehran, Waksman, and SCAI 2023 time-based frameworks—and outline patient-related, procedural, anatomical, and stent-related risk factors. The pathophysiology of neointimal hyperplasia and neoatherosclerosis is discussed with reference to its clinical implications. Intracoronary imaging with intravascular ultrasound (IVUS) or optical coherence tomography (OCT) is central to ISR characterisation and treatment planning. Current international guidelines support imaging use in ISR management, though it is important to recognise that this recommendation is based largely on observational and surrogate-endpoint data rather than ISR-specific randomised trials demonstrating reductions in hard clinical outcomes, and practical barriers including cost, availability, and operator expertise must be acknowledged. Evidence-based treatment strategies—including drug-coated balloons (DCB), repeat DES implantation, lesion-modifying therapies, vascular brachytherapy, and coronary artery bypass grafting—are reviewed critically with reference to contemporary trial data and their specific clinical applicability. The choice between DCB and repeat DES is addressed with greater nuance, accounting for ISR type (BMS-ISR versus DES-ISR), lesion pattern, stent layering, and bleeding risk. Management considerations in complex subsets—chronic total occlusion ISR, left main ISR, saphenous vein graft ISR, and recurrent ISR—are also addressed. We propose a practical, substrate-driven management framework aligned with the 2024 ESC, 2021 ACC/AHA/SCAI, and 2018 JCS/JSCVS guidelines. Future research priorities include ISR-specific randomised trials with hard clinical endpoints, prospective validation of imaging-guided treatment algorithms, head-to-head comparisons of DCB platforms, and investigation of pharmacological strategies targeting neoatherosclerosis progression. Full article

This single-center prospective observational study evaluated peri-procedural changes in circulating markers of endothelial glycocalyx injury in patients with chronic limb-threatening ischemia undergoing lower extremity endovascular treatment. Fifty patients (mean age 72.2 years; 56% with diabetes mellitus; 42% current smokers) underwent percutaneous transluminal angioplasty, most commonly involving the femoropopliteal segment and using 4F introducer sheaths. Serum concentrations of syndecan-1, heparan sulfate, and hyaluronic acid were measured using ELISA before and one day after the procedure. No significant differences were observed between baseline and post-procedural biomarker levels, with minimal median changes, overlapping interquartile ranges, and negligible paired effect sizes. Although individual biomarker trajectories demonstrated considerable interindividual variability, no consistent directional trend was identified. Furthermore, demographic and clinical factors, including age, sex, diabetes, and smoking status, as well as procedural variables such as stent implantation, sheath size, and intervention level, were not associated with biomarker changes in univariate or multivariable analyses. These findings suggest that contemporary endovascular revascularization is biologically well tolerated and does not induce detectable systemic endothelial glycocalyx disruption. Nevertheless, the interpretation of these findings is limited by the moderate sample size and single-center design of the study. In addition, syndecan-1, heparan sulfate, and hyaluronic acid are not exclusive markers of endothelial glycocalyx injury and may also reflect extracellular matrix turnover and tissue remodeling. Full article

Background: Medical device-associated infections represent a major component of healthcare-associated infections. Biofilm formation promotes microbial persistence on device surfaces, reduces antimicrobial susceptibility, and contributes to multidrug resistance (MDR), complicating diagnosis and treatment. Materials and Method: This study investigated biofilm production and antimicrobial resistance in microorganisms recovered from 100 indwelling and implantable medical devices, including urinary and venous catheters, urethral stents, catheter tips, and orthopedic or prosthetic materials, collected at a tertiary-care hospital (AOU “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy). Microbiological cultures were performed using direct and enrichment methods. Microbial identification was carried out by MALDI-TOF MS, antimicrobial susceptibility testing by VITEK^® (bioMérieux, Marcy-l'Étoile, France) 2 according to EUCAST criteria, and biofilm production was assessed using the crystal violet tissue culture plate assay. MDR status was defined according to international guidelines. Results: Microbial growth was detected in the majority of analized devices, frequently with polymicrobial contamination. Within the study cohort, coagulase-negative staphylococci (CoNS) were the most frequently recovered microorganisms (20%), followed by Klebsiella pneumoniae (10%), Candida albicans (9%), Staphylococcus aureus (9%), Enterococcus faecalis (8%), and Escherichia coli (8%). A significant association was observed between multidrug resistance and biofilm production, with MDR isolates showing a markedly higher likelihood of being biofilm producers compared with non-MDR isolates (OR 9.50; 95% CI 2.72–42.96; p < 0.005). Biofilm formation also differed significantly among device types (p = 0.028). Conclusions: These findings indicate a high prevalence of biofilm-producing MDR microorganisms among isolated recovered from medical devices in our cohort and highlight a significant association between MDR phenotype and biofilm production. These results provide a microbiological characterization of device-associated isolates that may support future studies on infection dynamics and control strategies. Full article

Background and Clinical Significance: Metallic stents represent a breakthrough in the treatment of ureteric obstruction, improving patient quality of life. Despite their advantages, management of encrustation remains a difficult complication to address. This case series highlights the rare occurrence of permanent ureteral Wallstents remaining indwelling for over 20 years. It emphasizes that the function of these older devices can be successfully preserved using minimally invasive techniques. Case Presentation: This case series details three patients, two males, aged 75 and 69 years, diagnosed with colon cancer, and one female, aged 67 years, with cervical cancer, who presented with obstructive uropathy due to extrinsic malignant compression. As a therapeutic strategy, permanent ureteral Wallstents were placed in all three patients. Over time, the stents developed significant encrustation, leading to secondary obstruction. Clinical manifestations of this complication varied, ranging from asymptomatic hydronephrosis to acute symptomatic uropathy characterized by fever and localized pain. All cases were treated endoscopically with Ho:YAG laser lithotripsy, and urine flow was successfully restored. During the follow-up period, one patient experienced two recurrences that were managed with the same technique, another remained completely symptom-free, and the third was lost to long-term follow-up. Remarkably, the stents have remained functional for over 20 years post-implantation. Conclusions: This is a rare report documenting permanent ureteral Wallstents with such prolonged indwelling time. Furthermore, our findings suggest that through minimally invasive techniques, the function of these devices can be successfully preserved. Full article

Stenting is a minimally invasive treatment used in managing peripheral artery disease (PAD). However, clinical challenges persist, including in-stent thrombosis and restenosis, primarily driven by axial foreshortening or elongation and suboptimal balance between radial stiffness and flexibility inherent to conventional stent designs. This study proposes an innovative arrow-shaped geometry exhibiting zero Poisson’s ratio (ZPR) behaviour for 3D-printed self-expanding Nitinol stents. The complete stent deployment process was modelled using finite element analysis (FEA), including radial crimping and subsequent expansion to enable systematic parametric investigation while accounting for µ-3D printing constraints. Response surface methodology (RSM) rigorously evaluated mechanical performance, defining peak stress, chronic outward force (COF), radial resistive force (RRF), and foreshortening (FS) as constraint and objective functions within the optimisation framework. The optimised ZPR stent achieved favourable performance: extremely low foreshortening (|FS| ≤ 0.12%), representing outstanding axial stability compared with previously reported self-expanding stents, and a well-balanced radial response with ~50% higher radial strength than positive Poisson’s ratio (PPR) structures, while 16.67% lower than negative Poisson’s ratio (NPR) counterparts. These results highlight the ZPR stent’s capability to minimise axial deformation while maintaining adequate radial support, highlighting substantial potential for precise, stable deployment in PAD applications. Full article

Background: Aneurysm treatment options are rapidly evolving, as evidenced by the recent introduction and widespread adoption of flow diversion and intrasaccular devices. However, there is a need to understand how these newer technologies are used for difficult-to-treat aneurysms. The main aims of this study were to investigate the variation in aneurysm treatment recommendations among neurosurgeons, interventional radiologists, and interventional neurologists and to generally describe trends in endovascular treatment. Methods: In this survey-based study conducted from June to September 2024, participants were presented with clinical vignettes and asked to choose preferred treatment options, with responses analyzed based on demographic variables including specialty, age, and training prior to and after the introduction of flow diversion. Results: A total of 108 respondents completed the study with a representative mix of specialties—(45 (42.5%) radiologists, 22 (20.8%) neurologists, and 39 (36.8%) neurosurgeons. Sixty-six (61.1%) trained after the introduction of flow diversion. Treatment recommendations were significantly different by specialty (p < 0.001). The Kappa statistic to assess variation in responses showed significant variation in treatment preferences across aneurysm subtypes, ranging from poor (κ = 0.07) to fair (0.31). Treatment of ruptured aneurysms varied by specialty with radiologists opting for stent-assisted coiling at a higher rate than neurologists or neurosurgeons (p < 0.001). There was no significant difference in rates of recommending flow diversion or intrasaccular devices between those who had trained before and after their introduction (p = 0.97). Conclusion: The study highlights the dynamic nature of aneurysm management and considerable variability among different specialties. Further exploration into the rationale for each decision is needed to understand how specialty training affects these decisions. Full article

Endobiliary photodynamic therapy (PDT) in cholangiocarcinoma (CCA) is used mainly for local palliation of malignant biliary obstruction, particularly in extrahepatic and perihilar disease. This Review synthesizes the clinical evidence on endobiliary PDT while using drainage, infection control, stent strategy, light delivery, and systemic-therapy context as an interpretive framework rather than as practice recommendations. This narrative review was informed by targeted searching of PubMed/MEDLINE, Embase, and Web of Science from database inception through to 31 December 2025, supplemented by reference-list screening. We prioritized prospective studies, comparative cohorts, systematic reviews, and relevant guidance documents. Across the literature, the clearest support for PDT concerns selected local biliary palliation, including decompression, stent patency or delayed dysfunction, and symptom relief. Survival signals remain inconsistent: early positive studies contrast with the negative PHOTOSTENT-02 randomized trial and are highly confounded by drainage adequacy, infection control, retreatment strategy, and systemic-therapy access. We therefore interpret PDT as a context-dependent local biliary strategy rather than an established survival-prolonging treatment, and we highlight the clinical variables that make published outcome signals more or less interpretable. Full article

Background: Interventional cardiology is increasingly being reshaped by rapid progress in non-invasive cardiovascular imaging. Coronary computed tomography angiography (CTCA), once used mainly to exclude obstructive coronary artery disease (CAD), is now being adopted as a broader planning instrument before percutaneous coronary intervention (PCI). Its ability to generate high-resolution three-dimensional visualization of the coronary tree, together with functional assessment through CT-derived fractional flow reserve (FFR-CT) and more advanced plaque analysis supported by artificial intelligence (AI), has expanded its relevance from diagnosis alone to strategic procedural preparation. In this setting, CTCA can help refine lesion assessment, anticipate technical complexity, and support better procedural and clinical outcomes. Technological Advancements: The value of CTCA for both diagnosis and risk stratification has increased substantially with recent technical innovation. Among the most important developments is the maturation of FFR-CT, which enables non-invasive physiological interrogation of coronary stenoses using computational modeling. At the same time, artificial intelligence and deep learning tools are reshaping the CTCA workflow by improving automation, facilitating plaque analysis, and highlighting adverse plaque characteristics such as positive remodeling, spotty calcification, and the napkin-ring sign. Clinical Applications: In modern catheterization practice, CTCA is increasingly used to address anatomically demanding scenarios. Its role is particularly valuable in chronic total occlusion (CTO) intervention, where it can delineate occlusion length, stump characteristics, vessel course, and collateral anatomy before the procedure. Its usefulness also extends beyond CTO PCI by supporting vessel sizing, stent planning, and anticipation of lesion preparation requirements in complex coronary disease. Challenges: Despite these advantages, several barriers continue to limit wider implementation, including blooming from heavy calcification, radiation burden, contrast-related renal concerns, and the practical difficulty of embedding CTCA-based planning into routine workflows. Conclusions: CTCA is becoming an increasingly important adjunct in PCI planning because it can combine anatomical definition, physiological interpretation, and plaque-level information before invasive treatment is undertaken. Overall, this review emphasizes CTCA not only as a diagnostic modality, but also as a practical pre-procedural roadmap that can guide lesion selection, stent planning, calcium modification strategies, and overall PCI strategy. Full article

Background/Objectives: Evaluation of real-world outcomes of standalone implantation of the third-generation trabecular micro-bypass device (iStent infinite) in eyes with mild to severe primary open-angle glaucoma (POAG). Materials: This retrospective, uncontrolled consecutive case series included eyes undergoing standalone iStent infinite implantation at a single U.S. practice. Outcomes were assessed through 12 months, including changes in intraocular pressure (IOP) and medication burden (primary), proportions achieving IOP ≤ 12/15/18 mmHg and medication categories (secondary), and safety. Subgroup analyses were completed based on preoperative IOP, glaucoma severity, and medication burden. Results: Fifty-one eyes (mean age 66.5 ± 10.8 years) were included. Mean baseline IOP was 20.1 ± 5.4 mmHg on 2.1 ± 1.2 medications. At month 12, the mean IOP decreased to 16.0 ± 3.6 mmHg (−4.1 mmHg, −20.4%; p < 0.001), and mean medications decreased to 1.5 ± 1.2 (−28.6%; p < 0.001). The proportion of eyes achieving IOP ≤ 18/15/12 mmHg increased from 41.2%/15.7%/3.9% to 79.6%/42.9%/16.3%, respectively (all p < 0.001). Medication-free eyes increased from 15.7% to 30.6%, while eyes requiring ≥ 3 medications decreased from 47.1% to 20.4%. Eyes with baseline IOP > 18 mmHg achieved greater IOP reduction (−27.8%), whereas eyes with baseline IOP ≤ 18 mmHg maintained stable IOP with reduced medications. Kaplan–Meier analysis demonstrated 12-month freedom from incisional reintervention of 92.2%. No intraoperative complications occurred. Transient self-resolving hyphema was observed in 3.9% of eyes. A secondary incisional surgery was performed in four eyes (7.8%); no vision-threatening complications were reported. Conclusions: Standalone iStent infinite implantation resulted in significant IOP and medication reductions with a favorable safety profile over 12 months, with outcomes aligned with preoperative treatment goals. These results suggest potential benefit as a less invasive real-world glaucoma intervention, warranting confirmation in larger prospective studies. Full article

Intraprocedural rupture (IPR) during stent-assisted coiling (SAC) after stent deployment can create a narrow and rapidly changing management problem: hemorrhage control, anticoagulation reversal, acute thrombotic occlusion, and postprocedural cerebrospinal fluid diversion may all become urgent within the same clinical sequence. We report a fatal IPR during SAC of an unruptured anterior communicating artery (AComA) aneurysm and use the case as an anchor for a targeted case-based narrative review. A 71-year-old woman underwent SAC for a 5.1-mm posteriorly directed AComA aneurysm with a bleb after treatment for vertebrobasilar ischemia. Fourth-coil insertion produced tactile resistance and contrast extravasation. Protamine reversal and temporary A1 flow control reduced the leak, but filling defects then developed from the internal carotid artery terminus to the A1 and M1 segments, requiring rescue thrombectomy. Computed tomography showed subarachnoid hemorrhage and intraventricular hemorrhage; same-day progression with hydrocephalus required bilateral external ventricular drainage. The patient died on postoperative day 7. This case highlights IPR during SAC as a time-dependent hemorrhagic–thrombotic escalation rather than a single technical event. We propose a staged assistant–operator communication model for risk mapping, rupture recognition, hemostatic-route preservation, thrombotic surveillance, and transition to computed tomography, external ventricular drainage, and intensive care. Full article

Esophageal squamous cell carcinoma (ESCC) is a highly aggressive malignancy in which radiotherapy plays a uniquely central role compared with other gastrointestinal cancers. Definitive chemoradiotherapy (dCRT) is widely used as a curative treatment; however, a substantial proportion of patients develop residual or recurrent disease, creating a complex clinical scenario that requires tailored salvage strategies. Salvage esophagectomy offers the potential for long-term survival but remains technically demanding and is associated with significant morbidity because of radiation-induced tissue damage. Less invasive local therapies, such as endoscopic submucosal dissection and photodynamic therapy, may provide effective treatment in selected patients, although their indications are limited by tumor characteristics and post-radiation fibrosis. In addition, immune checkpoint inhibitors have demonstrated promising efficacy in advanced ESCC and may represent a potential therapeutic option in the salvage setting. For patients who are not candidates for curative treatment, palliative esophageal stenting remains an important option for symptom relief, although prior radiotherapy may increase the risk of treatment-related complications. Given the diversity of available treatment modalities and their associated risks, a multidisciplinary and individualized treatment approach is essential. Further prospective studies are warranted to optimize treatment algorithms and improve outcomes in patients with ESCC after dCRT. Full article

Background/Objectives: Epidemiological studies over the first decades of the 21st century have reported a decrease in cardiovascular disease (CVD) morbidity and mortality. Changes in coronary care for acute myocardial infarction (AMI) over these years, including the COVID-19 pandemic period, have been less studied in Eastern and Central Europe. The study aimed to assess changes in coronary care—the time of medical assistance and treatment—for AMI patients over 2000–2023 in urban Kaunas residents aged 25–64. Methods: The data source was study cases from the Kaunas Ischemic Heart Disease Registry (Registry)—Kaunas city residents aged 25–64 years included in the Registry according to MONICA project protocol evaluation methodologies. Data were analyzed by sex and age group (25–54 and 55–64 years). Descriptive statistics (chi-square and z-score values) were used to evaluate the data; the significance level was p < 0.05. A logistic regression analysis was performed to assess the odds ratios of death within 28 days across six time periods. Results: The proportion of AMI patients hospitalized up to 2 h from the onset of pain accounted for about one-fifth of all hospitalized patients in 2000–2016, while in 2017–2023, it significantly decreased. In 2017–2023, compared with 2000–2004 and 2009–2016, significantly fewer men who developed AMI were hospitalized within the first 2 h of emergency presentation (p < 0.05). Over the whole study period, fewer women with AMI were hospitalized within the first 2 h of pain as compared to men (p < 0.05). There were no significant differences in time from pain onset to hospitalization between the age groups. At the same time, from 2009 to 2012, more young AMI patients were hospitalized within the first 2 h (p < 0.05). Percutaneous coronary angioplasty (PTCA) with stenting (PCI) increased 30 times from 2000–2004 to 2020–2023. PCI has been the most available treatment for men with AMI since 2009 and stayed stable from 2013 (66.0%) until 2023 (72.1%). Women with AMI tended to get less PCI, PTCA, and coronary artery bypass grafting (CABG) than men. The pre-pandemic and COVID-19 periods did not differ in the proportions of reperfusion treatment methods used in both men and women. Thrombolysis was very rare, and since 2017, it has not been used in Kaunas because PCI has become more accessible. PCI (2000–2016) and CABG (2009–2016) were more prevalent among the 25–54-year-old AMI patients (p < 0.05). From 2017 to 2023, there were no differences between age groups in the reperfusion procedures used, nor were there differences in treatment between these groups during the pre-pandemic (2017–2019) and peri-COVID-19 pandemic (2020–2023) periods. Conclusions: In Kaunas, the treatment of patients with AMI has improved significantly over the past 20 years. The use of PCI has increased greatly, and the rate of CABG surgery stayed stable, while only every fifth patient has been admitted to the hospital in a timely manner. Men were more likely to receive PCI, and older patients were more likely to undergo CABG. Compared to the period of 2000–2004, the chance of dying within 28 days after AMI was significantly lower in 2017. Full article

Background/Objectives: Midurethral sling (MUS) surgery is a standard treatment for stress urinary incontinence in women. Obturator-route MUS procedures reduce retropubic morbidity, but rare concealed hemorrhagic complications can be severe and rapidly progressive. This report describes a complex case of life-threatening hemorrhage, upper urinary tract extravasation, and delayed infection involving a persistent pelvic collection after obturator-route MUS. Methods: We reviewed the clinical course, imaging findings, interventions, and follow-up of a 77-year-old woman who developed severe complications after outpatient obturator-route MUS. A descriptive narrative summary of published hemorrhagic complications after TOT or TVT-O procedures was also performed. Result: On postoperative day 1, the patient presented with left lower abdominal pain, dizziness, vomiting, tachycardia, and severe anemia. Contrast-enhanced computed tomography showed active bleeding from the left obturator artery, an 11.5 cm pelvic hematoma with bladder displacement, and upper urinary tract contrast extravasation at the left renal pelvis and ureteropelvic junction. Emergency transcatheter arterial embolization and left percutaneous nephrostomy were performed, followed by delayed antegrade double-J ureteral stenting. Four months later, she developed E. coli urosepsis with a persistent 7.9 cm paravesical collection. Persistent symptoms despite initial antibiotic therapy required broad-spectrum antibiotics and percutaneous catheter drainage. The drainage fluid was serous, and S. hominis isolated from the drainage culture was interpreted as a contaminant; therefore, the collection was managed as a clinically suspected infection involving a persistent pelvic collection rather than as a microbiologically confirmed infected hematoma. Conclusions: After obturator-route MUS, severe abdominal or pelvic pain, dizziness, tachycardia, hypotension, or abrupt hemoglobin decline should prompt contrast-enhanced CT to evaluate for concealed pelvic arterial bleeding and associated urinary tract extravasation. Early multidisciplinary coordination and follow-up of persistent pelvic collections may be important in complex cases. Full article

Recent advancements in biology and medicine have facilitated the progress of nerve regeneration that markedly improves the treatment of peripheral nerve injuries, enhancing outcomes and recovery rates. It has been reported that erythropoietin (EPO) is currently being studied as a potential agent for neural repair. However, much evidence has confirmed that EPO treatment can induce systemic adverse effects in the clinical fields, including coronary stent thrombosis and deep vein thrombosis. Herein, a derivative of EPO without any hematopoietic activities, which is named carbamylated erythropoietin (CEPO), has been synthesized and investigated for its effects on peripheral neural repair both in vitro and in vivo. The in vitro experimental results demonstrated that CEPO enhanced Schwann cell viability, proliferation, migration, and nerve growth factor (NGF) expression, while the optimal concentration of CEPO was found to be 25 μg/mL. The in vivo observations at 21 days post-injection indicated that the CEPO group exhibited a significant functional improvement in the sciatic nerve injury model, guiding regrowing axons across the injury site. Thus, CEPO serves as a promising candidate or adjunctive strategy for peripheral nerve injuries, demonstrating promising clinical applications and potential for enhancing Schwann cell viability, proliferation, and migration, as well as anticipated nerve axon development. Full article