Reducing amount of contrast agent after compression of right brachial artery using a blood pressure cuff in computed tomography cerebrovascular angiography

2021 ◽  
pp. 1-10
Author(s):  
Gyeong Rip Kim ◽  
ung Ho Kim ◽  
Soon Ki Sung ◽  
Chang Hyeun Kim ◽  
Sang Bong Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Side Effects ◽  
Contrast Agent ◽  
Brachial Artery ◽  
Slice Thickness ◽  
Pressure Cuff ◽  
Imaging Results ◽  
Study Results ◽  
The Mean

OBJECTIVE: To invastgate feasibility of low-dose contrast agent in cerebral computed tomography angiography (CTA) to alleviate side effects. METHOD: Siemens’ Somatom Definition AS+CT scanner, Heine’s blood pressure monitor G7-M237 (BP cuff) and Ultravist contrast agent (370 mg Iodine/ml) are used. CTA is acquired using following scan parameters including slice thickness of 1mm, image acquisition parameters of 128×0.6 mm, pitch size of 0.8 mm, 175 effective mAs, 120 kVp tube voltage, scan delay time of 3 seconds, and the scan time of 4 seconds. This study is conducted by securing the IV route in the left antecubital vein before injection of contrast agent, wrapping BP cuff around the branchial artery of the opposite right arm after setting the pressure to 200 mmHg. Then, the injection rate of the contrast agent is fixed at 4.5 cc/sec and contrast agent was injected in three different amounts (70, 80, and 100 cc). Bp cuff is released from this moment when HU value reachs 100. RESULT: In this study, the mean HU values measured from common carotid artery are 412.45±5.89 when injecting 80cc contrast agent and using BP cuff and 399.64±5.51 when injecting 100 cc contrast agenet and not using BP cuff, respectively. In middle cerebral artery M1, the mean HU values are 325.23±38.29 when injecting 80cc contrast agent and using BP cuff and 325.00±30.63 when injecting 100cc contrast agent blood and not using pressure cuff, respectively. Difference of mean HU values is not statistically significant (p >  0.05) with and without using BP cuff. CONCLUSION: This study demonstrates that reducing amount of contrast agent is possible when the right brachial artery is compressed using BP cuff. Study results indicate that reducing 20% injection of contrast agent in CT cerebrovascular angiography can still yield comparable imaging results with conventional contrast angent usage, which implies that less side effects are expected with a contrast agent injection. Thus, this study can serve as a reference for potential reducing side effect during CT cerebrovascular angiography.

Association between Patients with Metabolic Syndrome and Other Various Factors Defining Metabolic Syndrome: A Cross-Sectional Study

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Diseases ◽  
Abdominal Obesity ◽  
Positive History ◽  
The Metabolic Syndrome ◽  
Study Results ◽  
History Of ◽  
The Mean

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.

scholarly journals The comparison of bolus tracking and test bolus techniques for computed tomography thoracic angiography in healthy beagles

2013 ◽  
Vol 84 (1) ◽  
Author(s):  
Nicolette Cassel ◽  
Ann Carstens ◽  
Pieter Becker
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Test Dose ◽  
Dose Length Product ◽  
Bolus Tracking ◽  
Iodinated Contrast ◽  
Iodinated Contrast Agent ◽  
Test Bolus ◽  
The Mean ◽  
Computed Tomography Dose Index

Computed tomography thoracic angiography studies were performed on five adult beagles using the bolus tracking (BT) technique and the test bolus (TB) technique, which were performed at least two weeks apart. For the BT technique, 2 mL/kg of 300 mgI/mL iodinated contrast agent was injected intravenously. Scans were initiated when the contrast in the aorta reached 150 Hounsfield units (HU). For the TB technique, the dogs received a test dose of 15% of 2 mL/kg of 300 mgI/mL iodinated contrast agent, followed by a series of low dose sequential scans. The full dose of the contrast agent was then administered and the scans were conducted at optimal times as identified from time attenuation curves. Mean attenuation in HU was measured in the aorta (Ao) and right caudal pulmonary artery (rCPA). Additional observations included the study duration, milliAmpere (mA), computed tomography dose index volume (CTDI[vol]) and dose length product (DLP). The attenuation in the Ao (BT = 660 52 HU ± 138 49 HU, TB = 469 82 HU ± 199 52 HU, p = 0.13) and in the rCPA (BT = 606 34 HU ± 143 37 HU, TB = 413 72 HU ± 174.99 HU, p = 0.28) did not differ significantly between the two techniques. The BT technique was conducted in a significantly shorter time period than the TB technique (p = 0.03). The mean mA for the BT technique was significantly lower than the TB technique (p = 0.03), as was the mean CTDI(vol) (p = 0.001). The mean DLP did not differ significantly between the two techniques (p = 0.17). No preference was given to either technique when evaluating the Ao or rCPA but the BT technique was shown to be shorter in duration and resulted in less DLP than the TB technique.

scholarly journals A STUDY ON CLINICO- RADIOLOGICAL PRESENTATION OF STROKE AND ITS ASSOCIATION WITH OUTCOME

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Arindam Nag ◽  
Dr. Sourav Nag ◽  
Dr Suraj Mondal ◽  
Dr Yashpal Yadav
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Ischemic Stroke ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Cerebrovascular Accident ◽  
Diastolic Pressure ◽  
Modified Rankin Scale ◽  
Study Population ◽  
The Mean

BACKGROUND:  Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and arteriovenous malformations. A stroke, or cerebrovascular accident, is defined by this abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Thus, the definition of stroke is clinical, and laboratory studies including brain imaging are used to support the diagnosis. AIMS:  1.To correlate clincoradiological findings in terms of prognosis, 2. To know different types of stroke along with its area of involvement and vascular distribution and its relation with outcome, 3. Role of CT SCAN brain as an early diagnostic modality to say clinical outcome. METHODS: This descriptive epidemiological study with a cross sectional study design is to be conducted in the department of medicine (indoor), R.G.KAR Medical College and Hospital. 1st June 2017 to 31st may 2018. 100 cases to be selected during study period based on following criteria. Detailed clinical history, clinical examinations with Radiological imaging like computed tomography of brain is done. We use scoring system like Intracerebral haemorrhage score, Glasgow coma scale, Modified rankin scale. Based on clinical examination proforma all the study population had been examined including recording of blood pressure and Glasgow coma score at the time of admission. Analysed by Modified Rankin scale till the 5th day post-hospital admission after stroke. RESULT: Among the total 100 study population 59 cases were of Infarction and 41 cases were of Haemorrhagic type of stroke. Within the 59 Cases of Infarction 39 (i.e. 66%) were male cases and 20 (i.e 34%) were female cases. Within the 41 cases of Haemorrhage 29 (i.e. 71%) were male and 12 (i.e. 29%) were female.  The mean age of the study population of Infarction cases was 55.55 years ±12.84 SD. The mean age of the study population of Haemorrhage cases was 57.48years±13.46SD. Infraction cases show increased mortality among the group having systolic blood & diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. Hemorrhagic cases show increased mortality among the group having systolic blood pressure, diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. CONCLUSION: Incidence of haemorrhage is much higher in India (41% as per our study). The study population between 51- 60 years is most predominant age group in both the types of stroke. Most of the infarction cases presents with unconsciousness followed by slurring of speech.  Most common presenting symptoms of Haemorrhagic stroke are unconsciousness, present at about 56% of cases. The most prominent risk factor in our study population is undetected and/or uncontrolled hypertension.  Study population with SBP ≥180 and/or DBP ≥110 mm of Hg group have increased rate of mortality from stroke. The major type of ischemic stroke in our study population is partial anterior circulation stroke (PACI) 47.4%. Most of the study population having  Infarction has developed severe disability at the end of 5 days of observation, comprising of 40.5% of the total observation. Keywords:  CVA (cerebrovascular accident), CT Scan (computed tomography), MRI (Magnetic resonance imaging), GCS Scale (Glasgow coma scale)

scholarly journals Push-Dose Pressors During Peri-intubation Hypotension in the Emergency Department: A Case Series

2021 ◽  
Vol 5 (4) ◽  
pp. 390-393
Author(s):  
Abdullah Bakhsh ◽  
Leena Alotaibi
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Mean Arterial Pressure ◽  
Side Effects ◽  
Case Series ◽  
Rapid Sequence Intubation ◽  
Emergency Physicians ◽  
Rapid Sequence ◽  
Lethal Complications ◽  
The Mean

Introduction: Emergency physicians frequently encounter critically ill patients in circulatory shock requiring definitive airway procedures. Performing rapid sequence intubation in these patients without blood pressure correction has lethal complications. Questioning the efficacy and fearing side effects of push-dose pressors (PDP) has created an obstacle for their use in the emergency department (ED) setting. In this case series we describe the efficacy and side effects of PDP use during peri-intubation hypotension in the ED. Case series: We included 11 patients receiving PDPs in this case series. The mean increase in systolic blood pressure was 41.3%, in diastolic blood pressure 44.3%, and in mean arterial pressure 35.1%. No adverse events were documented in this case series. Conclusion: The use of push-dose pressors during peri-intubation hypotension may potentially improve hemodynamic status when used carefully in the ED.

AN EVALUATION OF THE FLUSH METHOD FOR DETERMINING BLOOD PRESSURES IN INFANTS

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 53-62
Author(s):  
Arthur J. Moss ◽  
Wilbert Liebling ◽  
Wallace O. Austin ◽  
Forrest H. Adams
Keyword(s):  
Blood Pressure ◽  
Congenital Heart ◽  
Older Children ◽  
Blood Pressure Cuff ◽  
Pressure Cuff ◽  
Direct Measurements ◽  
Blood Pressures ◽  
Accurate Procedure ◽  
The Mean ◽  
Disease Analysis

Using the flush technique, determinations of blood pressure were made on 294 normal infants from 1 day to 1 year of age and on 23 additional infants and older children with congenital heart disease. Analysis of the data showed that: The method was found to be a practical and relatively accurate procedure in the office or clinic. The pressure at the ankle was usually significantly lower than that at the wrist. Comparative studies with auscultatory and direct measurements indicated that values obtained by the flush technique represent the mean rather than the systolic blood pressure. Readings obtained with a 5 cm blood pressure cuff did not differ significantly from those obtained with a 7.0 cm or 9.5 cm cuff.

scholarly journals Pilot Application of Varied Equipment and Procedural Techniques to Determine Clinical Blood Pressure Measurements

2018 ◽  
Vol 34 (6) ◽  
pp. 446-457
Author(s):  
John P. Mickley ◽  
Kevin D. Evans ◽  
Rachel L. Tatarski ◽  
Carolyn M. Sommerich
Keyword(s):  
Blood Pressure ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Pressure Measurements ◽  
Study Results ◽  
The Mean ◽  
Measurement Devices ◽  
Stage 1 ◽  
Clinical Blood Pressure

High blood pressure, screened with a patient’s blood pressure (BP), is found in 1 out of 3 adults in the United States. A cohort of 39 participants had BP measured following the American Heart Association (AHA) protocol, utilizing three different measurement devices: manual sphygmomanometer (MA), automated Midmark IQ vitals (IQ), and an automated Omron home unit (OM). All subjects had BP measured with the IQ device while not adhering to the AHA protocol. Two protocols were denoted PR (protocol following AHA guidelines) or TY (lacking protocol). Results demonstrated a mean systolic BP with IQ-TY > OM-PR > IQ-PR > MA-PR, all (p≤0.01). The mean diastolic BP for IQ-TY > IQ-PR, OM-PR, and MA-PR, with IQ-TY significantly higher than the other 3 (p≤0.01). Comparing participants categorized in each hypertension stage, IQ-TY categorized 7participants as stage 1 hypertensive while OM-PR categorized 3, and both MA-PR and IQ-PR only categorized 1. Study results suggest a potential for possible misclassification of patients based on BP protocol.

A Multicentre Study Examining the Substitution of Trasidrex for the Free Combination of Slow-Trasicor and Navidrex-K

1979 ◽  
Vol 7 (6) ◽  
pp. 524-527 ◽  
Author(s):  
A F Ebbutt ◽  
R W Elsdon Dew
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Practice ◽  
Essential Hypertension ◽  
Side Effects ◽  
Open Study ◽  
Global Assessment ◽  
Pressure Control ◽  
Time Intervals ◽  
The Mean

A multicentre, open study of general practice patients with essential hypertension who were currently being treated with oxprenolol and cyclopenthiazide was undertaken in which the patients were transferred to Trasidrex for 12 weeks. Weight, blood pressure, heart rate and side-effects were assessed pre-trial and at 4-week intervals. A global assessment was also made at the same time intervals. The mean serum potassium remained virtually unchanged after 12 weeks treatment with Trasidrex. Blood pressure control was marginally improved during the study and it is thought possible that better patient compliance might explain this. Trasidrex was tolerated equally as well as the free combination.

scholarly journals Cardiac remodelling following thoracic endovascular aortic repair for descending aortic aneurysms

2018 ◽  
Vol 55 (6) ◽  
pp. 1061-1070 ◽  
Author(s):  
Theodorus M J van Bakel ◽  
Christopher J Arthurs ◽  
Foeke J H Nauta ◽  
Kim A Eagle ◽  
Joost A van Herwaarden ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Computed Tomography Angiography ◽  
Fluid Structure Interaction ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Fluid Structure ◽  
Structure Interaction ◽  
Lv Mass ◽  
The Mean

Abstract OBJECTIVES Current endografts for thoracic endovascular aortic repair (TEVAR) are much stiffer than the aorta and have been shown to induce acute stiffening. In this study, we aimed to estimate the impact of TEVAR on left ventricular (LV) stroke work (SW) and mass using a non-invasive image-based workflow. METHODS The University of Michigan database was searched for patients treated with TEVAR for descending aortic pathologies (2013–2016). Patients with available pre-TEVAR and post-TEVAR computed tomography angiography and echocardiography data were selected. LV SW was estimated via patient-specific fluid–structure interaction analyses. LV remodelling was quantified through morphological measurements using echocardiography and electrocardiographic-gated computed tomography angiography data. RESULTS Eight subjects were included in this study, the mean age of the patients was 68 (73, 25) years, and 6 patients were women. All patients were prescribed antihypertensive drugs following TEVAR. The fluid–structure interaction simulations computed a 26% increase in LV SW post-TEVAR [0.94 (0.89, 0.34) J to 1.18 (1.11, 0.65) J, P = 0.012]. Morphological measurements revealed an increase in the LV mass index post-TEVAR of +26% in echocardiography [72 (73, 17)  g/m2 to 91 (87, 26)  g/m2, P = 0.017] and +15% in computed tomography angiography [52 (46, 29)  g/m2 to 60 (57, 22)  g/m2, P = 0.043]. The post- to pre-TEVAR LV mass index ratio was positively correlated with the post- to pre-TEVAR ratios of SW and the mean blood pressure (ρ = 0.690, P = 0.058 and ρ = 0.786, P = 0.021, respectively). CONCLUSIONS TEVAR was associated with increased LV SW and mass during follow-up. Medical device manufacturers should develop more compliant devices to reduce the stiffness mismatch with the aorta. Additionally, intensive antihypertensive management is needed to control blood pressure post-TEVAR.

scholarly journals Measurement of brachial artery endothelial function using a standard blood pressure cuff

2015 ◽  
Vol 36 (11) ◽  
pp. 2247-2268
Author(s):  
Jonathan S Maltz ◽  
Geoffrey H Tison ◽  
Hugh F Alley ◽  
Thomas F Budinger ◽  
Christopher D Owens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Blood Pressure Cuff ◽  
Pressure Cuff

A comparative study on post-operative analgesic effect by intrathecal midazolam and neostigmine with control group

2017 ◽  
Vol 5 (3) ◽  
pp. 863
Author(s):  
Rashmi Dubey ◽  
Roseline Ali ◽  
Rashim Vachhani ◽  
Nishant Baghel
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Lower Limbs ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Preservative Free ◽  
Effective Analgesia

Background: Pain happens to be the most common suffering during postoperative period, which is not generally effectively treated. There is good evidence in literature that addition of midazolam to spinal bupivacaine improved postoperative analgesia when compared to spinal bupivacaine alone. Neostigmine represents a novel approach to providing analgesia. Recent studies showed that intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The present study was undertaken to evaluate analgesic effects of intrathecal Midazolam and neostigmine.Methods: The present study was carried out in the department of anaesthesiology, CCM medical college, Durg Chhattisgarh, India during study period August 2015 to July 2016. The study comprised of 60 patients undergoing surgery of lower abdomen below umbilicus (T10) and lower limbs. Patients of age Group between 20-60 years of age of either sex of ASA group I and II were included in the study. Pre-anesthetic evaluation was done prior to surgery. The patients were randomly divided into 3 groups of 20 patients each. Data was compiled in MS excel and checked for its completeness and correctness, then it was analyzed.Results: Mean age in Group I was 39.3+1.5 years. in Group II was 37.8±11.7 years, in Group III was 42.2±13.7 years. In group I maximum 14 patients (70%) had analgesia of less than 4 hours. Mean duration of analgesia was 3.73±0.87 hours. In group II maximum 18 patients (90%) had analgesia 4-8 hours. The mean duration of analgesia was 6.34±1.28 hours. In group III 10 patients (50%) had analgesia of 4-8 hours and 10 patients (50%) had analgesia of 8-12 hours. The mean duration was 8.35±1.36. The difference in VAS score in group in group I and group III is significant. There was no statistically significant change in systolic blood pressure, diastolic blood pressure, Pulse rate & respiratory rate attributable to intrathecal Midazolam and neostigmine.Conclusions: Addition of preservative free midazolam to inteathecal bupivacaine prolongs duration of effective analgesia as compared to bupivacaine alone without any side effects. Addition of preservative free neostigmine to intrathecal bupivacaine prolongs duration of effective analgesia and sensory and motor block without any significant side effects.

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