Three-Dimensional Rotational Angiography in Peripheral Endovascular Interventions

2003 ◽  
Vol 10 (3) ◽  
pp. 595-600 ◽  
Author(s):  
Jos C. van den Berg ◽  
Frans L. Moll
Keyword(s):  
Three Dimensional ◽  
Region Of Interest ◽  
Arterial Disease ◽  
Anatomical Location ◽  
Rotational Angiography ◽  
Endovascular Interventions ◽  
Area Of Interest ◽  
Continuous Rotation ◽  
Peripheral Arterial Diseases ◽  
Peripheral Arterial

Purpose: To demonstrate the feasibility and applicability of 3-dimensional rotational angiography (3D-RA) in the assessment of candidates for endovascular treatment of occlusive or aneurysmal arterial disease. Technique: In 3D-RA, a continuous rotation of the fluoroscopic tube around the region of interest is made while intra-arterial contrast is continuously infused. The area of interest is placed in the isocenter in both frontal and lateral planes. Images are acquired at a rate of 12.5 frames per second at a rotation speed of 30° per second. Injection protocols are adjusted according to the anatomical location. The acquisition takes 8 seconds and yields 100 contrast-enhanced cinefluoroscopic images that are automatically reconstructed within 5 minutes to yield a 3D volume that can be rotated and viewed in any direction. Measuring the diameter of the target vessel and length of the lesion can be performed in the same session. An initial evaluation of this technique in 101 patients with known peripheral vascular disease yielded diagnostically adequate images preprocedurally while adding a maximum of only 10 minutes to the endovascular procedure: 5 minutes for reconstruction and another 2 to 5 minutes for measurements, which were made without difficulty in all cases. 3D-RA aided in selection of the optimal fluoroscopic tube angulation for the endovascular procedures and provided assessment of the interventional results comparable to angiography. Conclusions: Our preliminary experience suggests that 3D-RA appears to be a valid tool in the pre- and periprocedural assessment of patients treated endovascularly for both aneurysmal and occlusive peripheral arterial diseases.

A comparative study of geometry-based methods and intra-arterial pressure measurements to assess the hemodynamic significance of equivocal iliac artery stenoses

Vascular ◽  
2018 ◽  
Vol 27 (2) ◽  
pp. 119-127
Author(s):  
Stefan GH Heinen ◽  
Wouter Huberts ◽  
Daniel AF van den Heuvel ◽  
Frans N van de Vosse ◽  
Jean-Paul PM de Vries ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Iliac Artery ◽  
Visual Inspection ◽  
Arterial Disease ◽  
Lumen Diameter ◽  
Pressure Measurements ◽  
Rotational Angiography ◽  
3D Rotational Angiography ◽  
Peripheral Arterial ◽  
Diameter Reduction

Objectives To date, the ultimate decision to treat iliac artery stenoses in patients suffering from symptomatic peripheral arterial disease is based on the patient’s symptoms and on visual inspection of angiographical images. The primary aim of this study was to investigate the accuracy of geometry-based methods (i.e. visual inspection and quantitative vascular analysis (Viewforum version R7.2v1 Advanced vessel analysis, Philips Healthcare, Best, The Netherlands) of 3D rotational angiography) to identify the severity of equivocal iliac artery stenosis in peripheral arterial disease patients with intra-arterial hyperemic pressure measurements (gold standard) as a reference. Methods Twenty patients with symptomatic iliac artery stenoses were subjected to 3D rotational angiography. Intra-arterial pressure measurements under hyperemic conditions were performed across 24 visually identified iliac artery stenoses. Three experienced interventional-radiologists retrospectively estimated the lumen diameter reduction by visual inspection. Furthermore, quantitative vascular analysis was performed on the 3D rotational angiography data. Geometry-based estimates were classified into two groups: lumen diameter reduction of <50% (non-significant) and diameter reduction [Formula: see text]50% (significant), and compared to the intra-arterial hyperemic pressure gradients. A stenosis causing a pressure gradient (Δp) ≥10 mmHg was considered hemodynamically significant. Results Visual inspection and quantitative vascular analysis correctly identified hemodynamically significant stenoses in, respectively, 83% and 67% of the 24 iliac artery stenoses. Quantitative vascular analysis-based identification of hemodynamic significant stenoses (Δp ≥ 10 mmHg) could be optimized by lowering the threshold to a 42% lumen diameter reduction which improved the accuracy from 67% to 83%. Conclusions Visual inspection of 3D rotational angiography by experienced interventional-radiologists has an 83% accuracy to identify hemodynamic significant iliac artery stenoses (Δ p ≥10 mmHg). The use of quantitative vascular analysis software did not improve accuracy.

Image-guided vascular neurosurgery based on three-dimensional rotational angiography

2007 ◽  
Vol 106 (3) ◽  
pp. 501-506 ◽  
Author(s):  
Peter W. A. Willems ◽  
Theo Van Walsum ◽  
Peter A. Woerdeman ◽  
Everine B. Van De Kraats ◽  
Gerard A. P. De Kort ◽  
...  
Keyword(s):  
Image Registration ◽  
Navigation System ◽  
Three Dimensional ◽  
Region Of Interest ◽  
Small Region ◽  
Rotational Angiography ◽  
Vascular Tree ◽  
Data Set ◽  
3D Rotational Angiography ◽  
Vascular Neurosurgery

✓Three-dimensional rotational angiography is capable of exquisite visualization of cerebral blood vessels and their pathophysiology. Unfortunately, images obtained using this modality typically show a small region of interest without exterior landmarks to allow patient-to-image registration, precluding their use for neuronavigation purposes. The aim of this study was to find an alternative technique to enable 3D rotational angiography–guided vascular neurosurgery. Three-dimensional rotational angiograms were obtained in an angiographic suite with direct navigation capabilities. After image acquisition, a navigated pointer was used to touch fiducial positions on the patient's head. These positions were located outside the image volume but could nevertheless be transformed into image coordinates and stored in the navigation system. Prior to surgery, the data set was transferred to the navigation system in the operating room, and the same fiducial positions were touched again to complete the patient-to-image registration. This technique was tested on a Perspex phantom representing the cerebral vascular tree and on two patients with an intracranial aneurysm. In both the phantom and patients, the neuronavigation system provided 3D images representing the vascular tree in its correct orientation, that is, the orientation seen by the neurosurgeon through the microscope. In one patient, tissue shift was clearly observed without significant changes in the orientation of the structures. Results in this study demonstrate the feasibility of using 3D rotational angiography data sets for neuronavigation purposes. Determining the benefit of this type of navigation should be the subject of future studies.

scholarly journals Wound-directed revascularisation in the Diabetic Foot patients

2016 ◽  
Vol 6 (6) ◽  
pp. 722-731
Author(s):  
N. Kononenko ◽  
A. Sheikhali
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Arterial Disease ◽  
Term Treatment ◽  
Lower Limbs ◽  
Long Term Treatment ◽  
Peripheral Arterial Diseases ◽  
Foot Lesions ◽  
One Year ◽  
Peripheral Arterial

Introduction: Peripheral arterial diseases in patients with diabetic foot have significant features in pathogenesis, manifestations and course compared with peripheral arterial disease. These features require different approaches to treatment and the the angiosome theory can help increase the effectiveness of revascularization in patients with diabetic foot. The aim: Analyse the results of revascularisation of lower extremity arteries in the patients with ischemic diabetic foot ulcers according to the angiosome theory. Materials and metods: We analysed 98 revascularisations of arteries of 77 lower limbs in 74 ischemic diabetic foot patients for the period from 2017 to 2021. Angioplasties were performed in 71 cases (72,5%), open operations – in 21 (21,4%), hybrid operations – 6 (6,1%). According to angiosome theory we divided the revascularizations into two groups. І group – direct revascularizations (DR) – 57 cases, ІІ group – indirect revascurizations (IR) – 21 cases. Results: Within 6 months foot lesions healing fixed in І group (DR) - 81.7%, in ІІ group (IR) – 78.6%. Major amputations were the consequences of 17,1% revascularizations: DR group – 12,4%, IR group – 33,3%. Functional capacity of the lower extremity within one year was saved in 79,3% in DR group and in 57,9% in IR group. Repeated revascularizations accounted for 21,4% of cases: in DR group – 20,5%, in IR group – 25%. The results of the statistical analysis revealed the dependence of the risk of amputation on adherence to angiosome theory during revascularization. Conclusions: Angiosome-targeted revascularization in the area of foot lesions increases efficiency of the revascularization and improves immediate and long-term treatment results.

scholarly journals Effect of Peptidylarginine Deiminase 4 on Endothelial Progenitor Cell Function in Peripheral Arterial Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Jialin Pan ◽  
Wenqin Liu ◽  
Ye Chen ◽  
Chi Zhang ◽  
Cong Lin
Keyword(s):  
Peripheral Arterial Disease ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Therapeutic Effect ◽  
Arterial Disease ◽  
Peptidylarginine Deiminase ◽  
Endothelial Progenitor ◽  
Hematopoietic Stem ◽  
Peripheral Arterial Diseases ◽  
Peripheral Arterial

At present, the global prevalence of peripheral arterial disease is increasing year by year, and it has become a worldwide disease. Studies have shown that transplanting endothelial progenitor cells (EPCs) into ischemic tissues can improve the tissue ischemia, thereby having a therapeutic effect on peripheral arterial diseases. This indicates that EPCs play a therapeutic effect in peripheral arterial disease. Recent studies have shown that peptidylarginine deiminase (PAD) is involved in the regulation of epigenetics and its inhibitor Cl-amidine can improve endothelium-dependent vasodilation and significantly reduce the formation of arterial thrombosis. It can also play a role in hematopoietic stem cells that share the same origin with EPCs. Therefore, we speculate that PAD4 may also have an effect on EPCs through a similar mechanism, thereby participating in the damage and repair of peripheral arterial disease. Therefore, we first detected the expression of PAD4 in EPCs of peripheral arterial disease and detected changes in the number and function of endothelial progenitor cells in peripheral blood after injecting the PAD4 inhibitor Cl-amidine into mice. A mouse model of lower limb ischemia was established to explore the effect of PAD4 on the function of EPCs in peripheral arterial disease. The results show that PAD4 is highly expressed in peripheral arterial diseases and the PAD4 inhibitor Cl-amidine can increase the number of EPCs and can treat peripheral arterial diseases by improving the proliferation, migration, and vascularization of EPCs.

scholarly journals Rock-Hard Chronic Thrombotic Occlusion and Its Management in Endovascular Interventions

2018 ◽  
Vol 35 (05) ◽  
pp. 461-468 ◽  
Author(s):  
Sreekumar Madassery
Keyword(s):  
Lower Extremity ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Surgical Approaches ◽  
Invasive Approach ◽  
Endovascular Recanalization ◽  
Endovascular Interventions ◽  
Flow Through ◽  
Peripheral Arterial

AbstractEndovascular recanalization for patient with peripheral arterial disease and the end of its spectrum critical limb ischemia (CLI) has become a preferred method of revascularization due to advancement of techniques and equipment, allowing reduction of limb amputations while maintaining a minimally invasive approach compared to surgical approaches. Interventionalists have undertaken a progressively increasing complexity of diseased vessels in the hopes of providing inline unobstructed flow through occlusions for patients with claudication as well as direct flow to a nonhealing wound in patients with CLI. One of the major roadblocks encountered in lower extremity recanalization procedures is managing severely calcified chronic thrombotic occlusions which decrease luminal revascularization, ultimately increasing use of adjunctive interventions such as subintimal tracking, reentry device utilization, and stent placement. Understanding the histopathology and classification of lower extremity calcifications, imaging findings, and escalation of equipment use provides a thorough background in dealing with these specific cases.

scholarly journals Metabolic disorder and outcomes of reconstructive interventions in patients with peripheral arterial disease

2019 ◽  
Vol 11 (3) ◽  
pp. 33-40
Author(s):  
Nikolay I. Glushkov ◽  
Michael A. Ivanov ◽  
Petr D. Puzdryak ◽  
Kristina V. Samko ◽  
Alina A. Isakova ◽  
...  
Keyword(s):  
Metabolic Disorders ◽  
Hybrid Methods ◽  
Arterial Disease ◽  
Hybrid Technique ◽  
Minimally Invasive Techniques ◽  
Arterial Segment ◽  
Endovascular Interventions ◽  
Atherosclerotic Lesions ◽  
Peripheral Arterial ◽  
Invasive Techniques

The purpose of this study was to assess the effect of metabolic disorders on the effects of revascularization in patients with obliterating atherosclerosis. Materials and methods. The reconstruction was performed in 253 patients with femoral-tibial arterial segment lesion (98 open operations, 116 endovascular interventions and 39 patients were treated with hybrid technique). Results. Endovascular revascularization techniques are justified in case of disorders of carbohydrate metabolism. Conventional operations remain the method of choice in the case of those variants of atherosclerotic lesions, where minimally invasive techniques are impossible. Conclusions. Metabolic disorders in patients with peripheral atherosclerosis on the background of severe comorbid pathology may be the basis for choosing hybrid methods of revascularization.

Predicting the prevalence of peripheral arterial diseases: modelling and validation in different cohorts

VASA ◽  
2016 ◽  
Vol 45 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Yiqiang Zhan ◽  
Jie Zhuang ◽  
Ying Dong ◽  
Hong Xu ◽  
Dayi Hu ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Pulse Pressure ◽  
Smoking Status ◽  
Density Lipoprotein ◽  
Arterial Disease ◽  
Operating Characteristics ◽  
Goodness Of Fit Test ◽  
Training Cohort ◽  
Peripheral Arterial Diseases ◽  
Peripheral Arterial

Abstract. Background: To develop models for prevalence estimation of peripheral arterial disease (PAD) and to validate them in an external cohort. Methods: Model training cohort was a population based cross-sectional survey. Age, sex, smoking status, body mass index, total cholesterol (TC), high density lipoprotein (HDL), TC/HDL ratio, low density lipoprotein, fasting glucose, diabetes, hypertension, pulse pressure, and stroke history were considered candidate predicting variables. Ankle brachial index ≤ 0.9 was defined as the presence of peripheral arterial disease. Logistic regression method was used to build the prediction models. The likelihood ratio test was applied to select predicting variables. The bootstrap method was used for model internal validation. Model performance was validated in an external cohort. Results: The final models included age, sex, pulse pressure, TC/HDL ratio, smoking status, diabetes, and stroke history. Area under receiver operating characteristics (AUC) with 95% confidence interval (CI) of the final model from the training cohort was 0.74 (0.70, 0.77). Model validation in another cohort revealed AUC (95% CI) of 0.72 (0.70, 0.73). P value of Hosmer-Lemeshow’s model goodness of fit test was 0.75 indicating good model calibration. Conclusions: The developed model yielded a moderate usefulness for predicting the prevalence of PAD in general population.

Sign in / Sign up

Export Citation Format

Share Document