scholarly journals Extra & Intravascular Ultrasound (E&IVUS) Guided Intervention for Femoropopliteal Arterial Occlusive Lesions.

2021 ◽  
Author(s):  
Takuya Haraguchi ◽  
Nozomi Sawada ◽  
Masanaga Tsujimoto ◽  
Masato Furuya ◽  
Saori Itai ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Operation Time ◽  
Artery Occlusion ◽  
Short Axis ◽  
Short Axis Image ◽  
Cross Sectional ◽  
Difficult Time ◽  
Combined Use ◽  
Interventional Devices ◽  
Vascular Structures

Abstract Background: Intravascular ultrasound (IVUS) shows vascular structures and positions of interventional devices in cross sectional-short axis to support interventions, especially for complex lesions. On the other hand, extravascular ultrasound (EVUS) visualizes the devices and vessel structures in long and short axis and reduces the radiation exposure by avoiding the use of fluoroscopy during guidewire manipulation. The images obtained from EVUS handling to guide the guidewire manipulation in both long and short axis is more difficult, time consuming, and stressful than IVUS, which is in short axis only. To solve this issue, we propose a novel guidewire crossing method in conjunctive with the use of both modalities, named “extra and intravascular ultrasound (E&IVUS)” guided intervention.Main text: This is the first report of a combined use of EVUS and IVUS for femoropopliteal occlusions. EVUS-guided intervention is mandatory to check the position of the device in long and short axis. However, the images of long axis are sometimes different from the original ones when EVUS is required to image from the short axis to the long axis. E&IVUS allows to dedicate EVUS to acquisition of the long axis and IVUS to the short axis view when confirming the device position. As a result, E&IVUS shortens the operation time and reduces the stress due to the manipulation of the probe to switch from the long to short axis image and vice versa. Moreover, we can accurately manipulate the guidewire to perform intimal tracking according to the information of EVUS long axis and the IVUS short axis images. Case involved a 76-year-old female with right superficial femoral artery occlusion was angiographically contrasted from a contralateral 6-Fr sheath. A hard wire supported with an over-the-wire typed IVUS was advanced into the CTO with EVUS and IVUS to confirm their positions until the guidewire crossing. We repeatedly performed this process, and all intimal tracking succeeded. The drug-coating balloons appropriately sized by IVUS measurement were deployed. Finally, a sufficient blood flow was achieved without complications.Conclusions: E&IVUS is a preferred strategy than using EVUS or IVUS alone. We should evaluate the clinical outcomes of this technique.

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.

Distribution and Characteristics of Intrathoracic Lymphadenopathy in TB/HIV Co-Infection

2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh
Keyword(s):  
Lymph Nodes ◽  
Cross Sectional Study ◽  
Short Axis ◽  
Mediastinal Lymph Nodes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Hilar Adenopathy ◽  
The Right ◽  
Pulmonary Abnormalities

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.

scholarly journals Integrated backscatter-intravascular ultrasound and modification of plaque during excimer laser coronary angioplasty

2021 ◽  
Author(s):  
Satoru Sasaki ◽  
Kenji Nakajima ◽  
Keizo Watanabe ◽  
Yudai Nozaki ◽  
Tadashi Yuguchi ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Excimer Laser ◽  
Coronary Angioplasty ◽  
Coronary Plaque ◽  
Cross Sectional ◽  
Integrated Backscatter ◽  
Before And After ◽  
Vessel Volume ◽  
Integrated Backscatter Intravascular Ultrasound ◽  
Excimer Laser Coronary Angioplasty

AbstractThis study aims to test the hypothesis that the effect of excimer laser coronary angioplasty (ELCA) not only vaporizes thrombi and their underlying coronary plaque, it also changes their quality. We performed a series of cross-sectional analyses in 52 lesions in 51 patients before and after ELCA with integrated backscatter-intravascular ultrasound (IB-IVUS). The constituent parts of the plaque can be assessed by IB-IVUS (i.e., calcified, fibrous, lipid) according to integrated backscatter values. Minimum lumen diameter, lumen volume and vessel volume expanded after ELCA, while plaque volume did not significantly decrease. There was also a decrease of ‘lipid’ component (35.4–30.3%, P < 0.001) and an increase of IB-IVUS-derived ‘fibrous’ part (34.5–38.3%, P < 0.001). These results may help in understanding plaque change after ELCA. Excimer laser coronary angioplasty seems to contribute to the modification of coronary plaque composition in addition to debulking it.

Dimensional disparity between duplex and intravascular ultrasound in the assessment of iliac vein stenosis

2021 ◽  
pp. 1358863X2110036
Author(s):  
Seshadri Raju ◽  
William Walker ◽  
Chandler Noel ◽  
Riley Kuykendall ◽  
Thomas Powell ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Venous Pressure ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Systematic Bias ◽  
Cross Sectional ◽  
External Iliac Vein ◽  
The Difference ◽  
Vein Stenosis ◽  
Linear Regressions

Minimum iliac vein caliber necessary to maintain normal peripheral venous pressure can be derived by the Poiseuille equation. Duplex was compared to intravascular ultrasound (IVUS) in the assessment of iliac vein stenosis in this single center retrospective study. Parallel IVUS and duplex caliber data for common iliac vein (CIV) and external iliac vein (EIV) in 382 limbs were separately compared. One or both segments were stenotic by IVUS criteria in 213 limbs. Neither segment was stenotic by IVUS in 22 limbs. Bland–Altman analyses and Passing–Bablok linear regressions were used. Duplex calibers were dimensionally smaller than corresponding IVUS images of CIV and EIV segments in Bland–Altman comparison by a mean of 54 mm2 and 34 mm2, respectively. Passing–Bablok regression suggested the difference was due to a systematic bias and not proportional. Duplex yields a smaller cross-sectional image of CIV and EIV compared to IVUS. Duplex is not a reliable diagnostic test for iliac vein stenosis.

Aortic root measurement on CT: linear dimensions, aortic root area and comparison with echocardiography. A retrospective cross sectional study

2021 ◽  
Vol 94 (1121) ◽  
pp. 20201232
Author(s):  
Kai'En Leong ◽  
Henry Knipe ◽  
Simon Binny ◽  
Heather Pascoe ◽  
Nathan Better ◽  
...  
Keyword(s):  
Aortic Root ◽  
Intraclass Correlation ◽  
Maximal Dimension ◽  
Short Axis ◽  
Cross Sectional ◽  
Root Area ◽  
Linear Dimensions ◽  
Root Measurement ◽  
Better Than ◽  
Excellent Reproducibility

Objective: We sought to assess the different CT aortic root measurements and determine their relationship to transthoracic echocardiography (TTE). Methods: TTE and ECG-gated CT images were reviewed from 70 consecutive patients (mean age 54 ± 18 years; 67% male) with tricuspid aortic roots (trileaflet aortic valves) between Nov 2009 and Dec 2013. Three CT planes (coronal, short axis en face and three-chamber) were used for measurement of nine linear dimensions. TTE aortic root dimension was measured as per guidelines from the parasternal long axis view. Results: All CT short axis measurements of the aortic root had excellent reproducibility (intraclass correlation coefficient, ICC 0.96–0.99), while coronal and three-chamber planes had lower reproducibility with ICC 0.90 (95% CI 0.84–0.94) and ICC 0.92 (0.87–0.95) respectively. CT coronal and short axis maximal dimensions were systematically larger than TTE (mean 2 mm larger, p < 0.001), while CT cusp to commissure measurements were systematically smaller (CT RCC-comm mean 2 mm smaller than TTE, p < 0.001). All CT short axis measurements had excellent correlation with aortic root area with CT short axis maximal dimension marginally better than the rest (Pearson’s R 0.97). Conclusion: Systematic differences exist between CT and TTE dependent on the CT plane of measurement. All CT short axis measurements of the aortic root had excellent reproducibility and correlation with aortic root area with maximal dimension appearing marginally better than the rest. Our findings highlight the importance of specifying the chosen plane of aortic root measurement on CT. Advances in knowledge: Systematic differences in aortic root dimension exist between TTE and the various CT measurement planes. CT coronal and short axis maximal dimensions were systematically larger than TTE, while CT cusp to commissure measurements were smaller. CT readers should indicate the plane of measurement and the specific linear dimension to avoid ambiguity in follow-up and comparison.

scholarly journals 701-2 The Final % Cross-sectional Narrowing (Residual Plaque Burden) is the Strongest Intravascular Ultrasound Predictor of Angiographic Restenosis

1995 ◽  
Vol 25 (2) ◽  
pp. 35A ◽  
Author(s):  
Gary S. Mintz ◽  
Ya Chien Chuang ◽  
Jeffrey J. Popma ◽  
Augusto D. Pichard ◽  
Kenneth M. Kent ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Plaque Burden ◽  
Cross Sectional ◽  
Angiographic Restenosis

scholarly journals Psychosocial aspects of work and minor psychic disorders in nursing: use of combined models

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Evelin Daiane Gabriel Pinhatti ◽  
Renata Perfeito Ribeiro ◽  
Marcos Hirata Soares ◽  
Júlia Trevisan Martins ◽  
Maria Ribeiro Lacerda ◽  
...  
Keyword(s):  
Social Support ◽  
Psychosocial Aspects ◽  
Mental Illnesses ◽  
Cross Sectional ◽  
Combined Use ◽  
Psychic Disorders ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Self Reporting Questionnaire ◽  
Demand Control

ABSTRACT Objective: to analyze the combined use of models for the evaluation of work-related psychosocial aspects and their association with the prevalence of Minor Psychics Disorders among nursing workers. Method: cross-sectional study with a sample of 285 nursing workers. Data collection was performed through the application of a structured sociodemographic and occupational questionnaire and the Demand-Control-Support, Effort-Reward Imbalance and Self-Reporting Questionnaire. Descriptive analysis and a multiple logistic regression were performed. Results: the prevalence of suspicion of minor psychics disorders was 32.6%. The dimensions of both models were associated with mental health. The full Effort-Reward Imbalance and Demand-Control and Social Support models predict Minor Psychics Disorders to a greater extent than the combined use of partial models. Conclusion: it was found that the Effort-Reward Imbalance model captured better the magnitude of the Minor Psychics Disorders in this sample of workers compared to the Demand-Control and Social Support model. However, the concomitant use of the theoretical models revealed unique contributions in the evaluation of Minor Psychics Disorders. Considering the complexity of mental illnesses, it is important that different factors be evaluated.

scholarly journals Quantitative Prediction of the Location of Carotid Bifurcation and Neurovascular Structures in the Carotid Region: A Cross-Sectional Cadaveric Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Daniel W. Griepp ◽  
Abin Sajan ◽  
Robert DiRaimo ◽  
Lev Starikov ◽  
Samuel Márquez
Keyword(s):  
Cranial Nerve ◽  
Carotid Bifurcation ◽  
Quantitative Prediction ◽  
Mastoid Process ◽  
Superior Thyroid Artery ◽  
Cross Sectional ◽  
Important Landmark ◽  
Vascular Structures ◽  
Neurological Surgery ◽  
Neurovascular Structures

Introduction. The carotid region is encountered in vascular and neurological surgery and carries a potential for vascular and cranial nerve trauma. The carotid bifurcation is an especially important landmark and difficult to predict based on currently established landmarks. This study is a detailed analysis of the carotid region and proposes a novel methodology to predict the height of the bifurcation. Materials and Methods. Superficial and deep dissections were performed on the anterior triangle of the neck to expose the carotid region in twenty-one formalin-fixed donor cadavers. Musculoskeletal and neurovascular structures were assessed in relation to the carotid bifurcation and the medial border of the clavicle (MBC). Results. The carotid bifurcation occurred, on average, 11.4 mm higher on the left ( p < 0.001 ; 95% CI: 9.28, 13.54). The superior thyroid artery ( p < 0.001 ), facial vein ( p < 0.001 ), and cranial nerve XII ( p < 0.001 ) were all more distal on the left side when measured from the MBC while the angle of the mandible and stylohyoid muscle remained symmetric. Left- and right-sided vascular structures were symmetric when measured from the carotid bifurcation. Conclusions. Neurovascular structures within the carotid region are likely to be anatomically superior on the left side while vessels are likely to remain symmetric in relation to the carotid bifurcation. When measured from the MBC, the bifurcation height can be predicted by multiplying the distance between the MBC and mastoid process by 0.65 (right side) or 0.74 (left side). This novel methodological estimation may be easily learned and directly implemented in clinical practice.

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