scholarly journals Robotized ultrasound imaging of the peripheral arteries – a phantom study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Felix von Haxthausen ◽  
Jannis Hagenah ◽  
Mark Kaschwich ◽  
Markus Kleemann ◽  
Verónica García-Vázquez ◽  
...  
Keyword(s):  
Arterial Disease ◽  
Peripheral Arteries ◽  
Vessel Lumen ◽  
First Choice ◽  
The Us ◽  
Image Center ◽  
2D Ultrasound ◽  
The Mean ◽  
Peripheral Arterial ◽  
Complex Scenario

AbstractThe first choice in diagnostic imaging for patients suffering from peripheral arterial disease (PAD) is 2D ultrasound (US). However, for a proper imaging process, a skilled and experienced sonographer is required. Additionally, it is a highly user-dependent operation. A robotized US system that autonomously scans the peripheral arteries has the potential to overcome these limitations. In this work, we extend a previously proposed system by a hierarchical image analysis pipeline based on convolutional neural networks (CNNs) in order to control the robot. The system was evaluated by checking its feasibility to keep the vessel lumen of a leg phantom within the US image while scanning along the artery. In 100% of the images acquired during the scan process the whole vessel lumen was visible. While defining an insensitivity margin of 2.74 mm, the mean absolute distance between vessel center and the horizontal image center line was 2.47 mm and 3.90 mm for an easy and complex scenario, respectively. In conclusion, this system presents the basis for fully automatized peripheral artery imaging in humans using a radiation-free approach.

High tolerance of progressive elastic compression in peripheral arterial disease

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 413-417 ◽  
Author(s):  
Serge Couzan ◽  
Jean-François Pouget ◽  
Claire Le Hello ◽  
Céline Chapelle ◽  
Silvy Laporte ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Return Flow ◽  
High Tolerance ◽  
Compression Stockings ◽  
Short Term ◽  
Poor Tolerance ◽  
The Mean ◽  
Peripheral Arterial

Summary. Background: Theoretically progressive compression stockings, which produce a higher compression at the calf than at the ankle level, improve venous return flow without exacerbating peripheral arterial insufficiency (PAD). We aimed to evaluate the short-term tolerance of elastic progressive compression stockings on peripheral arterial vascularisation in patients with symptomatic PAD and associated mild venous insufficiency. Patients and methods: Monocentric, prospective, open pilot study of 18 patients (acceptability study, 6 x 6 plan) evaluating the short-term tolerance of progressive compression stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in patients with PAD (ankle brachial index ABI > 0.60 < 0.75) and chronic venous insufficiency (C1s–C4 stages of the CEAP classification). Day 15 tolerance was evaluated by a composite primary criteria comprising: no decrease > 15 % of ABI on each side, no decrease > 15 % of toe brachial index (TBI) on each side and no decrease > 25 % of the number of active plantar flexions performed while standing. Results: The proportion of men was 77.8 %, mean age was 77.3 ± 7.5 years and no patient were diabetic. At inclusion, the mean low ABI was 0.60 ± 0.04 and the mean high ABI was 0.77 ± 0.18. The mean low TBI was 0.32 ± 0.09 and the mean high TBI 0.46 ± 0.15. The mean number of active standing plantar flexions was 33.0 ± 5.0. The majority of the patients were classified in CEAP C2s and C3 classes (class 2: 16.7 %, class C2s: 27.8 %, class C3: 44.4 %, class C4: 5.6 % and class C4s: 5.6 %). Poor tolerance occurred in no patient. By day 30, no patient had worsening of their arterial and venous symptoms. No adverse events occurred during the study. Conclusions: These results suggest a high tolerance of progressive elastic stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in symptomatic PAD.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

scholarly journals The relation of anatomical distribution of symptomatic peripheral arterial disease (PAD) with HbA1c level in patients with type 2 diabetes mellitus

2021 ◽  
Vol 12 ◽  
pp. 204201882110005
Author(s):  
Nawaf J. Shatnawi ◽  
Nabil A. Al-Zoubi ◽  
Hassan M. Hawamdeh ◽  
Yousef S. Khader ◽  
Mowafeq Heis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Hba1c Level ◽  
Arterial Disease ◽  
Anatomical Distribution ◽  
The Mean ◽  
Peripheral Arterial

Aims: Increased level of glycated hemoglobin (HbA1c) is associated with an increased prevalence of peripheral arterial disease (PAD). This study aimed to assess the relationship between the anatomical distribution of symptomatic PAD lesions in patients with type 2 diabetes and HbA1c levels at the time of PAD diagnosis. Patients and methods: A retrospective study was conducted at King Abdullah University Hospital during the period August 2011 to December 2015. Consecutive patients with type 2 diabetes presented with symptomatic PAD confirmed by computed tomography-angiography (CTA) were included in this study. CTA images were reviewed. Relevant information including demographic data, PAD symptoms, comorbidities, HbA1c level, lipid profile, C-reactive protein and the mean platelets volume were retrieved from medical records. Results: A total of 332 patients with type 2 diabetes (255 males and 77 females) were included in this study. The mean HbA1c at the time of PAD diagnosis was 8.68% (±2.06%). The prevalence of hemodynamic relevant atherosclerotic lesions of the superficial femoral artery, popliteal artery, leg vessels, femoro-popliteal, and crural segments was significantly higher in patients with HbA1c >7.5% compared with patients with HbA1c ⩽7.5%. Conclusion: The anatomical distribution of symptomatic PAD in patients with type 2 diabetes mellitus differed significantly according to HbA1c level at the time of PAD diagnosis.

scholarly journals Case Report: ENDOVASCULAR STENTING IN PERIPHERAL ARTERIAL DISEASE OF LOWER EXTREMITY

2017 ◽  
Vol 52 (2) ◽  
pp. 140
Author(s):  
Yudi Her Oktaviono
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Transluminal Angioplasty ◽  
Focal Lesions ◽  
First Choice ◽  
History Of ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency. Especially for high-grade stenoses or short arterial occlusions, percutaneous transluminal angioplasty (PTA) should be the method of first choice followed by the best surgical procedure later on. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures and risk factor control is mandatory.

scholarly journals The Influence of Heating on Toe pressure in Patients with Peripheral Arterial Disease

2017 ◽  
Vol 107 (1) ◽  
pp. 62-67 ◽  
Author(s):  
N. Settembre ◽  
T. Kagayama ◽  
P. Kauhanen ◽  
P. Vikatmaa ◽  
Y. Inoue ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Skin Temperature ◽  
Arterial Disease ◽  
Pressure Measurements ◽  
Baseline Measurement ◽  
The Third ◽  
The Mean ◽  
Peripheral Arterial ◽  
Different Response ◽  
Toe Pressure

Background and Aim: The toe skin temperature in vascular patients can be low, making reliable toe pressure measurements difficult to obtain. The aim of this study was to evaluate the effect of heating on the toe pressure measurements. Materials and Methods: A total of 86 legs were examined. Brachial pressure and toe pressure were measured at rest in a supine position using a laser Doppler device that also measured skin temperature. After heating the toes for 5 min with a heating pad, we re-measured the toe pressure. Furthermore, after heating the skin to 40° with the probe, toe pressures were measured a third time. Results: The mean toe skin temperature at the baseline measurement was 24.0 °C (standard deviation: 2.8). After heating the toes for 5 min with a warm heating pad, the skin temperature rose to a mean 27.8 °C (standard deviation: 2.8; p = 0.000). The mean toe pressure rose from 58.5 (standard deviation: 32) to 62 (standard deviation: 32) mmHg (p = 0.029). Furthermore, after the skin was heated up to 40 °C with the probe, the mean toe pressure in the third measurement was 71 (standard deviation: 34) mmHg (p = 0.000). The response to the heating varied greatly between the patients after the first heating—from −34 mmHg (toe pressure decreased from 74 to 40 mmHg) to +91 mmHg. When the toes were heated to 40 °C, the change in to toe pressure from the baseline varied between −28 and +103 mmHg. Conclusion: Our data indicate that there is a different response to the heating in different clinical situations and in patients with a different comorbidity.

Infrainguinal Arterial Intervention: Is There a Role for an Atherectomy Device?

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Leila Mureebe ◽  
James F. McKinsey
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Atheromatous Plaque ◽  
Peripheral Arteries ◽  
Invasive Treatment ◽  
Attractive Option ◽  
Percutaneous Removal ◽  
Peripheral Arterial ◽  
Redwood City

Excision of atheromatous plaque is an attractive option for the minimally invasive treatment of peripheral arterial disease. Approved for use in 2003, the SilverHawk Plaque Exicison System (FoxHollow Technologies, Redwood City, CA) is a catheter-based plaque excision device allowing percutaneous removal of atheromatous material. This device represents the most recent generation of atherectomy tools. Overall experience with plaque debulking in the peripheral arteries spans almost two decades, and understanding of the technique continues to evolve. This article reviews the technology, current practices, and data on plaque excision.

Abstract 318: Determinants of Red Blood Cell Omega-3-Fatty Acid Content in Patients With Peripheral Arterial Disease

2014 ◽  
Vol 34 (suppl_1) ◽  
Author(s):  
Emily V Nosova ◽  
Christopher D Owens ◽  
Karen C Chong ◽  
Hugh F Alley ◽  
Michael S Conte ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Peripheral Arterial Disease ◽  
Blood Cell ◽  
Fish Oil ◽  
Red Blood Cell ◽  
Arterial Disease ◽  
Omega 3 ◽  
History Of ◽  
The Mean ◽  
Peripheral Arterial

Objectives: Despite available medical therapies, patients with peripheral arterial disease (PAD) remain at high risk for cardiovascular events. n-3 polyunsaturated fatty acids (PUFAs), derived from marine sources, have been shown to improve cardiovascular mortality. The omega-3 index (O3I), a proportion of the n-3 PUFAs eicosapentanoic acid and docosahexanoic acid in the red blood cell membrane, correlates with cardiovascular risk. We sought to determine the clinical factors associated with the O3I in patients with PAD. Methods: This cross-sectional study included 111 patients, who had an ankle-brachial index of < 0.9 associated with claudication symptoms. We used linear regression to determine the association between demographic and lifestyle factors and the O3I. Results: The mean age of the cohort was 69 ± 8 years, 37% had diabetes mellitus (Hemoglobin A1c: 7 ± 1%), and 94% had smoked. The mean O3I was 5 ± 2%. Table 1 shows the variables associated with O3I in regression analyses. In a multivariate model, an independent association was maintained with increasing age, BMI, and a history of smoking and fish oil intake. Conclusions: In a cohort of patients with PAD, older age, elevated BMI, and prior fish oil supplementation predicted a higher O3I. A history of smoking correlated with a lower O3I. Our findings suggest that targeting nutrition and tobacco use with therapeutic interventions has potential to reduce cardiovascular risk among PAD patients.

scholarly journals Relationship between vascular age and atherosclerosis-related cardiovascular diseases

2021 ◽  
Vol 26 (6) ◽  
pp. 4540
Author(s):  
R. N. Najafov
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Diseases ◽  
Arterial Disease ◽  
Clinical Tool ◽  
Positive Correlation ◽  
Chi Squared ◽  
Vascular Age ◽  
Online Calculator ◽  
The Mean ◽  
Peripheral Arterial

Aim. To determine the relationship between vascular age (VA) and atherosclerosis-related cardiovascular diseases in patients with hypertension and hyperlipidemia.Material and methods. The study involved 241 residents of Baku. The mean age was 58,7±10,9 years. There were 119 women (49,4%) and 122 (50,6%) men. The mean body mass index was 27,77±4,19 kg/m2. Data on family history, smoking, obesity, diabetes, chronic kidney disease, revascularization, peripheral arterial disease, angina pectoris, drug intake, lipid profile, systolic and diastolic blood pressure were analyzed. Patient VA was estimated using an online calculator.Results. The patient VA was on average 78,0±15,1 years. Pearson's correlation analysis showed a positive correlation between biological age (BA) and estimated VA (0,719; 95% confidence interval: 0,651-0,775; p<0,001). Pearson's chi-squared test with Monte Carlo simulation showed that within 10-month followup, myocardial infarction (MI) in presented sample was more common in age subgroups of 50-59 (10,0%) and 60-69 (8,3%) years. At the same time, in the group defined by VA, myocardial infarction was more common in the age subgroup of 70-79 (7,0%) and >80 years (13,3%). MI+stroke+revascularization in the group defined by BA was more common in age subgroups of 50-59 (12,0%) and 60-69 (14,5%) years, and in the group defined by VA, MI+stroke+revascularization was more common in age subgroups of 70-79 (11,6%) and >80 years (19,9%).Conclusion. A significant positive correlation was found between BA and VA. In case of VA >70 years, the incidence of MI+stroke+revascularization increases approximately 3-5 times. Thus, the assessment of VA is an effective clinical tool that allows to inform the patient about possible cardiovascular events and to develop preventive measures.

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