MedWorm: Angiography

CTA Combined with CT Perfusion for Assessing the Efficacy of Anti-angiogenic Therapy in Rabbit VX2 Tumors

Academic Radiology — Thu, 09 Feb 2012 07:45:53 +0100

Conclusions: It is feasible to assess the efficacy of antiangiogenic therapy on VX2 tumors using three-dimensional CTA combined with CT perfusion. Three-dimensional CTA can display the morphologic changes of tumor vessels, while CT perfusion can predict the functional changes of tumor vessels after antiangiogenic therapy. (Source: Academic Radiology)

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Dual Imaging Catches Risk of Second Stroke (CME/CE)

MedPage Today Emergency Medicine — Wed, 08 Feb 2012 17:43:02 +0100

NEW ORLEANS (MedPage Today) -- CT angiography should be included with brain CT for early detection of severe arterial stenosis in those presenting with transient ischemic attack or minor stroke, researchers suggested. (Source: MedPage Today Emergency Medicine)

Long-Term Clinical and Angiographic Outcomes in Patients with Cervico-Cranial Dissections Treated with Stent Placement: A Meta-Analysis of Case Series

Journal of Neurotrauma — Wed, 08 Feb 2012 04:03:06 +0100

Journal of Neurotrauma , Vol. 0, No. 0. (Source: Journal of Neurotrauma)

CT/CTA a Practical Way to Assess Recurrent Stroke RiskCT/CTA a Practical Way to Assess Recurrent Stroke Risk

Medscape Today Headlines — Tue, 07 Feb 2012 20:24:49 +0100

For hospitals that lack ready access to MRI, using CT/CT angiography to assess intra- and extracranial vasculature is a good way to predict risk of recurrent stroke. Medscape Medical News (Source: Medscape Today Headlines)

Incidence of Asymptomatic Cerebral Microthromboembolism After Atrial Fibrillation Ablation Guided by Complex Fractionated Atrial Electrogram

Journal of Cardiovascular Electrophysiology — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: The incidence of cerebral microthromboembolism after CFAE ablation was not greater than previous reports in PVI. Cautious management is required during AF ablation, especially in the patients with low LVEF. (J Cardiovasc Electrophysiol, Vol. pp. 1‐7) (Source: Journal of Cardiovascular Electrophysiology)

Ten‐year Angiographic Result of a Large Right Coronary Artery Fistula Treated Percutaneously: Many Questions Remain Unanswered

Congenital Heart Disease — Tue, 07 Feb 2012 05:00:00 +0100

We describe an adult patient with right coronary artery to right atrium fistula, which was treated percutaneously 10 years earlier. His coronary angiogram done presently demonstrated no residual fistula, but there was persistence of aneurysmally dilated proximal right coronary artery segment that gave rise to many unanswered questions regarding management of coronary artery fistulas. We discuss the short‐ and long‐term therapeutic dilemmas in the management of coronary artery fistula. (Source: Congenital Heart Disease)

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Choroidal tuberculoma in a patient with ocular Behçet disease

International Ophthalmology — Mon, 06 Feb 2012 19:36:46 +0100

We report a case of choroidal tuberculoma associated with tuberculosis in a patient with ocular Behçet disease. A 25-year-old female with known ocular Behçet disease contracted tuberculosis 3 months earlier. She had been receiving methotrexate and oral steroids. Funduscopy of the left eye revealed a choroidal tuberculoma located superonasally to the optic disc. Fluorescein angiography showed a central area of hypofluorescence surrounded by a hyperfluorescent zone. Since she was already receiving antituberculosis treatment combined with oral steroids, the same treatment was continued. Diagnosis of the other diseases that may cause uveitis in patients with Behçet disease should not be missed. This is especially important since immunosuppressive drugs, that cause an increased in...

Repeat percutaneous coronary revascularization: Indications and outcomes in a “Real World” cohort

Catheterization and Cardiovascular Interventions — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions: In contemporary practice, patients undergoing a first stenting procedure have a low subsequent mortality, and the substantial majority (86.4%) requires no further revascularization over a median 3.8 year follow‐up. For those who do require repeat stenting, this is most commonly at a site remote from the first stent. © 2012 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Five-minute heart rate variability can predict obstructive angiographic coronary disease

Heart — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion Low HRV is strongly predictive of angiographic coronary disease regardless of other co-morbidities and is clinically useful as a risk predictor in patients with sinus rhythm. Clinical trial registration information http://clinicaltrials.gov/ct2/show/NCT00403351 www.armcad.com (Source: Heart)

Impact of continuous intracardiac ST-segment monitoring on mid-term outcomes of ICD-implanted patients with coronary artery disease. Early results of a prospective comparison with conventional ICD outcomes

Heart — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions Although, this study was underpowered by the small number of acute ischaemic events, ICD-based ST monitoring failed to provide a benefit over ICDs without this capability and increased unscheduled evaluations in patients with remote follow-up. The sensitivity and specificity of the algorithm still require validation. (Source: Heart)

Tako-tsubo cardiomyopathy precipitated by alcohol withdrawal.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

We report a case of TCM in a post-menopausal woman that was precipitated by alcohol withdrawal. (Cardiol J 2012; 19, 1: 81-85). PMID: 22298173 [PubMed - in process] (Source: Cardiology Journal)

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Angiotensin converting enzyme gene polymorphism is associated with severity of coronary artery disease in men with high total cholesterol levels.

J Appl Genet — Sat, 04 Feb 2012 05:00:00 +0100

This study examines whether renin-angiotensin-aldosterone system gene polymorphisms: ACE (encoding for angiotensin converting enzyme) c.2306-117_404 I/D, AGTR1 (encoding for angiotensin II type-1 receptor) c.1080*86A>C and CYP11B2 (encoding for aldosterone synthase) c.-344C>T are associated with the extension of coronary atherosclerosis in a group of 647 patients who underwent elective coronary angiography. The extension of CAD was evaluated using the Gensini score. The polymorphisms were determined by PCR and RFLP assays. The associations between genotypes and the extent of coronary atherosclerosis were tested by the Kruskal-Wallis test, followed by pairwise comparisons using Wilcoxon test. The population has been divided into groups defined by: sex, smoking habit, past myocardial i...

Polymorphisms in the VEGF-A in polypoidal choroidal vasculopathy in a Korean population

Japanese Journal of Ophthalmology — Fri, 03 Feb 2012 17:53:15 +0100

Conclusions The rs833069 polymorphism in VEGF-A was significantly associated with the risk of PCV in a Korean population. Content Type Journal ArticleCategory Clinical InvestigationPages 1-7DOI 10.1007/s10384-012-0119-6Authors Dong Ho Park, Department of Ophthalmology, School of Medicine, Kyungpook National University, #50 Samduk-dong-2-ga, Jung-gu, Daegu, 700-721 South KoreaIn Taek Kim, Department of Ophthalmology, School of Medicine, Kyungpook National University, #50 Samduk-dong-2-ga, Jung-gu, Daegu, 700-721 South Korea Journal Japanese Journal of OphthalmologyOnline ISSN 1613-2246Print ISSN 0021-5155 (Source: Japanese Journal of Ophthalmology)

Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?

European Radiology — Fri, 03 Feb 2012 17:11:57 +0100

Abstract We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since 1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, 2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, 3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, 4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to ...

Fibromuscular dysplasia: a differential diagnosis of vasculitis

Revista Brasileira de Reumatologia — Fri, 03 Feb 2012 10:19:07 +0100

A displasia fibromuscular (DFM) envolve artérias de pequeno e médio calibre e é uma causa bem conhecida de hipertensão em mulheres jovens caucasianas, quando envolve as artérias renais. A etiologia da DFM permanece desconhecida, a despeito de inúmeras teorias. Há suspeita de um componente genético, já que a doença atinge primariamente caucasianos. Também é descrita associação entre DFM e antígeno de histocompatibilidade HlA-DRw6. Os principais sítios acometidos são as artérias renais, cerebrais, carótidas, viscerais, ilíacas, subclávias, braquiais e poplíteas. As manifestações clínicas correlacionam-se com o sítio acometido, e a hipertensão arterial sistêmica é um sintoma frequente pelo acometimento das artérias renais em 60%-75% dos casos. O diagnóstico da D...

Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

CardioVascular and Interventional Radiology — Fri, 03 Feb 2012 07:19:24 +0100

Conclusion Empiric arterial embolization may be advantageous in patients with a duodenal source of hemorrhage but not in patients with gastric hemorrhage. Content Type Journal ArticleCategory Clinical InvestigationPages 1-9DOI 10.1007/s00270-012-0351-yAuthors Elnasif Arrayeh, Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, Room M-361, San Francisco, CA 94134, USANicholas Fidelman, Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, Room M-361, San Francisco, CA 94134, USARoy L. Gordon, Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, Room M-361, San Francisco, CA 94134, USAJeanne M. LaBerge, Department of Radiology, University of California San Francisco, 5...

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Mechanisms for an effect of acetylcysteine on renal function after exposure to radio-graphic contrast material: study protocol

BMC Clinical Pharmacology — Fri, 03 Feb 2012 05:00:00 +0100

DiscussionContrast-induced nephropathy represents a significant source of hospital morbidity and mortality. Over the last ten years, acetylcysteine has been administered prior to contrast to reduce the risk of contrast-induced nephropathy. Randomized controlled trials, however, have not reliably demonstrated renoprotection; a recent large randomized controlled trial assessing a dose of oral acetylcysteine selected without mechanistic insight did not reduce the incidence of contrast-induced nephropathy. Our study should reveal the mechanism of effect of acetylcysteine on renal function and identify an appropriate route for future dose response studies and in time randomized controlled trials.Trial registration: Clinical Trials.gov: NCT00558142; EudraCT: 2006-003509-18. (Source: BMC Clinical...

Hypertension and longitudinal changes in cerebral blood flow. The smart‐mr study

Annals of Neurology — Fri, 03 Feb 2012 05:00:00 +0100

We examined the longitudinal association of hypertension, BP, and antihypertensive drugs with change in parenchymal cerebral blood flow (pCBF) in 575 patients with manifest atherosclerotic disease (mean age 57±10 years) from the SMART‐MR study. Total CBF was measured at baseline and at follow‐up with MR angiography and was expressed per 100mL brain volume as an indicator of cerebral perfusion. Automated brain segmentation was used to quantify brain tissue volumes and cerebrospinal fluid on MRI.Results:Mean (SD) baseline parenchymal CBF was 52.3 (9.8) mL/min/100mL and after 3.9 years (range=3.0‐5.8) of follow‐up declined to 50.7 (10.3) mL/min/100mL. Regression analyses, adjusted for age, sex, follow‐up time, and vascular risk showed that untreated and poorly controlled hypertensi...

Usefulness of CT Angiography for Therapeutic Decision Making in Thrombolyzing Intubated Patients with Suspected Basilar Artery Thrombosis

Journal of Neuroimaging — Fri, 03 Feb 2012 05:00:00 +0100

CONCLUSIONIn patients with BAT, intubated before assessment by neurologist, CTA might help in confirming the diagnosis and facilitating therapeutic decision making for initiating thrombolysis. J Neuroimaging 2012;XX:1–4. (Source: Journal of Neuroimaging)

“From Bench to Practice”, ESC Congress set for Munich this summer

European Society of Cardiology — Thu, 02 Feb 2012 16:43:01 +0100

In response to feedback from delegates, this year’s congress will kick off on Saturday with a fuller day of scientific sessions. The grand finale on Wednesday will be a two-hour highlight session in which world leading experts summarise all the new and exciting developments in basic, clinical and population sciences presented at the congress. Read more about this year's event.... Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of th...

Leading Medical Groups Collaborate To Ensure Consistent, Responsible Uptake Of Transcatheter Aortic Valve Replacement

Health News from Medical News Today — Thu, 02 Feb 2012 09:00:00 +0100

With the U.S. Food and Drug Administration's recent approval of transcatheter aortic valve replacement (TAVR) for patients with aortic valvular stenosis, the American College of Cardiology Foundation (ACCF), along with the American Association for Thoracic Surgery (AATS), the Society for Cardiovascular Angiography and Interventions (SCAI) and the Society of Thoracic Surgeons (STS), today released an expert consensus document to provide important guidance on its use... (Source: Health News from Medical News Today)

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Superficial temporal artery aneurysm: Diagnosis and treatment options

Head and Neck — Thu, 02 Feb 2012 05:00:00 +0100

ConclusionPseudoaneurysms are mostly the result of blunt trauma as opposed to true aneurysms which usually occur spontaneously. Surgical resection is a safe treatment modality, but endovascular treatment might be considered in a selected group of patients. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)

Asian age‐related macular degeneration phenotyping study: rationale, design and protocol of a prospective cohort study

Clinical and Experimental Ophthalmology — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions: This study will provide in‐depth longitudinal data of the evolution of clinical features, risk factors, natural history and treatment pattern and response of Asian age‐related macular degeneration and polypoidal choroidovasculopathy, allowing unique insights into pathogenesis and the design of new treatment strategies.© 2012 The Authors. Journal compilation © 2012 Royal Australian and New Zealand College of Ophthalmologists (Source: Clinical and Experimental Ophthalmology)

CT/CT Angiography and MRI Findings Predict Recurrent Stroke After Transient Ischemic Attack and Minor Stroke: Results of the Prospective CATCH Study.

Stroke — Thu, 02 Feb 2012 05:00:00 +0100

CONCLUSIONS: Early assessment of the intracranial and extracranial vasculature using CT/CTA predicts recurrent stroke and clinical outcome in patients with transient ischemic attack and minor stroke. In many institutions, CTA is more readily available than MRI and physicians should access whichever technique is more quickly available at their institution. PMID: 22302109 [PubMed - as supplied by publisher] (Source: Stroke)

Intravitreal bevacizumab alone versus in combination with photodynamic therapy for the treatment of neovascular maculopathy in patients aged 50 years or older: 1‐year results of a prospective clinical study

Acta Ophthalmologica — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: The results of our 12‐month prospective study indicate that intravitreal bevacizumab alone has similar efficacy and safety to bevacizumab plus PDT for treatment of patients with neovascular AMD, even treatment‐naïve patients. The addition of PDT did not assist in reducing the required total number of bevacizumab injections. (Source: Acta Ophthalmologica)

Association of cerebral blood flow with the development of cardiac death or urgent heart transplantation in patients with systolic heart failure

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion Cerebral blood flow was associated with the development of long-term outcomes in systolic HF, and therefore may be useful in identifying patients suitable for heart transplantation. This finding is especially relevant for patients in whom exercise tests may not be performed sufficiently. (Source: European Heart Journal)

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Endothelial function assessment: flow-mediated dilation and constriction provide different and complementary information on the presence of coronary artery disease

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion Endothelial function assessment provides modest but statistically significant additional information in predicting the presence of CAD. (Source: European Heart Journal)

Cardiac Computed Tomography—Evidence, Limitations and Clinical Application

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

Coronary CT angiography and coronary calcium scoring offer a new approach to the diagnosis of coronary artery disease (CAD). They hold significant promise in improving patient outcomes, through identification of atherosclerosis and improved risk assessment.Coronary calcium scoring has proven predictive value concerning the occurrence of future cardiovascular events and outperforms current risk evaluation methods such as the Framingham Risk Score.Coronary CT angiography allows visualisation of the coronary artery lumen, detection of stenoses as well as visualisation of both calcified and non-calcified plaque.The accuracy of coronary CT angiography to detect obstructive coronary artery disease has been established by numerous trials. In particular the negative predictive value of the test ap...

An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Stent design lowers angiographic but not clinical adverse events in stenting of symptomatic intracranial stenosis – results of a single center study with 100 consecutive patients

International Journal of Stroke — Wed, 01 Feb 2012 05:00:00 +0100

ConclusionDespite a high technical success, the rate of clinical adverse events at 30 days after intracranial angioplasty and stenting is high independently of the stent design. Thus, further development of intracranial stent systems and careful patient selection are mandatory. (Source: International Journal of Stroke)

Isoproterenol stress test during catheterization of patients with coarctation of the aorta

Pediatrics International — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Significant pressure gradients over the coarctation site develop at IST in pediatric patients with repaired CoA or in preoperative patients with mild coarctation.© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society (Source: Pediatrics International)

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Blood oxygen level dependent angiography (BOLDangio) and its potential applications in cancer research

NMR in Biomedicine — Wed, 01 Feb 2012 05:00:00 +0100

In this study, the BOLD effect is investigated under different levels of oxygen inhalation for the development of a novel angiographic MRI technique, blood oxygen level dependent angiography (BOLDangio). Under short‐term (<10 min) generalized hypoxia induced by inhalation of 8% oxygen, we measure BOLD contrast as high as 25% from vessels at 9.4T using a simple gradient echo (GRE) pulse sequence. This produces high‐resolution 2D and 3D maps of normal and tumour brain vasculature in less than 10 minutes. Additionally, this technique reliably detects metastatic tumours and tumour‐induced intracranial hemorrhage. BOLDangio provides a sensitive research tool for MRI of vasculature under normal and pathological conditions. Thus, it may be applied as a simple monitoring technique for mea...

ACR Appropriateness Criteria® Acute Trauma to the Knee

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

There are more than 1 million visits to the ER annually in the United States for acute knee trauma. Many of these are twisting injuries in young patients who can walk and bear weight, and emergent radiography is not required. Several clinical decision rules have been devised that can considerably reduce the number of radiographic studies ordered without missing a clinically significant fracture. Although fractures are seen on only 5% of emergency department knee radiographs, 86% of knee fractures result from blunt trauma. In patients with falls or twisting injuries who have focal tenderness, effusion, or inability to bear weight, radiography should be the first imaging study performed. If radiography shows no fracture, MRI is best for evaluating for a suspected meniscal or ligament tear or...

Med Sci Monit 2012; 18(2):CR51-57 "Indocyanine green angiography in chronic central serous chorioretinopathy"

Medical Science Monitor — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: ICGA is a very useful examination that enables ophthalmologists to visualize choroidal changes due to chronic CSC, as well as to diagnose occult CNV in chronic CSC. (Source: Medical Science Monitor)

Med Sci Monit 2012; 18(2):MT7-18 "Safety of embolic protection device-assisted and unprotected intravascular ultrasound in evaluating carotid artery atherosclerotic lesions"

Medical Science Monitor — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Carotid IVUS is safe and, for the less severe lesions in particular, it may not require mandatory EPD use. High-risk lesions can be safely evaluated with IVUS under flow reversal/blockade. (Source: Medical Science Monitor)

Pedicled Flaps in Association With Distal Bypass for Lower-Limb Salvage

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our results suggest that pedicle flaps are feasible after distal bypass in patients with lower-extremity occlusive artery disease. This technique expands the indication for limb salvage with low morbidity. (Source: Annals of Vascular Surgery)

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Giant, Metachronous Bilateral Dorsalis Pedis Artery True Aneurysms

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

This report is the first to describe the clinical, radiographic, operative, and pathologic findings associated with large, bilateral dorsalis pedis artery true aneurysms in a single patient. A 61-year-old African American woman complained of difficulty in wearing shoes. She had a moderately firm, nontender, pulsatile mass on the dorsum of her right foot. Computed tomography and angiography confirmed dorsalis pedis artery aneurysm with sufficient collateralization. She underwent resection without reconstruction. Pathologic analysis revealed a true aneurysm (8 × 5.3 × 4.1 cm3) containing intralumenal thrombus. Treatment for small symptomatic and large dorsalis pedis artery aneurysms remains resection with or without reconstruction. (Source: Annals of Vascular Surgery)

Efficacy and safety of enoxaparin compared with unfractionated heparin in the pharmacoinvasive management of acute ST-segment elevation myocardial infarction: Insights from the TRANSFER-AMI trial

American Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Aims: An early invasive strategy after fibrinolysis for ST-elevation myocardial infarction (STEMI) improves outcomes, but the relative efficacy and safety of enoxaparin compared with unfractionated heparin (UFH) as part of this approach are unknown.Methods and Results: In the TRANSFER-AMI trial, patients with high-risk STEMI received fibrinolysis and were then randomized to either standard treatment or to immediate transfer for coronary angiography. In this substudy, the outcome of patients aged (Source: American Heart Journal)

Coronary Slow Flow.

Circulation Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: CSFP is associated with male sex and obesity. Multivessel involvement may be a marker of more severe, diffuse disease. Further studies are needed to investigate this hypothesis. PMID: 22293446 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Left Anterior Descending Coronary Artery Pseudoaneurysm Compressing the Main Pulmonary Artery in a Patient with Behçet's Disease

Echocardiography — Wed, 01 Feb 2012 05:00:00 +0100

We report the case of a 22‐year‐old female with LAD pseudoaneurysm who underwent surgical repair with transesophageal echocardiography guidance. We describe the importance of the use of an alternative view to define the origin and location of this unusual pathology. (Echocardiography ****;**:E1–E3) (Source: Echocardiography)

Prognostic Value of Coronary CT Angiography

Cardiology Clinics — Wed, 01 Feb 2012 05:00:00 +0100

Coronary computed tomography angiography (CTA) is a highly accurate noninvasive test that is increasingly used in symptomatic patients primarily for the diagnosis of coronary artery disease (CAD). Beyond its proven accuracy, data have now clearly demonstrated the incremental prognostic information available from coronary CTA related to the presence, extent, and severity of obstructive and nonobstructive CAD across a variety of clinical settings and patient populations. Current evidence supports the use of coronary CTA not only for the diagnosis of CAD in appropriately selected symptomatic patients but also to further refine their cardiovascular risk assessment following testing. (Source: Cardiology Clinics)

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Cardiac CT in the Emergency Department

Cardiology Clinics — Wed, 01 Feb 2012 05:00:00 +0100

Current triage strategies are not effective in correctly identifying patients suffering from acute coronary syndrome (ACS). The diagnostic workup of patients presenting with acute chest pain continues to represent a major challenge for emergency department (ED) personnel. This statement holds especially true for patients with a low to intermediate likelihood for ACS. Taking current concepts for the diagnosis and management of patients presenting with acute chest pain to the ED into account, this article discusses the evidence and potential role of coronary computed tomography angiography to improve management of patients with possible ACS. (Source: Cardiology Clinics)

Acute ST‐elevation myocardial infarction in a 24‐year‐old woman with atheromatous coronary artery disease

Emergency Medicine Australasia — Wed, 01 Feb 2012 05:00:00 +0100

We report the case of a 24‐year‐old Torres Strait Islander woman who presented to a rural hospital ED with chest pain suspicious for myocardial ischaemia and was found to have an anterior ST‐elevation myocardial infarction. She was thrombolysed and transferred to a tertiary centre where subsequent angiography revealed atheromatous disease of the left anterior descending coronary artery. We believe this to be one of the youngest reported cases of myocardial infarction due to atheromatous coronary artery disease, and demonstrates important learning points regarding the demographics and risk factors of indigenous patients with chest pain. (Source: Emergency Medicine Australasia)

Takayasu arteritis as a cause of arterial hypertension. Case report and literature review

European Journal of Pediatrics — Tue, 31 Jan 2012 07:06:39 +0100

Conclusion: The rarity of the disorder and the heterogeneous nature of its clinical manifestation predispose to a late diagnosis and delayed treatment. Our report highlights the fact that the condition can and does occur in a pediatric population in Europe and hence must be considered in patients presenting with suggestive symptoms and signs, especially in young patients with unexplained hypertension. Clinical suspicion and proper imaging are crucial for the correct diagnosis and management of patients with TA. A brief review of literature completes this report. Content Type Journal ArticleCategory Case ReportPages 1-7DOI 10.1007/s00431-012-1674-zAuthors Elżbieta Sadurska, Department of Pediatric Cardiology, Medical University of Lublin, ul. Chodźki 2, 20-093 Lublin, PolandRen...

Angina Pectoris with Troponin Increase in Arrhythmogenic Right Ventricle Dysplasia: Case Article and Review of the Literature

Pediatric Cardiology — Tue, 31 Jan 2012 07:04:43 +0100

Abstract A 16-year-old Hispanic girl with arrhythmogenic right-ventricle dysplasia (ARVD) presented with angina pectoris and troponin increase on three occasions. There was a family history of sudden cardiac death in a cousin. Her mother was diagnosed with ARVD. The patient herself had a history of nonsustained ventricular tachycardia but did not meet diagnostic criteria for ARVD. Cardiac workup, including serial transthoracic echocardiograms and a coronary angiogram, showed a structurally normal heart without coronary artery stenosis. Results of cardiac magnetic resonance imaging were questionable, but endomyocardial biopsy did not show evidence of viral myocarditis by polymerase chain reaction. Genetic testing confirmed ARVD. Content Type Journal ArticleCategory Case...

ACCF/AATS/SCAI/STS release consensus document to help guide use of minimally invasive heart therapy

EurekAlert! - Medicine and Health — Tue, 31 Jan 2012 05:00:00 +0100

(American College of Cardiology) With the USFood and Drug Administration's recent approval of transcatheter aortic valve replacement for patients with aortic valvular stenosis, the American College of Cardiology Foundation, along with the American Association for Thoracic Surgery, the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons, today released an expert consensus document to provide important guidance on its use. (Source: EurekAlert! - Medicine and Health)

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Acquired arteriovenous fistula associated with traumatic oroantral fistula: Endovascular treatment

Head and Neck — Tue, 31 Jan 2012 05:00:00 +0100

ConclusionsArteriovenous fistulas may accompany oroantral fistulas created by trauma or surgery and should be considered in patients presenting with chemosis and proptosis. Treatment with embolization should be performed before surgical intervention. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)

Mean cerebral blood flow measurements using phase contrast MRI in the first year of life

NMR in Biomedicine — Tue, 31 Jan 2012 05:00:00 +0100

In this study, mean global CBF was measured in 21 infants under the age of one, using non‐invasive MRI techniques adapted to the neonatal population. Mean CBF was computed as the ratio of blood flow delivered to the brain (measured using phase contrast MRI) and brain volume (computed by segmenting anatomical MR images). Tests in adult volunteers and repeated measurements showed the flow measurements using the proposed method to be both accurate and reproducible. It was also found that cardiac gating need not be employed in infants with no known cardiac pathology.The developed technique can easily be appended to a neonatal MRI examination to provide rapid, robust, and non‐invasive estimates of mean CBF, thus providing a means to monitor developmental or pathology‐related alterations i...

Aortic Annulus Diameter Measurement: What Is the Best Modality?

Annals of Thoracic and Cardiovascular Surgery — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion: We conclude that the aortic annulus diameter, measured by multidetector computed tomography, is the best modality to measure the aortic annulus diameter. PMID: 22293314 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovascular Surgery)

Radionuclide and angiographic assessment of pulmonary perfusion after fontan procedure: comparative interim outcomes.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:19:33 +0100

CONCLUSIONS: After the Fontan procedure, hypostatic redistribution of pulmonary blood flow is characteristic. The weak pulse of blood, in the absence of ventricular ejection, can promote pulmonary vascular changes, but at later (intermediate) follow-up, the decline in vascular resistance that results carries no benefit in terms of blood perfusion or oxygenation. Microcirculatory arteriovenous shunting is the likely cause. In this study of functional pulmonary hemoperfusion, radionuclide imaging was deemed superior to angiocardiography. PMID: 22269727 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Segmentectomy simulation using a virtual three-dimensional safety margin.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:12:53 +0100

We report 2 cases of primary lung cancer for which we performed segmentectomy based on preoperative simulations by 3D-CTA with virtual 3D safety margins. We found this technique easy to use for simulations and useful for safely performing segmentectomy for small tumors in lung cancer. PMID: 22269767 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

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Various clinical scenarios leading to development of the string sign of the internal thoracic artery after coronary bypass surgery: the role of competitive flow, a case series

Journal of Cardiothoracic Surgery — Mon, 30 Jan 2012 05:00:00 +0100

Conclusions: The most common cause of the development of the string sign of a LIMA graft due to competitive flow is overassessment of the lesion of the LAD. Regression of a previous lesion or some other neighboring graft can also cause the phenomenon. (Source: Journal of Cardiothoracic Surgery)

Pretest heart disease probability ‘should be considered’ before using CTA

MedWire News - Cardiology — Mon, 30 Jan 2012 00:00:00 +0100

Pretest probability for coronary artery disease and coronary calcium scoring should be considered before using computed tomography angiography for excluding obstructive CAD, researchers say. (Source: MedWire News - Cardiology)

Honey Don’t: grayanotoxins, sex, and affairs of the heart

The Poison Review — Sun, 29 Jan 2012 18:39:15 +0100

3.5 out of 5 stars Mad-Honey Sexual Activity and Acute Inferior Myocardial Infarctions in a Married Couple. Yarlioglues M et al. Tex Heart Inst J 2011;38:577-80. Full text Mad honey – produced from nectar of Rhododendron ponticum - contains grayanotoxins, cyclic hydrocarbons that have two main toxic effects: They bind to sodium channels and maintain them in an open state. They activate the vagus nerve, causing bradycardia and hypotension. Symptoms typically begin within 4 hours of ingestion. Mild toxicity causes dizziness, while more severe intoxication can manifest as impaired consciousness, syncope, and AV block. Mad honey is often consumed for its purported aphrodisiac effects. This interesting report describes and middle-aged married couple who consumed 1 tablespoon of m...

Comparison of Serum Creatinine and Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy after Coronary Angiography and Interventions [Evidence-Based Medicine and Test Utilization]

Clinical Chemistry — Sat, 28 Jan 2012 05:00:00 +0100

CONCLUSIONS: Variations from the serum creatinine baseline offer better diagnostic accuracy for predicting CIN at an earlier stage than similar variations in Cys. An additional diagnostic value of Cys over the determination of serum creatinine in the setting of CIN was not observed. (Source: Clinical Chemistry)

Angiographic Findings of Primary Versus Salvage Varicoceles Treated with Selective Gonadal Vein Embolization: An Explanation for Surgical Treatment Failure

Journal of Endourology — Sat, 28 Jan 2012 04:08:16 +0100

Journal of Endourology , Vol. 0, No. 0. (Source: Journal of Endourology)

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Severe left main coronary stenosis in a young female patient, 6 years after mediastinal radiation therapy for non-Hodgkin lymphoma: assessment by coronary angiography and intravascular ultrasound

Clinical Research in Cardiology — Fri, 27 Jan 2012 17:53:45 +0100

Severe left main coronary stenosis in a young female patient, 6 years after mediastinal radiation therapy for non-Hodgkin lymphoma: assessment by coronary angiography and intravascular ultrasound Content Type Journal ArticleCategory Letter to the EditorsPages 1-4DOI 10.1007/s00392-012-0413-9Authors Grigorios Korosoglou, Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, GermanyArnt V. Kristen, Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, GermanyMartin Andrassy, Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, GermanyHugo A. Katus, Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, GermanyStefan E. Hardt, ...

Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting

Clinical Research in Cardiology — Fri, 27 Jan 2012 17:53:44 +0100

Conclusions For adequate risk assessment in ULMCA patients, consideration of both comorbidities and coronary anatomic complexity, is essential. A combination of angiographic and clinical risk scores improves the prognostic value for the prediction of 1-year MACE risk and is superior to stand-alone scores. Content Type Journal ArticleCategory Original PaperPages 1-9DOI 10.1007/s00392-012-0417-5Authors Jan-Malte Sinning, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität, Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, GermanyViktoria Stoffel, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität, Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, GermanyEberhard Grube, M...

Autologous stem cell therapy in the treatment of limb ischaemia induced chronic tissue ulcers of diabetic foot patients

International Journal of Clinical Practice — Fri, 27 Jan 2012 14:21:21 +0100

Conclusion: The transplantation of BMCs as well as TRCs proved to be safe and feasible. Improvements of microcirculation and complete wound healing were observed in the transplant groups. (Source: International Journal of Clinical Practice)

Distribution of Coronary Artery Stenosis After Radiation for Breast Cancer [Breast Cancer]

Journal of Clinical Oncology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion An increase of stenosis in mdLAD + dD in irradiated left-sided BC and an association between high-risk RT and stenosis in hotspot areas for radiation indicate a direct link between radiation and location of coronary stenoses. (Source: Journal of Clinical Oncology)

Value of percutaneous embolotherapy for the management of traumatic vascular limb injury.

Acta Radiologica — Fri, 27 Jan 2012 05:00:00 +0100

ConclusionEmbolotherapy for the management of hemorrhagic, traumatic vascular injuries in upper and lower limbs is relatively safe, very effective without recurrence or other embolization-related symptoms. PMID: 22287145 [PubMed - as supplied by publisher] (Source: Acta Radiologica)

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Extensive Cerebellar Venous Malformation Associated with a Varix and Cavernous Malformations: a Case Report.

Cerebellum — Fri, 27 Jan 2012 05:00:00 +0100

We report the case of a 67-year-old woman with tinnitus, whose cranial magnetic resonance images and selective catheter angiograms showed extensive cerebellar venous malformation with cavernous malformations and varix. Injury of vessel walls by increased blood flow in the draining vein of the malformation may have led to the development of cavernous malformations and a varix. To our knowledge, such association with an extensive cerebellar venous malformation has not been reported. PMID: 22282266 [PubMed - as supplied by publisher] (Source: Cerebellum)

MRA suitable for monitoring most cerebral aneurysms

MedWire News - Stroke — Fri, 27 Jan 2012 01:46:39 +0100

Magnetic resonance angiography can be used for routine follow up of all but the smallest cerebral aneurysms after coiling, say researchers. (Source: MedWire News - Stroke)

Pseudoaneurysm of Lumbar Artery following a Vertebral Biopsy: A Case Report

Advances in Pharmacological Sciences — Thu, 26 Jan 2012 18:56:20 +0100

A 74-year-old man developed a severe low back pain and a fever. In the initial examinations, a collapse of the L5 anterosuperior vertebral body and narrowing of the L4/5 disc space were identified on radiographs, and the laboratory data showed inflammatory results. A computed tomography (CT) and a magnetic resonance imaging showed collapse of L5. A needle biopsy was performed to make a diagnosis; however, an abdominal pain and a hypotension appeared after the biopsy. An abdominal CT showed a hematoma in the retroperitoneal space, and an angiography revealed a left fourth lumbar artery pseudoaneurysm. The pseudoaneurysm was treated with transcatheter placement of microcoils. Although haemorrhagic complications following needle biopsy are very rare, patients with large amounts of vertebral d...

Pure Motor Monoparesis in the Leg due to a Lateral Medullary Infarction

Advances in Pharmacological Sciences — Thu, 26 Jan 2012 18:56:20 +0100

A 76-year-old man with essential hypertension abruptly presented with slight left-sided leg weakness, despite normal strength in the other extremities. Left-sided Babinski's reflex was detected. There were no other neurologic abnormalities. Cranial magnetic resonance imaging demonstrated a small infarction in the lower lateral medulla oblongata on the left side. Cranial magnetic resonance angiography demonstrated an absence of flow of the left vertebral artery. He became asymptomatic within 10 days under intravenous antiplatelet agent. The corticospinal tract fibers innervating the lower extremity caudal to the pyramidal decussation might be involved. We emphasize that this is a first reported case of pure motor monoparesis in the leg due to lateral medullary infarction. (Source: Advan...

Patient Management After Noninvasive Cardiac Imaging: Results From SPARC (Study of Myocardial Perfusion and Coronary Anatomy Imaging Roles in Coronary Artery Disease)

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:11 +0100

Conclusions: Overall, noninvasive testing had only a modest impact on clinical management of patients referred for clinical testing. Although post-imaging use of cardiac catheterization and medical therapy increased in proportion to the degree of abnormality findings, the frequency of catheterization and medication change suggests possible undertreatment of higher risk patients. Patients were more likely to undergo cardiac catheterization after computed tomography angiography than after single-photon emission computed tomography or positron emission tomography after normal/nonobstructive and mildly abnormal study findings. (Study of Perfusion and Anatomy's Role in Coronary Artery [CAD] [SPARC]; NCT00321399) (Source: Journal of the American College of Cardiology)

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Ruptured Aneurysm of the Sinus of Valsalva: Insights From Magnetic Resonance First-Pass Myocardial Perfusion Imaging

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:11 +0100

A 58-year-old man presented with anterior non–ST-segment elevation myocardial infarction. Echocardiography showed a large pericardial effusion that was drained and found to be hemorrhagic. Angiography revealed “unobstructed” coronary arteries, whereas contrast-enhanced computed tomography (CT) showed some extravasation of contrast suggestive of a ruptured sinus of Valsalva aneurysm (A, arrows). Cardiovascular magnetic resonance (CMR) was performed, visualizing a structure adjacent to the anterior wall. First-pass perfusion demonstrated its communication with the aortic root but no extravasation of contrast into the pericardial space (C, arrow, Online Video 1). There was also a small anterior transmural scar. During cardiac surgery, a small, closed dimple deep in a recess immediately ...

Many Heart Scans Not Put to Good Use, Study Finds

Diagnostic Imaging — Thu, 26 Jan 2012 12:00:00 +0100

SPECT, PET and CT angiography results were not leading to therapeutic changes in the patients receiving them. (Source: Diagnostic Imaging)

Cardiac MR Imaging of Nonischemic Cardiomyopathies: Imaging Protocols and Spectra of Appearances [Review]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Recent technologic advances in cardiac magnetic resonance (MR) imaging have resulted in images with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MR is a valuable imaging technique for detection and assessment of the morphology and functional characteristics of the nonischemic cardiomyopathy. It has gained acceptance as a standalone imaging modality that can provide further information beyond the capabilities of traditional modalities such as echocardiography and angiography. Black-blood fast spin-echo MR images allow morphologic assessment of the heart with high spatial resolution, while T2-weighted MR images can depict acute myocardial edema. Contrast material–enhanced images can depict and be used to quantify myocardial edema, infil...

Effect of Computerized Clinical Decision Support on the Use and Yield of CT Pulmonary Angiography in the Emergency Department [Computer Applications]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: Implementation of evidence-based CDS in the ED was associated with a significant decrease in use, and increase in yield, of CT pulmonary angiography for the evaluation of acute PE. © RSNA, 2011 (Source: Radiology)

Acute Ischemic Stroke: Infarct Core Estimation on CT Angiography Source Images Depends on CT Angiography Protocol [Neuroradiology]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: CT angiography protocol changes designed to speed imaging and optimize arterial opacification are associated with significant overestimation of infarct size on CT angiography source images. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110896/-/DC1 (Source: Radiology)

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Digital Subtraction CT Angiography for Detection of Intracranial Aneurysms: Comparison with Three-dimensional Digital Subtraction Angiography [Neuroradiology]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: Digital subtraction CT angiography has a high sensitivity and specificity in depicting intracranial aneurysms with different sizes and at different locations, compared with 3D DSA. © RSNA, 2011 (Source: Radiology)

American Thoracic Society Documents: An Official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline--Evaluation of Suspected Pulmonary Embolism in Pregnancy [Special Report]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Discussion: The recommendations presented in this guideline are based upon the currently available evidence; availability of new clinical research data and development and dissemination of new technologies will necessitate a revision and update. Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11114045/-/DC1 © American Thoracic Society, 2011 (Source: Radiology)

Postoperative neurological complications and risk factors for pre-existing silent brain infarction in elderly patients undergoing coronary artery bypass grafting.

Atherosclerosis — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSION: Patients with SBI were ranked at moderate risk of neurological complications after CABG between control and BI. Increased age, renal dysfunction, and preoperative cognitive impairment appeared to be strongly associated with SBI. PMID: 22278375 [PubMed - as supplied by publisher] (Source: Atherosclerosis)

Relationship of urocortin-2 with systolic and diastolic functions and coronary artery disease: an observational study.

Anadolu Kardiyol Der... — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSION: Ucn-2 is elevated in mild to moderate SD. But, DD (impaired relaxation pattern), or CAD (without myocardial infarction) seems to have no effect on Ucn-2 hormone levels. PMID: 22281790 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

Survival of patients with well-developed collaterals undergoing CABG or medical treatment: An observational case-controlled study.

Anadolu Kardiyol Der... — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSION: There was no significant difference regarding the survival rates in patients with well-developed coronary collaterals proceeding with CABG or medical treatment. PMID: 22281787 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

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Flow Diverters at and Beyond the Level of the Circle of Willis for the Treatment of Intracranial Aneurysms.

Stroke — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSIONS: Aneurysms at and beyond the circle of Willis are amenable to selective treatment with FDs. PMID: 22282890 [PubMed - as supplied by publisher] (Source: Stroke)

Postoperative neurological complications and risk factors for pre-existing silent brain infarction in elderly patients undergoing coronary artery bypass grafting

Journal of Anesthesia — Wed, 25 Jan 2012 18:13:52 +0100

Conclusion Patients with SBI were ranked at moderate risk of neurological complications after CABG between control and BI. Increased age, renal dysfunction, and preoperative cognitive impairment appeared to be strongly associated with SBI. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00540-012-1327-4Authors Asuka Ito, Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011 JapanTomoko Goto, Department of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Kumamoto, 862-0965 JapanKengo Maekawa, Department of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Kumamoto, 862-0965 JapanTomoko Baba, Department of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Kumamot...

The contribution of posterior circulation to memory function during the intracarotid amobarbital procedure

Journal of Neurology — Wed, 25 Jan 2012 18:13:21 +0100

Abstract The purpose of this study was to evaluate the contribution of posterior circulation to memory function by comparing memory scores between patients with and without a foetal-type posterior cerebral artery (FTP) during the intracarotid amobarbital procedure (IAP) in epilepsy patients. Patients undergoing bilateral IAP between January 2004 and January 2010 were retrospectively included. Pre-test angiograms were assessed for the presence of a FTP. Memory function scores (% correct) after right and left injections were obtained. Functional significance of FTP was affirmed by relative occipital versus parietal EEG slow-wave increase during IAP. Memory and EEG scores were compared between patients with and without FTP (Mann–Whitney U test). A total of 106 patients ...

Local Morphology Fitting Active Contour for Automatic Vascular Segmentation

IEEE Transactions on Biomedical Engineering — Wed, 25 Jan 2012 14:46:09 +0100

In this paper, we propose an active contour model using local morphology fitting for automatic vascular segmentation on 2-D angiogram. The vessel and background are fitted to fuzzy morphology maximum and minimum opening, separately, using linear structuring element with adaptive scale and orientation. The minimization of the energy associated with the active contour model is implemented within a level set framework. As in the current local model, fitting the image to local region information makes the model robust against the inhomogeneous background. Moreover, selective local estimations for fitting that are precomputed instead of updated in each contour evolution makes the evolution of level set robust again initial location compared to the current local model. The results on synthetic i...

First-in-man study of paclitaxel-eluting stent BiOSS (Bifurcation Optimisation Stent System) dedicated for coronary bifurcation stenoses: three months results.

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

Conclusions: The BiOSS bifurcation dedicated stent is a feasible device, with promising safety and short-term clinical effectiveness/ profile. Kardiol Pol 2012; 70, 1: 45-52. PMID: 22267425 [PubMed - in process] (Source: Kardiologia Polska)

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Comparison of serum gamma-glutamyltransferase levels between patients with cardiac syndrome X and healthy asymptomatic individuals.

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

Conclusions: GGT activity in patients with cardiac syndrome X was higher than in healthy controls. Moreover, GGT activity was further increased in those patients with cardiac syndrome X who had also MS. Kardiol Pol 2012; 70, 1: 31-37. PMID: 22267422 [PubMed - in process] (Source: Kardiologia Polska)

Giant Intracranial Pial Arteriovenous Fistula Treated by Endovascular Intervention

min - Minimally Invasive Neurosurgery — Wed, 25 Jan 2012 05:00:00 +0100

Minim Invasive Neurosurg 2011; 54: 247-249DOI: 10.1055/s-0031-1283127Arteriovenous fistulas (AVF) are rare vascular lesions of the brain that differ from arteriovenous malformations as they present a direct connection between artery and vein, without interposition of the nidus. They are fed by one or more arterial branches, with a single draining vein. Clinically they can be revealed through cerebral hemorrhage, convulsive crisis, neurological deficit, heart failure in neonates and infants, headache, bruit, or intracranial hypertension symptoms.A 30-year-old patient was found unconscious on a public street, presenting a generalized tonic-clonic convulsive crisis. At admission, she presented with ocular proptosis, conjunctival hyperemia and bilateral jugular turgescence. The cranial compute...

Acute lower limb ischaemia due to delayed upstream migration of an iliac stent

Interactive CardioVascular and Thoracic Surgery — Wed, 25 Jan 2012 05:00:00 +0100

We report a case of acute limb ischaemia due to unusual upstream stent migration into the aorta 2 years after successful kissing stenting. Angiography showed a misplacement of both common iliac stent into the aorta, upstream migration with a fracture on the left external iliac stent into the iliac common artery, occlusion of the left iliac and femoral artery, dilatation of aortic bifurcation and stent separation on the right side. The patient underwent a successful axillo-bifemoral bypass graft. Vessel wall remodelling due to overestimation of stent size, aortic turbulence and rebound effect may explain this complication. (Source: Interactive CardioVascular and Thoracic Surgery)

Potential Effects of Alendronate on Fibroblast Growth Factor 23 Levels and Effective Control of Hypercalciuria in an Adult with Jansen's Metaphyseal Chondrodysplasia.

The Journal of Clinical Endocrinology and Metabolism — Wed, 25 Jan 2012 05:00:00 +0100

Conclusion:The long-term follow-up of our JMC patient has provided insight on therapeutic strategies to control hypercalciuria, on the potential effects of alendronate on FGF23 levels, and on the lack of detectable cardiovascular disease at young adulthood after prolonged exposure to hypercalcemia. PMID: 22278430 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

A history of early stent thrombosis is associated with prolonged clot lysis time.

Thrombosis and Haemostasis — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Pankiw-Bembenek O, Zalewski J, Goralczyk T, Undas A Abstract It has been demonstrated that formation of compact plasma fibrin clots resistant to plasmin-mediated lysis characterises patients following in-stent thrombosis (IST). The relationship between defective fibrinolysis, reflected as prolonged clot lysis time (CLT) and IST is unclear. We sought to investigate whether patients with acute and subacute IST have impaired fibrinolytic capacity. We studied 41 definite IST patients, including 15 with acute and 26 with subacute IST experienced 2-73 months prior to enrollment, versus 41 controls matched for demographics, cardiovascular risk factors, concomitant treatment and angiographic/stent parameters. CLT, reflecting lysis of a tissue factor-induced plasma clot by exogenou...

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Novel Noninvasive Detection of the Fovea Avascular Zone Using Confocal Red-Free Imaging in Diabetic Retinopathy and Retinal Vein Occlusion [Retina]

Investigative Ophthalmology — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions. The findings suggest that confocal red-free imaging is a simple, reliable, safe, and noninvasive method for effectively imaging the FAZ. This procedure has the potential to be used for the noninvasive detection and quantification of FAZ in screening, initial evaluation, and follow-up observation of progressive ischemic retinopathies such as DR and RVO. (Source: Investigative Ophthalmology)

Randomized Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stents vs. Sirolimus-Eluting Stents for Percutaneous Coronary Intervention in Chronic Total Occlusion.

Circulation Journal — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions: The effectiveness and safety of ZES are similar to those of SES and therefore it is a good treatment option in patients undergoing PCI for CTO with DESs. PMID: 22277317 [PubMed - as supplied by publisher] (Source: Circulation Journal)

The relationship between optical coherence tomography patterns, angiographic parameters and visual acuity in age-related macular degeneration

International Ophthalmology — Tue, 24 Jan 2012 18:09:18 +0100

Abstract To assess the relationships between visual acuity (VA), fluorescein angiographic parameters and optical coherence tomography (OCT) patterns in exudative age-related macular degeneration (AMD). Fifty eyes with confirmed diagnosis of new exudative AMD who underwent fluorescein angiography (FA) and OCT evaluation were reviewed retrospectively. The greatest linear diameter of lesion (GLD) by FA and central foveal thickness (CFT) by OCT were measured. The OCT scans were evaluated for the presence of diffuse retinal thickening (D), cystic spaces (C), subretinal fluid (S) and pigment epithelial detachment (P) and five OCT patterns were detected (D + S; C; C + S; P + C + S; P + D + S). Angiographic classification ...

Fast-Track Intubation for Accelerated Interventional Stroke Treatment

Neurocritical Care — Tue, 24 Jan 2012 07:55:42 +0100

Conclusions In acute stroke patients, intubation prior to interventional recanalization therapy can delay treatment initiation. The implementation of an I-SOP accelerates interventional treatment initiation. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s12028-012-9671-7Authors Oliver Herrmann, Department of Neurology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, GermanyAndreas Hug, Spinal Cord Injury Center, University Hospital Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg, GermanyJulian Bösel, Department of Neurology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, GermanyJuliana Johanna Petersen, Institute of General Practice, Goethe-University of Frankfurt/Main, Theo...

Factors associated with enlargement of chorioretinal atrophy after intravitreal bevacizumab for myopic choroidal neovascularization

Graefe's Archive for Clinical and Experimental Ophthalmology — Tue, 24 Jan 2012 07:53:15 +0100

Conclusions Our findings showed that eyes with a larger CNV at the baseline and longer follow-up period had a greater risk of developing a ChRA like non-treatment, even if IVB treatment was performed for mCNV. Content Type Journal ArticleCategory Retinal DisordersPages 1-9DOI 10.1007/s00417-011-1921-4Authors Riyo Uemoto, Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, JapanHoumei Nakasato-Sonn, Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, JapanTatsukata Kawagoe, Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, JapanMeguro Akir...

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Non-invasive assessment of atherosclerotic coronary lesion length using multidetector computed tomography angiography: comparison to quantitative coronary angiography

The International Journal of Cardiovascular Imaging — Tue, 24 Jan 2012 07:32:54 +0100

Abstract Multidetector computed tomography angiography (CTA) provides information on plaque extent and stenosis in the coronary wall. More accurate lesion assessment may be feasible with CTA as compared to invasive coronary angiography (ICA). Accordingly, lesion length assessment was compared between ICA and CTA in patients referred for CTA who underwent subsequent percutaneous coronary intervention (PCI). 89 patients clinically referred for CTA were subsequently referred for ICA and PCI. On CTA, lesion length was measured from the proximal to the distal shoulder of the plaque. Quantitative coronary angiography (QCA) was performed to analyze lesion length. Stent length was recorded for each lesion. In total, 119 lesions were retrospectively identified. Mean lesion length o...

The association between soluble lectin-like oxidized low-density lipoprotein receptor-1 levels and patients with isolated coronary artery ectasia

Journal of Thrombosis and Thrombolysis — Tue, 24 Jan 2012 07:30:11 +0100

In this study, we found significantly higher levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 in coronary artery ectasia patients when compared to control subjects with normal coronary arteries, suggesting that soluble lectin-like oxidized low-density lipoprotein receptor-1 may be involved in the pathogenesis of coronary artery ectasia. Content Type Journal ArticlePages 1-7DOI 10.1007/s11239-011-0668-4Authors Mehmet Balin, Department of Cardiology, Elazig Education and Research Hospital, Elazig, TurkeyAhmet Celik, Department of Cardiology, Elazig Education and Research Hospital, Elazig, TurkeyM. Ali Kobat, Department of Cardiology, Elazig Education and Research Hospital, Elazig, Turkey Journal Journal of Thrombosis and ThrombolysisOnline ISSN 1573-...

Demonstration of liver metastases on postmortem whole body CT angiography following inadvertent systemic venous infusion of the contrast medium

International Journal of Legal Medicine — Tue, 24 Jan 2012 07:15:46 +0100

Abstract An 86-year-old woman was hospitalized for breathlessness and a large right-sided pleural effusion. Approximately 1 h after thoracentesis, she developed a hemothorax resulting in hypotension and death. Routine postmortem CT scanning showed a large volume right hemothorax and a markedly enlarged liver. In an attempt to determine the origin of bleeding prior to autopsy, a postmortem CT angiogram was performed. Following inadvertent cannulation of the left long saphenous vein and infusion of ∼1,700 mL of a polyethylene glycol 200 and iodine-based radiographic contrast solution into systemic veins using a mechanical pump, CT scanning revealed a dense hepatic "parenchogram" containing multiple large, filling defects indicative of metastases. These were confi...

Spot sign score predicts rapid bleeding in spontaneous intracerebral hemorrhage

Emergency Radiology — Tue, 24 Jan 2012 06:55:15 +0100

This study was conducted to determine whether spot sign score correlates with average rate of hematoma expansion and whether average rate of expansion predicts in-hospital mortality and clinical outcome in spontaneous intracerebral hemorrhage (ICH). The study included 367 patients presenting to the Emergency Department (ED) from January 1, 2000 to December 31, 2008 with nontraumatic ICH. All received noncontrast computed tomography (NCCT) of the head and multidetector CT angiography (MDCTA) on presentation to the ED and a follow-up NCCT within 48 h. Imaging was used to determine the hematoma location and volume, average rate of expansion, and spot sign score. Primary outcome measures included in-hospital mortality and clinical outcome based on modified Rankin Scale at 3 mon...

Clinical, radiological profile and outcome in pediatric Spetzler–Martin grades I–III arteriovenous malformations

Child's Nervous System — Tue, 24 Jan 2012 06:48:00 +0100

Conclusion The aim of treating a pediatric AVM should be complete obliteration of the AVM considering the high risk of hemorrhage and the morbidity and mortality associated with hemorrhage. With careful planning and adopting a multimodality treatment, complete obliteration can definitely be achieved. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s00381-011-1668-6Authors Anup P. Nair, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014 IndiaRaj Kumar, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014 IndiaAnant Mehrotra, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Luckno...

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MSCT diagnosis of aneurysms associated with an unusual variant: atypical triplication anterior cerebral artery

Surgical and Radiologic Anatomy — Tue, 24 Jan 2012 06:46:18 +0100

Abstract Atypical triplication anterior cerebral artery is a rare entity and the variation is an important factor leading to aneurysm. A patient with aneurysm that arises from the bifurcation of the distal anterior cerebral arteries is presented. The contralateral anterior cerebral artery is also presented, and there is no communication between the left and the right anterior cerebral artery. The findings from multiple slice CT angiography in this case are illustrated and discussed. The recognition of this variant is important for the therapy planning. Content Type Journal ArticleCategory Anatomic VariationsPages 1-4DOI 10.1007/s00276-011-0928-1Authors Cong Sun, Shandong Provincial Medical Imaging Institute, Shandong Key Laboratory of Cardiovascular and Cerebrovascula...

Duplicate origin and fenestration of the middle cerebral artery on MR angiography

Surgical and Radiologic Anatomy — Tue, 24 Jan 2012 06:46:17 +0100

Conclusions In our institution, we observed 0.11% prevalence of duplicate origin of the MCA on MR angiography, and all were small and mimicked fenestration. Clinically, an important difference between duplicate origin and fenestration of the MCA is the potential collateral circulation available from the inferior branch in the case of saddle embolism occlusion of only the superior branch when there is duplicate origin of the MCA. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00276-012-0936-9Authors Akira Uchino, Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 JapanNaoko Saito, Department of Diagnostic Radiology, Saitama Medical University International ...

Segmentectomy Simulation Using a Virtual Three-Dimensional Safety Margin [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Refractory Spasm of Coronary Arteries and Grafted Conduits After Isolated Coronary Artery Bypass Surgery [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Diffuse RVS after CABG is a rare but lethal condition. Our experience, although limited, indicates that in such cases an aggressive treatment, that is, prompt extracorporeal membrane oxygenation institution and controlled cardiocirculatory assistance, represents the preferred solution to face such a dramatic event and may save patient lives. (Source: The Annals of Thoracic Surgery)

Radionuclide and Angiographic Assessment of Pulmonary Perfusion After Fontan Procedure: Comparative Interim Outcomes [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions After the Fontan procedure, hypostatic redistribution of pulmonary blood flow is characteristic. The weak pulse of blood, in the absence of ventricular ejection, can promote pulmonary vascular changes, but at later (intermediate) follow-up, the decline in vascular resistance that results carries no benefit in terms of blood perfusion or oxygenation. Microcirculatory arteriovenous shunting is the likely cause. In this study of functional pulmonary hemoperfusion, radionuclide imaging was deemed superior to angiocardiography. (Source: The Annals of Thoracic Surgery)

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Relationship of the lumbar lordosis angle to the abdominal aortic bifurcation and inferior vena cava confluence levels

Clinical Anatomy — Tue, 24 Jan 2012 05:00:00 +0100

This study showed that the level of bifurcation of the aorta and the level of confluence of the IVC may vary with the variations of the LLA. Clin. Anat. 2012. © 2012 Wiley Periodicals, Inc. (Source: Clinical Anatomy)

Cardiac hybrid imaging

European Journal of Echocardiography — Tue, 24 Jan 2012 05:00:00 +0100

combines different imaging modalities in a way where both modalities equally contribute to image information. The most common and best-studied approach is to combine computed tomography coronary angiography (CTCA) and myocardial perfusion imaging either with single-photon emission computed tomography or with positron emission tomography (PET). This combination is a promising tool for evaluation of coronary artery disease since it allows visualization of coronary atherosclerotic lesions and their haemodynamic consequences in a single study and it appears to offer superior diagnostic accuracy when compared with stand-alone imaging. More recent applications are a combination of CTCA and cardiac magnetic resonance imaging by using software image fusion and utilization of commercially availabl...

Resting coronary flow velocity in the functional evaluation of coronary artery stenosis: study on sequential use of computed tomography angiography and transthoracic Doppler echocardiography

European Journal of Echocardiography — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion Sequential use of CTA and TTDE is feasible for combined anatomic and functional evaluation of coronary stenoses. Compared with coronary CTA alone, addition of TTDE improved PPV for detection of significant CAD. (Source: European Journal of Echocardiography)

Brachial artery hyperaemic blood flow velocity in relation to established indices of vascular function and global atherosclerosis

Clinical Physiology and Functional Imaging — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion: The SDFV ratio was related to established markers of both vasodilation and arterial compliance, and to global atherosclerosis. Future larger studies have to evaluate whether the SDFV ratio is related to global atherosclerosis independently of traditional risk factors. (Source: Clinical Physiology and Functional Imaging)

Clinical outcomes of intracoronary eptifibatide bolus only versus intracoronary bolus and intravenous infusion of eptifibatide in primary percutaneous coronary intervention.

Acute Cardiac Care — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Soon D, Ho HH, Loh KK, Ooi YW, Foo D, Jafary FH, Ong PJ Abstract Intracoronary bolus of eptifibatide during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has been shown to result in higher local platelet glycoprotein IIb/IIIa receptor occupancy with improved microvascular perfusion. It is unclear whether intracoronary administration of eptifibatide in a larger patient population results in favourable clinical outcomes. We evaluated the safety and efficacy of two regimens of intracoronary eptifibatide (bolus only versus bolus followed by intravenous infusion) in patients undergoing primary PCI for ST-elevation MI. They were divided into two groups: Group A (n = 67) who received fixed-dose intracoronary eptifibatide bolus only and Group B ...

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High frequency of Neuropeptide Y Leu7Pro polymorphism in an Iranian population and its association with coronary artery disease.

Gene — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSIONS: The frequency of Leu7Pro polymorphism of NPY was 5.9% in our Iranian population; higher than reported for other Asian populations. The Leu7Pro polymorphism was associated with CAD in an Iranian population. PMID: 22289186 [PubMed - as supplied by publisher] (Source: Gene)

Angiographic, ECG and MRI Methods and Area at Risk in AMIAngiographic, ECG and MRI Methods and Area at Risk in AMI

Medscape Today Headlines — Tue, 24 Jan 2012 04:00:00 +0100

Clinical outcome after AMI largely depends on final infarct size, but what method is best to evaluate the extent of the infarct? Heart (Source: Medscape Today Headlines)

Overuse of Health Care Services in the United States: An Understudied Problem [Special Article]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions The robust evidence about overuse in the United States is limited to a few services. Reducing inappropriate care in the US health care system likely requires a more substantial investment in overuse research. (Source: Archives of Internal Medicine)

Dual-beam-scan Doppler optical coherence angiography for birefringence-artifact-free vasculature imaging

Optics Express — Mon, 23 Jan 2012 05:00:00 +0100

Dual-beam-scan Doppler optical coherence angiography (DB-OCA) enables high-speed, high-sensitivity blood flow imaging. However, birefringence of biological tissues is an obstacle to vasculature imaging. Here, the influence of polarization and birefringence on DB-OCA imaging was analyzed. A DB-OCA ... (Source: Optics Express)

High-penetration swept source Doppler optical coherence angiography by fully numerical phase stabilization

Optics Express — Mon, 23 Jan 2012 05:00:00 +0100

A high-penetration swept-source optical coherence tomography (HP-SS-OCT) system based on a 1-μm short cavity laser is developed. Doppler OCT processing is applied, along with a custom-made numerical phase stabilization algorithm; this process does not require additional calibration hardware. ... (Source: Optics Express)

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“Choke” vessels between vascular territories of the abdominal wall: Literature review and rare case of Leriche's syndrome

Clinical Anatomy — Mon, 23 Jan 2012 05:00:00 +0100

AbstractWe undertook a review of the anatomical changes of “choke” vessels between the internal thoracic artery (ITA) and deep inferior epigastric artery (DIEA), as highlighted by a case of aortoiliac occlusive disease (Leriche's syndrome), and discuss the physiological concepts observed with regard to surgical delay procedures within the abdominal wall performed prior to abdominal cutaneous free flaps and coronary artery bypass grafting. Computed tomographic angiography (CTA) was undertaken on a patient with a rare case of Leriche's syndrome and a literature review of over 200 references on the anatomy, physiology and clinical uses of choke vessels in the abdominal wall was undertaken. The CTA demonstrated that in patients with Leriche's syndrome, there is a marked dilatation of all I...

Multimodal imaging of dry age‐related macular degeneration

Acta Ophthalmologica — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: Simultaneous recording of SD OCT scans provided ultrastructural data for the evaluation of NIR, FAF, NIA and FA in dry AMD. Near‐infrared autofluorescence might detect earlier than FAF areas of RPE cell loss at the GA margin. (Source: Acta Ophthalmologica)

An Unusual Case of Gastrointestinal Bleeding

Journal of Nanomaterials — Sun, 22 Jan 2012 16:10:59 +0100

A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrant mass that was confirmed by computed tomography angiogram (CTA), which showed an 8 cm well-defined retroperitoneal vascular mass. 123Iodine metaiodobenzylguanidine (123MIBG) scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paraganglioma that was treated with chemotherapy. This case represents an unusual presentation of a paraganglioma associated with gastrointestinal (GI) bleeding and highlights the utility of CTA and 123MIBG in evaluation and treatment. (Source: Journal of Nanomaterials)

Transarterial Chemoembolization for Hepatocellular Carcinomas in Watershed Segments: Utility of C-Arm Computed Tomography for Treatment Planning

Journal of Vascular and Interventional Radiology : JVIR — Sat, 21 Jan 2012 08:07:51 +0100

We describe the impact C-arm CT can have on determining a dual blood supply in watershed region tumors and, more importantly, its ability to portray incomplete treatment at the time of the procedure itself. An exemption from obtaining informed consent was provided by the institutional review board for this retrospective report. All data were handled in compliance with the Health Insurance Portability and Accountability Act. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Endovascular Therapy of Saccular Aortic Aneurysm

Journal of Vascular and Interventional Radiology : JVIR — Sat, 21 Jan 2012 08:07:50 +0100

Based on a computed tomographic (CT) angiography study, a 23-year-old woman with Takayasu aortitis and abdominal pain was diagnosed with large 5.2-cm saccular abdominal aortic aneurysm near an occluded left renal artery (a; available in color online at www.jvir.org) and nonfunctional left kidney, small ectasia of inferior mesenteric artery origin, and mild diffuse aortic disease. There was no previous trauma or abdominal sepsis. Open surgical repair was undesirable, as the aortic tissue in the vicinity of the aneurysm was abnormal. The close proximity to right renal artery precluded endovascular stent-grafting. (Source: Journal of Vascular and Interventional Radiology : JVIR)

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Facial vein aneurysm associated with sialadenitis

Journal of Clinical Ultrasound — Sat, 21 Jan 2012 07:58:15 +0100

AbstractA 20 year‐old man presented with pain and swelling of the left submandibular area. Neck sonography revealed enlargement of the submandibular gland, coarsening of its echotexture with a few calculi and a multiloculated cystic lesion. Doppler sonography revealed venous flow within the cystic lesion and aneurysmal dilatation of the adjacent facial vein. CT angiography confirmed the facial vein aneurysm. We hypothesize that inflammation of the gland had weakened the wall of the adjacent facial vein, causing aneurysmal dilatation. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012; (Source: Journal of Clinical Ultrasound)

Lung adenocarcinoma with peculiar growth to the pulmonary artery and thrombus formation: Report of a case

World Journal of Surgical Oncology — Sat, 21 Jan 2012 05:00:00 +0100

Conclusions: This is the first reported case of radical resection of a lung cancer with invasion along the pulmonary artery wherein a benign thrombus had formed. In general, surgery would be the treatment of choice for a pulmonary artery mass. (Source: World Journal of Surgical Oncology)

Macular ischaemia: a contraindication for anti-VEGF treatment in retinal vascular disease?

The British Journal of Ophthalmology — Fri, 20 Jan 2012 19:54:58 +0100

Authors: Manousaridis K, Talks J Abstract Anti-vascular endothelial growth factor (anti-VEGF) therapy has been shown to be effective at improving vision in patients with macular oedema due to diabetic retinopathy and vein occlusions, but blocking VEGF at least in theory could be detrimental to vascular integrity. For this reason, some patients with macular ischaemia were excluded from studies showing the effectiveness of therapy. A considerable number of patients present with mixed pathology of macular oedema and macular ischaemia and it is often impossible to determine the degree to which ischaemia accounts for decreased vision. In this review, the authors have dealt with the specific question of whether or not there is evidence to support potential worsening of the macular perfus...

Diagnostic Accuracy of Computed Tomography Coronary Angiography According to Pre-Test Probability of Coronary Artery Disease and Severity of Coronary Arterial Calcification: The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) International Multicenter Study

Journal of the American College of Cardiology — Fri, 20 Jan 2012 13:57:13 +0100

Objectives: The purpose of this study was to assess the impact of patient population characteristics on accuracy by computed tomography angiography (CTA) to detect obstructive coronary artery disease (CAD). Background: The ability of CTA to exclude obstructive CAD in patients of different pre-test probabilities and in presence of coronary calcification remains uncertain. Methods: For the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study, 371 patients underwent CTA and cardiac catheterization for the detection of obstructive CAD, defined as ≥50% luminal stenosis by quantitative coronary angiography (QCA). This analysis includes 80 initially excluded patients with a calcium score ≥600. Area under the receiver-operating characterist...

Coronary Computed Tomography Angiography: The Challenge of Coronary Calcium⁎

Journal of the American College of Cardiology — Fri, 20 Jan 2012 13:57:13 +0100

In this issue of the Journal, Arbab-Zadeh et al. () report on the influence of calcification and the pre-test likelihood of disease on the diagnostic accuracy of coronary computed tomography angiography (CTA) in a small multicenter study (CORE-64 [Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography]). Their report provides valuable insights into the importance of coronary calcification as an unresolved limitation of CTA. The original CORE-64 report pre-specified exclusion of patients with a calcium score >600 Agatston units, a criterion that eliminated 89 of 405 patients (22%) from the analysis (). In the current paper (), the authors have appropriately included such patients, documenting an important limitation in the diagnostic accuracy of CTA when appli...

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In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography

The International Journal of Cardiovascular Imaging — Fri, 20 Jan 2012 07:07:36 +0100

This study sought to compare lumen dimensions as assessed by 3D quantitative coronary angiography (QCA) and by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), and to assess the association of the discrepancy with vessel curvature. Coronary lumen dimensions often show discrepancies when assessed by X-ray angiography and by IVUS or OCT. One source of error concerns a possible mismatch in the selection of corresponding regions for the comparison. Therefore, we developed a novel, real-time co-registration approach to guarantee the point-to-point correspondence between the X-ray, IVUS and OCT images. A total of 74 patients with indication for cardiac catheterization were retrospectively included. Lumen morphometry was performed by 3D QCA and IVUS or OCT. For quantit...

Outpatient evaluation and management of patients with ventricular premature beats or non-sustained ventricular tachycardia

Europace — Fri, 20 Jan 2012 05:00:00 +0100

In this survey, European physicians who deal with arrhythmia patients gave their opinions about diagnostic work up when they see patients with ventricular premature beats (VPBs) or non-sustained ventricular tachycardia (NSVT). In general, similar work-up regimens were used for these two arrhythmias except for coronary angiography, which was considered by one in four physicians when dealing with NSVT but by almost none for VPBs. The majority of physicians believe that it is acceptable to abstain from pharmacological therapy in an asymptomatic patient with VPBs. When considering second-line therapy almost half of the respondents would consider amiodarone in patients with NSVT whereas almost none would when dealing with VPBs. When the effect of therapy was evaluated, its influence on symptoms...

Radial versus femoral access for primary percutaneous coronary intervention: is there a preferred route to the heart?

Heart — Fri, 20 Jan 2012 05:00:00 +0100

In their paper published in Heart, Mamas et al report on a meta-analysis of studies comparing radial with the more traditional femoral access route for primary percutaneous coronary intervention (PCI) in patients presenting with ST elevation myocardial infarction (STEMI)1 (see page 303.). Even though radial access PCI currently appears to be an evolving technique, this approach has in fact been in use for a long time. In the 1940s, the radial approach was used by Radner in Sweden for diagnostic aortographies.2 In 1960, Mason Sones Jr, a paediatric cardiologist at Cleveland Clinic, performed the first coronary angiography via a brachial artery cut-down. This technique was replaced by the femoral artery approach in the 1960s by Melvin Judkins, a radiologist at the University of Oregon in Por...

A bridge too far

Heart — Fri, 20 Jan 2012 05:00:00 +0100

A man in his 60s with no prior cardiac history presented with a non-ST-elevation acute coronary syndrome. Coronary angiography revealed a moderate lesion in mid-left anterior-descending artery (figure 1A) and two muscular bridges visible only in systole (figure 1B). The myocardial fractional flow reserve (FFR), after an intracoronary bolus of 120 μg adenosine with the wire in distal vessel, was 0.74. The fixed stenosis was implanted with a stent (figure 1C). The result was angiographically locally excellent, but the repeat FFR was 0.73 (figure 1D). The proximal bridge was therefore implanted with a stent (figure 1E). The result was also angiographically excellent, but the repeat FFR was 0.77 in distal vessel, 0.83 proximal to the distal bridge and 0.85 proximal to both mid-vessel s...

Association of social support and coping strategies with acute coronary syndrome: A case-control study.

Journal of Cardiology — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: Improvement in social support and adaptive coping strategies should be considered in patients with chronic ischemic heart disease (IHD) to reduce the risk of ACS. PMID: 22266457 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

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Association of plasma cystatin C levels with angiographically documented coronary artery disease in patients of Indian origin.

Journal of Cardiology — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: In Indian patients with CAD, higher PCyC levels are associated with more severe CAD. The association of PCyC with severe CAD remains robust even in patients with normal or mildly impaired renal function. Cystatin C may have potential clinical usefulness as a marker for identification of high risk CAD patients. PMID: 22266456 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

CHOP-10 Limits Postnatal Neovascularization Through the Control of eNOS Gene Expression.

Circulation — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSIONS: This study identifies CHOP-10 as an important transcription factor modulating vessel formation and maturation. PMID: 22265908 [PubMed - as supplied by publisher] (Source: Circulation)

Indocyanine Green Angiography for Intra-operative Assessment in Vascular Surgery.

PubMed: Eur J Vasc Endovasc ... — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: HEMS angiography can accurately assess peripheral arterial perfusion in surgical cases with ASO and AAA. PMID: 22264591 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Long-term outcome of endovascular reconstruction with the Pipeline embolization device in the management of unruptured dissecting aneurysms of the intracranial vertebral artery.

Journal of Neurosurgery — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions Reconstruction using a flow-diverting device is an attractive alternative in definitive treatment of dissecting VA aneurysms, demonstrating favorable long-term clinical and angiographic outcomes and the ability to maintain parent artery and side-branch patency. It is particularly useful in cases with eloquent side-branch or dominant VA involvement. PMID: 22264186 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Gamma Knife surgery for basal ganglia and thalamic arteriovenous malformations.

Journal of Neurosurgery — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions Gamma Knife surgery offers a reasonable chance of obliterating basal ganglia and thalamic AVMs and does so with a low risk of complications. It is an optimal treatment option in patients for whom the anticipated risk of microsurgery is too high. PMID: 22264181 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

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CT Angiography Found Less Helpful in Patients With High Calcium Scores

Forbes.com Healthcare News — Thu, 19 Jan 2012 19:02:41 +0100

Computed tomography angiography (CTA) has been proposed as a less invasive method to exclude obstructive coronary artery disease (CAD), but no consensus has been achieved about its clinical role in different patient subsets. Now a new report published in JACC from the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study shows that CTA may not be worthwhile in people with a calcium score of 600 or above or who already have a high pre-test probability of having CAD. (Source: Forbes.com Healthcare News)

Candidates and major determinants for endovascular repair of abdominal aortic aneurysms in Korean patients

Heart and Vessels — Thu, 19 Jan 2012 08:04:40 +0100

Abstract The purpose of this study was to determine what proportion of patients with an abdominal aortic aneurysm (AAA) would be eligible for endovascular aneurysm repair (EVAR) and to examine the major determinants for suitability of EVAR with the currently available indications. We retrospectively reviewed 3-D reconstructed computed tomography angiography of 88 patients with an atherosclerotic AAA who underwent open repair or EVAR between October 2003 and October 2010 at the Cardiovascular Center, Seoul National University Bundang Hospital. Of the 88 patients, 71 (80.7%) were treated with open repair and 17 (19.3%) were treated with EVAR. The rate of minor complications, postprocedural intensive care unit stay, and total hospital stay were significantly lower in the EVAR...

Does Nebivolol Prevent Contrast‐Induced Nephropathy in Humans?

Clinical Cardiology — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions:Pretreatment with nebivolol is protective against nephrotoxic effects of contrast media. © 2012 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose. (Source: Clinical Cardiology)

Inline Directionally Independent Peak Velocity Evaluation Reduces Error in Peak Antegrade Velocity Estimation in Patients Referred for Cardiac Valvular Assessment

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Relative to standard through-plane imaging, MaxVelocity more closely approximates echocardiography for noninvasive assessment of peak antegrade velocity. Improved accuracy is critical for surgical decision making in patients with aortic valvular disease. Therefore, MaxVelocity provides an easy approach to quantify peak velocity as part of a routine clinical MRI protocol. (Source: American Journal of Roentgenology)

Visceral Artery Aneurysms

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

We report 5 cases of visceral aneurysms, all treated differently—ligation, aneurysmectomy (with splenectomy), emergency and elective coil embolization, and conservatively. We will further give a review of the literature on etiology, diagnosis, and treatment options. (Source: Vascular and Endovascular Surgery)

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External Iliac Vein Thrombosis in an Athletic Cyclist With a History of External Iliac Artery Endofibrosis and Thrombosis

Vascular and Endovascular Surgery — Thu, 19 Jan 2012 05:00:00 +0100

We report a case of extensive left lower limb deep venous thrombosis (DVT) including the external iliac vein diagnosed in a 57-year-old athletic cyclist with a history of external iliac artery thrombosis. (Source: Vascular and Endovascular Surgery)

Clinical situations in which coronary CT angiography confers superior diagnostic information compared with coronary angiography.

Diagnostic and Interventional Radiology — Thu, 19 Jan 2012 05:00:00 +0100

Authors: Kantarci M, Doganay S, Karcaaltincaba M, Karabulut N, Erol MK, Yalcin A, Duran C, Dursun M, Karakaya A, Tatli S Abstract In this review, we aimed to outline the clinical and pathological conditions for which multidetector computed tomography coronary angiography (MDCT-CA) should be the preferred method because of its advantages over conventional coronary angiography (CCA). A consistent body of literature suggests that MDCT-CA is more than just complementary to CCA and that it provides more valuable diagnostic information in certain clinical situations, such as complex coronary artery variations, aorto-ostial lesions, follow-up of bypass grafts, myocardial bridging, coronary artery fistulas, aortic and coronary artery dissections, and cases in which the coronary ostia canno...

Assessment of coronary stent deployment using computer enhanced x‐ray images‐validation against intravascular ultrasound and best practice recommendations

Catheterization and Cardiovascular Interventions — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: When using the SB system, two projection angles should be used to image the stent. For absolute measurements, the guide catheter should be used for calibration purposes. Relative measures of stent size, which are probably sufficient for assessment of deployment, also give good agreement with similar measures on IVUS, and require no calibration. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Sympathetic Nervous System Regulates Bone Marrow-Derived Cell Egress Through Endothelial Nitric Oxide Synthase Activation: Role in Postischemic Tissue Remodeling.

Arteriosclerosis, Thrombosis and Vascular Biology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSIONS: These results unravel, for the first time, a major role for the sympathetic nervous system in BM-derived cell egress through stromal eNOS activation. PMID: 22267478 [PubMed - as supplied by publisher] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)

Endurance Athletes with Intermittent Claudication Caused by Iliac Artery Stenosis Treated by Endarterectomy with Vein Patch - Short- and Mid-term Results.

PubMed: Eur J Vasc Endovasc ... — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSIONS: Precise diagnosis and meticulously performed endarterectomy with vein patching have satisfactory results in mid-term follow-up with acceptable risk in endurance athletes complaining of intermittent claudication due to iliac artery stenosis. PMID: 22264590 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

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Residual Flow After Cerebral Aneurysm Coil Occlusion: Diagnostic Accuracy of MR Angiography.

Stroke — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSIONS: MRA has sufficient accuracy for screening of aneurysm residual flow after coil occlusion. Due to its lower negative predictive value, recurrent aneurysms should be confirmed with digital subtraction angiogram before planning a retreatment. Routine use of MRA to follow small aneurysms should wait better estimation of its performance in this particular subgroup. PMID: 22267824 [PubMed - as supplied by publisher] (Source: Stroke)

FAME II: Additional Thoughts About FFR in the Real World

Forbes.com Healthcare News — Wed, 18 Jan 2012 19:31:40 +0100

Earlier today I reported the news that enrollment in the FAME II study had been stopped early by the DSMB. From the initial presentation of the first FAME trial several years ago, I've been fascinated by the potential of this technology, since it offers the tantalizing prospect of helping identify atherosclerotic lesions that actually will benefit from an intervention. But FFR is not a free ride. The downside is that you have to perform a lesser intervention (angiography) in order to determine the validity of the greater intervention (PCI). (Source: Forbes.com Healthcare News)

Levels of apolipoproteins as risk factors for coronary artery disease

Jornal Vascular Brasileiro — Wed, 18 Jan 2012 12:07:02 +0100

INTRODUCTION: The Saudi population is renowned for their unhealthy diet and physical inactivity. OBJECTIVE:To investigate apolipoproteins B (apo B), A-I (apo A-I) and B/A-I as risk factors that might be associated with increased incidence of the coronary artery disease. METHODS: Two hundred and twenty subjects suspected of having the coronary artery disease underwent coronary angiography and blood draw following a 12-hour fast. Apolipoproteins B and A-I were both measured by turbidimetric methods. RESULTS: One hundred and forty subjects were positive and 80 subjects were negative for the coronary artery disease. Both apolipoproteins were found to be statistically significant as risk factors for the coronary artery disease: apolipoprotein B (105.33±29.22 versus 94.56±24.35 mg/dL, p

Popliteal Venotomy During Posterior Cruciate Ligament Reconstruction in the Setting of a Popliteal Artery Bypass Graft

Arthroscopy — Wed, 18 Jan 2012 12:06:12 +0100

We present the first report, to our knowledge, of an isolated injury to a popliteal vein during arthroscopic posterior cruciate ligament reconstruction. Unfortunately, the venotomy led to cardiopulmonary arrest and flash pulmonary edema in this patient. Preoperative planning is paramount to assess risk of injury to vascular structures, which may be increased in patients who have had prior procedures on the affected knee. Furthermore, vascular surgery consultation preoperatively after a magnetic resonance angiogram or venogram and avoiding the use of epinephrine in the arthroscopy fluid should be considered when performing these higher-risk procedures. (Source: Arthroscopy)

Clinical re-evaluation of the relationship between gluteal injuries and embolized arteries in patients with massive hemorrhage following pelvic fracture

European Journal of Trauma and Emergency Surgery — Wed, 18 Jan 2012 06:59:49 +0100

Conclusions If possible, we recommend selective embolization avoiding the superior and inferior gluteal arteries. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00068-011-0174-6Authors S. Hamaguchi, Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, JapanY. Nakajima, Department of Radiology, St. Marianna University School of Medicine, Kawasaki, JapanT. Inoue, Department of Radiology, Yokohama City University Graduate School, Yokohama, Japan Journal European Journal of Trauma and Emergency SurgeryOnline ISSN 1863-9941Print ISSN 1863-9933 (Source: European Journal of Trauma and Emergency Surgery)

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In vivo physiological saline-infused hepatic vessel imaging using a two-crystal-interferometer-based phase-contrast X-ray technique

Journal of Synchrotron Radiation — Wed, 18 Jan 2012 05:00:00 +0100

Using a two-crystal-interferometer-based phase-contrast X-ray imaging system, the portal vein, capillary vessel area and hepatic vein of live rats were revealed sequentially by injecting physiological saline via the portal vein. Vessels greater than 0.06 mm in diameter were clearly shown with low levels of X-rays (552 µGy). This suggests that in vivo vessel imaging of small animals can be performed as conventional angiography without the side effects of the presently used iodine contrast agents. (Source: Journal of Synchrotron Radiation)

The Basilic Vein: An Alternative Conduit for Complex Iliofemoral Reconstruction.

PubMed: Eur J Vasc Endovasc ... — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSION: Iliofemoral arterial reconstruction with autologous basilic vein is feasible and may be a valid alternative when the use of prosthetic material is contraindicated. PMID: 22264425 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Fetal trans-apical stent delivery into the pulmonary artery: prospects for prenatal heart-valve implantation [BASIC SCIENCE]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS Our study demonstrates the principal technical feasibility of a prenatal stent delivery into the pulmonary artery using a novel trans-apical hybrid-intervention technique. This approach demonstrates the first step towards possible future minimally invasive prenatal heart-valve-implantation procedures. (Source: European Journal of Cardio-Thoracic Surgery)

Evaluation of coronary allograft vasculopathy using multi-detector row computed tomography: a systematic review [TX [amp ] MCS]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

This article systematically reviews the literature to determine the accuracy of MDCT in CAV assessment. An English-language literature search was performed using EMBASE, OVID, PubMed, and Cochrane Library databases. Studies that directly compared MDCT with CCA and/or IVUS for the detection of coronary artery stenosis or significant intimal thickening in cardiac transplant patients were analyzed. Data were pooled to obtain weighted sensitivities, specificities, and diagnostic accuracies. Negative and positive predictive values (NPV/PPV) were calculated. A total of seven studies with a sum of 272 patients were included in this review. There were three studies examining 16-slice MDCTand four studies looking at 64-slice MDCT in CAV. Using per-segment analysis, MDCTassessed between 91% and 96% ...