Duplex Ultrasound of Renal Transplants

Magnetic resonance imaging of renal transplants: its value in the differentiation of acute rejection and cyclosporin a nephrotoxicity

Clinical Radiology ◽

10.1016/s0009-9260(88)80369-6 ◽

1988 ◽

Vol 39 (2) ◽

pp. 220-228

Author(s):

L TESTRAKE ◽

L SCHULTZEKOOL ◽

L PAUL ◽

A TEGZESS ◽

J WEENINGS ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Acute Rejection ◽

Cyclosporin A ◽

Resonance Imaging ◽

Renal Transplants

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Crush implantation of a self-expanding interwoven stent over a subintimally recanalized standard stent in a TASC D lesion of the superficial femoral artery

VASA ◽

10.1024/0301-1526/a000238 ◽

2012 ◽

Vol 41 (6) ◽

pp. 458-462 ◽

Cited By ~ 4

Author(s):

Vogel ◽

Strothmeyer ◽

Cebola ◽

A. Katus ◽

Blessing

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Popliteal Artery ◽

Duplex Ultrasound ◽

Stent Fracture ◽

Nitinol Stent ◽

Nitinol Stents ◽

Walking Capacity ◽

Radial Strength ◽

Good Treatment Option

We demonstrate feasibility of implantation of a self-expanding interwoven nitinol stent in a claudicant, where recanalization attempt of a heavily calcified, occluded superficial femoral artery (TASC D lesion) was complicated by a previously implanted, fractured standard stent. Wire passage through the occlusion and beyond the fractured stent could only be achieved through the subintimal space. A dedicated reentry device was used to allow distal wire entry into the true lumen at the level of the popliteal artery. Despite crushing of the fractured stent with a series of increasingly sized standard balloons, a significant recoil remainded in the area of the crushed stent. To secure patency of the femoro-popliteal artery we therefore decided to implant the novel self-expanding interwoven nitinol stent (Supera Veritas (TM), IDEV), whose unique feature is an exceptional high radial strength. Patient presented asymptomatic without any impairment of his walking capacity at three month follow up and duplex ultrasound confirmed patency of the stent. Subintimal recanalizations can be complicated by previously implanted stents, in particular in the presence of stent fracture, where intraluminal wire passage often can not be achieved. Considering the high radial strength and fracture resistance, interwoven nitinol stents represent a good treatment option in those challenging cases and they can be used to crush standard nitinol and ballonexpandable stents.

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Very distal vein bypass in patients with thromboangiitis obliterans

VASA ◽

10.1024/0301-1526/a000624 ◽

2017 ◽

Vol 46 (4) ◽

pp. 304-309 ◽

Cited By ~ 4

Author(s):

Achim Neufang ◽

Carolina Vargas-Gomez ◽

Patrick Ewald ◽

Nicolaos Vitolianos ◽

Tolga Coskun ◽

...

Keyword(s):

Conservative Treatment ◽

Vein Graft ◽

Duplex Ultrasound ◽

Critical Limb Ischaemia ◽

Thromboangiitis Obliterans ◽

Surgical Revascularization ◽

Autologous Vein ◽

Therapeutic Concept ◽

Autologous Vein Graft ◽

Vein Bypass

Abstract. Background: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. Patients and methods: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking. Angiography was able to identify a suitable distal arterial segment for the bypass which was revascularized by means of an autologous vein graft. Grafts were followed with repetitive duplex ultrasound. Revision of the bypass graft was initiated if indicated by pathological duplex findings. Results: In all cases a bypass could be constructed with either the ipsilateral greater saphenous vein or arm veins. A distal origin configuration was possible in three cases with popliteo-pedal or cruro-pedal bypasses. In the fourth case the distal superficial femoral artery was used for inflow. Two early graft thromboses underwent successful revision. During follow-up, duplex ultrasound identified graft stenoses in three bypasses which were successfully treated with endovascular techniques. All grafts are patent with complete resolution of ischaemic symptoms after 46, 42, 32, and 29 months. The patients remained non-smokers and returned to a professional life. Conclusions: Surgical therapy with distal vein bypass for persistent ischaemic symptoms after definitive cessation of smoking seems feasible in selected cases with TAO and a suitable distal artery. Close follow-ups of the patients with duplex ultrasound are necessary to identify developing vein graft stenoses. Angioplasty seems to be an important part of the long-term therapeutic concept.

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Modulation of carotid strain by statin therapy in atherosclerosis patients

VASA ◽

10.1024/0301-1526/a000596 ◽

2017 ◽

Vol 46 (2) ◽

pp. 108-115 ◽

Cited By ~ 3

Author(s):

Christian Alexander Schaefer ◽

Anna Katharina Blatzheim ◽

Sebastian Gorgonius Passon ◽

Kristin Solveig Pausewang ◽

Nadjib Schahab ◽

...

Keyword(s):

Statin Therapy ◽

Pulse Wave ◽

Ultrasound Examination ◽

Ankle Brachial Index ◽

Radial Strain ◽

Strain Analysis ◽

Duplex Ultrasound ◽

Strain Imaging ◽

The Common

Abstract. Background: The beneficial effect of statin therapy on the progress of atherosclerotic disease has been demonstrated by numerous studies. Vascular strain imaging is an arising method to evaluate arterial stiffness. Our study examined whether an influence of statin therapy on the vessel wall could be detected by vascular strain imaging. Patients and methods: 88 patients with recently detected atherosclerosis underwent an angiological examination including ankle-brachial index (ABI), pulse wave index (PWI), central puls ewave velocity and duplex ultrasound. Captures for vascular strain analysis were taken in B-mode during ultrasound examination of the common carotid artery and evaluated using a workstation equipped with a speckle tracking based software. A statin therapy was recommended and after six months a follow-up examination took place. Meanwhile, the non-adherence of a group of patients (N = 18) lead to a possibility to observe statin effects on the vascular strain. Results: In the statin non-adherent group the ABI decreased significantly to a still non-pathological level (1.2 ± 0.2 vs. 1.0 ± 0.2; p = 0.016) whereas it stagnated in the adherent group (1.0 ± 0.2 vs. 1.0 ± 0.2; p = 0.383). The PWI did not differ in the non-adherent group (180.5 ± 71.9 vs. 164.4 ± 75.8; p = 0.436) but under statin therapy it decreased significantly (261.8 ± 238.6 vs. 196.4 ± 137.4; p = 0.016). In comparison to the adherent group (4.2 ± 2.0 vs. 4.0 ± 1.8; p = 0.548) under statin therapy the radial strain decreased significantly in the non-adherent group (4.7 ± 2.0 vs. 3.3 ± 1.1; p = 0.014). Conclusions: Our findings reveal a beneficial influence of statin therapy on the arterial wall detected by vascular strain analysis.

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Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽

10.1055/s-0037-1622301 ◽

2010 ◽

Vol 39 (02) ◽

pp. 69-71 ◽

Cited By ~ 6

Author(s):

T. M. Proebstle ◽

Keyword(s):

Side Effects ◽

Thermal Ablation ◽

Clinical Success ◽

Clinical Success Rate ◽

Duplex Ultrasound ◽

Multicenter Trial ◽

Saphenous Veins ◽

Clinical Control ◽

Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

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