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Memarian S, Krokidis M, O'Sullivan G, Peynircioglu B, Rossi M, Kashef E. CIRSE Standards of Practice on Arterial Access for Interventions. Cardiovasc Intervent Radiol 2023; 46:302-309. [PMID: 36705706 DOI: 10.1007/s00270-022-03349-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/20/2022] [Indexed: 01/28/2023]
Abstract
This CIRSE Standards of Practice document is aimed at healthcare professionals (including interventional radiologists) performing endovascular procedures to provide best practices for performing arterial access for interventions. It has been developed by an expert writing group under the guidance of the CIRSE Standards of Practice Committee. This paper encompasses up-to-date clinical and technical aspects in performing safe and appropriate arterial access for interventions.
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Affiliation(s)
| | - Miltiadis Krokidis
- School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| | | | - Bora Peynircioglu
- Department of Radiology, Hacettepe UTF, Sihhiye Campus, Ankara, Turkey
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Xing B, He Z, Zhou F, Zhao Y, Shan T. Automatic force-controlled 3D photoacoustic system for human peripheral vascular imaging. BIOMEDICAL OPTICS EXPRESS 2023; 14:987-1002. [PMID: 36874482 PMCID: PMC9979678 DOI: 10.1364/boe.481163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 06/18/2023]
Abstract
Photoacoustic (PA) imaging provides unique advantages in peripheral vascular imaging due to its high sensitivity to hemoglobin. Nevertheless, limitations associated with handheld or mechanical scanning by stepping motor techniques have precluded photoacoustic vascular imaging from advancing to clinical applications. As clinical applications require flexibility, affordability, and portability of imaging equipment, current photoacoustic imaging systems developed for clinical applications usually use dry coupling. However, it inevitably induces uncontrolled contact force between the probe and the skin. Through 2D and 3D experiments, this study proved that contact forces during the scanning could significantly affect the vascular shape, size, and contrast in PA images, due to the morphology and perfusion alterations of the peripheral blood vessels. However, there is no available PA system that can control forces accurately. This study presented an automatic force-controlled 3D PA imaging system based on a six-degree-of-freedom collaborative robot and a six-dimensional force sensor. It is the first PA system that achieves real-time automatic force monitoring and control. This paper's results, for the first time, demonstrated the ability of an automatic force-controlled system to acquire reliable 3D PA images of peripheral blood vessels. This study provides a powerful tool that will advance PA peripheral vascular imaging to clinical applications in the future.
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Affiliation(s)
- Baicheng Xing
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Zhengyan He
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Fang Zhou
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Yuan Zhao
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- These authors contributed equally to this work
| | - Tianqi Shan
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- These authors contributed equally to this work
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Chen T, Liu L, Ma X, Zhang Y, Liu H, Zheng R, Ren J, Zhou H, Ren Y, Gao R, Chen N, Zheng H, Song L, Liu C. Dedicated photoacoustic imaging instrument for human periphery blood vessels: A new paradigm for understanding the vascular health. IEEE Trans Biomed Eng 2021; 69:1093-1100. [PMID: 34543187 DOI: 10.1109/tbme.2021.3113764] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A novel photoacoustic imaging system based on a semi-ring transducer array is proposed to imageperipheralbloodvessels. The system's penetration depth is deep (~15 mm) with high spatial (~200 m) and temporal resolution. In a clinical study, volumetric photoacoustic data of limbs were obtained within the 50s (for a FOV of 15 cm4 cm) with the volunteers in the standing and sitting posture. Compared to the previous studies, our system has many advantages, including (1) Larger field of view; (2) Finer elevational and in-plane resolutions; (3) Enhanced 3D visualization of peripheralvascular networks; (4) Compact size and better portability. The 3D visualization and cross-sectional images of five healthy volunteers clearly show the vascular network and the system's ability to image submillimeter blood vessels. This high-resolution PA system has great potential for imaging human periphery vasculatures noninvasively in clinical research.
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Cates NK, Elmarsafi T, Bunka TJ, Walters ET, Akbari CM, Zarick C, Evans KK, Steinberg JS, Attinger CE, Kim PJ. Peripheral Vascular Disease Diagnostic Related Outcomes in Diabetic Charcot Reconstruction. J Foot Ankle Surg 2019; 58:1058-1063. [PMID: 31679658 DOI: 10.1053/j.jfas.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 03/31/2019] [Accepted: 06/13/2019] [Indexed: 02/03/2023]
Abstract
Postreconstructive outcomes were compared in diabetic patients with Charcot neuroarthropathy (CN) who had peripheral arterial disease (PAD) diagnosed with angiography versus patients who were diagnosed clinically. A retrospective review was performed of patients with diabetic CN requiring reconstruction secondary to ulceration and/or acute infection. Of the 284 patients in the CN osseous reconstruction cohort, after accounting for exclusion criteria, 59 (20.8%) patients with PAD were included in the analyses. Forty (67.8%) of these 59 patients were diagnosed with PAD clinically and 19 (32.2%) were diagnosed with the use of angiography. Bivariate analysis was used to compare outcomes between those diagnosed with PAD via angiography versus those diagnosed clinically for the following postreconstruction outcomes: wound healing, delayed healing, surgical site infection, pin tract infection, osteomyelitis, dehiscence, transfer ulcer, new site of Charcot collapse, contralateral Charcot event, nonunion, major lower extremity amputation, and return to ambulation. Bivariate analysis found return to ambulation postreconstruction (p = .0054) to be the only statistically significant factor. There was a trend toward significance for major lower extremity amputation, with higher rates of amputation in the clinically diagnosed PAD arm. Return to ambulation indicates improved functional outcomes. The main goal of limb salvage should be focused on improving the patient's functional performance. With significantly faster rates of return to ambulation and a trend toward decreased rates of major amputation, angiography was found to be a better assessor of PAD than clinical evaluations.
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Affiliation(s)
- Nicole K Cates
- Resident Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Tammer Elmarsafi
- Attending Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Taylor J Bunka
- Resident Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Elliot T Walters
- Research Fellow, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Cameron M Akbari
- Attending Physician, Department of Vascular Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Caitlin Zarick
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Karen K Evans
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - John S Steinberg
- Co-Director of the Center for Wound Healing and Director of Podiatric Residency Training Program, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC.
| | - Christopher E Attinger
- Co-Director of the Center for Wound Healing and Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Paul J Kim
- Professor and Program Director, Center for Wound Healing and Hyperbaric Medicine, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
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Wray P, Lin L, Hu P, Wang LV. Photoacoustic computed tomography of human extremities. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-8. [PMID: 30784244 PMCID: PMC6380242 DOI: 10.1117/1.jbo.24.2.026003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/29/2019] [Indexed: 05/04/2023]
Abstract
We present a method of imaging angiographic structures in human extremities, including hands, arms, legs, and feet, using a newly developed photoacoustic computed tomography (PACT) system. The system features deep penetration (1.8 cm in muscular tissues) with high spatial and temporal resolutions. A volumetric image is acquired within 5 to 15 s while each cross sectional image is acquired within 100 μs. Therefore, we see no blurring from motion in the imaging plane. Longitudinal and latitudinal cross-sectional images of a healthy volunteer clearly show the vascular network of each appendage and highlight the system's ability to image major and minor vasculatures, without the use of an external contrast or ionizing radiation. We also track heartbeat-induced arterial movement at a two-dimensional frame rate of 10 Hz. This work substantiates the idea that PACT could be used as a noninvasive method for imaging human vasculatures.
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Affiliation(s)
- Parker Wray
- California Institute of Technology, Caltech Optical Imaging Laboratory, Department of Electrical Engineering, Pasadena, California, United States
| | - Li Lin
- California Institute of Technology, Caltech Optical Imaging Laboratory, Andrew and Peggy Cheng Department of Medical Engineering, Pasadena, California, United States
| | - Peng Hu
- Washington University in St. Louis, Department of Biomedical Engineering, St. Louis, Missouri, United States
| | - Lihong V. Wang
- California Institute of Technology, Caltech Optical Imaging Laboratory, Department of Electrical Engineering, Pasadena, California, United States
- California Institute of Technology, Caltech Optical Imaging Laboratory, Andrew and Peggy Cheng Department of Medical Engineering, Pasadena, California, United States
- Address all correspondence to Lihong V. Wang, E-mail:
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