Preoperative Sizing of Grafts for Transfemoral Endovascular Aneurysm Management: A Prospective Comparative Study of Spiral CT Angiography, Arteriography, and Conventional CT Imaging

1997 ◽  
Vol 4 (3) ◽  
pp. 252-261 ◽  
Author(s):  
Ivo A.M.J. Broeders ◽  
Jan D. Blankensteijn ◽  
Marco Olree ◽  
Willem Mali ◽  
Bert C. Eikelboom
Keyword(s):  
Imaging Techniques ◽  
Ct Scanning ◽  
Spiral Ct ◽  
Computed Tomographic Angiography ◽  
Radiological Investigation ◽  
Computed Tomographic ◽  
First Choice ◽  
Conventional Ct ◽  
The Impact ◽  
Graft Selection

Purpose: To define the impact of spiral computed tomographic angiography (CTA) with image reconstruction on graft selection for Transfemoral Endovascular Aneurysm Management (TEAM) by comparing it to conventional computed tomography (CT) and contrast arteriography. Methods: Twenty-one candidates for TEAM were included. The diameters of the superior and inferior aneurysm necks and lengths between the graft attachment sites were measured using the three imaging techniques. These measurements and their consequences on graft selection were studied. Results: The difference in length sizing between spiral CTA and arteriography never exceeded 1 cm; however, lengths measured by conventional CT scanning resulted in underestimation of graft length in 91% of patients. Graft diameters were chosen too small in 62% of the patients when based on arteriographic diameter measurements. A graft of similar diameter was selected by spiral CTA and conventional CT scanning in 81% of the patients, while minor oversizing by conventional CT scanning was found in 14%. Conclusions: Neither conventional CT scanning nor arteriography is adequate as a sole preoperative radiological investigation for TEAM graft sizing. Spiral CTA with image processing produces all information required for selection of tho-optimal graft size and should be regarded the method of first choice for this purpose.

Imaging Modalities for Aortic Endografting

1997 ◽  
Vol 4 (2) ◽  
pp. 111-123 ◽  
Author(s):  
Hugh G. Beebe
Keyword(s):  
Image Processing ◽  
Intravascular Ultrasound ◽  
Imaging Techniques ◽  
Aortic Surgery ◽  
Three Dimensional ◽  
Image Data ◽  
Dimensional Accuracy ◽  
Ct Scanning ◽  
Spiral Ct ◽  
Conventional Ct

One of the most fundamental and influential differences between conventional surgery and endovascular grafting for aortic aneurysm is the central role of imaging in every aspect of management. This review summarizes five imaging techniques for aortic endografting: intravascular ultrasound, contrast angiography, conventional computed tomography (CT), spiral CT with image processing, and magnetic resonance angiography (MRA). External ultrasound and intravascular ultrasound have important relevance to endovascular aortic surgery. Artifacts of arteriography include magnification, thrombus effect, foreshortening of tortuosity, loss of luminal detail, parallax error, and projection errors. Conventional CT scans have artifacts and difficulties also. Diameter measurement by CT suffers from methodology errors and observer variability. If conventional CT and angiography are used for endovascular aortic graft planning, both should be obtained since neither alone provides sufficient data. The use of spiral CT scanning and computerized image processing has clearly aided the preoperative definition of aneurysm morphology both in terms of dimensional accuracy and by adding diagnostic information. MRA is capable of producing three-dimensional images, axial sections, and longitudinal projections in any plane. It can detect blood flow without contrast medium, but gadolinium enhances MRA by avoiding the “signal dropout” artifact. Technology exists to provide new forms of imaging for endovascular surgery that combines three-dimensional models with on-line image data in a process called “data fusion.” This may offer improved ease and accuracy for conducting endovascular procedures in the future.

Diagnostic workup and endovascular treatment of popliteal artery trauma

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Cheong J. Lee ◽  
Rory Loo ◽  
Max V. Wohlauer ◽  
Parag J. Patel
Keyword(s):  
Vascular Injury ◽  
Gold Standard ◽  
Imaging Techniques ◽  
Computed Tomographic Angiography ◽  
Vascular Trauma ◽  
Endovascular Techniques ◽  
Computed Tomographic ◽  
Arterial Injuries ◽  
Arterial Trauma ◽  
Peripheral Arterial

Abstract. Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard. Initial clinical assessment of vascular injury is aided by readily available imaging techniques such as duplex ultrasonography and high resolution computed tomographic angiography. Conventional catheter based angiography, however, remain the gold standard in the determination of vascular injury. There are limited data examining the outcomes of endovascular techniques to address popliteal arterial injuries. In this review, we examine the imaging modalities and current approaches and data regarding endovascular techniques for the management popliteal arterial trauma.

scholarly journals Mitral Annular Caseous Calcification: A Rare Variant of a Common Echocardiographic Finding Discovered with Advanced Imaging Techniques

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
William L. Pomeroy ◽  
Brian Markelz ◽  
Kevin Steel ◽  
Ahmad M. Slim
Keyword(s):  
Mitral Valve ◽  
Imaging Techniques ◽  
Computed Tomographic Angiography ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Echocardiographic Finding ◽  
Artery Disease ◽  
Tomographic Angiography ◽  
Annular Calcification ◽  
Vessel Coronary Artery

We present the case of a 90-year-old diabetic male and medically managed three-vessel coronary artery disease with evidence of an oval, nonmobile echo-density located on the posterior mitral valve annulus measuring two centimeters in diameter without significant impingement of the mitral valve on initial screening echocardiogram which was initially thought to be prominent mitral annular calcification which was later confirmed to be a rare case of caseoma as confirmed by both cardiac magnetic resonance (CMR) as well as coronary computed tomographic angiography (CCTA).

Impact of Several Factors on the Diagnostic Interpretability of Coronary Computed Tomographic Angiography Using a 256-Detector Row CT Scanner

2021 ◽  
Vol 17 ◽  
Author(s):  
Lixue Xu ◽  
Nan Luo ◽  
Yi He ◽  
Zhenghan Yang
Keyword(s):  
Predictive Value ◽  
Signal To Noise Ratio ◽  
Invasive Coronary Angiography ◽  
Computed Tomographic Angiography ◽  
Ct Scanner ◽  
Logistic Regression Models ◽  
Computed Tomographic ◽  
Stenosis Severity ◽  
Calcium Load ◽  
The Impact

Purpose: To explore the impact of patient-related, vessel-related, image quality-related and cardiovascular risk factors on CCTA interpretability using 256-detector row Computed Tomography (CT). Methods: One hundred ten patients who underwent CCTA and Invasive Coronary Angiography (ICA) were consecutively retrospectively enrolled from January 2018 to October 2018. Using ICA as the reference standard, ≥50% diameter stenosis was defined as the cut-off criterion to detect the diagnostic performance of CCTA. Diagnostic reproducibility was investigated by calculating the interrater reproducibility of CCTA. Multiple logistic regression models were performed to evaluate the impact of 14 objective factors. Results: A total of 1019 segments were evaluated. The per-segment sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CCTA were 76.8%, 93.7%, 91.2%, 67.8% and 95.9%, respectively. The per-segment diagnostic reproducibility was 0.44 for CCTA. Regarding accuracy, a negative association was found for stenosis severity, calcium load and hyperlipidaemia. Regarding sensitivity, calcium load and diabetes mellitus (DM) were positively related. Regarding specificity, a negative correlation was observed between stenosis severity and calcium load. Regarding interrater reproducibility, stenosis severity and calcium load were negatively associated, whereas male sex and the signal-to-noise ratio (SNR) were positively related (all p<0.05). Conclusion: Per-segment 256-detector row CCTA performance was optimal in stenosis-free or occluded segments. Heavier calcium load was associated with poorer CCTA interpretability. On the one hand, our findings confirmed the rule-out value of CCTA; on the other hand, they suggested improvements in calcium subtractions and deep learning-based tools to improve CCTA diagnostic interpretability.

Aneurysm Sac Pressure Measurement with a Pressure Sensor in Endovascular Aortic Aneurysm Repair

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 264-269 ◽  
Author(s):  
Lisandro Carnero ◽  
Ross Milner
Keyword(s):  
Imaging Techniques ◽  
Standard Of Care ◽  
Computed Tomographic Angiography ◽  
Current Standard ◽  
Pressure Sensing ◽  
Computed Tomographic ◽  
Radiologic Imaging ◽  
The Us ◽  
Tomographic Angiography ◽  
Aneurysm Repair

Aortic endograft surveillance is a necessity for the lifetime of a patient owing to the risk of endoleaks and device complications. The current standard of care for surveillance is radiologic imaging. The most commonly used modality is computed tomographic angiography. Magnetic resonance angiography and ultrasonography have also been used as surveillance tools. These imaging techniques have risks and limitations, and alternative surveillance tools are being investigated. Remote pressure sensing is a promising technology that can provide adjunctive support to the current imaging modalities. The technology is applicable to both abdominal and thoracic endograft implantation and surveillance. It has recently gained clearance from the US Food and Drug Administration for acute aneurysm exclusion during an abdominal endograft insertion. As more data are accumulated, it may be possible for remote pressure sensing to replace current imaging techniques as the sole modality for endograft surveillance.

scholarly journals Multimodality Imaging in the Diagnosis of Prosthetic Valve Endocarditis: A Brief Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Maxwell D. Eder ◽  
Krishna Upadhyaya ◽  
Jakob Park ◽  
Matthew Ringer ◽  
Maricar Malinis ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Prosthetic Valve Endocarditis ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Duke Criteria ◽  
Positron Emission ◽  
Leukocyte Scintigraphy

Infective endocarditis is a common and treatable condition that carries a high mortality rate. Currently the workup of infective endocarditis relies on the integration of clinical, microbiological and echocardiographic data through the use of the modified Duke criteria (MDC). However, in cases of prosthetic valve endocarditis (PVE) echocardiography can be normal or non-diagnostic in a high proportion of cases leading to decreased sensitivity for the MDC. Evolving multimodality imaging techniques including leukocyte scintigraphy (white blood cell imaging), 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), multidetector computed tomographic angiography (MDCTA), and cardiac magnetic resonance imaging (CMRI) may each augment the standard workup of PVE and increase diagnostic accuracy. While further studies are necessary to clarify the ideal role for each of these imaging techniques, nevertheless, these modalities hold promise in determining the diagnosis, prognosis, and care of PVE. We start by presenting a clinical vignette, then evidence supporting various modality strategies, balanced by limitations, and review of formal guidelines, when available. The article ends with the authors' summary of future directions and case conclusion.

Computed tomographic and endoscopic analysis of supraorbital ethmoid cells

2007 ◽  
Vol 137 (4) ◽  
pp. 562-568 ◽  
Author(s):  
Luo Zhang ◽  
Demin Han ◽  
Wentong Ge ◽  
Jianhua Tao ◽  
Xianzhong Wang ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Ct Scanning ◽  
Spiral Ct ◽  
Sinus Surgery ◽  
Spiral Computed ◽  
Computed Tomographic ◽  
Endoscopic Anatomy ◽  
Frontal Recess ◽  
Frontal Sinuses ◽  
Chinese Subjects

Objectives The aim of this study is to look at the incidence of supraorbital ethmoid cells (SOEC) in normal Chinese subjects by using spiral computed tomography (CT) scanning. In addition, subjects with chronic rhinosinusitis with SOEC were reviewed for endoscopic analysis. Methods A total of 202 normal Chinese subjects underwent spiral CT. Meanwhile, a retrospective review of patients who had undergone endoscopic sinus surgery over a 1-year period was conducted. Results SOEC showed an incidence of 5.4% (22 sides), and all of them arose from the anterior ethmoid cells. On coronal CT, an SOEC might give the appearance of multiple frontal sinuses, type III frontal cells, suprabullar cells, frontal bullar cells, inter-frontal septal cells, or that there was a septation present within the frontal sinus. Meanwhile, 11 chronic rhinosinusitis patients with 12 SOEC were identified. Conclusion A thorough knowledge of endoscopic anatomy and CT of the frontal recess and various fronto-ethmoid cells were required for safe dissection of the SOEC and frontal ostium.

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