Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses
Abstract Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity. Therefore, additional angiographic morphologic descriptors affecting hemodynamic significance are required. To evaluate quantitative stenosis analysis and plaque descriptors by CCTA in predicting the hemodynamic significance of ICAS and to compare it with quantitative catheter coronary angiography (QCA). QCA was performed in 65 patients (mean age 63 ± 9 years; 47 men) with 76 ICAS (40–70 %) on CCTA. Plaque descriptors were determined including circumferential extent of calcification, plaque composition, minimal lumen diameter (MLD) and area, diameter stenosis percentage (Ds %), area stenosis percentage and stenosis length on CCTA. MLD and Ds % were also analyzed on QCA. FFR was measured on 52 ICAS lesions on CCTA and QCA. The diagnostic values of the best CCTA and QCA descriptors were calculated for ICAS with FFR ≤ 0.80. Of the 76 ICAS on CCTA, 52 (68 %) had a Ds % between 40 and 70 % on QCA. Significant intertechnique correlations were found between CCTA and QCA for MLD ...
The aim of this study was to describe patients', radiographers' and radiography students ’ experiences of the developed 360° virtual counselling environment (360°VCE) for the coronary computed tomography angiography (cCTA).
ConclusionsThis study demonstrated the feasibility of total laparoscopic pancreaticoduodenectomy combined with vascular resection and artificial vascular graft reconstruction in properly selected cases of pancreatic cancer with vein involvement after neoadjuvant chemotherapy. It is worth noting that skilled laparoscopic technicians and effective teamwork are necessities for safe completion of the procedure.
AbstractAccurate pulmonary artery (PA) imaging is necessary for management of patients with complex congenital heart disease (CHD). The ability of newer imaging modalities such as 3D rotational angiography (3DRA) or phase-contrast magnetic resonance angiography (PC-MRA) to measure PA diameters has not been compared to established angiography techniques. Measurements of PA diameters (including PA stenosis and PA stents) from 3DRA and non-contrast-enhanced PC-MRA were compared to 2D catheter angiography (CA) and multi-slice computed tomography (MSCT) in a swine CHD model (n = 18). For all PA segments 3DRA had ...
Conclusion Utilization of this anatomic variant in stacked or dual-pedicled autologous breast reconstruction results in antegrade IMA perfusion of both primary and secondary flaps, as well as improved size match compared with other anastomotic options. Knowledge of the vascular anatomy and variations in the inferior epigastric system is crucial to both preventing complications and optimizing flap planning and outcome. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
Craniofacial trauma accounts for a large number of medical encounters in the United States and is associated with significant morbidity and mortality. The role of imaging, particularly computed tomography (CT) and CT angiography (CTA) can significantly enhance the evaluation of patients with craniofacial trauma, assisting with appropriate management and surgical planning. Radiologic studies additionally provide information about soft tissue and vascular trauma which cannot always be excluded by physical examination.
Conditions: Abdominal Aortic Aneurysm; Endoleak; Stent-Graft Endoleak Interventions: Diagnostic Test: 18F Sodium Fluoride Positron Emission Tomography / Computed Tomography; Diagnostic Test: CT Aortic Angiogram; Diagnostic Test: 12-month CT Aortic Angiogram; Other: 24-month review Sponsors: University of Edinburgh; NHS Lothian; NHS Greater Glasgow and Clyde; NHS Lanarkshire; NHS Tayside Not yet recruiting
Recently, computed tomography pulmonary angiography (CTPA) has emerged as the first line modality for the diagnosis of pulmonary embolism (PE) as it is fast, reliable and widely available . However, with increasing use of CTPA, there has been an associated increase in the incidence of PE with no significant change in mortality . Overuse of CTPA leads to unnecessary radiation and contrast exposure, increased costs, as well as incidental findings, raising the question of over-diagnosis of clinically insignificant PEs conferring a major burden on both patients and healthcare system (2,3).
Pulmonary embolism (PE) is a common and potentially fatal diagnosis that must be considered in the emergency department (ED) setting in patients presenting with chest pain or shortness of breath. PE accounts for approximately 100,000 deaths annually in the United States and, according to some studies, this rate is increasing (1). Although computed tomography pulmonary angiography (CTPA) is the gold standard imaging modality for the diagnosis of PE, point-of-care ultrasound (POCUS) is often more readily available and can be used to quickly obtain critical information regarding global cardiac function and direct management.
AbstractPurposeDelayed cerebral ischemia represents a significant cause of poor functional outcome for patients with vasospasm after subarachnoid hemorrhage. We investigated whether delayed cerebral ischemia could be detected by the arterial opacification of internal carotid artery at the level of the skull base.MethodsIn this exploratory, nested retrospective cohort diagnostic accuracy study, patients with clinical and/or transcranial Doppler suspicion of vasospasm who underwent four-dimensional computed tomography angiography were included. They were split into two groups for the main endpoint analysis, according to the ...
CONCLUSIONS: Aortic RP detected by NOGA was strongly associated with a higher maximum WSS in the aortic arch derived by CFD using 3D-CT. The maximum WSS value may have an important role in the underlying mechanism of not only aortic atherosclerosis, but also aortic RP. PMID: 33012739 [PubMed - as supplied by publisher]