scholarly journals Evaluation of preoperative computed tomography angiography in association with conventional angiography versus computed tomography angiography only, in the endovascular treatment of aortic diseases

2013 ◽  
Vol 46 (5) ◽  
pp. 265-272 ◽  
Author(s):  
Patrick Bastos Metzger ◽  
Eduardo Rafael Novero ◽  
Fabio Henrique Rossi ◽  
Samuel Martins Moreira ◽  
Frederico Augusto Linhares ◽  
...  

Objective To evaluate the association of conventional angiography (AG) with computed tomography angiography (CTA) as compared with CTA only, preoperatively, in the treatment of aortic diseases. Materials and Methods Retrospective study involving patients submitted to endovascular treatment of aortic diseases, in the period from January 2009 to July 2010, with use of preoperative CTA + conventional AG or CTA only. The patients were divided into two groups, namely: G1 – thoracic aortic diseases; and G2 – abdominal aortic diseases. G1 was subdivided into 1A (preoperative AG + CTA) and 1B (preoperative CTA). G2 was subdivided into 2C (CTA + AG) and 2D (CTA only). Results The authors evaluated 156 patients. In subgroups 1A and 1B, the rate of technical success was, respectively, 100% and 94.7% (p = 1.0); and the rate of therapeutic success was, respectively, 81% and 58% (p = 0.13). A higher number of complications were observed in subgroup 1B (p = 0.057). The accuracy in the calculation of the prosthesis was higher in subgroup 1A (p = 0.065). In their turn, the rate of technical success in subgroups 2C and 2D was, respectively, 92.3% and 98.6% (p = 0.17). The rate of therapeutic success was 73% and 98.6% (p = 0.79). Conclusion Preoperative conventional AG should be reserved for cases where CTA cannot provide all the information in the planning of a therapeutic intervention.

2008 ◽  
Vol 65 (3) ◽  
pp. 365-376 ◽  
Author(s):  
Roberto Iezzi ◽  
Antonio Raffaele Cotroneo ◽  
Riccardo Marano ◽  
Antonella Filippone ◽  
Maria Luigia Storto

2020 ◽  
Vol 73 (1-2) ◽  
pp. 29-35
Author(s):  
Aleksandar Spasic ◽  
Viktor Till ◽  
Marijana Basta-Nikolic ◽  
Djordje Milosevic ◽  
Darka Hadnadjev-Simonji ◽  
...  

Introduction. Imaging is essential in the assessment of endovascular infrarenal abdominal aortic repair results. Complications include endoleaks, graft migration, kinking and infolding, stenosis, occlusion, and secondary ruptures. Examination Modalities. Contemporary imaging strategies are based on using noninvasive imaging modalities. After endovascular infrarenal abdominal aortic repair, the standard evaluation modality is computed tomography angiography, whereas additional modalities include magnetic resonance imaging, ultrasonography, and radiography. However, although an invasive imaging method, digital subtraction angiography is still performed in some patients. Computed tomography angiography provides excellent contrast, spatial resolution, and exact measurements of structures of interest, which is essential in the follow-up. Follow-up Protocol. Currently recommended follow-up protocol in the first year is contrast- enhanced computed tomography imaging at 1 and 12 months after the procedure. Conclusion. Due to its characteristics, reproducibility and availability, computed tomography angiography remains the cornerstone diagnostic modality of post-procedural assessment in patients with endovascular infrarenal abdominal aortic repair.


Stroke ◽  
2021 ◽  
Author(s):  
Vera Sharashidze ◽  
Raul G. Nogueira ◽  
Alhamza R. Al-Bayati ◽  
Nirav Bhatt ◽  
Fadi B Nahab ◽  
...  

Background and Purpose: Carotid web (CaW) is an intimal form of fibromuscular dysplasia (FMD) involving the carotid bulb which has been increasingly recognized as a potential cause of recurrent ischemic strokes. It is overlooked as a separate entity and often dismissed if no coexistent signs of classic FMD changes are observed. We aim to evaluate the frequency of classic FMD in high-yield vascular territories in patients with symptomatic CaW. Methods: This was a retrospective analysis of a symptomatic CaW database of 2 comprehensive stroke centers (spanning September 2014–October 2020). The diagnosis of a CaW during a stroke workup was defined as the presence of a shelf-like linear filling defect in the posterior aspect of the carotid bulb on computed tomography angiography in patients with acute ischemic stroke or transient ischemic attack of undetermined cause after a thorough evaluation. Neck computed tomography angiography and renal conventional angiography images were independently evaluated by two readers blinded to the laterality and clinical details to inspect the presence of underlying classic FMD. Results: Sixty-six patients with CaW were identified. Median age was 51 years (interquartile range, 42–57), and 74% were women. All patients had neck computed tomography angiography (allowing for bilateral vertebral and carotid evaluation), whereas 47 patients had additional digital subtraction angiography (which evaluated 47 carotids ipsilateral to the stroke and 10 contralateral carotids). Internal carotid artery classic FMD changes were noted in only 6 out of 66 (9%) in the ipsilateral carotids. No contralateral carotid or vertebral artery classic FMD changes were observed. Renal artery catheter-based angiography was obtained in 16 patients/32 arteries and only 1 patient/2 renal arteries demonstrated classic FMD changes. Conclusions: CaW phenotype is uncommonly associated with classic FMD changes. Coexistent classic FMD does not constitute a useful marker to corroborate or exclude CaW diagnosis.


Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1493-1502
Author(s):  
Eveline J.A. Wiegers ◽  
Maxim J.H.L. Mulder ◽  
Ivo G.H. Jansen ◽  
Esmee Venema ◽  
Kars C.J. Compagne ◽  
...  

Background and Purpose— Collateral circulation status at baseline is associated with functional outcome after ischemic stroke and effect of endovascular treatment. We aimed to identify clinical and imaging determinants that are associated with collateral grade on baseline computed tomography angiography in patients with acute ischemic stroke due to an anterior circulation large vessel occlusion. Methods— Patients included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; n=500) and MR CLEAN Registry (n=1488) were studied. Collateral status on baseline computed tomography angiography was scored from 0 (absent) to 3 (good). Multivariable ordinal logistic regression analyses were used to test the association of selected determinants with collateral status. Results— In total, 1988 patients were analyzed. Distribution of the collateral status was as follows: absent (7%, n=123), poor (32%, n=596), moderate (39%, n=735), and good (23%, n=422). Associations for a poor collateral status in a multivariable model existed for age (adjusted common odds ratio, 0.92 per 10 years [95% CI, 0.886–0.98]), male (adjusted common odds ratio, 0.64 [95% CI, 0.53–0.76]), blood glucose level (adjusted common odds ratio, 0.97 [95% CI, 0.95–1.00]), and occlusion of the intracranial segment of the internal carotid artery with occlusion of the terminus (adjusted common odds ratio 0.50 [95% CI, 0.41–0.61]). In contrast to previous studies, we did not find an association between cardiovascular risk factors and collateral status. Conclusions— Older age, male sex, high glucose levels, and intracranial internal carotid artery with occlusion of the terminus occlusions are associated with poor computed tomography angiography collateral grades in patients with acute ischemic stroke eligible for endovascular treatment.


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