Dynamic contrast-enhanced CT-derived blood flow measurements enable early prediction of long term outcome in metastatic renal cell cancer patients on antiangiogenic treatment

2021 ◽  
Author(s):  
Annabel Spek ◽  
Anno Graser ◽  
Jozefina Casuscelli ◽  
Bernadett Szabados ◽  
Severin Rodler ◽  
...  
Keyword(s):  
Cell Cancer ◽  
Term Outcome ◽  
Flow Measurements ◽  
Long Term Outcome ◽  
Antiangiogenic Treatment ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Blood Flow Measurements

Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study

2017 ◽  
Vol 27 (8) ◽  
pp. 1550-1556 ◽  
Author(s):  
Davide Marini ◽  
Matteo Castagno ◽  
Michele Millesimo ◽  
Francesca Ferroni ◽  
Gaetana Ferraro ◽  
...  
Keyword(s):  
Left Atrium ◽  
Percutaneous Closure ◽  
Caval Vein ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Superior Caval Vein ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

AbstractBackgroundData regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.MethodsIn all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.ResultsIn one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.ConclusionsPercutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

Abstract 2008: Impact of Hyperglycemia on Myocardial Damage and its Prognostic Implications in Patients with Acute ST-Segment Elevation Myocardial Infarction (STEMI) Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging (CMR)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Christoph J Jensen ◽  
Markus Jochims ◽  
Kai Nassenstein ◽  
Michael Bell ◽  
Thomas Schlosser ◽  
...  
Keyword(s):  
Logistic Regression Model ◽  
Microvascular Obstruction ◽  
Myocardial Damage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Glucose Levels ◽  
Contrast Enhanced ◽  
Lv Mass ◽  
The Impact

To investigate the impact of admission glucose levels on myocardial damage and long term outcome in patients with acute STEMI using contrast-enhanced CMR. 130 consecutive patients (104 males; mean age 59.4±11.8 years) with first reperfused STEMI were included. Hyperglycemia was defined as glucose levels above 7.8mmol/l. CMR was performed within 3.9±2.2 days after admission on a 1.5 Tesla MR System. The imaging protocol included SSFP cine sequences for the calculation of LV function, volumes and mass. Total no reflow volumes (NRV) and delayed enhancement volumes (DEV) were calculated from planimetry of the IR-SSFP stacks of short axis images by disc-summation performed early / late following administration of 0.2mmol/kg/BW of gadodiamid. NRV and DEV were expressed as percent of LV Mass (NR%, DE%). Continuous variables were compared by Mann-Whitney test. Correlation of admission hyperglycemia and NR% was tested by spearman rank test. Patients were prospectively followed for 30±9 months. A stepwise logistic regression model was used to analyze the impact of hyperglycemia and CMR parameters on NR% and outcome. 55 of 130 (42%) patients had hyperglycemia on admission. Patients with admission hyperglycemia had lower LV ejection fraction (38.6±12.9% vs. 47.7±11.9%, p=0.001), greater ESV (89.2±39.2ml vs. 71.7±34.1ml, p=0.002), greater LV Mass (156.7±40.4g vs. 136.3±36.7g, p=0.003), larger DE% (19.3±13.8% vs. 9.7±8.5%, p<0.001) and larger NR% (8.1± 9.2% vs. 2.3± 4.2%, p<0.001). Admission hyperglycemia correlated moderate but significant to DE% (r=0.386, p<0.001) and NR% (r=0.421, p<0.001). In a multivariable logistic regression model admission hyperglycemia was an independent predictor (OR 6.8; CI 2.8 −16.6) of extensive (> median) microvascular obstruction, extensive delayed enhancement (OR 3.2; CI 1.5–7.1) and was associated with an increased risk for death and reinfarction (OR 4.7; CI 1.2–18.3) during follow up. Admission hyperglycemia in acute, reperfused STEMI is independently related to the extent of microvascular obstruction on early contrast-enhanced CMR and is associated with worse long-term outcome. Thus, CMR may play a major role in monitoring effects of glucose control on myocardial damage in AMI.

505 Long term outcome of laparoscopic radical nephrectomy for renal cell cancer

2004 ◽  
Vol 3 (2) ◽  
pp. 129
Author(s):  
R. Peschel ◽  
R. Neururer ◽  
G. Bartsch ◽  
F. Zussner ◽  
K. Jeschke
Keyword(s):  
Renal Cell Cancer ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Cell Cancer ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Laparoscopic Radical Nephrectomy

Long-term Outcome After Resection of Isolated Thoracic Lymph Node Metastases of Renal Cell Cancer

2020 ◽  
Vol 109 (1) ◽  
pp. 262-269
Author(s):  
Stefan Sponholz ◽  
Moritz Schirren ◽  
Selma Oguzhan ◽  
Mesut Mese ◽  
Joachim Schirren
Keyword(s):  
Lymph Node ◽  
Renal Cell Cancer ◽  
Lymph Node Metastases ◽  
Renal Cell ◽  
Cell Cancer ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Thoracic Lymph Node ◽  
Node Metastases

Acute aortic syndromes

2020 ◽  
pp. 3674-3680
Author(s):  
James D. Newton ◽  
Andrew R.J. Mitchell ◽  
Adrian P. Banning
Keyword(s):  
Transoesophageal Echocardiography ◽  
Mri Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Acute Aortic Syndromes ◽  
Adjacent Structures ◽  
Enhanced Ct ◽  
Penetrating Ulcer ◽  
Acute Dissection

The acute aortic syndromes are acute dissection, intramural haematoma, and penetrating ulcer, and all involve disruption of the wall of the aorta with potentially devastating consequences. Although relatively uncommon, left unrecognized and untreated they can carry a mortality rate of up to 2% per hour and 50% within the first few weeks. Physical signs typically reflect the region of the aorta involved and effects of pressure on adjacent structures: evidence of new aortic regurgitation or development of pulse deficits should be actively sought. Abnormalities on the chest radiograph and ECG are common, but neither investigation is diagnostic and further imaging is always necessary by MRI, contrast-enhanced CT, or transoesophageal echocardiography, depending on local availability and the clinical condition of the patient. In the long term, strenuous efforts to control blood pressure are indicated for all patients who have survived aortic dissection, with repeat imaging at least once a year.

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