Intravascular Ultrasound Guidance for Peripheral Vascular Interventions

1994 ◽  
Vol 1 (1) ◽  
pp. 71-80 ◽  
Author(s):  
Marco Scoccianti ◽  
Christopher S. Verbin ◽  
George E. Kopchok ◽  
Martin R. Back ◽  
Carlos E. Donayre ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ultrasound Guidance ◽  
Long Term Results ◽  
Cross Sectional ◽  
Future Studies ◽  
Endovascular Interventions ◽  
Interventional Devices ◽  
Intravascular Stents ◽  
Ivus Imaging

Intravascular ultrasound (IVUS) imaging during peripheral endovascular interventions adds important information regarding the distribution of disease by providing controlled measurements of the cross-sectional area of the vessel lumen and wall prior to and following procedures. IVUS is useful in determining the mechanism and efficacy of balloon angioplasty, in guiding atherectomy devices, and in assuring appropriate placement of intravascular stents. The incorporation of an IVUS element into catheter-based interventional devices may improve the immediate and long-term results of endovascular interventions by decreasing complications from dissection and perforation of the arterial wall. Combined IVUS-stent prototype catheters are being developed to enable imaging and deployment simultaneously. Similar devices are being explored to enhance expedient, precise delivery of endoluminal grafts. Future studies of endovascular techniques should include IVUS, when possible, to accurately quantitate the initial efficacy of devices and to determine the nature and distribution of recurrent lesions.

The Clinical Value of Three-Dimensional Intravascular Ultrasound Imaging

1995 ◽  
Vol 2 (4) ◽  
pp. 356-364 ◽  
Author(s):  
Donald B. Reid ◽  
Myles Douglas ◽  
Edward B. Diethrich
Keyword(s):  
Intravascular Ultrasound ◽  
Three Dimensional ◽  
Longitudinal Axis ◽  
Three Dimensions ◽  
Clinical Value ◽  
Intravascular Ultrasound Imaging ◽  
Endovascular Interventions ◽  
Exact Reconstruction ◽  
Intravascular Stents ◽  
Ivus Imaging

Two-dimensional (2D) intravascular ultrasound (IVUS) imaging can now be reconstructed into three dimensions from serial 2D images captured following a “pullback” of the IVUS catheter through the target site. Three-dimensional (3D) reconstructions provide “longitudinal” and “volume” images. The former is similar to an angiogram and can be examined in three dimensions by rotating the image around its longitudinal axis, providing clinically useful information during endovascular procedures. The volume view takes longer to create and is not an exact reconstruction, but it provides images that can be rotated into any spatial position. It visualizes the luminal aspect of the vessel particularly well. The clinical value of 3D IVUS is in the diagnosis of vascular disease and the assessment of endovascular interventions. Three-dimensional IVUS, which provides better, more informative images than 2D IVUS, can be particularly useful intraprocedurally in detecting inaccurate deployment of intravascular stents and endoluminal grafts.

scholarly journals The earlier, the better or the worse? Towards accurate management of patients with arthralgia at risk for RA

2020 ◽  
Vol 79 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Annette van der Helm-van Mil ◽  
Robert B M Landewé
Keyword(s):  
Daily Practice ◽  
Long Term Results ◽  
Current Status ◽  
Controlled Trials ◽  
Future Studies ◽  
Clinical Arthritis ◽  
The One ◽  
Firm Evidence ◽  
Early Phases

The favourable long-term results of early treatment in patients with classified rheumatoid arthritis have resulted in an increasing interest in the diseases phases preceding clinical arthritis. The hypothesis to test is that an intervention in these early phases may better prevent or reduce disease persistence than an intervention when arthritis has become clinically manifest. While several placebo-controlled trials are still ongoing, to date there is no firm evidence that this hypothesis truly holds. Therefore, it is important to reflect on the current status of arthralgia preceding clinical arthritis. Inherent to every new field of research, attitudes are conflicting, with opinions propagating innovation (based on the fear of undertreatment) on the one hand, and critical sounds pleading for more restraint (fear of overtreatment) on the other hand. In this Viewpoint, we will examine these divergent opinions, relate them to a preferred ultimate scenario and provide considerations for future studies and daily practice.

scholarly journals Long-Term Results of Endovascular Femoropopliteal Interventions

2018 ◽  
Vol 27 (03) ◽  
pp. 151-157 ◽  
Author(s):  
Luke Marone ◽  
Robert Hacker
Keyword(s):  
Limb Salvage ◽  
Univariate Analysis ◽  
Limb Ischemia ◽  
Major Amputation ◽  
Long Term Results ◽  
Secondary Patency ◽  
Endovascular Interventions ◽  
Significant Difference ◽  
Societal Consensus

Background and Objective Short-term results of endovascular intervention for femoropopliteal lesions have been extensively reported; however, there exists a paucity of long-term objective data related to outcomes of these interventions. We sought to characterize these long-term results including patency, limb salvage, and mortality. Methods From May 2003 to July 2009, all patients who underwent technically successful endovascular balloon angioplasty and/or stenting for Trans-Atlantic Inter-Societal Consensus (TASC) II B, C, and D lesions were identified in a retrospective fashion. Patient demographics, clinical characteristics, arterial noninvasive data, and angiographic anatomic data were evaluated. Results A total of 236 limbs in 186 patients (mean age 74, range 37–94) were treated. Lesion distributions by TASC II classification B, C, and D were 121 (51.3%), 37 (15.7%), and 78 (33%), respectively. Critical limb ischemia (CLI) was the indication for intervention in 42.4% of patients. Five-year primary and primary-assisted patency rates stratified by TASC II classification were B: 55.1%, 91.9%; C: 37.4%, 74.6%; D: 35.5%, 67%, respectively (p = 0.23). Secondary patency based on TASC II classification was B: 92.9%, C: 83%, and D: 75.9%, respectively. Univariate analysis identified age > 75, CLI, and cerebrovascular disease as predictors for loss of patency. Reinterventions to maintain patency were required in 26.5% of TASC II B, 43.2% of TASC II C, and 25.6% of TASCII D lesions (p = NS) and mean time to reintervention ranged from 22 to 29 months with no significant difference related to TASC II classification. A total of eight limbs (3.38%) were converted to open revascularization with two (0.85%) having a change in their initial preoperatively identified bypass target site. Three limbs (1.27%) required a major amputation during follow-up. Survival at 5 years was 44.3%; CLI and smoking were identified as risk factors for death (hazard ratio [HR] 2.6, 1.75–3.84, p < 0.001, HR 3.33, 1.70–6.52, p < 0.001), respectively. Conclusion Long-term patency of endovascular interventions for complicated femoropopliteal lesions is acceptable across TASC II classification and is associated with excellent limb salvage. Mortality in this patient cohort is significant with CLI and smoking being identified as predictors of death.

How Does the Pathophysiology Influence the Treatment of Pelvic Congestion Syndrome and is the Result Long-lasting?

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 58-64 ◽  
Author(s):  
M Greiner ◽  
M Dadon ◽  
P Lemasle ◽  
P Cluzel
Keyword(s):  
Long Term Results ◽  
Cross Sectional ◽  
Pelvic Congestion Syndrome ◽  
Venous Anomalies ◽  
Embolic Agents ◽  
Cross Sectional Imaging ◽  
Pelvic Congestion

The objectives of this study are to consider the influence of pathophysiology in the treatment of pelvic congestion syndrome (PCS) and to determine the criteria which impact on the long-term results. A classification of venous pathology including three types of pathophysiological conditions, independent of the location of the pelvic venous pathology, is developed and illustrated. These types, diagnosed by cross-sectional imaging and confirmed by phlebography, are associated with a specific therapeutic plan. The long-term results are dependent on the quality of the initial Phlebographic mapping that must be selective and complete, the angiographic findings, in particular the study of collaterals feeding the venous anomalies, the treatment of all venous anomalies, the respect of contraindications, the use of appropriate materials and the occurrence of new pregnancies. In conclusion, the feasibility and satisfactory short-term results of endovascular treatment of PCS are admitted. Questions remain regarding the effectiveness of the different embolic agents and the long-term results of this treatment.

AS-138: Clinical Long-Term Outcomes after DES Stenting with or without Intravascular Ultrasound Guidance

2010 ◽  
Vol 105 (9) ◽  
pp. 59A ◽  
Author(s):  
Noriyuki Kinoshita ◽  
Keisuke Ohota ◽  
Takeshi Yamada ◽  
Nobuyuki Miyai ◽  
Reo Nakamura ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ultrasound Guidance ◽  
Long Term Outcomes

scholarly journals Role for Endovascular Therapy in Chronic Mesenteric Ischemia

2009 ◽  
Vol 23 (5) ◽  
pp. 365-373 ◽  
Author(s):  
Romaric Loffroy ◽  
Eric Steinmetz ◽  
Boris Guiu ◽  
Valérie Molin ◽  
Benjamin Kretz ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Mesenteric Ischemia ◽  
Rare Condition ◽  
Primary Treatment ◽  
Transluminal Angioplasty ◽  
Mesenteric Arteries ◽  
Long Term Results ◽  
Chronic Mesenteric Ischemia ◽  
Interventional Devices

Chronic mesenteric ischemia is a rare condition that is caused by stenosis or occlusion of the mesenteric arteries and usually manifests as abdominal pain. While surgical revascularization has been the standard treatment for symptomatic patients, recent advances in interventional devices and techniques have made endovascular treatment feasible and effective. Percutaneous transluminal angioplasty with stent placement is now recognized as a minimally invasive means of obtaining good long-term results with an acceptable recurrence rate; consequently, the technique is suggested for the primary treatment of chronic mesenteric ischemia. The present article discusses the indications and principles of endovascular treatment, and reviews the literature, with emphasis on short- and long-term outcomes, particularly morbidity and mortality rates.

Intravascular Ultrasound: The Ultimate Tool for Abdominal Aortic Aneurysm Assessment and Endovascular Graft Delivery

1997 ◽  
Vol 4 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Rodney A. White ◽  
Carlos Donayre ◽  
George Kopchok ◽  
Irwin Walot ◽  
Eric Wilson ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Three Dimensional ◽  
Aortic Aneurysms ◽  
Developmental Studies ◽  
Abdominal Aortic ◽  
Device Placement ◽  
Vascular Structures ◽  
Ivus Imaging ◽  
Aortic Morphology

Intravascular ultrasound (IVUS) imaging is a relatively new, rapidly evolving technology that enables precise catheter-based assessment of the dimensions and morphology of vascular structures and lesions. In extensive preclinical laboratory developmental studies and in clinical cases of endograft deployment for treatment of abdominal aortic aneurysms, we have found IVUS invaluable for determining key parameters of aortic morphology before and during interventions and for assessing the accuracy of deployment after device placement. By combining the IVUS data with information obtained from angiography, magnetic resonance imaging, and computed tomography (axial and three-dimensional reconstructions), we have been able to size devices and choose optimal fixation sites to prevent endoleaks and maintain luminal patency acutely and in the long term.

scholarly journals Impact of Post-Procedural Intravascular Ultrasound Findings on Long-Term Results Following Self-Expanding Nitinol Stenting in Superficial Femoral Artery Lesions

2013 ◽  
Vol 77 (6) ◽  
pp. 1543-1550 ◽  
Author(s):  
Kojiro Miki ◽  
Kenichi Fujii ◽  
Masashi Fukunaga ◽  
Daizo Kawasaki ◽  
Masahiko Shibuya ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Long Term Results ◽  
Ultrasound Findings
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