Jain, Ashit; Ventura, Hector O.; Collins, Tyrone J.; Ramee, Stephen R.; White, Christopher J.
Annual angiographic assessment to determine the presence or progression of allograft coronary artery disease (CAD) has been unable to modify the natural history of this disease. Coronary angioscopy is a sensitive method to detect the early presence of coronary artery disease and in a retrospective analysis severity of CAD by angioscopy correlated with the time since transplantation. The purpose of this study was to prospectively evaluate progression of coronary artery disease over a one year period in 40 cardiac transplant recipients. The progression of coronary artery disease as assessed by angioscopy is directly related to time after transplantation and therefore angioscopy may be the method of choice for detection and evaluation of therapeutic regimens to control allograft coronary artery disease.
Uchida, Yasumi; Yoshida, Tomoe; Shimoyama, Ei; Uchida, Yasuto
Low-density lipoprotein (LDL) is an important risk factor for coronary artery disease, but its localization within the human coronary arterial wall is poorly understood. Imaging of LDL in 30 coronary arteries excised from 15 subjects who underwent autopsy was performed using near-infrared fluorescent angioscopy system and using indocyanine green dye as a biomarker of LDL. The percentage incidence of LDL in 28 normal segments, 24 white plaques (early stage of plaque growth), and 21 yellow plaques (mature stage of plaque) classified by conventional angioscopy, was 14.2, 79.1 (p Coronary near-infrared fluorescent angioscopy showed similar results in 7 patients in vivo. Our results suggested that LDL begins to deposit in the human coronary arterial wall in the early stage of atherosclerosis, increasingly deposits with plaque growth and decreases in the mature stage; and therefore, molecular therapy targeting LDL should be started before plaque maturation.
李新平; 陈伟; 朱智明
[ Objective ] To explore the clinical value of CT virtual angioscopy (CTVA) in the pre- and postpro-cedure evaluation of aortic arch related diseases. [Methods] 37 cases with thoracic disease underwent aortic CT angiography on a dual-source CT scanner. CTVA of aortic arch were performed with Fly-through software in all cas-? Es by using aortic CT angiographic source image data. [Results] 34 of 37 (92%) cases showed successful CTVA images, including aortic dissection (n =12), aneurysm (n =4), pseudoaneurysm (n =3), Takayasu arteritis (n =2),aortic coarctation (n =1), aneurysm combined with aortic dissection (n =1) and 11 patients following surgical or endovascu-lar procedures. CTVA of aortic arch could identify the ostia and its variations of supra-aortic vessels, estimate the localization of abnormalities with respect to supra-aortic vessels and display the stent grafts. [ Conclusions ] CTVA of aortic arch enables non-invasive visualization of the inner contours of the vasculature, and has certain instructive significance in the diagnostic classification, preprocedure planning and postprocedure evaluation for aortic arch related diseases.%目的 探讨CT仿真血管内镜(CTVA)在主动脉弓相关疾病术前和术后评价中的价值.方法 采用双源CT对37例胸主动脉疾病患者行主动脉CT成像检查,并将主动脉CT成像的源图像调至Fly-through软件中,对所有病例行主动脉弓CTVA观察.结果 92％(34/37)的病例获得了满意的CTVA图像,包括主动脉夹层12例、真性动脉瘤4例、假性动脉瘤3例、多发性大动脉炎2例、主动脉缩窄1例、真性动脉瘤合并夹层1例及11例术后随访病例.主动脉弓CTVA能明确弓上分支血管开口位置与变异、判断病变与弓上分支开口的空间关系以及显示支架型血管.结论 主动脉弓CTVA能无创观察血管腔内情况,对主动脉弓相关疾病的诊断分型、术前计划和术后评价具有一定的指导意义.
Matsui, Daichi; Ishii, Katsunori; Awazu, Kunio
To identify high-risk atherosclerotic lesions, we require detailed information on the stability of atherosclerotic plaques. In this study, we quantitatively classified the lipid volume fractions in atherosclerotic plaque phantoms by a novel angioscope combined with near-infrared multispectral imaging. The multispectral angioscope was operated at peak absorption wavelengths of lipid in vulnerable plaques (1150, 1200, and 1300 nm) and at lower absorption wavelengths of water. The potential of the multispectral angioscope was demonstrated in atherosclerotic plaque phantoms containing 10-60 vol.% lipid and immersed in saline solution. The acquired multispectral data were processed by a spectral angle mapper algorithm, which enhanced the simulated plaque areas. Consequently, we classified the lipid volume fractions into five categories (0-5, 5-15, 15-30, 30-50, and 50-60 vol.%). Multispectral angioscopy at wavelengths around 1200 nm is a powerful tool for quantitatively evaluating the stability of atherosclerotic plaques based on the lipid volume fractions. PMID:26861978
van Ooijen, PMA; Nieman, K; de Feyter, PJ; Oudkerk, M
With the advent of noninvasive coronary imaging techniques like multidetector computed tomography and electron beam computed tomography, new representation methods such as intracoronary visualization. have been introduced. We explore the possibilities of these novel visualization techniques and comp
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Mehra, M. R.; Ventura, H O; Smart, F W; Stapleton, D D; Collins, T J; Ramee, S R; Murgo, J P; White, C. J.
The major cause of late death in cardiac transplant recipients is cardiac allograft vasculopathy, also referred to as cardiac transplant atherosclerosis, which occurs in as many as 45% of transplant recipients who survive longer than 1 year. It differs from typical atherosclerosis in that intimal hyperplasia is concentric and diffuse, the internal elastic lamina remains intact, calcification is rare, and the disease tends to develop rapidly. Intravascular ultrasound and coronary angioscopy ar...
Esplugas, E; Alfonso, F; Alonso, J J; Asín, E; Elizaga, J; Iñiguez, A; Revuelta, J M
Interventional cardiology has had an extraordinary expansion in last years. This clinical guideline is a review of the scientific evidence of the techniques in relation to clinical and anatomic findings. The review includes: 1. Coronary arteriography. 2. Coronary balloon angioplasty. 3. Coronary stents. 4. Other techniques: directional atherectomy, rotational atherectomy, transluminal extraction atherectomy, cutting balloon, laser angioplasty and transmyocardial laser and endovascular radiotherapy. 5. Platelet glycoprotein IIb/IIIa inhibitors. 6. New diagnostic techniques: intravascular ultrasound, coronary angioscopy, Doppler and pressure wire. For the recommendations we have used the classification system: class I, IIa, IIb, III like in the guidelines of the American College of Cardiology and the American Heart Association.
Jensen, Bjarke; Nielsen, Jan M; Axelsson, Michael; Pedersen, Michael; Löfman, Carl; Wang, Tobias
The multiple convergent evolution of high systemic blood pressure among terrestrial vertebrates has always been accompanied by lowered pulmonary pressure. In mammals, birds and crocodilians, this cardiac separation of pressures relies on the complete division of the right and left ventricles by a complete ventricular septum. However, the anatomy of the ventricle of most reptiles does not allow for complete anatomical division, but the hearts of pythons and varanid lizards can produce high systemic blood pressure while keeping the pulmonary blood pressure low. It is also known that these two groups of reptiles are characterised by low magnitudes of cardiac shunts. Little, however, is known about the mechanisms that allow for this pressure separation. Here we provide a description of cardiac structures and intracardiac events that have been revealed by ultrasonic measurements and angioscopy. Echocardiography revealed that the atrioventricular valves descend deep into the ventricle during ventricular filling and thereby greatly reduce the communication between the systemic (cavum arteriosum) and pulmonary (cavum pulmonale) ventricular chambers during diastole. Angioscopy and echocardiography showed how the two incomplete septa, the muscular ridge and the bulbuslamelle - ventricular structures common to all squamates - contract against each other in systole and provide functional division of the anatomically subdivided ventricle. Washout shunts are inevitable in the subdivided snake ventricle, but we show that the site of shunting, the cavum venosum, is very small throughout the cardiac cycle. It is concluded that the python ventricle is incapable of the pronounced and variable shunts of other snakes, because of its architecture and valvular mechanics.
Uchida, Y; Masuo, M; Tomaru, T; Kato, A; Sugimoto, T
Coronary arteries isolated from cadavers autopsied within 7 hours after death were perfused with canine arterial blood, and the processes of thrombus formation at the segments stenosed with atheroma and the thrombolytic effects of urokinase were investigated by angioscopy. Ten minutes of blood perfusion caused thin mural thrombi localized at the stenotic or nonstenotic segments. During 30 minutes of blood perfusion, the thin mural thrombi of the outlet or inlet of the segment grew into a doughnut-shaped thrombus. Also, the thin mural thrombi in the stenotic segment grew into a streamer-like thrombus and drifted downstream. These thrombi grew in size with increasing perfusion time and finally obstructed the stenotic segment. Globular thrombi close to the outlet also were formed in a few preparations. Unlike the thrombi at the stenotic segment, the mural thrombi in the nonstenotic segments did not grow into massive thrombi. The thrombi were reduced in size within 10 minutes of perfusion with 320 U/ml or more of urokinase. During thrombolysis, sandstorm-like dispersion of the blood cells occurred, small fragments detached from the mother thrombus and flew downstream, or the fibrin core of the thrombus was exposed. The results indicate the usefulness of angioscopy for the dynamic and serial investigation of thrombosis and thrombolysis. PMID:3766368
A new medical imaging technique for arterial walls based on laser-induced autofluorescence spectroscopy is reported. The internal surface of isolated arteries with or without atherosclerosis is irradiated with an argon ion laser (458 nm) and the peak intensity of the excited autofluorescence spectrum is related to the composition of the arterial wall. The higher autofluorescence intensity in the range between approximately 480 and 630 nm for grossly calcified tissue compared to normal or noncalcified atherosclerotic tissue is used to produce maps of the arterial wall. These images delineate the calcified areas of the sample with good spatial resolution. If this technique can be adapted to the endoscopic visualization of arteries in vivo (angioscopy), it could become an important tool for the diagnosis of atherosclerosis and for the monitoring of atheroma ablation during laser angioplasty
A. A. Komkov
Full Text Available Achievements of interventional cardiology in the treatment of coronary artery disease are based on coronary balloon angioplasty with implanting bare metal stents and drug eluting stents. Questions of complications such as early stent thrombosis and restenosis of stent were solved in a considerable degree. However, with the lengthening of the followup period, the problem of late complications became obvious. Except endothelization and fibromuscular proliferation in stented coronary arteries the process of plaque formation has an important influence on later complications in follow-up period more than one year. This process was defined as neoatherosclerosis. This is verified by clinical manifestations of the disease, histological studies, angioscopy, intravascular ultrasound and optical-coherence tomography in stented patients. Dynamic observation of the condition in stentedcoronary arteries showed multistep proliferation with restenosis, its regression, and neoatherosclerosis development. Evidences of neoatherosclerosis formation in stented coronary arteries are considered in this review.
何卫红; 陈伟; 周晖
目的 初步探讨双源CT冠状动脉成像时利用仿真内镜诊断冠状动脉疾病的潜在价值.方法 使用Fly-through软件对40例双源CT冠状动脉成像病例行仿真内镜观察,并与CT冠状动脉成像常规方法和传统冠状动脉造影术进行比较.结果 40例患者共120支冠状动脉中,92％(110/120)的冠状动脉可行仿真内镜成像；仿真内镜判断有意义的冠状动脉狭窄正确率为85％( 41/48)；常规CT冠状动脉成像不能判断的9处严重钙化,仿真内镜显示为显著或高度狭窄；4枚冠状动脉支架内和3支桥血管仿真内镜显示通畅.结论 仿真内镜可立体显示正常和病变冠状动脉腔内情况,是CT冠状动脉成像后处理方法的的重要补充.%[Objective] To explore the potential clinical value of virtual endoscopy in detecting coronary artery lesions. [Methods] Forty patients underwent dual-source CT coronary angiography. Virtual endoscopies were simulated in 120 coronary arteries using the Fly-through software, with routine imaging post-processing methods of CT coronary angiography and conventional coronary angiography as the reference standard. [Results] Virtual endo- scopies of 92% (110/120) major coronary artery were successfully performed with good image quality, and the accuracy of virtual coronary angioscopy was 85% (41/48) for detecting hemodynamically significant stenoses confirmed by conventional coronary angiography. Using virtual coronary angioscopy, 9 severe calcified coronary arteries were identified as significant or severe stenoses, while unable to estimate by routine CT coronary angiography. Virtual endoscopies of intracoronary stents (n=4) or bypass grafts (n=4) were patency. [Conclusions] Endoscopy of coronary arteries using dual-source CT allows comprehensive 3-dimensional delineation of the vessel lumen, and can be used as an important complement to the routine post-processing methods of CT coronary angiography in some cases.
Over the past decade, multidetector row computed tomography (MDCT) has become the most reliable and established of the noninvasive examination techniques for detecting coronary heart disease. Now MDCT is chasing intravascular ultrasound (IVUS) in terms of spatial resolution. Among the components of vulnerable plaque, MDCT may detect lipid-rich plaque, the lipid pool, and calcified spots using computed tomography number. Plaque components are detected by MDCT with high accuracy compared with IVUS and angioscopy when assessing vulnerable plaque. The TWINS study and TOGETHAR trial demonstrated that angioscopic loss of yellow color occurred independently of volumetric plaque change by statin therapy. These 2 studies showed that plaque stabilization and regression reflect independent processes mediated by different mechanisms and time course. Noncalcified plaque and/or low-density plaque was found to be the strongest predictor of cardiac events, regardless of lesion severity, and act as a potential marker of plaque vulnerability. MDCT may be an effective tool for early triage of patients with chest pain who have a normal electrocardiogram (ECG) and cardiac enzymes in the emergency department. MDCT has the potential ability to analyze coronary plaque quantitatively and qualitatively if some problems are resolved. MDCT may become an essential tool for detecting and preventing coronary artery disease in the future. (author)
Microaneurysms are important in the diagnosis of vascular changes caused by carbon disulfide. They can be diagnosed by ophtholmoscopy, angiography or angioscopy. In our opinion even a careful ophthalmoscopic investigation is sufficient for diagnosis, so that angiography is not absolutely necessary for any mass survey. The incidence of microaneurysms correlates with the duration (both daily and total) as well as with the intensity of exposure to carbon disulfide. The quantity correlates closely with the intensity of exposure. The incidence of microaneurysms is not correlated to age; however it was found to be highest in 40-50-year-old men working with staple fibers, whereas in the spinning department it occurred in 50-55-old men. Microaneurysms are found equally frequently in active workers and invalids. There was no difference between the two groups with regard to degenerative changes of the macula. However, the changes found in the eyes of men from the staple fiber department were more pronounced than in those from the spinning department.
Full Text Available Percutaneous coronary intervention (PCI may be complicated by periprocedural myocardial infarction (PMI as manifested by elevated cardiac biomarkers such as creatine kinase (CK-MB or troponin T. The occurrence of PMI has been shown to be associated with worse short- and long-term clinical outcome. However, recent studies suggest that PMI defined by biomarker levels alone is a marker of atherosclerosis burden and procedural complexity but in most cases does not have independent prognostic significance. Diagnostic multi-modality imaging such as intravascular ultrasound, optical coherence tomography, coronary angioscopy, near-infrared spectroscopy, multidetector computed tomography, and magnetic resonance imaging can be used to closely investigate the atherosclerotic lesion in order to detect morphological markers of unstable and vulnerable plaques in the patients undergoing PCI. With the improvement of technical aspects of multimodality coronary imaging, clinical practice and research are increasingly shifting toward defining the clinical implication of plaque morphology and patients outcomes. There were numerous published data regarding the relationship between pre-PCI lesion subsets on multi-modality imaging and post-PCI biomarker levels. In this review, we discuss the relationship between coronary plaque morphology estimated by invasive or noninvasive coronary imaging and the occurrence of PMI. Furthermore, this review underlies that the value of the multimodality coronary imaging approach will become the gold standard for invasive or noninvasive prediction of PMI in clinical practice.
The aim of this study was to determine the prevalence and location of enlarged mediastinal and hilar lymph nodes in patients with pulmonary arterial hypertension (PAH) due to chronic pulmonary thromboembolism (CPTE) and to identify possible causes. Thoracic CT images of 85 patients(43 men and 42 women, aged 18-80 years) with PAH in whom CPTE was confirmed at surgery (n = 75) or angiography and angioscopy (n = 10) were evaluated by two thoracic radiologists to determine the presence, size and location of lymph nodes more than 1 cm in the short axis. The presence of pleural and pericardial effusions and parenchymal abnormalities were also noted. Enlarged lymph nodes were identified in 38 patients (44.7%), including 11 with possible causes of lymphadenopathy other than CPTE. In the 27 patients with CPTE alone, 67 enlarged lymph nodes were detected (average 2.5 per patient). Nine patients had three or more enlarged lymph nodes. The most common sites of lymph node enlargement were American Thoracic Society locations 7 (n = 13), 6 (n = 10), 11L (n = 9), 10R (n = 7) and 4R (n = 7). Pleural and pericardial effusions were more common in patients with CPTE who also had lymphadenopathy than in the group with no lymphadenopathy (P < 0.05). Lymph node enlargement is common in patients with PAH caused by CPTE. The frequent association of lymphadenopathy with pleural and pericardial effusions suggest a possible pathophysiological mechanism of increased lymphatic flow caused by right heart failure.
Pedro J. Barrios Fuentes
Full Text Available The case of a male, white skin, 38 years old patient who came to the emergency department because of a severe respiratory distress is reported. The left patella fracture history was collected and an immobilization cast was implemented. The posterior to anterior chest X-ray showed opacities in the form of a veil at the base of the left hemithorax as well as increased cardiothoracic rates. A lung computed tomography angiography scan was performed using a SIEMENS SESATION 64 multislice computed tomography scanner. The study was rebuilt using volume rendering technique and 3D applications with virtual angioscopy. Thrombus occlusion was evident at the trunk of the left pulmonary artery and its branches. The patient was admitted for anticoagulation treatment. Patients with patellar fracture as a trigger for this serious condition involving life-risk had not been treated in this hospital, that is why it was decided to publish this case, as well as for the implementation of such an innovative, useful and quick diagnosis aided by multislice computed tomography angiography.
Wahle, Andreas; Mitchell, Steven C.; Ramaswamy, Sharan D.; Chandran, Krishnan B.; Sonka, Milan
Conventional reconstructions from intravascular ultrasound (IVUS) stack the frames as acquired during the pullback of the catheter to form a straight three-dimensional volume, thus neglecting the vessel curvature and merging images from different heart phases. We are developing a comprehensive system for fusion of the IVUS data with the pullback path as determined from x-ray angiography, to create a geometrically accurate 4-D (3-D plus time) model of the coronary vasculature as basis for computational hemodynamics. The overall goal of our work is to correlate shear stress with plaque thickness. The IVUS data are obtained in a single pullback using an automated pullback device; the frames are afterwards assigned to their respective heart phases based upon the ECG signal. A set of 3-D models is reconstructed by fusion of IVUS and angiographic data corresponding to the same ECG-gated heart phase; methods of computational fluid dynamics (CFD) are applied to obtain important hemodynamic data. Combining these models yields the final 4-D reconstruction. Visualization is performed using the platform-independent VRML standard for a user-friendly manipulation of the scene. An extension for virtual angioscopy allows an easy assessment of the vessel features within their local context. Validation was successfully performed both in-vitro and in-vivo.
Critical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes (ACS) and sudden cardiac death. Autopsy studies have identified a subgroup of high-risk patients with disrupted vulnerable plaque and modest stenosis. Consequently, a clinical need exists to develop methods to identify these plaques prospectively before disruption and clinical expression of disease. Recent advances in invasive and noninvasive imaging techniques have shown the potential to identify these high-risk plaques. The anatomical characteristics of the vulnerable plaque such as thin cap fibroatheroma and lipid pool can be identified with angioscopy, high frequency intravascular ultrasound, intravascular MRI, and optical coherence tomography. Efforts have also been made to recognize active inflammation in high-risk plaques using intravascular thermography. Plaque chemical composition by measuring electromagnetic radiation using spectroscopy is also an emerging technology to detect vulnerable plaques. Noninvasive imaging with MRI, CT, and PET also holds the potential to differentiate between low and high-risk plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque neither has been shown to definitively predict outcome. Nevertheless in contrast, there has been a parallel development in the physiological assessment of advanced atherosclerotic coronary artery disease. Thus recent trials using fractional flow reserve in patients with modest non flow-limiting stenoses have shown that deferral of PCI with optimal medical therapy in these patients is superior to coronary intervention. Further trials are needed to provide more information regarding the natural history of high-risk but non flow-limiting plaque to establish patient-specific targeted therapy and to refine plaque stabilizing strategies in the future.
Full Text Available OBJECTIVES: Oxidized low-density lipoprotein (oxLDL plays a key role in the formation of atherosclerotic plaques. However, its localization in human coronary arterial wall is not well understood. The present study was performed to visualize deposition sites and patterns of native oxLDL and their relation to plaque morphology in human coronary artery. METHODS: Evans blue dye (EB elicits a violet fluorescence by excitation at 345-nm and emission at 420-nm, and a reddish-brown fluorescence by excitation at 470-nm and emission at 515-nm characteristic of oxLDL only. Therefore, native oxLDL in excised human coronary artery were investigated by color fluorescent microscopy (CFM using EB as a biomarker. RESULTS: (1 By luminal surface scan with CFM, the % incidence of oxLDL in 38 normal segments, 41 white plaques and 32 yellow plaques that were classified by conventional angioscopy, was respectively 26, 44 and 94, indicating significantly (p<0.05 higher incidence in the latter than the former two groups. Distribution pattern was classified as patchy, diffuse and web-like. Web-like pattern was observed only in yellow plaques with necrotic core. (2 By transected surface scan, oxLDL deposited within superficial layer in normal segments and diffusely within both superficial and deep layers in white and yellow plaques. In yellow plaques with necrotic core, oxLDL deposited not only in the marginal zone of the necrotic core but also in the fibrous cap. CONCLUSION: Taken into consideration of the well-known process of coronary plaque growth, the results suggest that oxLDL begins to deposit in human coronary artery wall before plaque formation and increasingly deposits with plaque growth, exhibiting different deposition sites and patterns depending on morphological changes.
The characteristics of vulnerable plaque are thin fibrous cap, high proportional atherosclerotic core, increased plaque inflammation, and intraplaque hemorrhage. Vulnerable plaques are apt to rupture,causing platelet adhesion, platelet aggregation, and thrombosis. Vulnerable plaque rupture within coronary artery may induce acute coronary events. Intravascular ultrasounds, virtual histology, palpography, optical coherence tomography, intravascular magnetic resonance imaging, angioscopy, and spectroscopy are currently methods for detecting vulnerable plaque. Drugs, regional therapy, and stents are main strategies for treating vulnerable plaque nowadays.%易损斑块的特征是纤维帽薄、动脉粥样硬化斑块核心比例高、斑块炎症明显及伴斑块内出血.易损斑块易发生破裂,引起血小板黏附聚集和血栓形成.冠状动脉内易损斑块破裂可引起急性冠脉事件.血管内超声、虚拟组织学成像、激应图成像、光学相干断层成像、血管内磁共振显像、血管镜、分光镜等是目前检测易损斑块的主要手段.对冠状动脉内易损斑块应积极干预,药物、局部治疗、安放支架等是目前治疗易损斑块的主要方法.
Indira Martínez Chavarría
Full Text Available The case of a male, white skin, 38 years old patient who came to the emergency department because of a severe respiratory distress is reported. The left patella fracture history was collected and an immobilization cast was implemented. The posterior to anterior chest X-ray showed opacities in the form of a veil at the base of the left hemithorax as well as increased cardiothoracic rates. A lung computed tomography angiography scan was performed using a SIEMENS SESATION 64 multislice computed tomography scanner. The study was rebuilt using volume rendering technique and 3D applications with virtual angioscopy. Thrombus occlusion was evident at the trunk of the left pulmonary artery and its branches. The patient was admitted for anticoagulation treatment. Patients with patellar fracture as a trigger for this serious condition involving life-risk had not been treated in this hospital, that is why it was decided to publish this case, as well as for the implementation of such an innovative, useful and quick diagnosis aided by multislice computed tomography angiography.Se presenta el caso de un paciente del sexo masculino, de color de piel blanca, de 38 años de edad que acudió al Servicio de Urgencias por padecer de dificultad respiratoria. Se recogió el antecedente de fractura a nivel de rótula izquierda e inmovilización con yeso. El rayos X del tórax en posición postero anterior mostró opacidades en forma de velo en la base del hemitórax izquierdo e índice cardiotorácico aumentado. Se realizó angiotomagrafía pulmonar en tomógrafo multicorte SIEMENS SESATION 64. Se reconstruyó el estudio con las aplicaciones VRT y 3D con angioscopia virtual. Se evidenció oclusión por trombo a nivel del tronco de la arteria pulmonar izquierda y sus ramas. Se ingresó para tratamiento de anticoagulación. Por no haber sido observado en este medio, en pacientes con fractura de rótula como factor desencadenante de esta afección grave que puede
张庆桥; 陈雪荣; 闵继忠; 祖茂衡; 徐浩; 顾玉明; 李国均; 魏宁; 许伟; 刘洪涛; 崔艳峰
originated from the site of IVC occlusions in 9 patients were detected by the 3D-DSA.However.the 2D-DSA provided excellent visualization of the vascular structures of the IVC in 7 patients.and the collateral vessels origihated from the site of IVC occlusions were shown in 2 patients.The 3D-DSA was significantly superior to the 2D-DSA in detecting the IVC obstructions and the collateral vessels(P＜0.05).The virtual angioscopy of the 3D-DSA was able to visualize free IVC thrombosis in 3 paitents.and mural IVC thrombosis in 1 patient.The procedures were successful in all patients.There were no other complications except the rupture of IVC in 1 patient.Conclusion The 3D-DSA can offer valuable informations in diagnosis of IVC obstruction.and it may play an important role in interventional treatment of Budd-Chiari syndrome.