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Journal of Vascular Surgery Mar 2019
Topics: Angiography; Endarterectomy, Carotid
PubMed: 30798843
DOI: 10.1016/j.jvs.2018.07.025 -
International Journal of Molecular... Jun 2023Diabetic choroidopathy was first described on histopathological specimens of diabetic eyes. This alteration was characterized by the accumulation of PAS-positive... (Review)
Review
Diabetic choroidopathy was first described on histopathological specimens of diabetic eyes. This alteration was characterized by the accumulation of PAS-positive material within the intracapillary stroma. Inflammation and polymorphonuclear neutrophils (PMNs) activation are crucial elements in choriocapillaris impairment. The evidence of diabetic choroidopathy in vivo was confirmed with multimodal imaging, which provides key quantitative and qualitative features to characterize the choroidal involvement. The choroid can be virtually affected in each vascular layer, from Haller's layer to the choriocapillaris. However, the damage on the outer retina and photoreceptor cells is essentially driven by a choriocapillaris deficiency, which can be assessed through optical coherence tomography angiography (OCTA). The identification of characteristic features of diabetic choroidopathy can be significant for understanding the potential pathogenic and prognostic implications in diabetic retinopathy.
Topics: Humans; Diabetic Retinopathy; Retina; Choroid; Retinal Vessels; Angiography; Tomography, Optical Coherence; Fluorescein Angiography; Diabetes Mellitus
PubMed: 37373315
DOI: 10.3390/ijms241210167 -
Journal of Vascular Surgery Aug 2017Unfamiliarity of endovascular surgeons with carbon dioxide (CO) angiography is one of the main reasons for its limited use. This review is intended to familiarize the... (Review)
Review
OBJECTIVE
Unfamiliarity of endovascular surgeons with carbon dioxide (CO) angiography is one of the main reasons for its limited use. This review is intended to familiarize the reader with the principles and applications of that modality.
METHODS
We conducted a comprehensive review of contemporary literature related to CO angiography and its use in the field of vascular and endovascular surgery, including technical details and diagnostic and interventional applications.
RESULTS
Cardinal physicochemical characteristics of CO include buoyancy, ultralow viscosity, and nonmixing with blood. Because of the risk of neurotoxicity, intra-arterial CO angiography should only be performed below the diaphragm. Venous CO angiography can be performed anywhere in the torso and extremities. Ultralow viscosity enables intraprocedural imaging during vascular interventions without the need to exchange for an angiographic catheter. Benefits, advantages, and emerging applications of CO angiography are listed. Potential complications and their avoidance and troubleshooting are discussed.
CONCLUSIONS
CO holds promise as an effective and versatile angiographic contrast agent. It is also a valuable modality for the guidance of endovascular interventions. Current availability of easy to use, safe, and portable CO delivery systems will likely expand the use of that modality even beyond the traditional indications of renal insufficiency and iodinated contrast allergy.
Topics: Angiography; Carbon Dioxide; Contrast Media; Endovascular Procedures; Equipment Design; Humans; Predictive Value of Tests; Radiography, Interventional; Reproducibility of Results; Risk Factors; Treatment Outcome; Vascular Diseases
PubMed: 28735955
DOI: 10.1016/j.jvs.2017.03.446 -
Diagnostic and Interventional Imaging Feb 2016Arterial spin labeling (ASL) perfusion-weighted magnetic resonance imaging is the only approach that enables direct and non-invasive quantitative measurement of cerebral... (Review)
Review
Arterial spin labeling (ASL) perfusion-weighted magnetic resonance imaging is the only approach that enables direct and non-invasive quantitative measurement of cerebral blood flow in the brain regions without administration of contrast material and without radiation. ASL is thus a promising perfusion imaging method for assessing cerebral blood flow in the pediatric population. Concerning newborns, there are current limitations because of their smaller brain size and lower brain perfusion. This article reviews and illustrates the use of ASL in pediatric clinical practice and discusses emerging cerebral perfusion imaging applications for children due to the highly convenient implementation of the ASL sequence.
Topics: Cerebral Angiography; Cerebrovascular Circulation; Child; Functional Neuroimaging; Humans; Magnetic Resonance Angiography; Spin Labels
PubMed: 26456912
DOI: 10.1016/j.diii.2015.09.001 -
Diagnostic and Interventional Imaging 2015Epistaxis is defined as flow of blood from the nasal fossae and is a common and benign disorder in the great majority of cases which does not require medical care. It... (Review)
Review
Epistaxis is defined as flow of blood from the nasal fossae and is a common and benign disorder in the great majority of cases which does not require medical care. It may however become a genuine medical or surgical emergency because of the amount, repeated episodes or patient's medical vulnerability (such as coronary artery disease patients). Epistaxis may be either primary or a symptom of an underlying disease. Four levels of problems need to be answered faced with epistaxis: recognizing it, and in particular not missing "epistaxis" due to swallowed blood or venous hemorrhage, which falls outside of the scope of interventional radiology; establishing the amount and its repercussions, particularly as a decompensating factor in another disease; investigating its cause and in particular never missing a tumor (male adolescents); obtaining hemostasis. Epistaxis varies not only in type and cause but must be considered in its clinical context. Arterial embolization is a treatment of choice for severe refractory epistaxis and some hemorrhages. When carried out by trained operators, it is an effective method with few risks of complications and is increasingly being used in reference centers (Brinjikji et al.). It remains, however, a method which is less widely used than surgery, particularly in the United States where in a series of 69,410 patients treated over the last 10 years for refractory epistaxis, 92.6% underwent surgical ligation, 6.4% embolization and 1% combined treatments (Brinjikji et al.). Epistaxis is occasionally catastrophic and requires extremely urgent management. In each case, close collaboration with the surgeon, the presence of an intensive care anesthetist and at least sedation are all factors which improve management and therefore the results of embolization. All patients and/or their friends/close family should have given "reliable, clear and appropriate" information.
Topics: Adolescent; Adult; Angiography; Cooperative Behavior; Embolization, Therapeutic; Emergency Medical Services; Epistaxis; Female; Humans; Interdisciplinary Communication; Ligation; Male; Recurrence; Tomography, X-Ray Computed; Young Adult
PubMed: 26194159
DOI: 10.1016/j.diii.2015.06.006 -
The Journal of Thoracic and... Jul 2018
Topics: Coronary Angiography; Coronary Vessels; Heart
PubMed: 29754787
DOI: 10.1016/j.jtcvs.2018.03.132 -
Scientific Reports Jan 2024World Health Organization stated that "Cardiovascular diseases (CVDs) are the leading cause of death globally. Angiography is an important method in diagnostic of CVD....
World Health Organization stated that "Cardiovascular diseases (CVDs) are the leading cause of death globally. Angiography is an important method in diagnostic of CVD. Standard-of-Care methods of angiography, such as X-Ray or CT- or MRI- angiography methods, being accurate and widely adopted in clinical practice, are bulky, expensive and energy in-efficient. X-ray and CT- angiography methods are also potentially hazardous as techniques require the use of ionizing contrast agents. Electromagnetic tomography (EMT) is an emerging medical imaging modality. EMT is applicable for safe functional imaging but suffers from a limited spatial resolution because of relatively large wavelength of electromagnetic radiation as compared to sizes of biological targets of particular interest, such as, for example blood vessels. Novel approach and method, presented in the study is capable to overcome such limitations and provide a mean for a dynamic, on-line EMT angiography. New method of EMT angiography was presented in application to cerebral angiography. Achieved imaging results clearly demonstrate applicability of the method for detecting small cerebral vessels of the diameter as small as 1.3 mm and to distinguish vessels with different dimensions. The technical challenges in the development of angiography capable EMT systems are assessed and discussed.
Topics: Humans; Cerebral Angiography; Tomography, X-Ray Computed; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Cardiovascular Diseases; Electromagnetic Phenomena
PubMed: 38245538
DOI: 10.1038/s41598-024-51632-4 -
Indian Journal of Ophthalmology Mar 2021
Topics: Fluorescein Angiography; Humans; Macular Degeneration
PubMed: 33595462
DOI: 10.4103/ijo.IJO_2842_20 -
The Cochrane Database of Systematic... Jan 2017Pulmonary embolism is a leading cause of pregnancy-related death. An accurate diagnosis in pregnant patients is crucial to prevent untreated pulmonary embolism as well... (Review)
Review
BACKGROUND
Pulmonary embolism is a leading cause of pregnancy-related death. An accurate diagnosis in pregnant patients is crucial to prevent untreated pulmonary embolism as well as unnecessary anticoagulant treatment and future preventive measures. Applied imaging techniques might perform differently in these younger patients with less comorbidity and altered physiology, who largely have been excluded from diagnostic studies.
OBJECTIVES
To determine the diagnostic accuracy of computed tomography pulmonary angiography (CTPA), lung scintigraphy and magnetic resonance angiography (MRA) for the diagnosis of pulmonary embolism during pregnancy.
SEARCH METHODS
We searched MEDLINE and Embase until July 2015. We used included studies as seeds in citations searches and in 'find similar' functions and searched reference lists. We approached experts in the field to help us identify non-indexed studies.
SELECTION CRITERIA
We included consecutive series of pregnant patients suspected of pulmonary embolism who had undergone one of the index tests (computed tomography (CT) pulmonary angiography, lung scintigraphy or MRA) and clinical follow-up or pulmonary angiography as a reference test.
DATA COLLECTION AND ANALYSIS
Two review authors performed data extraction and quality assessment. We contacted investigators of potentially eligible studies to obtain missing information. In the primary analysis, we regarded inconclusive index test results as a negative reference test, and treatment for pulmonary embolism after an inconclusive index test as a positive reference test.
MAIN RESULTS
We included 11 studies (four CTPA, five lung scintigraphy, two both) with a total of 695 CTPA and 665 lung scintigraphy results. Lung scintigraphy was applied by different techniques. No MRA studies matched our inclusion criteria.Overall, risk of bias and concerns regarding applicability were high in all studies as judged in light of the review research question, as was heterogeneity in study methods. We did not undertake meta-analysis. All studies used clinical follow-up as a reference standard, none in a manner that enabled reliable identification of false positives. Sensitivity and negative predictive value were therefore the only valid test accuracy measures.The median negative predictive value for CTPA was 100% (range 96% to 100%). Median sensitivity was 83% (range 0% to 100%).The median negative predictive value for lung scintigraphy was 100% (range 99% to 100%). Median sensitivity was 100% (range 0% to 100%).The median frequency of inconclusive results was 5.9% (range 0.9% to 36%) for CTPA and 4.0% (range 0% to 23%) for lung scintigraphy. The overall median prevalence of pulmonary embolism was 3.3% (range 0.0% to 8.7%).
AUTHORS' CONCLUSIONS
Both CTPA and lung scintigraphy seem appropriate for exclusion of pulmonary embolism during pregnancy. However, the quality of the evidence mandates cautious adoption of this conclusion. Important limitations included poor reference standards, necessary assumptions in the analysis regarding inconclusive test results and the inherent inability of included studies to identify false positives. It is unclear which test has the highest accuracy. There is a need for direct comparisons between diagnostic methods, including MR, in prospective randomized diagnostic studies.
Topics: Angiography; Female; Humans; Magnetic Resonance Angiography; Positron-Emission Tomography; Pregnancy; Pregnancy Complications, Hematologic; Pulmonary Embolism; Radionuclide Imaging; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 28124411
DOI: 10.1002/14651858.CD011053.pub2 -
Cardiovascular Journal of Africa 2016Pregnant women with known or suspected cardiovascular disease (CVD) often require cardiovascular imaging during pregnancy. The accepted maximum limit of ionising... (Review)
Review
Pregnant women with known or suspected cardiovascular disease (CVD) often require cardiovascular imaging during pregnancy. The accepted maximum limit of ionising radiation exposure to the foetus during pregnancy is a cumulative dose of 5 rad. Concerns related to imaging modalities that involve ionising radiation include teratogenesis, mutagenesis and childhood malignancy. Importantly, no single imaging study approaches this cautionary dose of 5 rad (50 mSv or 50 mGy). Diagnostic imaging procedures that may be used in pregnancy include chest radiography, fluoroscopy, echocardiography, invasive angiography, cardiovascular computed tomography, computed tomographic pulmonary angiography, cardiovascular magnetic resonance (CMR) and nuclear techniques. Echocardiography and CMR appear to be completely safe in pregnancy and are not associated with any adverse foetal effects, provided there are no general contra-indications to MR imaging. Concerns related to safety of imaging tests must be balanced against the importance of accurate diagnosis and thorough assessment of the pathological condition. Decisions about imaging in pregnancy are premised on understanding the physiology of pregnancy, understanding basic concepts of ionising radiation, the clinical manifestations of existent CVD in pregnancy and features of new CVD. The cardiologist/physician must understand the indications for and limitations of, and the potential harmful effects of each test during pregnancy. Current evidence suggests that a single cardiovascular radiological study during pregnancy is safe and should be undertaken at all times when clinically justified. In this article, the different imaging modalities are reviewed in terms of how they work, how safe they are and what their clinical utility in pregnancy is. Furthermore, the safety of contrast agents in pregnancy is also reviewed.
Topics: Angiography; Echocardiography; Female; Fetus; Heart Diseases; Humans; Pregnancy; Radiography, Thoracic; Thorax
PubMed: 27213857
DOI: 10.5830/CVJA-2016-022