TCT-74 Carotid Lesion Length Effect on Routine Doppler Velocities Used to Determine Carotid Stenosis Cross-Sectional Severity: Intravascular Ultrasound-Validated Analysis in the CARUS Study of 300 Consecutive Patients Referred for Potential Carotid Revascularization

ObjectiveWe investigated whether mental illness is associated with lower rates of carotid endarterectomy (CEA)/carotid artery stenting (CAS) after stroke due to carotid stenosis.MethodsIn this retrospective cross-sectional study, ischemic stroke cases due to carotid stenosis were identified in the 2007–2014 Nationwide (National) Inpatient Sample. Psychiatric conditions were identified by secondary ICD-9-CM diagnosis codes for schizophrenia/psychoses, bipolar disorder, depression, anxiety, or substance use disorders. Using logistic regression, we tested the association between psychiatric conditions and CEA/CAS, controlling for demographic, clinical, and hospital factors.ResultsAmong 37,474 included stroke cases, 6,922 (18.5%) had a psychiatric comorbidity. The presence of any psychiatric condition was associated with lower odds of CEA/CAS (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.78–0.90). Schizophrenia/psychoses (OR 0.72, 95% CI 0.55–0.93), depression (OR 0.83, 95% CI 0.75–0.91), and substance use disorders (OR 0.73, 95% CI 0.65–0.83) were each associated with lower odds of CEA/CAS. The association of mental illness and CEA/CAS was dose-dependent: compared to patients without mental illness, patients with multiple psychiatric comorbidities (OR 0.74, 95% CI 0.62–0.87) had lower odds of CEA/CAS than those with only one psychiatric comorbidity (OR 0.86, 95% CI 0.79–0.92; p value for trend <0.001).ConclusionThe odds of carotid revascularization after stroke is lower in patients with mental illness, particularly those with schizophrenia/psychoses, depression, substance use disorders, and multiple psychiatric diagnoses.

Download Full-text

HE ROLE OF INTRAVASCULAR ULTRASOUND (IVUS) IN QUANTITATIVE EVALUATION OF CORONARY ARTERY LESION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.4_5.8 ◽

2014 ◽

pp. 64-70

Author(s):

Minh Hung Ngo ◽

Cuu Long Nguyen ◽

Thanh Nhan Vo

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Intravascular Ultrasound ◽

Coronary Artery Lesion ◽

Lesion Length ◽

Cross Sectional ◽

Minimal Lumen Area ◽

Study Results ◽

Male Patients

Background: Intravascular Ultrasound (IVUS) has been being an effectively supportive tool at Cathlab. Objectives: We perform this study in order to evaluate the role of IVUS in coronary lesions. Method: All patients, who were treated at Choray hospital from 10/2009 to 10/2013 and had indication for IVUS, were enrolled in this study. This was a cross-sectional prospective study. Results: A total of 46 patients, in which male patients was 63%, was used IVUS procedure to evaluate coronary artery lesions. IVUS provided an exact and diffferent information about: lesion length (20,17 ± 6,43mm sv 17,39 ± 6,79mm; p < 0,001), reference vessle diameter (3,13 ± 0,60mm sv 2,81 ± 0,49mm; p < 0,001), minimal lumen area (3,19 ± 0,67mm2 sv 1,60 ± 0,98mm; p < 0,001) respectively when compared with coronary angiography. IVUS is a powerful tool for evaluating ostial lesions 4,35% (2/46); superficial cancification 19,56% (9/46); mural thrombus 2,17% (1/46) and vulnerable lesions 2,17% (1/46) in which coronary angiography can not reveal. There was no IVUS related complications documented. Conclusion: IVUS is an effective and safe tool in evaluation of coronary artery lesion. Key words: Coronary lesion, IVUS, angiography

Download Full-text

Integrated backscatter-intravascular ultrasound and modification of plaque during excimer laser coronary angioplasty

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-021-00797-0 ◽

2021 ◽

Author(s):

Satoru Sasaki ◽

Kenji Nakajima ◽

Keizo Watanabe ◽

Yudai Nozaki ◽

Tadashi Yuguchi ◽

...

Keyword(s):

Intravascular Ultrasound ◽

Excimer Laser ◽

Coronary Angioplasty ◽

Coronary Plaque ◽

Cross Sectional ◽

Integrated Backscatter ◽

Before And After ◽

Vessel Volume ◽

Integrated Backscatter Intravascular Ultrasound ◽

Excimer Laser Coronary Angioplasty

AbstractThis study aims to test the hypothesis that the effect of excimer laser coronary angioplasty (ELCA) not only vaporizes thrombi and their underlying coronary plaque, it also changes their quality. We performed a series of cross-sectional analyses in 52 lesions in 51 patients before and after ELCA with integrated backscatter-intravascular ultrasound (IB-IVUS). The constituent parts of the plaque can be assessed by IB-IVUS (i.e., calcified, fibrous, lipid) according to integrated backscatter values. Minimum lumen diameter, lumen volume and vessel volume expanded after ELCA, while plaque volume did not significantly decrease. There was also a decrease of ‘lipid’ component (35.4–30.3%, P < 0.001) and an increase of IB-IVUS-derived ‘fibrous’ part (34.5–38.3%, P < 0.001). These results may help in understanding plaque change after ELCA. Excimer laser coronary angioplasty seems to contribute to the modification of coronary plaque composition in addition to debulking it.

Download Full-text

Dimensional disparity between duplex and intravascular ultrasound in the assessment of iliac vein stenosis

Vascular Medicine ◽

10.1177/1358863x211003663 ◽

2021 ◽

pp. 1358863X2110036

Author(s):

Seshadri Raju ◽

William Walker ◽

Chandler Noel ◽

Riley Kuykendall ◽

Thomas Powell ◽

...

Keyword(s):

Intravascular Ultrasound ◽

Venous Pressure ◽

Iliac Vein ◽

Common Iliac Vein ◽

Systematic Bias ◽

Cross Sectional ◽

External Iliac Vein ◽

The Difference ◽

Vein Stenosis ◽

Linear Regressions

Minimum iliac vein caliber necessary to maintain normal peripheral venous pressure can be derived by the Poiseuille equation. Duplex was compared to intravascular ultrasound (IVUS) in the assessment of iliac vein stenosis in this single center retrospective study. Parallel IVUS and duplex caliber data for common iliac vein (CIV) and external iliac vein (EIV) in 382 limbs were separately compared. One or both segments were stenotic by IVUS criteria in 213 limbs. Neither segment was stenotic by IVUS in 22 limbs. Bland–Altman analyses and Passing–Bablok linear regressions were used. Duplex calibers were dimensionally smaller than corresponding IVUS images of CIV and EIV segments in Bland–Altman comparison by a mean of 54 mm2 and 34 mm2, respectively. Passing–Bablok regression suggested the difference was due to a systematic bias and not proportional. Duplex yields a smaller cross-sectional image of CIV and EIV compared to IVUS. Duplex is not a reliable diagnostic test for iliac vein stenosis.

Download Full-text

Accuracy of Newer Generation Dual Source Multi-Detector Computerized Tomography for Detection of Coronary In-stent restenosis in Comparison with Invasive Coronary Angiography and Intravascular Ultrasound: A Comparative Cross-Sectional Study

Zagazig University Medical Journal ◽

10.21608/zumj.2021.85316.2281 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Mohey Eldeen Eldeeb ◽

Mohamed Mostafa ◽

Tarek Nagiub ◽

Mohammed Alshair ◽

Islam Shehata

Keyword(s):

Coronary Angiography ◽

Intravascular Ultrasound ◽

Computerized Tomography ◽

Invasive Coronary Angiography ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Stent Restenosis ◽

Dual Source ◽

In Stent Restenosis

Download Full-text

Abstract P464: Thirty Day Stroke and Mortality After Carotid Revascularization Among Octogenarians With Symptomatic Carotid Stenosis: Real-World Data Analysis From a National Surgical Quality Registry

Stroke ◽

10.1161/str.52.suppl_1.p464 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mohammed Ali Alvi ◽

Yagiz Yolcu ◽

Kenan Rajjoub ◽

Ozan Dikilitas

Keyword(s):

Carotid Stenosis ◽

Real World ◽

Composite Outcome ◽

Real World Data ◽

Surgical Quality ◽

World Data ◽

Carotid Revascularization ◽

Symptomatic Carotid ◽

Quality Registry ◽

Symptomatic Carotid Stenosis

Introduction: Due to their exclusion from most clinical trials, outcomes of carotid revascularization via a carotid endarterectomy (CEA) or carotid artery stenting (CAS) among octogenarians are not well studied. Herein, we present analysis of thirty-day stroke and mortality of patients aged ≥ 80 using real-world data from a national surgical quality registry. Methods: The National Surgical Quality Improvement Program (NSQIP) targeted dataset for CEA and CAS was queried for patients aged ≥ 80 undergoing CEA and CAS between 2012-2018. Results: A total of 94 and 2,656 patients aged ≥ 80 with symptomatic carotid stenosis undergoing CAS and CEA (respectively) were identified. Patients in the CAS group were more likely to be over 90 (p=0.006). Patients in the CAS group were more likely to have high-risk anatomy (p<0.001) and more likely to be on aspirin preoperatively (p=0.02) but less likely to have higher ASA (p<0.001). Most patients in the group presented with an ipsilateral stroke (CAS: 43.6% and CEA: 41.7%). The rate of thirty-day composite outcome (stroke or death) was found to be 5.3% in the CAS group and 4.5% in the CEA group (p=0.714) (stroke: 2.1% for CAS and 3.2% for CEA; death: 4.3% for CAS and 1.7% for CEA). Upon multivariable analysis, procedure type (CAS vs CEA) was not found to be associated with the composite-outcome (OR 1.1, 95%CI 0.43-2.82,p=0.836). Symptom presentation other than ipsilateral stroke was found to be associated with significantly decreased odds of 30-day composite outcome (amaurosis-fugax/transient monocular blindness: OR 0.42,95%CI 0.21-0.86, p=0.02; TIA: OR 0.62, 95%CI 0.42-0.93,p=0.02), while higher age was found to be associated with significantly increased odds (OR 1.512, 95%CI 1.01-2.24, p=0.02). Conclusion: Real world analysis from a surgical quality registry show that both CAS and CEA are associated with optimal 30-day outcomes among octogenarians with symptomatic carotid stenosis.

Download Full-text

701-2 The Final % Cross-sectional Narrowing (Residual Plaque Burden) is the Strongest Intravascular Ultrasound Predictor of Angiographic Restenosis

Journal of the American College of Cardiology ◽

10.1016/0735-1097(95)91603-u ◽

1995 ◽

Vol 25 (2) ◽

pp. 35A ◽

Cited By ~ 13

Author(s):

Gary S. Mintz ◽

Ya Chien Chuang ◽

Jeffrey J. Popma ◽

Augusto D. Pichard ◽

Kenneth M. Kent ◽

...

Keyword(s):

Intravascular Ultrasound ◽

Plaque Burden ◽

Cross Sectional ◽

Angiographic Restenosis

Download Full-text

Utility of intravascular ultrasound in intracranial and extracranial neurointerventions: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital

Neurosurgical FOCUS ◽

10.3171/2011.10.focus11242 ◽

2012 ◽

Vol 32 (1) ◽

pp. E6 ◽

Cited By ~ 11

Author(s):

Peter Kan ◽

Maxim Mokin ◽

Adib A. Abla ◽

Jorge L. Eller ◽

Travis M. Dumont ◽

...

Keyword(s):

Intravascular Ultrasound ◽

Imaging Modality ◽

Interventional Cardiology ◽

Plaque Composition ◽

Intraluminal Thrombus ◽

Conventional Angiography ◽

Cross Sectional ◽

Case Examples ◽

Vessel Stenosis ◽

Wide Range

Intravascular ultrasound (IVUS) generates high-resolution cross-sectional images and sagittal reconstructions of the vessel wall and lumen. As a result, this imaging modality can provide accurate measurements of the degree of vessel stenosis, allow the detection of intraluminal thrombus, and analyze the plaque composition. The IVUS modality is widely used in interventional cardiology, and its use in neurointerventions has gradually increased. With case examples, the authors illustrate the utility of IVUS as an adjunct to conventional angiography for a wide range of intracranial and extracranial neurointerventions.

Download Full-text

Intravascular Ultrasound: Potential Tool to Assess Coronary Anastomosis Quality

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230301100212 ◽

2003 ◽

Vol 11 (2) ◽

pp. 143-146

Author(s):

Piergiorgio Tozzi ◽

Antonio F Corno ◽

Ludwig K von Segesser

Keyword(s):

Coronary Artery ◽

Intravascular Ultrasound ◽

Left Internal Mammary Artery ◽

Artery Bypass ◽

Ultrasound Images ◽

Cross Sectional ◽

Flow Measurements ◽

Off Pump ◽

The Mean ◽

Macroscopic Examination

Coronary angiography and Doppler flow measurements are most commonly used to assess the patency of anastomoses in the operating theater. Intravascular ultrasound might be another means of monitoring the surgical procedure during coronary artery bypass. Five sheep underwent off-pump bypass of the left anterior descending coronary artery using the left internal mammary artery. The running suture was evaluated by intraoperative fluoroscopy and a coronary intravascular ultrasound probe inserted into the target artery proximal to the anastomosis. Macroscopic examination of the anastomosis was performed to validate the angiographic and intravascular ultrasound images. The diameter, cross-sectional area, and compliance of each anastomosis were calculated in systole and diastole. All anastomoses were patent without signs of stenosis. In one case, intravascular ultrasound showed an intimal flap, which was confirmed by macroscopic examination. The mean major anastomotic diameter was 4.5 ± 0.5 mm on angiography and 4.0 ± 0.5 mm on intravascular ultrasound. From the ultrasound data, the mean cross-sectional anastomotic area was calculated as 6.21 ± 0.1 mm2 in systole and 5.49 ± 0.1 mm2 in diastole, and these data were used to calculate the cross-sectional anastomosis compliance. Coronary intravascular ultrasound can visualize intima-to-intima apposition and provide reliable calculations of anastomosis compliance.

Download Full-text