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Raynald, Chen N, Yang H, Tong X, Sui B, Qu H, Dong K, Wang Y, Miao Z, Mo D. Intravascular ultrasound characteristics of different types of stenosis in idiopathic intracranial hypertension with venous sinus stenosis. J Neurointerv Surg 2024; 16:506-511. [PMID: 37355254 DOI: 10.1136/jnis-2023-020345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/04/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND In this study, we analyzed the characteristics of different stenosis types in idiopathic intracranial hypertension (IIH) patients with venous sinus stenosis (VSS) using intravascular ultrasound (IVUS). METHODS We retrospectively reviewed data from patients who underwent IVUS evaluation during venography or stenting procedures between January 2014 and February 2022. RESULTS Among the 80 patients with intrinsic lesions, 47 cases were identified, including 41 single lesions and 6 multiple lesions. Single lesions consisted of 36 cases of AG, 3 cases of brain herniation, and 2 cases of septation. Multiple intrinsic lesions were found in 6 patients, with AG observed in the transverse sinus and sigmoid sinus. IVUS features varied depending on the anatomical variations of intrinsic stenosis. Additionally, among the 33 cases of extrinsic stenosis, two types were observed: unilateral compression (22 cases) and bilateral compression (11 cases), primarily affecting the transverse sinus. CONCLUSION IVUS effectively differentiated intrinsic and extrinsic types of stenosis and identified intraluminal and mural components of intrinsic stenosis.
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Affiliation(s)
- Raynald
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Na Chen
- Department of Neurology, Beijing Daxing Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hongchao Yang
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xu Tong
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Binbin Sui
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hui Qu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Kehui Dong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhongrong Miao
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Dapeng Mo
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
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Lehmann-Leo CD, Ramsthaler F, Birngruber CG, Verhoff MA. Assessment of renal glomerulosclerosis and thickness of the carotid intima-media complex as a means of age estimation in Western European bodies. Int J Legal Med 2021; 136:753-763. [PMID: 34773496 PMCID: PMC9005432 DOI: 10.1007/s00414-021-02705-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The estimation of age-at-death of unidentified cadavers is a central aspect of the identification process. With increasing age, the incidence of glomerulosclerosis and the thickness of the carotid wall have been observed to also increase. This correlation has been demonstrated in various international histological studies. The aim of our study was to assess whether these correlations also apply to a Western European population. METHODOLOGY In this retrospective observational study, kidney and common carotid artery samples from 216 cases autopsied at the Institute of Legal Medicine at the Justus-Liebig University in Giessen, Germany, were examined. Only cases with available tissue samples from both body sides were included. Exclusion criteria were poor sample quality and an age younger than 21 years. After histological processing, the tissue samples were assessed and digitally evaluated. Regression and classification analyses were used to investigate the correlation between age-at-death and intima-media thickness and age-at-death and the incidence of renal glomerular sclerosis. RESULTS Of the 216 autopsy cases, 183 were included for evaluation. Analysis of the carotid artery segments showed a strong correlation (Pearson correlation coefficient r = 0.887) between the intima-media-complex thickness and chronological age. Classification of the glomerulosclerotic incidence showed a correlation of 37.7-43.1% with the predicted age group. DISCUSSION Both the intima-media thickness and the proportion of sclerotic glomeruli can be used to estimate age in Western European cadavers. On the basis of these results, both methods are suited to supplement other already established methods for age-at-death estimation in the identification of an unknown cadaver.
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Affiliation(s)
- Carl Daniel Lehmann-Leo
- Institute of Legal Medicine, University Hospital of Frankfurt, Goethe University, Kennedyallee 104, 60596, Frankfurt/Main, Germany
- Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital Gießen and Marburg, Gießen, Germany
| | - Frank Ramsthaler
- Institute of Legal Medicine, University of Saarland, HomburgSaar, Germany
| | - Christoph G Birngruber
- Institute of Legal Medicine, University Hospital of Frankfurt, Goethe University, Kennedyallee 104, 60596, Frankfurt/Main, Germany
| | - Marcel A Verhoff
- Institute of Legal Medicine, University Hospital of Frankfurt, Goethe University, Kennedyallee 104, 60596, Frankfurt/Main, Germany.
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Abstract
SUMMARY The off-label use of drugs and devices in neuroendovascular procedures is common. Neurointerventionalists should be well aware of the level of evidence available in support of the off-label use of drugs and devices in their practice and some of the potential adverse events associated with them. These uses are categorized as I or II if they have been evaluated as primary or ancillary interventions in prospective trials/registries of neuroendovascular procedures and III if they were evaluated in case series. Category IV use is based on evaluation as primary or ancillary interventions in prospective trials/registries of non-neuroendovascular procedures. Physicians are allowed to use off-label drugs and procedures if there is strong evidence that they are beneficial for the patient. The neurointerventional professional societies agree that off-label use of drugs and devices is an important part of the specialty, but practicing providers should base their decisions on sound evidence when using such drugs and devices.
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Mokin M, Kan P, Abla AA, Kass-Hout T, Snyder KV, Levy EI, Siddiqui AH. Intravascular ultrasound in the evaluation and management of cerebral venous disease. World Neurosurg 2012; 80:655.e7-13. [PMID: 22484769 DOI: 10.1016/j.wneu.2012.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/13/2012] [Accepted: 04/03/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intravascular ultrasound (IVUS) is an important diagnostic tool in many interventions, particularly coronary and carotid artery angioplasty and stenting. In contrast, its application in the management of diseases of the cerebral venous system remains an unexplored territory. We report three patients in whom IVUS was used during angiography for the evaluation of venous flow obstruction secondary to venous sinus thrombosis, venous sinus stenosis, and a transverse sinus mass lesion, respectively. In addition, we review current literature to summarize previous experience, focusing on the advantages and limitations of IVUS technology in interventional cardiology, carotid artery disease, and venous disease. CASE DESCRIPTIONS In all three cases, IVUS was used without any complications and provided critical information that guided further management of these distinct diseases. IVUS helped diagnose the presence of intraluminal thrombus, severe stenosis, and a mass lesion in the transverse sinuses and also helped assess the response to angioplasty of the stenotic regions. CONCLUSIONS IVUS is a promising tool that has potential to improve diagnostic accuracy and to guide the management of several diseases of the cerebral venous system. The cases we describe suggest that IVUS can be successfully used when performing endovascular interventions in patients with obstruction of venous outflow secondary to venous sinus stenosis, thrombosis, or mass lesions.
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Affiliation(s)
- Maxim Mokin
- Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Neurology, Gates Vascular Institute, Kaleida Health, Buffalo, New York, USA
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Kan P, Mokin M, Dumont TM, Snyder KV, Siddiqui AH, Levy EI, Hopkins LN. Cervical Carotid Artery Stenosis: Latest Update on Diagnosis and Management. Curr Probl Cardiol 2012; 37:127-69. [DOI: 10.1016/j.cpcardiol.2011.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hänni M, Leppänen O, Smedby Ö. Postangioplasty Restenosis Followed with Magnetic Resonance Imaging in an Atherosclerotic Rabbit Model. Int J Biomed Imaging 2012; 2012:1-8. [PMID: 23316216 PMCID: PMC3536348 DOI: 10.1155/2012/747264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 11/27/2022] Open
Abstract
Rationale and Objectives. Testing a quantitative, noninvasive method to assess postangioplasty vessel wall changes in an animal model. Material and Methods. Six New Zealand white rabbits were subjected to atherosclerotic injury, including cholesterol-enriched diet, deendothelialization, and percutaneous transluminal angioplasty (PTA) in the distal part of abdominal aorta (four weeks after deendothelialization). The animals were examined with a 1.5T MRI scanner at three times as follows: baseline (six weeks after diet start and two days after PTA) and four weeks and 10 weeks after-PTA. Inflow angiosequence (M2DI) and proton-density-weighted sequence (PDW) were performed to examine the aorta with axial slices. To identify the inner and outer vessel wall boundaries, a dynamic contour algorithm (Gradient Vector Flow Snakes) was applied to the images, followed by calculation of the vessel wall dimensions. The results were compared with histopathological analysis. Results. The wall thickness in the lesion was significantly higher than in the control region at 4 and 10 weeks, reflecting induction of experimentally created after-angioplasty lesion. At baseline, no significant difference between the two regions was present. Conclusions. It is possible to follow the development of vessel wall changes after-PTA with MRI in this rabbit model.
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Abstract
Intravascular sonography is a valuable tool for the morphologic assessment of coronary atherosclerosis and the effect of pharmacologic and nonpharmacologic interventions on the progression or stabilization of atherosclerosis. An analysis of the different modes, applications, and limitations is provided on the basis of review of existing data from multiple clinical case studies, trials, and mechanistic studies. Intravascular sonography has been used to assess the outcomes of different percutaneous interventions, including angioplasty and stent implantation, and to provide detailed characterization of atherosclerotic lesions, aneurysms, and dissections within the cerebrovascular circulation. Evolution of intravascular sonographic technology has led to the development of more sophisticated diagnostic tools such as color-flow, virtual histology, and integrated backscatter intravascular sonography. The technologic advancement in intravascular sonography has the potential of providing more accurate information prior, during, and after a medical or endovascular intervention. Continued assessment of this diagnostic technique in both the intracranial and extracranial circulation will lead to increased use in clinical practice with the intent to improve outcomes.
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Affiliation(s)
- H Zacharatos
- Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, 55455, USA
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Hirokawa N, Koito K, Satoh T, Hori M, Saitoh M, Nishida M, Hata F, Nishi M, Hareyama M. Wall composition analysis of the human hepatic artery by intravascular ultrasound. J Med Ultrason (2001) 2008; 35:107-11. [DOI: 10.1007/s10396-008-0180-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Accepted: 04/23/2008] [Indexed: 01/17/2023]
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Abstract
Targets for cardiovascular gene therapy currently include limiting restenosis after balloon angioplasty and stent placement, inhibiting vein bypass graft intimal hyperplasia/stenosis, therapeutic angiogenesis for cardiac and lower-limb ischemia, and prevention of thrombus formation. While catheter angiography is still standard method to follow-up vascular gene transfer, other modern imaging techniques, especially intravascular ultrasound (IVUS), magnetic resonance (MR), and positron emission tomography (PET) imaging provide complementary information about the therapeutic effect of vascular gene transfer in humans. Although molecular imaging of therapeutic gene expression in the vasculatures is still in its technical development phase, it has already offered basic medical science an extremely useful in vivo evaluation tool for non- or minimally invasive imaging of vascular gene therapy.
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Affiliation(s)
- Hannu I Manninen
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, FIN-70210 Kuopio, Finland.
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Lovett JK, Redgrave JNE, Rothwell PM. A Critical Appraisal of the Performance, Reporting, and Interpretation of Studies Comparing Carotid Plaque Imaging With Histology. Stroke 2005; 36:1091-7. [PMID: 15774817 DOI: 10.1161/01.str.0000160749.61763.95] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Carotid plaque instability is an important determinant of stroke risk. There are now a number of different imaging techniques that provide information on carotid plaque morphology. However, it is unclear how they compare with one another or whether they can reliably assess plaque instability. Studies comparing imaging with pathology have shown highly variable results, even for similar imaging techniques. This may be because of variable pathology techniques rather than differences in imaging.
Methods—
We performed a systematic review of studies that compared carotid imaging with histology of the excised plaque published between January 1995 and September 2004. We assessed the quality and comparability of these studies. In particular, we determined which histology methods were used and whether observer reproducibility of the histology assessment was reported.
Results—
Among 73 eligible studies, histological methods were poorly reported and highly variable; 23% reported reproducibility data for imaging and only 12% reported reproducibility data for histology. Of 29 studies that reported quantitative results of blinded comparisons, there were methodological deficiencies and the results were highly variable. No study considered the extent to which the lack of reproducibility influenced the imaging-pathological correlations reported.
Conclusions—
Pathological correlation in studies of carotid plaque imaging cannot be reliably interpreted or compared because of incomparable and poorly reported histology methods. We make recommendations for the performance, reporting, and interpretation of imaging–pathological correlation studies and highlight the need for consensus guidelines.
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Affiliation(s)
- J K Lovett
- Stroke Prevention Research Unit, Department of Clinical Neurology, Radcliffe Infirmary, Oxford
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Ochiai R, Kisanuki A, Asada Y, Asato M, Tamura S, Sumiyoshi A. Intravascular ultrasound imaging in the assessment of atherosclerotic plaques in rabbit abdominal aorta: comparison with histologic findings. Invest Radiol 2002; 37:309-13. [PMID: 12021586 DOI: 10.1097/00004424-200206000-00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To examine the correlation between the echogenicity and the components of atherosclerotic plaques in rabbit. METHODS The atherosclerotic plaque formation in the abdominal aortas of hyperlipidemic or normolipidemic rabbits was stimulated by inserting polyethylene tubing. Intravascular ultrasound (30-MHz, 4.5 F catheter) investigation was performed at locations in the vessel. The intravascular ultrasound images of the plaques were evaluated and compared with the histologic findings. RESULTS Ultrasound images delineated areas showing hyperechoic or hypoechoic ultrasound beams in the plaques. Histologic studies revealed that the hyperechoic areas were closely associated with a dense fibrous extracellular matrix, whereas the hypoechoic areas corresponded to lesions showing a marked accumulation of foamy macrophages or proteoglycan-rich loose myxoid extracellular matrix with smooth muscle cell proliferation. CONCLUSION A good correlation between ultrasound images and histologic features was observed. These results suggest that intravascular ultrasound imaging could provide useful information for assessing the tissue characteristics of atherosclerotic lesions.
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Affiliation(s)
- Reiji Ochiai
- Department of Radiology, Miyazaki Medical College, Kiyotake, Japan.
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Berg MH, Manninen HI, Rasanen HT, Vanninen RL, Jaakkola PA. CT angiography in the assessment of carotid artery atherosclerosis. A comparative analysis with MR angiography with reference to contrast angiography and intravascular ultrasound. Acta Radiol 2002. [DOI: 10.1034/j.1600-0455.2002.430202.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Takahata H, Hayashi K, Kitagawa N, Kaminogo M, Koga H, Shibata S. Computerized Assessment of Carotid Plaque Echogenicity before Stenting. Interv Neuroradiol 2001; 7:171-4. [DOI: 10.1177/15910199010070s126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 09/15/2001] [Indexed: 11/16/2022] Open
Abstract
To assess the ability of transcutaneous ultrasound (US) to identify carotid atherosclerotic plaques at high risk for development of procedural strokes, the authors retrospectively analyzed the plaque echomorphology by means of gray-scale value (GSV). Both transcutaneous and intravascular US demonstrated a similar ability to characterize the atherosclerotic plaques. A case with embolic complication was proven to have had the lowest GSV in the studied cases. With computerized assessment of plaque echogenicity, pre-procedural transcutaneous US may be used to predict plaques that are associated with a high risk of distal embolization.
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Affiliation(s)
| | - K. Hayashi
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki; Japan
| | - N. Kitagawa
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki; Japan
| | - M. Kaminogo
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki; Japan
| | | | - S. Shibata
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki; Japan
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Affiliation(s)
- H V Vinters
- Department of Pathology and Laboratory Medicine, Section of Neuropathology, Brain Research Institute and Neuropsychiatric Institute, UCLA Medical Center, CHS 18-170, Los Angeles, California 90095-1732, USA
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Abstract
RATIONALE AND OBJECTIVES To evaluate neointimal hyperplasia, plaque distribution, and morphologic features of peripheral arterial stent-grafts with intravascular ultrasound (IVUS). METHODS Twenty-three patients with stenoses or occlusions of the pelvic or femoral arteries were treated with 31 stent-grafts. Angiography and IVUS of the stented artery were performed 13.9 +/- 9.7 months after stent implantation. Maximum in-stent restenosis was measured by IVUS. Plaque composition and lesion topography were also assessed. RESULTS The maximum in-stent restenosis was 53.2 +/- 26.5% for the femoral and 14.2 +/- 10.1 for pelvic arterial stent-grafts. Predilection sites of maximum neointimal tissue accumulation were the edges of the femoral stent-grafts. Only small amounts of neointimal hyperplasia were found in the stent-graft edges. No predilection site for maximum in-stent restenosis was found for the pelvic arterial stent-grafts. CONCLUSIONS Predilection sites of maximum in-stent restenosis were the edges of femoral stent-grafts in contrast to pelvic stent-grafts. Femoral stent-grafts showed significantly higher graded stenoses with IVUS than iliac stent-grafts. The authors' findings at IVUS did not change the treatment plan in these patients treated with stent-grafts.
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Manninen HI, Räsänen HT, Vanninen RL, Vainio P, Hippeläinen M, Kosma VM. Stent placement versus percutaneous transluminal angioplasty of human carotid arteries in cadavers in situ: distal embolization and findings at intravascular US, MR imaging and histopathologic analysis. Radiology 1999; 212:483-92. [PMID: 10429707 DOI: 10.1148/radiology.212.2.r99au48483] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare endovascular stent placement with percutaneous transluminal angioplasty (PTA) of carotid arteries with respect to distal embolization and findings at intravascular ultrasonography (US), magnetic resonance (MR) imaging, and histopathologic analysis. MATERIALS AND METHODS PTA was performed in situ in one carotid artery, and stent placement was performed in the other, in ten cadavers (age range, 57-82 years; mean age, 68 years) with severe atherosclerosis by using fluoroscopic and intravascular US guidance. The carotid artery was connected to a pressurized tubing system in which a pulsatile pump circulated water. The effluent water was collected during the interventions, and after filtration and staining, the embolic material was analyzed histologically. After the interventions, the arteries were excised and 1.5-T spin-echo MR imaging was performed. RESULTS No difference in severity of distal embolization during stent placement versus during PTA was found. The embolic particles were composed mainly of intimal strips and cellular constituents of the atherosclerotic plaques. MR imaging accurately depicted postinterventional changes, and the findings correlated closely with those of intravascular US and histopathologic analysis. CONCLUSION Although stent placement and PTA were associated with equal distal embolization, the smooth surface and fully patent arterial lumen depicted at intravascular US and MR imaging postinterventionally may indicate that stent placement is preferable to PTA.
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Affiliation(s)
- H I Manninen
- Department of Clinical Radiology, Kuopio University Hospital, Finland.
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Söder HK, Manninen HI, Matsi PJ. Angiographic characteristics of symptomatic recurrent disease after infrainguinal percutaneous transluminal angioplasty. Cardiovasc Intervent Radiol 1999; 22:219-23. [PMID: 10382053 DOI: 10.1007/s002709900370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the angiographic patterns of clinically manifest recurrent disease after infrainguinal percutaneous transluminal angioplasty (PTA) of stenoses and total occlusions. METHODS Among 326 infrainguinal PTAs on 263 consecutive patients, selective angiography was performed on 61 limbs of 52 patients 1-60 months after the primary intervention because of clinically suspected recurrent disease. Lesion-specific and patient-related factors were analyzed for 75 angiographically confirmed recurrent lesions in 57 limbs of 48 patients. RESULTS Recurrent disease was more frequently a stenosis when the original target lesion was a stenosis (92%, 44/48) than when the original lesion was a total occlusion (59%, 16/27; p < 0.001). When the original target lesion was a stenosis, the total length of the recurrent disease was longer than that of the original lesion [3.9 +/- 3.9 cm (mean +/- standard deviation) vs 2.8 +/- 2.7 cm; p = 0.03], while in the subgroup of original total occlusions the length of the recurrent lesion was shorter than that of the original occlusion (7.1 +/- 5.0 cm vs 9.9 +/- 6.9 cm; p = 0.02). Half the restenosis (22/44) extended beyond one or both ends of the original stenosis and 38% (6/16) of the reocclusions extended beyond the distal end of the original occlusion. CONCLUSIONS The type of recurrent disease depends on the original lesion type and the restenotic lesion frequently extends beyond one or both ends of the original target lesion.
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Affiliation(s)
- H K Söder
- Department of Clinical Radiology, Kuopio University Hospital, Finland
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Räsänen HT, Manninen HI, Vanninen RL, Vainio P, Berg M, Saari T. Mild carotid artery atherosclerosis: assessment by 3-dimensional time-of-flight magnetic resonance angiography, with reference to intravascular ultrasound imaging and contrast angiography. Stroke 1999; 30:827-33. [PMID: 10187887 DOI: 10.1161/01.str.30.4.827] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to evaluate the usefulness of 3-dimensional time-of-flight magnetic resonance angiography (3-D TOF MRA) in detection and quantification of mild atherosclerotic changes of carotid arteries with reference to intravascular ultrasound (IVUS) and contrast angiography. METHODS TOF MRA at 1.5 T, IVUS, and selective digital subtraction angiography were performed on 31 extracranial carotid arteries of 27 patients (mean age, 52 years; age range, 17 to 75 years) undergoing neuroendovascular interventions. The atherosclerotic lesions were registered, and quantitative measurements of plaque thickness, luminal diameters, and diameter stenosis were independently performed for the imaging modalities. RESULTS Among 170 arterial segments analyzed, IVUS revealed a total of 48 atherosclerotic lesions (mean diameter stenosis, 17%; range, 4% to 40%), only 25 of which were depicted on digital subtraction angiography. Analysis of the axial source images of TOF MRA resulted in sensitivity of 77% to 83% and specificity of 71% to 80% in lesion depiction for the 2 readers with reference to IVUS. The values of diameter stenosis measured from MRA and IVUS were closely interrelated (r=0.53 to 0.61, P<0.001). CONCLUSIONS Three-dimensional TOF MRA is feasible and moderately accurate for evaluation of mild atherosclerotic changes of carotid arteries.
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Affiliation(s)
- H T Räsänen
- Department of Clinical Radiology, Kuopio University Hospital, Finland.
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Manninen HI, Vanninen RL, Laitinen M, Räsänen H, Vainio P, Luoma JS, Pakkanen T, Tulla H, Ylä-Herttuala S. Intravascular ultrasound and magnetic resonance imaging in the assessment of atherosclerotic lesions in rabbit aorta. Correlation to histopathologic findings. Invest Radiol 1998; 33:464-71. [PMID: 9704286 DOI: 10.1097/00004424-199808000-00007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES The authors compare the usefulness of intravascular ultrasound (IVUS) and magnetic resonance imaging (MRI) for quantitation of atherosclerosis in hyperlipidemic rabbits, correlated with histopathology. METHODS Magnetic resonance imaging with T1- and T2-weighted spin echo sequences and three-dimensional time-of-flight MR angiography of the abdominal aorta was performed on seven rabbits using a 1.5 T MR imager and a standard head coil. X-ray angiography and IVUS examination (3.5 F/30 MHz imaging catheter) was performed via carotid artery access. RESULTS Time-of-flight MR angiography source images provided the best resolution and plaque-lumen contrast in visual comparison between the different MRI sequences. Intra- and interobserver reproducibilities of the lesion thickness and area measurements were similar in IVUS and MRI (Pearson correlations 0.52-0.97; P < 0.01). The measurements from IVUS and MRI correlated closely with each other as well as with those made from histopathologic specimens (Pearson correlations 0.50-0.79; P < 0.001). The measurements from IVUS were somewhat more accurate than those made from MRI. CONCLUSIONS Both MRI and IVUS with clinically available imaging equipments are feasible and accurate for the quantitation of experimental atherosclerosis of rabbit aorta.
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Affiliation(s)
- H I Manninen
- Department of Clinical Radiology, Kuopio University Hospital, University of Kuopio, Finland
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