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Each of these requires design thinking. This chapter will outline each of the seven stages and the design thinking aspects they entail, while subsequent chapters will look at specific stages of the process in more detail.
The design process engages a high degree of creativity but in a way that is controlled and directed by the process so that it is channelled towards producing a viable, practical solution to the design problem, meeting or excelling the stated aims of the brief.
While creativity in design is important, design is an activity that serves economic as well as creative goals.
The design process helps ensure Bigr-tae-Wo oie pert ool Resp Recon sie -1e- Uo tM MM 0 flere Bor Loc to generate a number of possible solutions and utilises various techniques or mechanisms that encourage participants to think Outside the box in the pursuit of creative or innovative solutions.
More From Danielle. Victor Henrique Oliveira. Weslley Leal. Ana Caroline Ribeiro. Ubaldo Rizzaldo Jr.
Jafer Gomes. Keywords: abdominal aortic aneurysm, risk factors, blood vessel prosthesis implantation, survival analysis Introduction Infrarenal abdominal aortic aneurysms AAA are the most common type and occur in around 2.
However, this technique is associated with non-negligible morbidity and mortality rates, long periods in hospital, and a need for blood transfusion. Nowadays, with the accumulation of experience and development of safer and more flexible prostheses, endovascular treatment can be considered the method of choice, even for patients whose surgical risk assessments and anatomic characteristics are favorable for the conventional open surgical technique.
However, the long-term survival curves for the two techniques are similar. The incidence of reinterventions is also higher after endovascular repair than after open surgical repair.
Methods This is a retrospective study conducted by analysis of the medical records of 45 patients treated with open or endovascular repair of infrarenal AAA from March to March in a quaternary hospital. There was no formal randomization of the patients treated at this service to choose the method employed open or endovascular repair.
However, the decision of which technique to use was taken in team meetings after analysis of tomographic anatomy, comorbidities, and surgical risk assessments. The remaining elective cases were treated with open surgery. For urgent cases ruptured or acutely expanding aneurysms , the technique was chosen based on stability of clinical status, favorability of anatomy, and immediate availability of endoprostheses.
Each patient studied only underwent one aneurysm repair procedure. Data on a total of 10 preoperative clinical variables and eight postoperative clinical variables were collected and input to an electronic spreadsheet.
Four medical records for surgical patients were incomplete two did not contain data on duration of surgery, one did not have complete laboratory test results, and one did not have an accessible imaging exam that could be used to analyze aneurysm diameter and were excluded from the study, leaving a total of 41 medical records for analysis. Correlations between the anatomic characteristics of the aneurysms and their outcomes were not studied because there was incomplete availability of examinations that could be used for reconstruction.
Other parameters analyzed were history of acute myocardial infarction less than 6 months previously, stroke, angina, abdominal pains, and aneurysm diameter. Ruptured AAA were diagnosed with imaging exams ultrasound or computed tomography.
The data collected for variables after AAA repair were hospital mortality occurring during the surgical procedure or in the immediate postoperative period , overall mortality death from any cause, outside of the hospital setting, after discharge , time in an intensive care unit for less than 24 hours, need for blood transfusion intraoperatively or postoperatively, acute kidney failure increase of 0. The follow-up period chosen for survival analysis was up to days.
The descriptive statistics calculated were means and standard deviations. Intergroup inferential analysis open surgery vs. Survival was analyzed using Kaplan-Meier curves with the log-rank test for comparison between groups.
Graphpad Prism version 7.