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Interventional Neuroradiology : Journal... Aug 2020Intracranial venous sinus stenting is gaining acceptance as an effective treatment for idiopathic intracranial hypertension (IIH). The typical approach is via femoral...
Intracranial venous sinus stenting is gaining acceptance as an effective treatment for idiopathic intracranial hypertension (IIH). The typical approach is via femoral venous and arterial access for transvenous stenting with simultaneous angiography. These patients are at an above average risk for groin complications considering obesity is typically associated with IIH and the need for heparinization and dual antiplatelet therapy. Here, we describe cerebral venography, angiography, and venous sinus stenting via a single upper extremity. We utilize a transradial approach for angiography and a venous access via the brachial or basilic vein. Over a series of 28 consecutive procedures, we were able to successfully access the intracranial venous sinuses via the arm without access site complications. This method offers the advantages of immediate patient mobilization after the procedure and more easily monitored and compressible access sites for easier post-procedural care.
Topics: Adult; Arm; Cerebral Angiography; Cranial Sinuses; Female; Fluoroscopy; Humans; Male; Manometry; Phlebography; Pseudotumor Cerebri; Stents
PubMed: 32340513
DOI: 10.1177/1591019920920992 -
Indian Journal of Ophthalmology Dec 2022Fundus fluorescein angiography (FFA) is usually performed intravenously through injection of sodium fluorescein dye. This procedure is difficult to perform in children...
Fundus fluorescein angiography (FFA) is usually performed intravenously through injection of sodium fluorescein dye. This procedure is difficult to perform in children and patients who are afraid of intravenous needles. Oral FFA can serve as a useful alternative to intravenous FFA in many cases and gives reliable results. We describe the recommended protocol and technique for doing oral FFA in adults and children.
Topics: Adult; Child; Humans; Fluorescein Angiography; Fluorescein; Needles
PubMed: 36453360
DOI: 10.4103/ijo.IJO_1220_22 -
NeuroImage Sep 2021Accurate detection and quantification of unruptured intracranial aneurysms (UIAs) is important for rupture risk assessment and to allow an informed treatment decision to... (Comparative Study)
Comparative Study
Accurate detection and quantification of unruptured intracranial aneurysms (UIAs) is important for rupture risk assessment and to allow an informed treatment decision to be made. Currently, 2D manual measures used to assess UIAs on Time-of-Flight magnetic resonance angiographies (TOF-MRAs) lack 3D information and there is substantial inter-observer variability for both aneurysm detection and assessment of aneurysm size and growth. 3D measures could be helpful to improve aneurysm detection and quantification but are time-consuming and would therefore benefit from a reliable automatic UIA detection and segmentation method. The Aneurysm Detection and segMentation (ADAM) challenge was organised in which methods for automatic UIA detection and segmentation were developed and submitted to be evaluated on a diverse clinical TOF-MRA dataset. A training set (113 cases with a total of 129 UIAs) was released, each case including a TOF-MRA, a structural MR image (T1, T2 or FLAIR), annotation of any present UIA(s) and the centre voxel of the UIA(s). A test set of 141 cases (with 153 UIAs) was used for evaluation. Two tasks were proposed: (1) detection and (2) segmentation of UIAs on TOF-MRAs. Teams developed and submitted containerised methods to be evaluated on the test set. Task 1 was evaluated using metrics of sensitivity and false positive count. Task 2 was evaluated using dice similarity coefficient, modified hausdorff distance (95 percentile) and volumetric similarity. For each task, a ranking was made based on the average of the metrics. In total, eleven teams participated in task 1 and nine of those teams participated in task 2. Task 1 was won by a method specifically designed for the detection task (i.e. not participating in task 2). Based on segmentation metrics, the top two methods for task 2 performed statistically significantly better than all other methods. The detection performance of the top-ranking methods was comparable to visual inspection for larger aneurysms. Segmentation performance of the top ranking method, after selection of true UIAs, was similar to interobserver performance. The ADAM challenge remains open for future submissions and improved submissions, with a live leaderboard to provide benchmarking for method developments at https://adam.isi.uu.nl/.
Topics: Cerebral Angiography; Datasets as Topic; Educational Measurement; Humans; Intracranial Aneurysm; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Random Allocation; Risk Assessment
PubMed: 34052465
DOI: 10.1016/j.neuroimage.2021.118216 -
Anatolian Journal of Cardiology 2020
Topics: Coronary Angiography; Coronary Vessels
PubMed: 32120371
DOI: 10.14744/AnatolJCardiol.2020.3 -
Asia-Pacific Journal of Ophthalmology...Deep learning (DL) is a subset of artificial intelligence based on deep neural networks. It has made remarkable breakthroughs in medical imaging, particularly for image... (Review)
Review
Deep learning (DL) is a subset of artificial intelligence based on deep neural networks. It has made remarkable breakthroughs in medical imaging, particularly for image classification and pattern recognition. In ophthalmology, there are rising interests in applying DL methods to analyze optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images. Studies showed that OCT and OCTA image evaluation by DL algorithms achieved good performance for disease detection, prognosis prediction, and image quality control, suggesting that the incorporation of DL technology could potentially enhance the accuracy of disease evaluation and the efficiency of clinical workflow. However, substantial issues, such as small training sample size, data preprocessing standardization, model robustness, results explanation, and performance cross-validation, are yet to be tackled before deploying these DL models in real-time clinics. This review summarized recent studies on DL-based image analysis models for OCT and OCTA images and discussed the potential challenges of clinical deployment and future research directions.
Topics: Angiography; Deep Learning; Humans; Tomography, Optical Coherence
PubMed: 34383717
DOI: 10.1097/APO.0000000000000405 -
International Journal of Environmental... Mar 2021The purpose of this study is to develop and apply a type of perineal underwear that protects the patient's physical privacy and to examine its effects on perineal...
The purpose of this study is to develop and apply a type of perineal underwear that protects the patient's physical privacy and to examine its effects on perineal discomfort and shame. This study collected primary data from 44 patients who visited Kyung Hee University hospital in Seoul city and were admitted to the neurosurgery ward to undergo angiography between 7 August 2017, and 30 April 2018. In this quasi-experimental study with a nonequivalent control group posttest-only design, participants were divided into an experimental group ( = 22) and a control group ( = 22). The control group used conventional protection, which involved wearing padding around the perineum, while the experimental group wore the perineal underwear developed in this study. The underwear group showed a significantly lower degree of shame (Z = -5.39, < 0.001) and perineal discomfort (Z = -5.88, < 0.001) than the padding group. In the padding group, women felt significantly more shame than men did (Z = -2.48, = 0.013). The use of the perineal underwear developed in this study significantly reduced the degree of shame and perineal discomfort in patients undergoing angiography. Such perineal underwear could also be useful for protecting patients' privacy during perineal examinations.
Topics: Angiography; Female; Humans; Male; Perineum; Seoul; Shame
PubMed: 33802344
DOI: 10.3390/ijerph18052480 -
Neurosurgical Review Dec 2023Spinal dural arteriovenous fistulas (SDAVFs) constitute the most common type of spinal vascular malformations. Their diagnosis requires spinal digital subtraction... (Meta-Analysis)
Meta-Analysis Review
Spinal dural arteriovenous fistulas (SDAVFs) constitute the most common type of spinal vascular malformations. Their diagnosis requires spinal digital subtraction angiography (DSA), which is time-consuming, requires catheterizing many vessels, and exposes patient to a high radiation and contrast doses. This study aims to evaluate the usefulness of time-resolved MR angiography (TR-MRA) in SDAVF diagnosis. We performed a systematic review of the PubMed and EMBASE databases followed by a meta-analysis. TR-MRA was an index test, and spinal DSA was a reference. Of the initial 324 records, we included 4 studies describing 71 patients with SDAVFs. In 42 cases, TR-MRA was true positive, and in 21 cases, it was true negative. We found 7 false-positive cases and 1 false negative. TR-MRA allowed for shunt level identification in 39 cases. Of these, the predicted level was correct in 23 cases (59%), to within 1 level in 38 cases (97.4%) and to within 2 levels in 39 cases (100%). The diagnostic odds ratio was 72.73 (95% CI [10.30; 513.35]), z = 4.30, p value < 0.0001. The pooled sensitivity was 0.98 (95% CI [0.64; 1.00]), and the pooled specificity was 0.79 (95% CI [0.10; 0.99]). The AUC of the SROC curve was 0.9. TR-MRA may serve as a preliminary study to detect SDAVFs and localize the shunt level with sensitivity and specificity as high as 98% and 79%, respectively. Unless the TR-MRA result is unequivocal, it should be followed by a limited spinal DSA.
Topics: Humans; Contrast Media; Magnetic Resonance Angiography; Spine; Angiography, Digital Subtraction; Central Nervous System Vascular Malformations
PubMed: 38072856
DOI: 10.1007/s10143-023-02242-7 -
Texas Heart Institute Journal Dec 2023
Topics: Humans; Coronary Angiography; Coronary Vessel Anomalies
PubMed: 38124263
DOI: 10.14503/THIJ-23-8351 -
AJNR. American Journal of Neuroradiology Jun 2022Differential Subsampling with Cartesian Ordering (DISCO), an ultrafast high-spatial-resolution head MRA, has been introduced. We aimed to determine the diagnostic...
BACKGROUND AND PURPOSE
Differential Subsampling with Cartesian Ordering (DISCO), an ultrafast high-spatial-resolution head MRA, has been introduced. We aimed to determine the diagnostic performance of DISCO-MRA in grading residual aneurysm in comparison with TOF-MRA in patients with treated intracranial aneurysms.
MATERIALS AND METHODS
Patients with endovascular treatment and having undergone DISCO-MRA, TOF-MRA, and DSA were included for review. The voxel size and acquisition time were 0.75 × 0.75 × 1 mm/6 seconds for DISCO-MRA and 0.6 × 0.6 × 1 mm/6 minutes for TOF-MRA. Residual aneurysms were determined using the Modified Raymond-Roy Classification on TOF-MRA and DISCO-MRA by 2 neuroradiologists independently and were compared against DSA as the reference standard. Statistical analysis was performed using the κ statistic and the χ test.
RESULTS
Sixty-eight treated intracranial aneurysms were included. The intermodality agreement was κ = 0.82 (95% CI, 0.67-0.97) between DISCO and DSA and 0.44 (95% CI, 0.28-0.61) between TOF and DSA. Modified Raymond-Roy Classification scores matched DSA scores in 60/68 cases (88%; χ = 144.4, < .001 for DISCO and 46/68 cases (68%; χ = 65.0, < .001) for TOF. The diagnostic accuracy for the detection of aneurysm remnants was higher for DISCO (0.96; 95% CI, 0.88-0.99) than for TOF (0.79; 95% CI, 0.68-0.88).
CONCLUSIONS
In patients with endovascularly treated intracranial aneurysms, DISCO-MRA provides superior diagnostic performance in comparison with TOF-MRA in delineating residual aneurysms in a fraction of the time.
Topics: Angiography, Digital Subtraction; Disease Progression; Embolization, Therapeutic; Follow-Up Studies; Humans; Intracranial Aneurysm; Magnetic Resonance Angiography
PubMed: 35672082
DOI: 10.3174/ajnr.A7532 -
Swiss Medical Weekly May 2021Since 1987 the Swiss Working Group Interventional Cardiology of the Swiss Society of Cardiology coordinates the assessment of invasive diagnostic and therapeutic heart...
Since 1987 the Swiss Working Group Interventional Cardiology of the Swiss Society of Cardiology coordinates the assessment of invasive diagnostic and therapeutic heart interventions across Switzerland. The aim of this report is to summarise the data for the year 2019, which was collected using a standardised questionnaire. In 2019, 37 centres performed a total of 57,975 coronary angiographies. In 48.2% of these cases a subsequent percutaneous coronary intervention was performed. Among a broad spectrum of structural heart interventions, we have observed a constant growth of transcatheter aortic valve implantations, and a total of 1912 transcatheter aortic valve implantations were performed in 2019.
Topics: Cardiac Catheterization; Coronary Angiography; Humans; Percutaneous Coronary Intervention; Registries; Stents; Switzerland; Transcatheter Aortic Valve Replacement
PubMed: 34000055
DOI: 10.4414/smw.2021.20495