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American Family Physician Feb 2022Hemoptysis is the expectoration of blood from the lower respiratory tract, usually from bronchial arteries. The most common causes are acute respiratory infections,...
Hemoptysis is the expectoration of blood from the lower respiratory tract, usually from bronchial arteries. The most common causes are acute respiratory infections, cancer, bronchiectasis, and chronic obstructive pulmonary disease. No cause is identified in 20% to 50% of cases. Hemoptysis must be differentiated from pseudohemoptysis, which is blood that originates from nasopharyngeal or gastrointestinal sources. The initial evaluation includes determining the severity of bleeding and stability of the patient and may require bronchoscopy for airway protection. Mild hemoptysis comprises more than 90% of cases and has a good prognosis, whereas massive hemoptysis has a high mortality rate. A history and physical examination can assist in identifying an etiology, but diagnostic testing is often required. Chest radiography is a good initial test, but it has limited sensitivity for determining the site and etiology of the bleeding. Computed tomography and computed tomography angiography of the chest with intravenous contrast are the preferred modalities to determine the etiology of bleeding; however, bronchoscopy may also be needed. In addition to supportive medical treatment, management should include treatment of the underlying etiology because recurrence often takes place in the absence of treatment of the identified cause. Bronchial arterial embolization is used to treat massive hemoptysis, particularly when an involved artery is noted on computed tomography angiography. Surgery is reserved for patients whose medical treatment and embolization are not effective.
Topics: Angiography; Bronchial Arteries; Bronchoscopy; Embolization, Therapeutic; Hemoptysis; Humans
PubMed: 35166503
DOI: No ID Found -
RoFo : Fortschritte Auf Dem Gebiete Der... Jan 2020Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients. (Review)
Review
BACKGROUND
Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients.
METHOD
This review discusses imaging techniques, diagnostic algorithms, imaging findings and endovascular treatment of acute thrombotic PE, and illustrates important differential diagnoses relating to the spectrum of acute non-thrombotic PE and non-embolic pulmonary artery disease. The review emphasizes information relevant for everyday radiological practice and highlights recent advances that can be readily applied in the clinical routine.
RESULTS/CONCLUSION
Computed tomography pulmonary angiography (CTPA) is the current reference standard for the diagnosis of acute PE. Ventilation and perfusion (VQ) scanning or - in centers with adequate expertise - magnetic resonance imaging (MRI) is indicated in pregnant or young patients and patients with contraindications to iodinated contrast. Invasive angiography is reserved for patients with intended endovascular treatment. Artifacts, acute non-thrombotic PE, chronic PE and non-embolic pulmonary artery diseases should always be considered as differential diagnoses.
KEY POINTS
· CTPA is the reference standard for the diagnosis of acute PE.. · MRI for acute PE should only be performed in centers with adequate expertise.. · Invasive angiography is reserved for patients with intended endovascular treatment.. · Artifacts and non-embolic pulmonary artery diseases can mimic acute pulmonary thromboembolism.. · Non-thrombotic and chronic PE are also differential diagnoses of acute pulmonary thromboembolism..
CITATION FORMAT
· Palm V, Rengier F, Rajiah P et al. Acute Pulmonary Embolism: Imaging Techniques, Findings, Endovascular Treatment and Differential Diagnoses. Fortschr Röntgenstr 2020; 192: 38 - 49.
Topics: Acute Disease; Adult; Aged; Angiography; Computed Tomography Angiography; Contrast Media; Diagnosis, Differential; Endovascular Procedures; Female; Humans; Lung; Magnetic Resonance Angiography; Male; Middle Aged; Pregnancy; Pulmonary Embolism; Ventilation-Perfusion Scan
PubMed: 31137046
DOI: 10.1055/a-0900-4200 -
Turk Kardiyoloji Dernegi Arsivi : Turk... Jun 2021
Topics: Arterial Occlusive Diseases; Coronary Angiography; Humans; Radial Artery; Ultrasonography, Interventional
PubMed: 34106057
DOI: 10.5543/tkda.2021.21114 -
RoFo : Fortschritte Auf Dem Gebiete Der... Mar 2024
Topics: Coronary Angiography; Radiography; Radiology; Computed Tomography Angiography; Insurance, Health
PubMed: 38382507
DOI: 10.1055/a-2226-5089 -
Ugeskrift For Laeger Oct 2020
Topics: Chest Pain; Coronary Angiography; Electrocardiography; Humans
PubMed: 33118500
DOI: No ID Found -
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 -
Journal of Reconstructive Microsurgery Mar 2022The benefits of preoperative perforator imaging for microsurgical reconstruction have been well established in the literature. (Review)
Review
BACKGROUND
The benefits of preoperative perforator imaging for microsurgical reconstruction have been well established in the literature.
METHODS
An extensive literature review was performed to determine the most commonly used modalities, and their applicability, advantages and disadvantages.
RESULTS
The review demonstrated varioius findings including decreases in operative time and cost with the use of CT angiography to identification of perforators for inclusion in flap design with hand-held Doppler ultrasound. Modalities like MR angiography offer alternatives for patients with contrast allergies or renal dysfunction while maintaining a high level of clarity and fidelity. Although the use of conventional angiography has decreased due to the availability of less invasive alternatives, it continues to serve a role in the preoperative evaluation of patients for lower extremity reconstruction. Duplex ultrasonography has been of great interest recently as an inexpensive, risk free, and extraordinarily accurate diagnostic tool. Emerging technologies such as indocyanine green fluorescence angiography and dynamic infrared thermography provide real-time information about tissue vascularity and perfusion without requiring radiation exposure.
CONCLUSION
This article presents an in-depth review of the various imaging modalities available to reconstructive surgeons and includes hand held Doppler ultrasound, CT angiography, MR angiography, conventional angiography, duplex ultrasonography, Indocyanine Green Fluorescence Angiography and Dynamic Infrared Thermography.
Topics: Angiography; Computed Tomography Angiography; Humans; Perforator Flap; Preoperative Care; Plastic Surgery Procedures; Surgical Flaps
PubMed: 34688218
DOI: 10.1055/s-0041-1736316 -
European Journal of Vascular and... Feb 2020
Topics: Acute Disease; Angiography; Anticoagulants; Europe; Heparin; Humans; Ischemia; Peripheral Arterial Disease; Preoperative Care; Societies, Medical; Specialties, Surgical; Vascular Surgical Procedures; Vasodilator Agents
PubMed: 31899099
DOI: 10.1016/j.ejvs.2019.09.006 -
Experimental Biology and Medicine... Oct 2021Optical coherence tomography angiography (OCTA) offers a noninvasive label-free solution for imaging retinal vasculatures at the capillary level resolution. In... (Review)
Review
Optical coherence tomography angiography (OCTA) offers a noninvasive label-free solution for imaging retinal vasculatures at the capillary level resolution. In principle, improved resolution implies a better chance to reveal subtle microvascular distortions associated with eye diseases that are asymptomatic in early stages. However, massive screening requires experienced clinicians to manually examine retinal images, which may result in human error and hinder objective screening. Recently, quantitative OCTA features have been developed to standardize and document retinal vascular changes. The feasibility of using quantitative OCTA features for machine learning classification of different retinopathies has been demonstrated. Deep learning-based applications have also been explored for automatic OCTA image analysis and disease classification. In this article, we summarize recent developments of quantitative OCTA features, machine learning image analysis, and classification.
Topics: Angiography; Capillaries; Deep Learning; Humans; Image Processing, Computer-Assisted; Retinal Diseases; Retinal Vessels; Tomography, Optical Coherence
PubMed: 34279136
DOI: 10.1177/15353702211026581 -
International Angiology : a Journal of... Aug 2023This study aimed to investigate whether intravascular ultrasound (IVUS) combined with angiography during percutaneous transluminal angioplasty impacts treatment...
BACKGROUND
This study aimed to investigate whether intravascular ultrasound (IVUS) combined with angiography during percutaneous transluminal angioplasty impacts treatment strategies and the 12-month patency of the femoropopliteal artery, compared to angiography alone.
METHODS
This retrospective, single-center study enrolled 137 patients who underwent a femoropopliteal endovascular intervention between February 2020 and May 2021. Among these interventions, 43 were guided by IVUS combined with angiography and the remaining 94 were guided by angiography only. Treatment strategies and 12-month patency were analyzed in both groups. Multivariable analysis was performed to clarify the predictors of restenosis within 12 months.
RESULTS
Primary patency at 12 months was significantly higher in the IVUS group than in the angiography group (56.4% vs. 76.7%, P=0.047). The reference diameter on IVUS images was greater than that on angiography images. Therefore, the IVUS group presented a higher balloon-to-vessel ratio [1.0 (0.97, 1.01) vs. 1.06 (1.0.1.25)]. More adjunctive stents were required in the angiography group. However, more dissections were performed in the IVUS group, with no difference in flow-limiting dissections between groups. Target disease length (odds ratio 1.02, P=0.021) and balloon-to-vessel ratio (odds ratio 0.01, P=0.021) were independent predictors of restenosis.
CONCLUSIONS
Compared with angiography guidance alone, IVUS guidance for femoropopliteal artery-related treatment can significantly increase primary patency. This finding may be explained by the selection of larger balloons in IVUS and the resulting sufficient plaque compression and elastic membrane stretch. Moreover, IVUS was shown to detect more non-flow-limiting dissections than angiography.
Topics: Humans; Angiography; Angioplasty; Femoral Artery; Retrospective Studies; Stents; Treatment Outcome; Ultrasonography, Interventional; Vascular Patency
PubMed: 37347157
DOI: 10.23736/S0392-9590.23.05064-2