scholarly journals Management of Subintimal Position of Kissing Stents using Re-entry Catheter with Cone Beam-Computed Tomography Image Overlaid onto Live Fluoroscopy

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Lorenzo Carlo Pescatori ◽  
Hicham Kobeiter ◽  
Haytham Derbel ◽  
Pascal Desgranges ◽  
Vania Tacher
Keyword(s):  
Color Doppler ◽  
Three Dimensional ◽  
False Lumen ◽  
Proximal Part ◽  
Lower Limbs ◽  
Cone Beam ◽  
Femoral Access ◽  
Invasive Approach ◽  
First Choice ◽  
Iliac Bifurcation

Background Several endovascular or surgical treatments have been proposed to treat total chronic occlusions of the iliac bifurcation. Nowadays, endovascular options are considered as a first choice because of the decreased per-operative morbi-mortality. Nevertheless, unexpected intraoperative events may occur, such as dissection or rupture of the iliac artery. We report a case of inadvertent bilateral false lumen kissing stents positioning, rescued with stents extensions guided with image fusion guidance.    Case presentation A 60-year-old male patient referred to our Department because of a severe bilateral claudication, 8 months after an iliac kissing stent for common iliac arteries occlusion. A CT angiography (CTA) was performed, showing a bilateral dissection of the aorto-iliac bifurcation at the proximal part of the stents, which were placed into the false lumen whereas the distal part was into the true lumens (TL). Lower limb perfusion was maintained by inferior mesenteric and hypogastric arteries.  As a CTA performed before the first endovascular intervention showed no dissection of the aortic bifurcation, the flaps were probably created during the previous interventions. An endovascular revision was planned. After a bilateral femoral access, the proximal part of the flap was pierced with a needle-based re-entry device, deployed under three-dimensional cone-beam CT image overlay with bi-planar fluoroscopy. The lumen patency was then restored with stents extensions up to the renal ostia. The final angiography showed stents patency. No complication occurred during the intervention. The patient was dismissed the day after, with good arterial femoral pulse and no further complications. An US color Doppler performed one month after the intervention showed satisfactory blood flow of both iliac and femoral arteries as well as a good flow in the lower limbs.    Conclusions The integration of modern 3D image guidance and novel endovascular devices allows the management of adverse events with a minimally-invasive approach.  

scholarly journals Applications of cone beam computed tomography in endodontics

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Ateksha Bhardwaj Khanna
Keyword(s):  
Computed Tomography ◽  
Treatment Planning ◽  
Cone Beam Computed Tomography ◽  
Oral Surgery ◽  
Three Dimensional ◽  
Conventional Radiography ◽  
Cone Beam ◽  
Oral Radiology ◽  
Manual Search ◽  
First Choice

Abstract Background Endodontic disease can adversely affect the quality of life and therefore early diagnosis and consequent timely treatment is of paramount importance for the Endodontist. Radiology is an essential component in treatment planning, disease monitoring and assessment of treatment outcome. Periapical radiographs and panoramic radiography are frequently utilised but they provide only two-dimensional representation of three-dimensional structures. The advent of cone beam computed tomography (CBCT) offers three-dimensional accuracy of the hard tissue images with a reasonable cost and this has revolutionised imaging of the dentomaxillofacial structures. This imaging system has been seen to overcome some limitations of conventional radiography, as brought out in this review. The improvement in the accuracy is, however, accompanied at the cost of increased radiation exposure to the patient. Nevertheless, smaller areas of exposure are normally appropriate for endodontic imaging, and adjustment in the exposure parameters can further moderate the effective dose (Loubele et al. 37(6):309-18, 2008). Aims and objectives The aim of this review is to present the pertinent literature on the various applications of cone beam computed tomography in the field of endodontics. Methods Literature was electronically searched on the following sources; Medline and Keats Library. Further, a manual search was performed on the following journals: International Endodontic Journal, Journal of Endodontics, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, Endodontology, Journal of Dental Research, European Journal of Oral Sciences & Odontology and Dentomaxillofacial Radiology. A preliminary search was performed to gain an idea of the available literature using keywords ‘Cone Beam Computed Tomography’ to view the volume of the literature evident and identify questions to be addressed in this review. The initial search showed 243 potential articles. After scrutinising the titles and abstracts of the retrieved articles, 70 relevant studies were reviewed in full text. Furthermore, ‘published guidelines on the use of CBCT’ were also searched so as to include the results as an additional source material. All the articles eligible to be included in the review were in the English language and ranged from the year 1960 to the present. Also all the studies reviewed were based on the various uses of cone beam computed tomography in the field of endodontics. The keywords used to search were ‘Cone Beam Computed Tomography (CBCT)’, ‘Conventional radiography’, ‘Applications of CBCT in endodontics’, ‘CBCT and tooth morphology’, ‘CBCT and apical periodontitis’, ‘CBCT and vertical root fractures’, ‘CBCT and resorption’, ‘CBCT and pre-surgical assessment’, ‘CBCT and dento-alveolar trauma’ and ‘CBCT and endodontic outcome’. Results Every case is unique and CBCT should be considered only after studying each case individually. CBCT imaging needs to be adopted or used where information from conventional imaging systems is either inadequate for the management of endodontic problems or inconclusive. Having said that, it is safe to state that CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses and enhanced resolution would be available.

scholarly journals Prenatal Sonographic Image of Sirenomelia with Anencephaly and Craniorachischisis Totalis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Takako Sugiura ◽  
Yuka Sato ◽  
Naoyuki Nakanami ◽  
Kiyomi Tsukimori
Keyword(s):  
Ultrasound Examination ◽  
Color Doppler ◽  
Three Dimensional ◽  
Final Diagnosis ◽  
Color Doppler Ultrasound ◽  
Lower Limbs ◽  
Ultrasound Images ◽  
Two Dimensional ◽  
Prenatal Counselling ◽  
Medical Termination

Sirenomelia is a rare congenital malformation characterized by varying degrees of fusion of the lower extremities. It is commonly associated with severe urogenital and gastrointestinal malformations; however, the association of sirenomelia with anencephaly and rachischisis totalis is extremely rare. To our knowledge, the prenatal sonographic images of this association have not been previously published. Here, we present prenatal sonographic images of this association, detected during the 17th week of gestation through combined two-dimensional, four-dimensional, and color Doppler ultrasound. Two-dimensional ultrasound images showed anencephaly, spina bifida, and possible fusion of the lower limbs. Three-dimensional HDlive rendering images confirmed the final diagnosis of sirenomelia with anencephaly and rachischisis totalis. The patient opted to undergo medical termination of pregnancy and delivered a fetus with fused lower limbs, anencephaly, and rachischisis totalis confirming the in utero imaging findings. Awareness of these rare associations will help avoid misdiagnoses and facilitate prenatal counselling. This case highlights the importance of a thorough ultrasound examination.

scholarly journals A three-dimensional electronic report of a venous echo color Doppler of the lower limbs: MEVeC®

2014 ◽  
pp. 549
Author(s):  
Marco Ciccone ◽  
Aldo Innocente Galeandro ◽  
Pietro Scicchitano ◽  
Annapaola Zito ◽  
Cristina Galeandro ◽  
...  
Keyword(s):  
Color Doppler ◽  
Three Dimensional ◽  
Lower Limbs

scholarly journals CT angiographic evaluation of perforators in the lower limb and their reconstructive implication

2012 ◽  
Vol 45 (03) ◽  
pp. 494-497 ◽  
Author(s):  
Visweswar Bhattacharya ◽  
Neeraj K. Agrawal ◽  
Gurab R. Chaudhary ◽  
Srivastava Arvind ◽  
Siddharth Bhattacharya
Keyword(s):  
Ct Angiography ◽  
Lower Limb ◽  
Color Doppler ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Vascular Tree ◽  
Arterial Tree ◽  
Perforator Flaps ◽  
Bony Landmarks ◽  
Iodinated Contrast

ABSTRACT Background: The perforator flaps evolved on the knowledge of the vascular tree from the main vascular trunk up to the subdermal plexus. Therefore, we thought that it′s necessary to map the whole vascular arcade by CT angiography. The aim of this study is to evaluate the perforators and the whole vascular tree of the lower limb by peripheral CT angiography with 3D reconstruction and intraoperative evaluation. This study helps in designing flaps of different constituents based on the selected perforators. Materials and Methods: Twenty patients having lower limb defects were selected. CT angiography was done using a non-ionic iodinated contrast media injected through the antecubital vein. The lower limbs were imaged using volume rendering CT scan machine. Three dimensional reconstructions were made. The whole arterial tree, along with the perforators, were mapped. Findings of the audio-Doppler were correlated with the CT angiographic observations. Further these evaluations were confirmed by intraoperative findings. Results: The three dimensional CT angiographic reconstruction with bone and soft tissue provided advanced knowledge of this vascular network. It delineated the main vessel, the perforators, their caliber, distance from fixed bony landmarks and course up to the subdermal plexus. These findings were confirmed during dissection of the proposed flap. The perforators were mainly musculocutaneous in the proximal leg and septocutaneous distally. Conclusions: The vascular details visualized by this technique made advancement over the existing methods namely color Doppler, audio Doppler, two dimensional angiography etc. It improved the understanding of perforator flaps and their successful clinical application.

Three dimensional cone-beam CT sialography in non tumour salivary pathologies: procedure and results

2019 ◽  
Vol 48 ◽  
pp. 226
Author(s):  
H. Bertin ◽  
R. Bonnet ◽  
M. Anquetil ◽  
A.S. Delemazure ◽  
E. Mourrain-Langlois ◽  
...  
Keyword(s):  
Cone Beam Ct ◽  
Three Dimensional ◽  
Cone Beam ◽  
Dimensional Cone

scholarly journals Accuracy and Reproducibility of Facial Measurements of Digital Photographs and Wrapped Cone Beam Computed Tomography (CBCT) Photographs

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 757
Author(s):  
Maged Sultan Alhammadi ◽  
Abeer Abdulkareem Al-mashraqi ◽  
Rayid Hussain Alnami ◽  
Nawaf Mohammad Ashqar ◽  
Omar Hassan Alamir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Cone Beam Computed Tomography ◽  
High Reliability ◽  
Three Dimensional ◽  
Cone Beam ◽  
Cross Sectional ◽  
Facial Profile ◽  
Digital Photographs ◽  
Gonial Angle

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.

scholarly journals Sirenomelia: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asiyeh Shojaee ◽  
Firooze Ronnasian ◽  
Mahdiyeh Behnam ◽  
Mansoor Salehi
Keyword(s):  
Case Reports ◽  
Three Dimensional ◽  
First Trimester ◽  
Mendelian Inheritance ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
White Family ◽  
Her Family ◽  
Caudal Regression ◽  
History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

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