WorldWideScience

Sample records for aortography

  1. Aortography

    International Nuclear Information System (INIS)

    Paulin, S.

    1986-01-01

    Aortography, the radiographic demonstration of the contrast filled central large vessel from which all organ systems of the human body derive their arterial blood supply, has a long history. In 1929, the very year when W. Forssmann reported that he had passed a catheter from an arm vein into his own right atrium, dos Santos and his colleagues reported the successful performance of abdominal aortography following direct puncture of this vessel with a needle. Angiographic study of the aorta may be performed in order to quantitate the degree of aortic valve incompetence, to delineate the topography of abnormal vascular pathways related to congenital malformations, or to search for congenital malformations, or to search for congenital or acquired vascular lesions that might be the cause of systemic hypertension

  2. Aortography following subdiaphragmal aortic biopsy

    International Nuclear Information System (INIS)

    Schimmler, J.

    1982-01-01

    A juxtaposition of the subdiaphragmal and infrarenal translumbar aortic biopsy sites showed decisive advantages in favour of the higher site: a more stable position because of better anatomic fixation and rarer incidence of vascular alterations, a wider vascular lumen. Disadvantages lie in the fact that the large visceral arteries (especially Tr. coeliacus) branch off nearly and in the close anatomic relationship to large abdominal organs and the thoracal region. Evaluation of the radiographical image of the vascular tree after subdiaphragmal aortic biopsy showed an average 82% of the vessels to the area of the Knees to be assessable (renal arteries approximately 93%, popliteal arteries approximately 70%). Beyong, the method proved unsatisfactory: 52% of the vessels could not, or not safety, be evaluated. A relatively broad spectrum of indications by comparison with transfemoral catheter aortography had no influence on the rate of complications with reference to either method. A comparison of the topographic conditions shows the need for even more scrupulons observation of the technique in subdiaphragmal biopsy than in the infrarenal one. To sum up the results obtained, subdiaphregmal translumbar aortography is to be preferred to the infrarenal one where transfemoral catheter aortography is contra-indicated, within the limits mentioned. (orig.) [de

  3. Clinical and radiographic indications for aortography in blunt chest trauma.

    Science.gov (United States)

    Kram, H B; Wohlmuth, D A; Appel, P L; Shoemaker, W C

    1987-08-01

    To determine which clinical and radiographic findings are valuable in selecting patients with blunt chest trauma for aortography, we analyzed the medical records and admission chest radiographs of 76 consecutive victims of blunt chest trauma with suspected thoracic aortic rupture during the past 7 years. All patients were evaluated by history, physical examination, chest radiography, and aortography; a total of 70 clinical and radiographic findings were independently assessed in each patient. The following occurred with significantly greater frequency in patients with thoracic aortic rupture than in those without: history of significant hypotension (mean arterial pressure less than 80 mm Hg) (p less than 0.04); the presence of upper extremity hypertension, bilateral lower extremity pulse pulse deficits, or an initial chest tube output greater than 750 ml of blood (p less than 0.05); and greater incidence of myocardial contusions, intra-abdominal injuries, and pelvic fractures compared with patients without thoracic aortic rupture (p less than 0.05). Mediastinal widening (equal to or greater than 8 cm) shown on anteroposterior chest radiography occurred in all patients with thoracic aortic rupture; however, its specificity was only 10.6%. Radiographic signs that were helpful in indicating the presence of thoracic aortic rupture included paratracheal stripe greater than 5 mm, rightward deviation of the nasogastric tube or central venous pressure line, blurring of the aortic knob, and an abnormal or absent paraspinous stripe. Upper rib fractures and mediastinal to thoracic cage width ratios at any level did not increase diagnostic accuracy for thoracic aortic rupture in the present series. Six patients in the series died, two of whom had thoracic aortic rupture.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

    International Nuclear Information System (INIS)

    Wicky, S.; Capasso, P.; Meuli, R.; Schnyder, P.; Fischer, A.; Segesser, L. von

    1998-01-01

    The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients. (orig.)

  5. Axillary artery counter-current aortography in the newborn with aortic arch obstruction

    International Nuclear Information System (INIS)

    Lau, K.C.; Lo, R.N.S.; Leung, M.P.

    1989-01-01

    13 newborn infants with aortic coarctation were evaluated by counter-current aortographic technique. The right radial or brachial artery approach (2 cases in each group) did not give successful aortic arch imaging while the right axiallary artery approach resulted in adequate imaging in each of 9 cases investigated. In 2, the axillary artery was transiently weakened but returned to normal within 24 hours. No other complications were encountered. Axillary artery counter-current aortography is a safe and relatively non-invasive procedure which can be used to image the aortic arch in the newborn babies when other non-invasive diagnosis of aortic arch obstruction is tentative. (orig.)

  6. Intraarterial contrast-enhanced MR aortography with and without parallel acquisition technique in patients with peripheral arterial occlusive disease.

    Science.gov (United States)

    Potthast, Silke; Bongartz, Georg M; Huegli, Rolf; Schulte, Anja-Carina; Schwarz, Jochen G; Aschwanden, Markus; Bilecen, Deniz

    2007-03-01

    Repeated intraarterial gadolinium injections are necessary in endovascular MRI-guided interventions; therefore a low-dose protocol with a short acquisition time is preferable. The purpose of this study was to conduct a quantitative comparison of intraarterial MR aortograms obtained with and without high-speed parallel acquisition technique. Intraarterial MR aortography was performed at 1.5 T on nine patients with peripheral arterial occlusive disease and in an aortic phantom with pulsatile flow. A 3D fast low-angle shot MRI sequence was used for standard technique (acquisition time, 20 seconds) and for parallel acquisition technique (acquisition time, 14 seconds). In all patients, a pigtail catheter was left in the suprarenal position after digital subtraction angiography. Contrast-enhanced intraarterial MR aortography was performed after automated injection of 50 mmol/L gadoterate dimeglumine at an injection rate of 4 mL/s. Contrast-to-noise ratio (CNR) and image quality were evaluated in both imaging series at different locations. In an aortic phantom with pulsatile flow, CNR was determined 1, 30, and 60 cm distal to the catheter tip with standard and parallel acquisition techniques. In all patients, intraarterial MR aortography was feasible with both acquisition techniques. No significant difference in CNR or image quality was observed in the patient study. Similar results were calculated for the pulsatile aortic flow phantom at all locations. Intraarterial MR aortography is feasible with parallel acquisition technique without a significant loss of CNR. This technique reduces contrast agent consumption approximately 30% owing to an approximately 30% reduction in acquisition time.

  7. Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography.

    LENUS (Irish Health Repository)

    Manning, Brian J

    2012-02-01

    OBJECTIVES: Cumulative radiation dose, cost, and increased demand for computed tomography aortography (CTA) suggest that duplex ultrasonography (DU) may be an alternative to CTA-based surveillance. We compared CTA with DU during endovascular aneurysm repair (EVAR) follow-up. METHODS: Patients undergoing EVAR had clinical and radiological follow-up data entered in a prospectively maintained database. For the purpose of this study, the gold standard test for endoleak detection was CTA, and an endoleak detected on DU alone was assumed to be a false positive result. DU interpretation was performed independently of CTA and vice versa. RESULTS: One hundred thirty-two patients underwent EVAR, of whom 117 attended for follow-up ranging from six months to nine years (mean, 32 months). Adequate aneurysm sac visualisation on DU was not possible in 1.7% of patients, predominantly due to obesity. Twenty-eight endoleaks were detected in 28 patients during follow-up. Of these, 24 were initially identified on DU (four false negative DU examinations), and eight had at least one negative CTA with a positive DU prior to diagnosis. Twenty-three endoleaks were type II in nature and three of these patients had increased sac size. There was one type I and four type III endoleaks. Two of these (both type III) had an increased sac size. Of 12 patients with increased aneurysm size of 5 mm or more at follow-up, five had an endoleak visible on DU, yet negative CTA and a further five had endoleak visualisation on both DU and CTA. Of six endoleaks which underwent re-intervention, all were initially picked up on DU. One of these endoleaks was never demonstrated on CTA and a further two had at least one negative CTA prior to endoleak confirmation. Positive predictive value for DU was 45% and negative predictive value 94%. Specificity of DU for endoleak detection was 67% when compared with CTA, because of the large number of false positive DU results. Sensitivity for DU was 86%, with all

  8. Importance of Contrast Aortography With Lotus Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the RESPOND Post-Market Study.

    Science.gov (United States)

    van Gils, Lennart; Wöhrle, Jochen; Hildick-Smith, David; Bleiziffer, Sabine; Blackman, Daniel J; Abdel-Wahab, Mohamed; Gerckens, Ulrich; Brecker, Stephen; Bapat, Vinayak; Modine, Thomas; Soliman, Osama I; Nersesov, Andrey; Allocco, Dominic; Falk, Volkmar; Van Mieghem, Nicolas M

    2018-01-22

    The aim of this post hoc analysis from the RESPOND (Repositionable Lotus Valve System-Post-Market Evaluation of Real World Clinical Outcomes) post-market study was to assess the final implantation depth on the contrast aortogram after Lotus valve (Boston Scientific, Marlborough, Massachusetts) transcatheter aortic valve replacement (TAVR) and to correlate with permanent pacemaker implantation (PPI) and paravalvular leak (PVL). Contrast aortography allows for the assessment of implantation depth and PVL during and after TAVR. Previous reports suggested an association between final device position and rates of PPI and PVL. The RESPOND study was a prospective, open-label, single-arm study in 41 centers evaluating outcomes after Lotus TAVR in routine clinical practice. Aortograms were collected at the Erasmus Medical Center and analyzed by researchers who were blinded to clinical outcomes. The primary analysis correlated implantation depth with PPI and PVL and required aortograms in a coaxial projection. The relation between implantation depth and need for PPI was assessed by multivariate logistic regression, adjusting for pre-defined confounders. A secondary analysis compared PVL analysis by contrast aortography with transthoracic echocardiography (TTE) performed by the independent core laboratory. A total of 724 angiographic studies were included in this analysis. Mean Lotus implantation depth was 6.67 ± 2.19 mm. The overall PPI rate was 35%. PPI rate was lower with shallow implants (analysis of the RESPOND study PPI was highly correlated with implantation depth, whereas PVL was not. Higher Lotus implantation may reduce need for PPI. Copyright © 2018. Published by Elsevier Inc.

  9. Translumbar aortography by catheter technique

    International Nuclear Information System (INIS)

    Hagen, B.; Honemeyer, U.; Meier-Duis, H.

    1982-01-01

    400 examinations performed during the last three years by TLA (only catheter technique) were subjected to critical analysis and studied particularly in respect to the rate of complications. We observed 13 complications (3.25%) of moderate severity, including 3 large hematomas (documented by CT), 3 paravasations and 7 dissections, but no fatal complication. Two (0.5%) of these complications had clinical evidence. The advantages of the catheter technique of TLA are described. Injections through rigid metal cannula should be avoided because of the high incidence of complications (mainly the increased risk of dissection). Downstream injection resulted in excellent visualization of peripheral occluding vascular disease. Upstream injection should be preferred to demonstrate the major abdominal arteries as well as supraceliac collateral circulation in the case of high Leriche syndrome. The low or intermediate puncture of the aorta is preferable to facilitate caudad direction of the catheter and to diminish the risk of damaging other vessels or puncturing an organ. (orig.) [de

  10. Aortography delays surgery of CT proven acute traumatic rupture of the thoracic aorta; Case report

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, A.; Moreno, R.; Martin, V.; Iniguez, A.; Alvarez, J. (Hospital Universitario de San Carlos, Madrid (Spain). Dept. de Radiodiagnostico, Servicio de Cirurgia Vascular, Servicio de Exploracion Cardiopulmonar, and Unidad de Cuidados Intensivos)

    1991-09-01

    A case of acute traumatic rupture of the thoracic aorta was diagnosed by dynamic CT. Angiographic confirmation was required, delaying surgical repair and contribution to the fatal outcome. If reliable findings of acute traumatic rupture of the thoracic aorta are shown by CT, we question the usefulness of angiographic confirmation in such cases. (orig.).

  11. Demonstration of ascending aorta in hypoplastic left heart syndrome with aortic atresia by balloon occlusion aortography

    International Nuclear Information System (INIS)

    Lo, R.N.S.; Leung, M.P.; Lau, K.C.

    1987-01-01

    Balloon occlusion angiography in the descending aorta produced clear retrograde visualization of the hypoplastic ascending aorta and related structures in eighteen neonates with aortic atresia. Transient bradycardia was the only complication observed. It is technically simpler than retrograde cannulation of the aorta via an arteriotomy and should be the method of choice when cardiac catheterization is required in patients with the hypoplastic left heart syndrome. (orig.)

  12. The thoracic aortography by Gd-DTPA enhanced ultrafast cine MR imaging. Assessment of thoracic aortic dilatation in aging and in patients with hypertension and aortic valve disease

    International Nuclear Information System (INIS)

    Matsumura, Kentaro; Nakase, Emiko; Kawai, Ichiyoshi; Saito, Takayuki; Kikkawa, Nobutada; Haiyama, Toru

    1995-01-01

    To assess the morphology of thoracic aorta, we had a trial of Gd-DTPA enhanced ultrafast cine MR imaging on the thoracic aorta. This method was provided with high quality thoracic aortogram during 15-20 seconds. In patients without hypertension and aortic valve disease, dimensions of ascending aorta and aortic arch were significantly correlated with aging. In patients with hypertension, dimensions of ascending aorta and aortic arch were significantly dilated. In patients with aortic valve disease, thoracic aorta was diffusely enlarged, especially in ascending aorta. Gd-DTPA enhanced ultrafact cine MR imaging was useful to assess the thoracic aortic anatomy and diseases. (author)

  13. Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Khoss, A.E.; Ponhold, W.; Pollak, A.; Schlemmer, M.; Weninger, M.

    1985-09-01

    When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries.

  14. Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography

    International Nuclear Information System (INIS)

    Khoss, A.E.; Ponhold, W.; Pollak, A.; Schlemmer, M.; Weninger, M.

    1985-01-01

    When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries. (orig.)

  15. 2D MR angiography of the aortic aneurysm

    International Nuclear Information System (INIS)

    Amanuma, Makoto; Hasegawa, Makoto; Watabe, Tsuneya; Heshiki, Atsuko

    1992-01-01

    2D time-of-flight MR angiography was performed in 6 cases of thoracic aortic aneurysm. Oblique saturation pulses were used to suppress the signals of the pulmonary artery and SVC, providing excellent selective MR aortograms. Three dimensional extension of the aneurysm and its relation with cervical branches were easily assessed. It could be possible to replace invasive aortography by this technique. (author)

  16. Translumbar carotid arteriography

    International Nuclear Information System (INIS)

    Maxwell, S.L. Jr.; Kwon, O.J.; Millan, V.G.

    1983-01-01

    In seven patients, carotid arteriography and arch aortography were performed using a translumbar catheter exchange sheath which facilitated selective catheterization. No significant complications occurred. The translumbar approach is easier than the auxillary approach, will result in fewer complications, and should be considered whenever a femoral arterial access is unavailable

  17. Digital substraction angiography in aortic dissection

    International Nuclear Information System (INIS)

    Khadzhidekov, V.; Mircheva, M.; Genov, P.

    1993-01-01

    Regardless of the technical progress in new noninvasive methods, aortography is still regarded as a method providing the necessary information for cases of aortic dissection, especially those requiring emergency operative management. Twenty-four DS-aortographies of patients suspected for aortic dissection are reviewed. Intraarterial DSA is less hazardous owing to the reduced flow rate and quantity of contrast medium required. The relative share of inadequate images is rather high, and conventional cineaortography cannot be invariably replaced by the digital subtracted one. However, angiographic examination in cases suspected for aortic dissection may start with intraarterial digital substraction, and provided the latter proves inconclusive, conventional cineaortography may be resorted to. 6 refs., 3 figs. (orig.)

  18. Pulmonary sequestration mimicring lun cancer: A case report

    Directory of Open Access Journals (Sweden)

    Adžić-Vukičević Tatjana N.

    2016-01-01

    Full Text Available Introduction. Pulmonary sequestration is a rare congenital anomaly and most intralobar sequestrations were located in lower lobes. Case report. We reported an unusual 28-yearold female patient with intralobar pulmonary sequestration on the left lower lobe, successfully treated with lobectomy. Computed tomography (CT of the chest with intravenous contrast revealed multiple clustered cystic lesions in the left lower lobe with aberrant artery from descedenting aorta. Additional aortography showed an aberrant artery (3 mm in diameter arising from the abdominal aorta and flowing into the lesion. Conclusion. Standard therapy regimen for pulmonary sequestration includes surgery. CT scan of thorax with intravenous contrast and aortography represent the gold standard for its diagnosis. Tumor-like shadows seen on the chest radiography or CT scans should not be always suspected on malignant lesions.

  19. Transcatheter embolization of a congenital intrahepatic arterioportal venous malformation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sing, T.M.Y.S.; Wong, K.P.; Young, N. [Westmead Hospital, Westmead, NSW, (Australia). Department of Radiaology; Le, S.D.V. [Bankstown-Lidcombe Hospital, Bankstown, NSW, (Australia). Department of Nuclear Medicine and Ultrasound

    1997-08-01

    Congenital intrahepatic arterioportal venous malformations (APVM) are uncommon lesions. A congenital intrahepatic APVM found incidentally in a 51 -year-old man during pre-operative aortography for an abdominal aortic aneurysm is reported here. This was successfully treated by transcatheter embolization of the involved hepatic artery prior to surgical repair of the aortic aneurysm. A 51-year-old smoker was admitted for pre-operative aortography of an abdominal aortic aneurysm (AAA). Liver function tests showed a mildly elevated alkaline phosphatase. There was no previous history of liver disease or trauma. Aortography demonstrated a large infra-renal AAA measuring 10 cm in diameter and 20 cm in length. The coeliac axis was noted to be grossly dilated with tortuous veins seen to the right side of the lower thoracic spine on delayed images. Coeliac angiography revealed a dilated intrahepatic vascular abnormality in the left lobe of the liver with late opacification of the portal vein. Contrast abdominal CT demonstrated the AAA and the dilated coeliac axis feeding a large vascular malformation in the lateral aspect of the left lobe of the liver. The arterial inflow was via the left hepatic artery and a large vein was seen leading into the left portal vein. Endoscopy showed no oesophageal varices. (authors). 11 refs., 7 figs.

  20. Duplex ultrasonography in the detection of celiac axis stenosis: a validation study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Min; Park, Jae Hyung; Choi, Young Ho; Seong, Nak Jong; Yoon, Chang Jin; Chung, Jin Wook [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-11-01

    To assess the predictive value of duplex ultrasonography in the detection of celiac axis (CA) stenosis. In 127 patients designated for coronary artery bypass graft surgery (CABG), lateral aortography for the evaluation of CA stenosis was performed between January and October 2001. Thirty-nine of these patients [M:F=30:9; age, 44-75 (mean, 62) years] underwent CA duplex scanning in the supine position using 2-4 MHz convex probes. CA diameters obtained at lateral aortography were subsequently measured by two radiologists, unaware of the duplex results, and the original duplex velocity values were determined using velocity criteria such as peak systolic velocity (PSV), peak diastolic velocity (PDV) and end diastolic velocity (EDV). CA stenosis was confirmed at lateral aortography in 13 patients (M:F=10:3), in all of whom CA stenosis was greater than 50%. PSV in the CA stenosis group (n=13) was 283{+-}96 cm/sec, PDV was 85{+-}49 cm/sec, and EDV was 55{+-}33 cm/sec, while the corresponding values in the normal CA group were 161{+-}55 cm/sec, 59{+-}21 cm/sec, and 32{+-}9 cm/sec, respectively. PSV was significantly different between the normal and stenosis groups (p<0.01). A threshold of PSV > 250 cm/sec provided high diagnostic accuracy in terms of sensitivity (77%), specificity (85%), positive predictive valve (71%), negative predictive value (88%) and accuracy (82%). EDV > 50 cm/sec provided lower sensitivity (46%), but higher specificity (96%). The most accurate predictive factor for celiac axis (CA) stenosis was increased PSV. Duplex ultrasonography can be used prior to angiographic evaluation as a screening test for patients in whom CA stenosis is suspected.

  1. A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

    International Nuclear Information System (INIS)

    Choo, Yeon Myung; Chang, Kee Hyun; Choi, Sung Jae

    1984-01-01

    One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddenly developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated multiple aneurysms in both common carotid arteries and abdominal aorta with organizing thrombi and thromboembolism of internal carotid artery

  2. Endovascular Treatment of Blunt Traumatic Abdominal Aortic Occlusion With Kissing Stent Placement

    International Nuclear Information System (INIS)

    Idoguchi, Koji; Yamaguchi, Masato; Okada, Takuya; Nomura, Yoshikatsu; Sugimura, Kazuro; Okita, Yutaka; Sugimoto, Koji

    2012-01-01

    Blunt traumatic abdominal aortic dissection is extremely rare and potentially deadly. We present the case of a 62-year-old man involved in a frontal car crash. After emergency undergoing laparotomy for bowel injuries, he was referred to our hospital due to acute ischemia of bilateral lower extremities on day 3 after the trauma. Computed tomography and aortography showed an aortobiiliac dissection with complete occlusion. This injury was successfully treated by endovascular treatment with “kissing”-technique stent placement, which appears to be a safe, effective, and minimally invasive treatment.

  3. Endovascular Treatment of Blunt Traumatic Abdominal Aortic Occlusion With Kissing Stent Placement

    Energy Technology Data Exchange (ETDEWEB)

    Idoguchi, Koji, E-mail: idoguchi@ares.eonet.ne.jp; Yamaguchi, Masato; Okada, Takuya [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Nomura, Yoshikatsu [Kobe University Hospital, Department of Cardiovascular Surgery (Japan); Sugimura, Kazuro [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Okita, Yutaka [Kobe University Hospital, Department of Cardiovascular Surgery (Japan); Sugimoto, Koji [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan)

    2012-10-15

    Blunt traumatic abdominal aortic dissection is extremely rare and potentially deadly. We present the case of a 62-year-old man involved in a frontal car crash. After emergency undergoing laparotomy for bowel injuries, he was referred to our hospital due to acute ischemia of bilateral lower extremities on day 3 after the trauma. Computed tomography and aortography showed an aortobiiliac dissection with complete occlusion. This injury was successfully treated by endovascular treatment with 'kissing'-technique stent placement, which appears to be a safe, effective, and minimally invasive treatment.

  4. Thalamic hemorrhage in a 4-year-old child induced by nephro-vascular hypertension

    International Nuclear Information System (INIS)

    Bianchi, E.; Savasta, S.; Torcetta, F.; Solmi, M.; Beluffi, G.; Gajno, T.M.

    1989-01-01

    A child affected by cardiomyopathy from the age of 12 months suddenly manifested right hemiparesis and dysarthria at the age of 48/12 years. Emergency brain CT showed a hemorrhage in progress in the left thalamic area. A serve from of hypertension was concomitant and resisted all pharmacological treatment. Retrograde transfemural aortography pointed out an atrophy of the right renal artery. This finding, together with the high renin and aldosterone values, indicated a nephrogenic hypertension causing both the cardiomyopathy found at 12 months of age and the endocranial hermorrhage. Right nephrectomy led to the normalization of blood pressure. (orig.)

  5. Infantile Aortic Coarctation in an Adult with Heart Failure.

    Science.gov (United States)

    Rumiz, Eva; Valero, Ernesto; Vilar, Juan Vicente; Santas, Enrique; Haba, Javier

    2017-01-01

    The aim of this case report is to highlight the importance of excluding aortic coarctation in a patient with a bicuspid aortic valve. A 56-year-old woman with hypertension was admitted complaining of progressive dyspnea. Transthoracic echocardiography showed a calcified, bicuspid aortic valve with severe stenosis. Aortography revealed the presence of severe narrowing of the aorta between the carotid and subclavian arteries. The patient was referred for cardiovascular surgery in which successful aortic valve replacement and aortic correction were performed. This case report shows an uncommon finding of infantile aortic coarctation in an adult patient admitted with heart failure. © 2016 S. Karger AG, Basel.

  6. Diagnosis of false proximal anastomosis aneurysms after aortofemoral reconstructive operations

    International Nuclear Information System (INIS)

    Pokrovskij, A.V.; Dan, V.N.; Karazeev, G.L.

    1993-01-01

    The paper deals with the diagnostic aspects of false aneurysms of proximal anastomosis of prostheses with the aorta on the basis of examination of 9 patients aged 3-65 years after aortofemoral reconstructive operations. The periods of the occurrence of false aneurysms were 2 weeks to 6 years. The causes of anastomosis aneurysms: infection, endartectomy fro the aorta at the site of applied anastomosis, progressive underlying disease. The authors provide strong evidence for a high informative value of various examinations, including ultrasound echoscanning, computer tomography, radioopaque aortography

  7. Emergency Endovascular Treatment of a Superior Mesenteric Artery Occlusion

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Critselis, Antonios; Magoulas, Dimitrios; Kagianni, Eleni; Kelekis, Dimitrios A.

    2001-01-01

    Endovascular treatment of acute mesenteric ischemia is rarely reported. We report a patient with a 1-year history of chronic mesenteric ischemia who presented with acute worsening of his symptoms and peritoneal signs. Aortography depicted an occlusion of the superior mesenteric artery, which was successfully managed with immediate percutaneous angioplasty (PTA) and stent placement. The patient's clinical condition improved markedly and an exploratory laparotomy performed the following day confirmed the viability of the intestine. He remains symptom-free 12 months after the procedure, and color Doppler follow-up showed that the stent is patent

  8. [Diagnosis and treatment of a rare intrapulmonary vascular anomaly in a child (author's transl)].

    Science.gov (United States)

    Mau, H; Tambor, U; Romaniuk, P

    1976-01-01

    In the present case an artery originating from the abdominal aorta and running through the diaphragma into the inferior lobe of the left lung was identified by retrograde aortography. It ended in a vascular coil which was drained by regular pulmonary veins. By transthoracal resection of pulmonary parenchyma and malformation was removed without complications. Such anomalies represent absolute but not urgent indications for surgery. Without treatment, the shunt volume will cause additional straining for the heart. Furthermore, pulmonary complications and thromboembolic processes may arise.

  9. Thalamic hemorrhage in a 4-year-old child induced by nephro-vascular hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, E.; Savasta, S.; Torcetta, F.; Solmi, M.; Beluffi, G.; Gajno, T.M.

    1989-08-01

    A child affected by cardiomyopathy from the age of 12 months suddenly manifested right hemiparesis and dysarthria at the age of 48/12 years. Emergency brain CT showed a hemorrhage in progress in the left thalamic area. A serve from of hypertension was concomitant and resisted all pharmacological treatment. Retrograde transfemural aortography pointed out an atrophy of the right renal artery. This finding, together with the high renin and aldosterone values, indicated a nephrogenic hypertension causing both the cardiomyopathy found at 12 months of age and the endocranial hermorrhage. Right nephrectomy led to the normalization of blood pressure. (orig.).

  10. Computed tomography of chest trauma

    International Nuclear Information System (INIS)

    Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

    1987-01-01

    Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient. (orig.) [de

  11. Cone-beam CT angiography of the thorax. An experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Katsuya; Shimada, Kazuhiro [Chiba Univ. (Japan). School of Medicine; Tadokoro, Hiroyuki (and others)

    1999-10-01

    The authors recently developed a cone-beam computed tomography (CT) scanner and this report presents their evaluation of its potential for thoracic vascular imaging. An X-ray tube and a video-fluoroscopic system were rotated around the objects and 360 projected images were collected in a 12-s scan. Each image was digitized and a 3 dimensional (D) image (256 x 256 x 256 voxel volume with a voxel dimension of 0.9 x 0.9 x 0.9 mm) was reconstructed. Two different 3D-CT angiographies were investigated in 2 pigs: right atriography and thoracic aortography. Each pig was anesthetized, mechanically ventilated and positioned within the scanner. Contrast agent was infused through the right atrium or the aortic root at a rate of 3 ml/s during the scan. The right atriography scan clearly delineated the anatomy of the pulmonary artery, heart chambers and thoracic aorta. The thoracic aortography scan also clearly delineated the aortic anatomy including the internal thoracic and intercostal arteries. In conclusion, cone-beam CT angiography is potentially useful for thoracic vascular imaging. (author)

  12. Cone-beam CT angiography of the thorax. An experimental study

    International Nuclear Information System (INIS)

    Yoshida, Katsuya; Shimada, Kazuhiro; Tadokoro, Hiroyuki

    1999-01-01

    The authors recently developed a cone-beam computed tomography (CT) scanner and this report presents their evaluation of its potential for thoracic vascular imaging. An X-ray tube and a video-fluoroscopic system were rotated around the objects and 360 projected images were collected in a 12-s scan. Each image was digitized and a 3 dimensional (D) image (256 x 256 x 256 voxel volume with a voxel dimension of 0.9 x 0.9 x 0.9 mm) was reconstructed. Two different 3D-CT angiographies were investigated in 2 pigs: right atriography and thoracic aortography. Each pig was anesthetized, mechanically ventilated and positioned within the scanner. Contrast agent was infused through the right atrium or the aortic root at a rate of 3 ml/s during the scan. The right atriography scan clearly delineated the anatomy of the pulmonary artery, heart chambers and thoracic aorta. The thoracic aortography scan also clearly delineated the aortic anatomy including the internal thoracic and intercostal arteries. In conclusion, cone-beam CT angiography is potentially useful for thoracic vascular imaging. (author)

  13. Atypical initial presentation of Takayasu arteritis as isolated supra-valvular aortic stenosis.

    Science.gov (United States)

    Kim, Do Yeon; Kim, Hwan Wook

    2016-01-19

    Among the vascular involvements of Takayasu arteritis, a supra-valvular aortic stenosis has been reported very rarely. We report a case of surgically corrected, supra-valvular aortic stenosis caused by Takayasu arteritis. A 32-year-old female was diagnosed with supra-valvular aortic stenosis by transthoracic echocardiography for the evaluation of cardiac murmur with constitutional symptoms. Under the impression of non-familial sporadic type of supra-valvular aortic stenosis, surgical correction was performed. However, after 1 year from the operation, we could know the cause of her disease through the findings of computed tomographic aortography that Takayasu arteritis was suspected. Takayasu arteritis should be considered in adult female patients presenting supra-valvular aortic stenosis with constitutional symptoms, even if no typical features of vascular involvement.

  14. Screening for traumatic aortic tear with chest CT

    International Nuclear Information System (INIS)

    Raptopoulos, V.; Sheiman, R.G.; Phillips, D.A.; Davidoff, A.; Silva, W.

    1990-01-01

    This paper determines if chest CT can be used in the screening of traumatic aortic tear, using CT evidence of mediastinal fluid (presumably blood) as a criterion for aortography. Dynamic CT limited to the region of the aortic arch was performed in all patients undergoing abdominal CT because of blunt trauma. Over a period of 2 years, 131 such patients also had thoracic aortograms performed within 123 hours of CT. Traumatic tear of the aorta was identified in 10 patients; all had abnormal CT scans (evidence of fluid), but only eight had abnormal chest radiographs. Of the 121 patients with normal aortograms, 86 had normal and 35 had abnormal CT scans. The chest radiographs were normal in 18 and abnormal in 103. Comparing chest radiography with CT, there was no significant difference in sensitivity (80% vs 100%), but the specificity and accuracy of CT were significantly higher (71% vs 15% and 74% vs 20%, respectively)

  15. Cateterismo retrógrado em neuro-radiologia

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    Sérgio F. Raupp

    1970-06-01

    Full Text Available The bases and technical cares for the neuro-radiological study of the aorto-cervical and spinal vessels employing the retrograde catheterization according to Seldinger technic and with the Odman-Ledin catheters are reported. The authors recommend type II neuroleptanalgesia as anesthesical sedative and the use of percutaneous punction of the femoral artery or, by choice, of the axilar or humeral artery. For the selective catheterization by femoral via, they make previously an aortography, in order to know the anatomy of the supra-aortic vessels, with control through the image-inten-sifier or fluoroscopy. They employ manual injection for the study of the supra-aortic vessels and a Gidlung injector for the contrast of the ascending aorta. Complications are discussed.

  16. Cateterismo retrógrado em neuro-radiologia Retrograde catheterization in Neuro-radiology

    Directory of Open Access Journals (Sweden)

    Sérgio F. Raupp

    1970-06-01

    Full Text Available The bases and technical cares for the neuro-radiological study of the aorto-cervical and spinal vessels employing the retrograde catheterization according to Seldinger technic and with the Odman-Ledin catheters are reported. The authors recommend type II neuroleptanalgesia as anesthesical sedative and the use of percutaneous punction of the femoral artery or, by choice, of the axilar or humeral artery. For the selective catheterization by femoral via, they make previously an aortography, in order to know the anatomy of the supra-aortic vessels, with control through the image-inten-sifier or fluoroscopy. They employ manual injection for the study of the supra-aortic vessels and a Gidlung injector for the contrast of the ascending aorta. Complications are discussed.

  17. Imaging findings in the right aortic arch with mirror image branching of arch vessels: An unusual cause of dysphagia

    Directory of Open Access Journals (Sweden)

    Guneet Singh

    2015-01-01

    Full Text Available We report a case of a 72-year-old female with a right aortic arch with mirror-image branching of arch vessels presenting with dysphagia, and characteristic images on barium esophagogram, contrast-enhanced computed tomography scan, and magnetic resonance aortography. Right-sided thoracic aortic arch with mirror-image branching of the brachiocephalic vessels causing dysphagia without associated congenital cardiac anomalies is extremely uncommon. Right-sided aortic arch is a rare congenital abnormality with incidence of 0.05-0.1% in the normal population. Anomalies of great vessels are usually incidental findings, because they are asymptomatic. Right aortic arch infrequently presents with a vascular ring that can cause complete or partial obstruction of the trachea and/or esophagus. The understanding of this arch anomaly is based on Edward′s hypothesis about the double arch system during embryonic developmental.

  18. Correção endovascular de dissecção de aorta ascendente Endovascular repair of ascending aortic dissection

    Directory of Open Access Journals (Sweden)

    José Carlos Dorsa Vieira Pontes

    2013-03-01

    Full Text Available Paciente de 84 anos com dissecção de aorta torácica tipo A de Stanford comprometendo todo o arco aórtico e aorta descendente. Proposto e aceito o tratamento endovascular em função da gravidade do quadro clínico. Procedeu-se à dissecção das artérias femorais comum bilateralmente. A aortografia confirmou a exclusão da falsa luz e a patência dos óstios coronarianos.Woman, 84 years-old, with Stanford type A thoracic aortic dissection committing aortic arch and descending aorta. Proposed and accepted endovascular treatment according to the severity of the clinical picture. Common femoral artery dissection bilaterally was done. Aortography confirmed the exclusion of the false lumen and patency of the coronary ostia.

  19. Infra-optic Course of Both Anterior Cerebral Arteries Associated with a Middle Cerebral Artery Aneurysm and an Aortic Coarctation

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    Ji, Cheol; Ahn, Jae Geun; Cho, Song Mee [Catholic University, St. Paul' s Hospital, Seoul (Korea, Republic of)

    2009-06-15

    A ruptured aneurysm at the bifurcation of the left middle cerebral artery with an infra- optic course of the bilateral anterior cerebral arteries was found in a 28-year-old woman. Both abnormal anterior cerebral arteries arose from the ipsilateral internal carotid arteries, at the level of the origin of ophthalmic arteries, passed underneath the ipsilateral optic nerves and turned upward at the ventral portion of the optic chiasm. In addition, an aortic coarctation was found with the use of thoracic aortography. An infra-optic course of the bilateral anterior cerebral arteries is an extremely rare anomaly. An infra-optic course of the bilateral anterior cerebral arteries is frequently associated with cerebral aneurysms and possibly with a coarctation aorta. The clinical features, radiological findings and possible genesis of this anomaly are presented.

  20. Congenital arteriovenous fistula of the horseshoe kidney with multiple hemangiomas

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    Lazić Miodrag

    2012-01-01

    Full Text Available Introduction. Congenital renal arteriovenous fistulas (AVF are rare, especially if they are associated with other developmental renal anomalies. Case Outline. A 34-year-old female was hospitalized due to total painless hematuria and bladder tamponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster-like vascular formation with multiple arteriovenous fistulas (AVF. Due to a large AVF gauge and poor flow of the efferent vein to the inferior vena cava, a surgical procedure of two renal artery segmentary branches ligation and division was performed. During the operative procedure, the presence of multiple superficial renal hemangiomas was detected. Conclusion. Although selective arterial embolization represents the preferable treatment option, conventional surgery remains favorable alternative in selected cases with large and complex AVF.

  1. Aorta and iliac artery

    International Nuclear Information System (INIS)

    Yao, J.S.T.; Neiman, H.L.

    1985-01-01

    The aorta and iliac artery constitute the major blood supply to the limbs, and the atherosclerotic process ranks as the most common disorder in this region. Clinical presentation ranges from acute to chronic. Atherosclerotic disease of the aorta associated with femoropopliteal disease is not uncommon. For simplicity, the aorta and iliac artery are considered as a unit, though isolated lesions of the aorta occur. The primary indication for arteriography is in patients who are candidates for reconstructive surgery or for percutaneous balloon dilatation. While diagnosis by clinical examination or noninvasive tests is not difficult, arteriography remains the essential diagnostic technique, especially when patients become candidates for therapy. Visualization of the aortoiliac system may be accomplished by translumbar aortography, catheter arteriography, or by intravenous digital subtraction angiography

  2. The radiology of prosthetic heart valves

    International Nuclear Information System (INIS)

    Steiner, R.M.; Flicker, S.

    1985-01-01

    The development of prosthetic heart valves in the late 1950s ushered in a new era in the treatment of heart disease. The radiologist has an important role to play preoperatively in the diagnosis of valvular heart disease. Radiology is valuable in identification of the implanted prosthetic valve and recognition of complications associated with valve implantation. Radiologists must be familiar with the imaging techniques best suited to evaluate the function of the valve prosthesis in question. In this chapter the authors discuss the radiographic approach to the evaluation of the status of patients for valve replacement and the imaging problems peculiar to the types of valves in current use. The relative value of plain-film radiography, fluoroscopy, videorecording and cinerecording, and aortography is addressed, as well as the potential value of magnetic resonance imaging and subsecond dynamic computed tomography

  3. Endovascular Stent for Coarctation of the Aorta in a Child and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hsu-Ting Cheng

    2011-08-01

    Full Text Available An 11-year-old, 35-kg boy underwent balloon angioplasty twice, at the ages of 4 years and 10 years, with only limited effect. He was admitted for another cardiac catheterization because of chest pain and breathlessness on exercise. Aortography revealed severe discrete coarctation of the aorta, with the narrowest diameter of 6 mm. The pressures of the ascending aorta and descending aorta were 115/72 mmHg and 93/66 mmHg, respectively. After implantation of a 16-mm-diameter stent, the systolic pressure gradient decreased from 22 mmHg to 0 mmHg. Annual follow-up for 6 years showed normal blood pressure, no exercise intolerance, and no recoarctation.

  4. The clinical significances of selective ovarian arterial angiography and embolization in the obstetrics and gynecology

    International Nuclear Information System (INIS)

    Duan Feng; Liu Fengyong; Wang Maoqiang

    2007-01-01

    Transcatheter internal iliac arterial embolization has become a first-choice treatment for control of life-threatened bleeding associated with pelvic tumors or obstetric disorders. Recently, uterine arterial embolization (UAE)has offered a successful alternative to surgery in the treatment of uterine fibroid. Clinical failure rates for this procedure was reported from 4% to 19% in literature, probably due to the existence of collateral flow to the pelvic lesions, especially the ovarian arteries (OA)being the most important source. Furthermore, the anastomosis between the ovarian and uterine arteries has been suggested as the pathway for nontarget embolization of the ovaries causing premature menopause. The OA are simple paired vessels and they usually arise from the anterolateral part of the abdominal aorta at the level of the second lumbar vertebra. Variations in origin of OA occur in 2%-10% with diameter smaller than 1.1 mm and routinely not identified on conventional aortography. However, in the presence of a uterine or other pelvic diseases, the OA become dilated as the result of pathologic blood supply demand. OA supply to the pelvic lesions are more frequently found in patients with large fundal fibroids, history of the pelvic surgery, post embolization of the uterine arteries, and dysplasia of uterine artery. In patient with one or more of these predisposing factors, the extent of OA supply to the pelvic lesions should be assessed using pigtail catheter pelvic aortography with the tip at the level of the renal arteries, followed by selective OA catheterization. In case of identified OA supply to the pelvic lesions, superselective embolization of the OA should be considered, using particles with diameters larger than 500 μm. Proximal OA embolization, in combination with bilateral UAE, may significantly increase the risk of iatrogenic ovarian dysfunction. When necessary in a premenopausal patient, OA embolization should be performed unilaterally and as near

  5. Aortic atherosclerosis is a key modulator of the prognostic value of postural blood pressure changes.

    Science.gov (United States)

    Courand, Pierre-Yves; Harbaoui, Brahim; Fay, Helène; Grandjean, Adrien; Milon, Hugues; Lantelme, Pierre

    2018-01-01

    Orthostatic blood pressure decrease or increase has been related to cardiovascular events in hypertensive patients. Large blood pressure changes after orthostatic stress are associated with autonomic and neurohormonal abnormalities; aortic atherosclerosis (ATS) may also play a role. We investigated the interaction of ATS on the prognostic value of postural blood pressure changes. In a cohort of 958 hypertensive patients with an aortography (mean ± standard deviation age 44 ± 11 years, 61% men, mean blood pressure 182/110 mmHg), blood pressure was measured after 10 min of rest in the supine position. Systolic blood pressure (SBP) was also measured in standing position, 1 min after the supine position. Blood pressure changes were calculated as supine SBP minus standing SBP and analyzed as absolute or arithmetic means. ATS was assessed using an aortography score. After 15 years of follow-up, 280 all-cause and 167 cardiovascular deaths occurred. In a multivariable Cox regression analysis adjusted for major cardiovascular risk factors and stratified according to ATS status, SBP changes were statistically associated with all-cause and cardiovascular mortality only in the presence of ATS: tertile 3 versus 1, 2.99 (1.37-6.49) and 4.08 (1.55-10.72) respectively, tertile 3 versus 2, 2.89 (1.29-6.46) and 4.82 (1.79-12.98), respectively (p for interaction: 0.003 for all-cause and 0.003 for cardiovascular mortality) for absolute changes. The hazard associated with the magnitude of SBP changes was more important than that associated with its direction. The prognostic significance of postural SBP changes is markedly influenced by ATS in hypertensive patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Helical CT of traumatic injuries of the thoracic aorta

    International Nuclear Information System (INIS)

    Mengozzi, E.; Burzi, M.; Miceli, M.; Lipparini, M.; Sartoni Galloni, S.

    2000-01-01

    Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline study, contrast-enhanced scans were acquired with pitch 1 in 87 patients. Helical CT showed aortic lesions in 9 of 256 patients examined. In all the 9 cases it was found a mediastinal hematoma and all of them had positive plain chest radiographic findings of mediastinal enlargement. Moreover, in 6 cases aortic knob blurring was also evident on plain chest film and in 5 cases depressed left mainstem bronchus and trachea deviation rightwards were observed. All aortic lesions were identified on axial scans and located at the isthmus of level. Aortic rupture was always depicted as pseudo diverticulum of the proximal descending tract and intimal flap. It was also found that periaortic hematoma in 6 cases and intramural hematoma in 1 case. There were non false positive results in the series: 7 patients with Helical CT diagnosis of aortic rupture were submitted to conventional aortography that confirmed both type and extension of the lesions as detected by Helical CT, and all findings were

  7. Effectiveness of the implementation of a simple radiation reduction protocol in the catheterization laboratory

    International Nuclear Information System (INIS)

    Jurado-Román, Alfonso; Sánchez-Pérez, Ignacio; Lozano Ruíz-Poveda, Fernando; López-Lluva, María T.; Pinilla-Echeverri, Natalia; Moreno Arciniegas, Andrea; Agudo-Quilez, Pilar; Gil Agudo, Antonio

    2016-01-01

    Background and purpose: A reduction in radiation doses at the catheterization laboratory, maintaining the quality of procedures is essential. Our objective was to analyze the results of a simple radiation reduction protocol at a high-volume interventional cardiology unit. Methods: We analyzed 1160 consecutive procedures: 580 performed before the implementation of the protocol and 580 after it. The protocol consisted in: the reduction of the number of ventriculographies and aortographies, the optimization of the collimation and the geometry of the X ray tube-patient-receptor, the use of low dose-rate fluoroscopy and the reduction of the number of cine sequences using the software “last fluoroscopy hold”. Results: There were no significant differences in clinical baseline features or in the procedural characteristics with the exception of a higher percentage of radial approach (30.7% vs 69.6%; p < 0.001) and of percutaneous coronary interventions of chronic total occlusions after the implementation of the protocol (2.1% vs 6.7%; p = 0,001). Angiographic success was similar during both periods (98.3% vs 99.2%; p = 0.2). There were no significant differences between both periods regarding the overall duration of the procedures (26.9 vs 29.6 min; p = 0.14), or the fluoroscopy time (13.3 vs 13.2 min; p = 0.8). We observed a reduction in the percentage of procedures with ventriculography (80.9% vs 7.1%; p < 0.0001) or aortography (15.4% vs 4.4%; p < 0.0001), the cine runs (21.8 vs 6.9; p < 0.0001) and the dose–area product (165 vs 71 Gyxcm 2 ; p < 0.0001). Conclusions: With the implementation of a simple radiation reduction protocol, a 57% reduction of dose–area product was observed without a reduction in the quality or the complexity of procedures. - Highlights: • This simple protocol can achieve a reduction in dose–area product of 57%. • It does not interfere with the quality or complexity of the procedures. • Full advantage of “Last Fluoroscopy Hold

  8. Radiation Exposure During Uterine Artery Embolization: Effective Measures to Minimize Dose to the Patient

    Energy Technology Data Exchange (ETDEWEB)

    Scheurig-Muenkler, Christian, E-mail: christian.scheurig@charite.de [Charité Universitaetsmedizin Berlin, Department of Diagnostic and Interventional Radiology (Germany); Powerski, Maciej J., E-mail: maciej.powerski@med.ovgu.de [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Mueller, Johann-Christoph, E-mail: johann-christoph.mueller@charite.de [Charité Universitaetsmedizin Berlin, Department of Diagnostic and Interventional Radiology (Germany); Kroencke, Thomas J., E-mail: Thomas.Kroencke@klinikum-augsburg.de [Klinikum Augsburg, Department of Radiology (Germany)

    2015-06-15

    PurposeEvaluation of patient radiation exposure during uterine artery embolization (UAE) and literature review to identify techniques minimizing required dose.MethodsA total of 224 of all included 286 (78 %) women underwent UAE according to a standard UAE-protocol (bilateral UAE from unilateral approach using a Rösch inferior mesenteric and a microcatheter, no aortography, no ovarian artery catheterization or embolization) and were analyzed for radiation exposure. Treatment was performed on three different generations of angiography systems: (I) new generation flat-panel detector (N = 108/151); (II) classical image amplifier and pulsed fluoroscopy (N = 79/98); (III) classical image amplifier and continuous fluoroscopy (N = 37/37). Fluoroscopy time (FT) and dose-area product (DAP) were documented. Whenever possible, the following dose-saving measures were applied: optimized source-object, source-image, and object-image distances, pulsed fluoroscopy, angiographic runs in posterior-anterior direction with 0.5 frames per second, no magnification, tight collimation, no additional aortography.ResultsIn a standard bilateral UAE, the use of the new generation flat-panel detector in group I led to a significantly lower DAP of 3,156 cGy × cm{sup 2} (544–45,980) compared with 4,000 cGy × cm{sup 2} (1,400–13,000) in group II (P = 0.033). Both doses were significantly lower than those of group III with 8,547 cGy × cm{sup 2} (3,324–35,729; P < 0.001). Other reasons for dose escalation were longer FT due to difficult anatomy or a large leiomyoma load, additional angiographic runs, supplementary ovarian artery embolization, and obesity.ConclusionsThe use of modern angiographic units with flat panel detectors and strict application of methods of radiation reduction lead to a significantly lower radiation exposure. Target DAP for UAE should be kept below 5,000 cGy × cm{sup 2}.

  9. Effectiveness of the implementation of a simple radiation reduction protocol in the catheterization laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Jurado-Román, Alfonso, E-mail: alfonsojuradoroman@gmail.com [Unidad de Hemodinámica, Servicio de Cardiología, Hospital General Universitario de Ciudad Real (Spain); Sánchez-Pérez, Ignacio; Lozano Ruíz-Poveda, Fernando; López-Lluva, María T.; Pinilla-Echeverri, Natalia; Moreno Arciniegas, Andrea [Unidad de Hemodinámica, Servicio de Cardiología, Hospital General Universitario de Ciudad Real (Spain); Agudo-Quilez, Pilar [Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid (Spain); Gil Agudo, Antonio [Servicio de Radiofísica y Protección Radiológica, Hospital General Universitario de Ciudad Real (Spain)

    2016-07-15

    Background and purpose: A reduction in radiation doses at the catheterization laboratory, maintaining the quality of procedures is essential. Our objective was to analyze the results of a simple radiation reduction protocol at a high-volume interventional cardiology unit. Methods: We analyzed 1160 consecutive procedures: 580 performed before the implementation of the protocol and 580 after it. The protocol consisted in: the reduction of the number of ventriculographies and aortographies, the optimization of the collimation and the geometry of the X ray tube-patient-receptor, the use of low dose-rate fluoroscopy and the reduction of the number of cine sequences using the software “last fluoroscopy hold”. Results: There were no significant differences in clinical baseline features or in the procedural characteristics with the exception of a higher percentage of radial approach (30.7% vs 69.6%; p < 0.001) and of percutaneous coronary interventions of chronic total occlusions after the implementation of the protocol (2.1% vs 6.7%; p = 0,001). Angiographic success was similar during both periods (98.3% vs 99.2%; p = 0.2). There were no significant differences between both periods regarding the overall duration of the procedures (26.9 vs 29.6 min; p = 0.14), or the fluoroscopy time (13.3 vs 13.2 min; p = 0.8). We observed a reduction in the percentage of procedures with ventriculography (80.9% vs 7.1%; p < 0.0001) or aortography (15.4% vs 4.4%; p < 0.0001), the cine runs (21.8 vs 6.9; p < 0.0001) and the dose–area product (165 vs 71 Gyxcm{sup 2}; p < 0.0001). Conclusions: With the implementation of a simple radiation reduction protocol, a 57% reduction of dose–area product was observed without a reduction in the quality or the complexity of procedures. - Highlights: • This simple protocol can achieve a reduction in dose–area product of 57%. • It does not interfere with the quality or complexity of the procedures. • Full advantage of “Last Fluoroscopy

  10. Incidental Finding of a Large Mobile Aortic Arch Mass during Conventional Angiography

    Directory of Open Access Journals (Sweden)

    Hassan Aghajani

    2018-02-01

    Full Text Available Thromboembolism occurs commonly in general practice and leads to significant health burden. Apart from cardiac sources, aortic atherosclerotic plaques contribute considerably to thromboembolism. A 63-year-old diabetic hypertensive woman referred to our center due to exertional chest pain unresponsive to optimal medical therapy and underwent coronary angiography. Owing to resistance during guide-wire advancement, an aortography was performed. Aortic arch injection demonstrated a large suspended mass distal to the left subclavian artery with free movement in the descending thoracic aorta. Echocardiography revealed widespread atherosclerotic changes in the aortic arch with a large hypermobile mass. Dual-source multi-slice (2 × 128:256 computed tomography angiography of the whole aorta revealed a large floating mass (in favor of a thrombus in the distal portion of the arch. The patient underwent coronary artery bypass grafting due to severe coronary artery disease. The intra-aortic mass, which was actually a large atherosclerotic plaque, was resected at the same session. She was discharged uneventfully and during a 1-year follow-up, she had no embolic events.

  11. Penile arteriography in vasculogenic impotence

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beum; Shim, Hyung Jin; Lee, Kwan Seh; Lee, Yong Chul; Kim, Kun Sang [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    1990-12-15

    Bifurcation aortography and selective internal pudendal arteriography were performed in 70 impotent men under the impression of vasculogenic impotence. Age range was 6 to 63 years old(average 32). 54 patients had the history of pelvic trauma. The studies were performed under local anesthesia and simultaneous intracavernosal and intraarterial Papavertine injection before filming. To reduce pain and arterial spasm, intraarterial Lidocaine and low osmolarity non-ionic contrast media were used. Arterial lesions were found in 50(93%) traumatic patients and 7(44%) non-traumatic patients. Internal iliac arterial lesion that causing pelvic steal syndrome was noted in 3 traumatic patients. Among trauma related cases there were bilateral arterial lesion in 19 patients and one axis lesion in 31 patients respectively. Among 16 non traumatic patients there were bilateral arterial lesions in 2 patients and unilateral lesion in 5 patients. Irrespective or bilaterally or unilaterally of the lesion, majority of arterial lesions were found at the distal internal pudendal artery or common penile artery level in traumatic patients. On the contrary, penile branch lesion was predominant site in non traumatic patients. With the improved arteriographic technique, selective penile arteriography appears accurate method in the diagnosis of arterial impotence.

  12. Transbrachial selective carotid DSA in outpatients: safety and efficacy

    International Nuclear Information System (INIS)

    Rosen, T.; Poretti, F.; Vorwerk, D.; Krawczynski, H.

    2003-01-01

    Purpose: To describe safety and efficacy of transbrachial selective carotid digital subtraction angiography (DSA) in outpatients. Materials and Methods: From July 1999 to November 2001, selective carotid angiography was performed in 141 outpatients preferably using a left brachial arterial approach. The average age of the patients was 68 years (range: 39-89 years). After flush aortography through a 4F-pigtail catheter, bilateral selective common carotid artery (CCA) catheterization was performed with 4F-Sidewinder-1 or Sidewinder-2 catheters. In 49 patients, Doppler-sonography was performed before or after arteriography. A total of 41 patients underwent carotid surgery. Results: Selective catheterization of the CCA was successful in 96% of the cases. The diagnostic quality of the opacified aortra and CCA images was good to excellent. The overall complication rate did not exceed 2.1%, and severe complications were not observed. One patient showed transient neurological symptoms and another mild nausea and agitation, probably as toxic reaction to the contrast medium. A single local hematoma developed after unsuccessful puncture of the brachial artery. Conclusion: Transbrachial selective carotid DSA is safe, reliable and well-tolerated in outpatients and achieves a superimposition-free CCA visualization. (orig.) [de

  13. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, K.; Suzuki, S.; Satomi, G. (Tokyo Women' s Medical Coll. (Japan). Heart Inst. and Hospital)

    1981-03-01

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia.

  14. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

    International Nuclear Information System (INIS)

    Nakamura, Kenji; Suzuki, Shin; Satomi, Gengi

    1981-01-01

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia. (author)

  15. Slow flow and mural thrombus in aortic diseases: Spin-echo MR findings and their differentiation

    International Nuclear Information System (INIS)

    Chung, Jin Wook; Park, Jae Hyung; Han, Man Chung

    1993-01-01

    In order to evaluate the ability of spin-echo MR imaging to differentiate slow flow from mural thrombus in aortic diseases, we reviewed the spin-echo MR images of 13 patients with intraaortic thrombus documented by CT (N=11) or aortography (N=2). Six patients had aortic aneurysms and seven had aortic dissections. Intraaortic mural thrombi were accompanied by flow-related intraluminal signal of various pattern and extents in all 13 patients. On 10 gated MR studies, slow flow regions showed ever-echo rephasing phenomenon (N=8), interslice variation of signal intensities of the intraluminal signal (N=7) and flow-related ghost artifact (N=2). However, these MR flow phenomena were obscured on two of three non-gated studies. Seven of 13 intraaortic thrombi remained hyperintense on T2-weighted second-echo images. In these circumstance, a hypointense boundary layer between slow flow and mural thrombus, which was caused by either ' boundary layer dephasing phenomenon' of slow flow or 'paramagnetic T2 shortening' of fresh clot at the edge of mural thrombus, was very useful in discriminating the area of slow flow from that of mural thrombus. Proper interpretation of spin-echo MR images may obviate the need for phase display imaging or gradient-echo imaging in differentiating slow flow and mural thrombus

  16. Treatment of celiac artery stenosis with interventional techniques

    International Nuclear Information System (INIS)

    Wang Maoqiang; Wang Zhijun; Liu Fengyong; Wang Zhongpu

    2005-01-01

    Objective: To present two cases of celiac artery (CA) stenosis treated successfully by interventional technique. Methods: Two patients characterised by chronic upper abdominal pain after eating, associated with weight loss and an epigastric bruit were treated with interventional procedure. The diagnosis was suggested by color Doppler imaging of the celiac axis and confirmed by aortography. One patient possessed the classic triad of median arcuate ligament syndrome (MALS). Arteriosclerosis was found to be responsible for the CA stenosis in another one. The interventional technique consisted of conventional PTA and stent placement in the CA. Results: Abdominal arteriograms in both patients showed severe stenosis (>90%) of CA. The stenotic segments were dilated and stented during the same session. One patient with balloon expandable Palmaz stent placed in the proximal celiac artery, another with 2 wallstents deployed in the CA trunk. The post procedural arteriograms showed good dilation of the lesions with immediate improvement of CA blood flow. Follow-up Doppler ultrasound scans showed normal flow patterns in the CA. Three months after the procedures, their upper gastrointestinal symptoms had resolved and regained body weights. They remained well and free of symptoms, at 16 months and 26 months follow-up, respectively, after the procedure. Conclusions: CA stenosis can successfully be treated with angioplasty and stenting. (authors)

  17. Transcatheter aortic-valve implantation with one single minimal contrast media injection.

    Science.gov (United States)

    Arrigo, Mattia; Maisano, Francesco; Haueis, Sabine; Binder, Ronald K; Taramasso, Maurizio; Nietlispach, Fabian

    2015-06-01

    Performing transcatheter aortic valve implantation (TAVI) with the use of minimal contrast in patients at high-risk for acute kidney injury (AKI). Contrast-induced nephropathy (CIN) is a major cause of AKI following TAVI and is associated with increased morbidity and mortality. The amount of contrast media used increases the risk for CIN. Computed tomography was omitted during the screening process. For the procedure transfemoral access was default. The self-expanding CoreValve prosthesis was chosen in all patients to minimize the risk of annular rupture in case of oversizing. Valve sizing was based on echocardiography, aortography, calcification on fluoroscopy, as well as weight and height of the patient. A single contrast injection was performed to confirm correct position of the pigtail catheter at the level of the annulus. The pigtail then served as the marker for the device landing zone. Intraprocedural assessment of the implantation result relied on echocardiography and hemodynamics. Five patients with severe aortic stenosis and at high risk for developing CIN were included. Device success was achieved in all patients and no major complications occurred. The median dose of injected contrast media was 8 ml (4-9). All but one patient had improved renal function after the intervention compared to baseline. Our study shows feasibility of performing TAVI with a single minimal contrast media injection, using a self-expandable valve. This technique has the potential to reduce the incidence of CIN. © 2015 Wiley Periodicals, Inc.

  18. Angiography

    International Nuclear Information System (INIS)

    Grinnell, V.S.; Mehringer, C.M.; Hieshima, G.B.

    1987-01-01

    The history of angiography is short, with its centennial approaching. A very brief review of milestones begins with the discovery of x-rays in 1895. Only a few months later contrast agents too toxic for human use were being injected into cadavers, severed limbs, and animals. The next major developments came in the late 1970s when percutaneous translumbar aortography and cerebral angiography were described. Contrast agents were now less toxic, and clinically useful angiography was a reality. In 1953 a technique for percutaneous vascular catheterization which formed the basis of many catheterization techniques to follow was described. In the 1970s the development of less invasive diagnostic methods such as computed tomography and diagnostic ultrasound decreased the indications for angiography, but newer interventional techniques such as embolization therapy and angioplasty have taken up the slack. Angiography remains the most important way to demonstrate vascular diseases graphically. Specific techniques such as angioplasty and digital subtraction angiography will be dealt with in other chapters. The authors hope to provide an overview of major areas of angiographic utilization. The basic techniques of arterial puncture and catheterization have been well described elsewhere

  19. Early mechanism of action of arterially infused ethanol: an experimental study on the influence of infusion speed

    International Nuclear Information System (INIS)

    Han, Joon Koo

    1988-01-01

    Abdominal aortography and histopathologic examination after absolute ethanol infusion at fast (0.4cc/sec) and slow speed (0.04cc/sec) were performed on 16 rats (2 controls. 7 fast infusion group. 7 slow infusion group). Angiographic and histopathologic findings were correlated and the findings of slow and fast infusion groups were studied. The results are as follows: 1. Histopathologic findings of the fast infusion group revealed wide area of glomerular and tubular collapses, obliteration of the free space between the Bowmann's capsule and glomerulus, sloughing and loss of the endothelium, fresh thrombi attached to the wall, and cleavage of the muscle layer of the arteries. 2. Angiographic findings of the fast infusion group revealed luminal irregularity, early obstruction of the aorta and the renal arteries, and delayed circulation time. 3. Histopathologic findings of the slow infusion group revealed degenerated, coalesced red blood cell packed in the glomeruli, focal areas of severe glomerular and tubular damage on relatively normal background, endothelial and muscular damage of the arteries. 4. Angiographic findings of the slow infusion group revealed focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but there was no obstruction of the major arteries. 5. In conclusion, author believes that endothelial damage and thrombus formation from the damaged vessel wall, as well as direct cytotoxicity and in situ emboli formation play a significant role in the embolic effect of absolute ethanol.

  20. An experimental study on the influence of infusion speed on the early mechanism of embolic effect of arterially infused absolute Ethanol in the rat

    International Nuclear Information System (INIS)

    Han, Joon Koo; Kim, Woo Ho; Lee, Byung Hee; Park, Kil Sun; Park, Jae Hyung; Kim, Chu Wan; Han, Man Chung

    1990-01-01

    In order to clarify the early mechanism of action of the tissue necrosis induced by intraarterially infused absolute ethanol, abdominal aortography and histopathologic examination after absolute ethanol infusion into aorta at fast (0.4ml/sec) and slow speed (0.04ml/sec) were performed on 22 rats (2 controls, 7 in fast infusion group, 7 in slow infusion group, 3 in fast and 3 in slow infusion groups during aorta compression, respectively). Histopathologic features under the light and scanning electron microscope were correlated with the angiographic findings within 30 minutes after ethanol infusion. The results are as follows : 1. In fast infusion group, histopathologic examination of the kidney showed severe glomerular and tubular damage. Extensive damage on endothelial and medial layer was noted in arteries, and fresh thrombi originated from the damaged arterial wall were seen. 2. Angiographic findings in the fast infusion group were luminal irregularity and early obstruction of large arteries. And circulation time was prolonged. 3. In slow infusion group, histopathologic examination of the kidney showed focal area of severe glomerular and tubular damage on relatively normal background. Endothelial and muscular damage was noted in arteries, but the degree of the damage was less severe than that of the fast infusion group. 4. Angiographic findings in the slow infusion group were focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but obstruction of the major arteries was not seen

  1. Transcatheter stenting of arterial duct in duct-dependent congenital heart disease

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    Đukić Milan

    2013-01-01

    Full Text Available Introduction. Critical congenital heart diseases (CHD are mostly duct-dependent and require stable systemic-pulmonary communication. In order to maintain patency of the ductus arteriosus (DA, the first line treatment is Prostaglandin E1 and the second step is the surgical creation of aortic-pulmonary shunt. To reduce surgical risk in neonates with the critical CHD, transcatheter stenting of DA can be performed in selected cases. Case Outline. A four-month old infant was diagnosed with the pulmonary artery atresia with ventricular septal defect (PAA/VSD. The left pulmonary artery was perfused from DA, and the right lung through three major aortopulmonary collaterals (MAPCAs. A coronary stent was placed in the long and critically stenotic DA, with final arterial duct diameter of 3.5 mm, and significantly increased blood supply to the left lung. After the procedure, the infant’s status was improved with regard to arterial oxygen saturation, feeding and weight gain. During the follow-up, one year later, aortography revealed in-stent stenosis. The left pulmonary artery, as well as the branches, was well-developed and the decision was made to proceed with further surgical correction. Conclusion. Stenting of DA can be an effective alternative to primary surgical correction in selected patients with duct-dependent CHD.

  2. Single Coronary Artery Anomaly: A Case Report and Review of Literature.

    Science.gov (United States)

    Elbadawi, Ayman; Baig, Basarat; Elgendy, Islam Y; Alotaki, Erfan; Mohamed, Ahmed H; Barssoum, Kirolos; Fries, David; Khan, Muhammad; Khouzam, Rami N

    2018-02-06

    Single coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities. A 56-year-old female presented with unstable angina. The patient reported complaints of typical chest pain on exertion few months prior to presentation, which progressed to become at rest. The pain was associated palpitations and dizziness. Past medical history was significant for hypertension and hyperlipidemia. Vital signs were stable. Physical examination was non-remarkable. Electrocardiogram showed normal sinus rhythm, with intermittent episodes of sinus bradycardia, and non-specific T-wave changes. Trans-thoracic echocardiogram showed normal left ventricular function and no segmental wall-motion abnormalities. Selective coronary angiography showed a normal left main coronary artery arising from left coronary cusp. The left main branched to a normal left anterior descending artery and to the left circumflex artery; a large vessel which supplied also the territory of the right coronary artery (RCA) through its terminal extension. Aortography showed absence of RCA with no other vessels arising from the right or non-coronary cusps. The patient was managed conservatively and discharged home with resolution of symptoms. We report a rare case of isolated single coronary artery with absent RCA. The patient presented with unstable angina, and was managed conservatively. Cardiologists should be aware of this rare condition, which carries a potential risk of sudden cardiac death.

  3. Very late mesenteric bare metal stent thrombosis in the setting of cessation of antiplatelet agents.

    Science.gov (United States)

    Ait-Mokhtar, O; Bayet, G; Benamara, S; Brunet, J; Hager, F X; Sainsous, J

    2015-06-01

    We report a case of a 73 year-old man admitted for acute mesenteric ischaemia. Eight years before, he had a first mesenteric ischaemic event treated by left colectomy and angioplasty of both main coeliac artery (MCA) and superior mesenteric artery (SMA); the patient was discharged on lifelong clopidogrel and aspirin. One month before his admission for the index event, he had a major haematuria; clopidogrel was stopped first, then aspirin because of recurrent haematuria. Five days after withdrawal of both antiplatelet drugs, the patient presented with acute mesenteric ischaemia. Urgent aortography showed in-stent occlusion of SMA and in-stent restenosis of MCA; we performed ad hoc thrombus aspiration of SMA and balloon angioplasty of MCA. The patient was discharged seven days after, without complications. This case shows that very late stent thrombosis in digestive artery can occur in the setting of antiplatelet arrest and urgent endovascular intervention constitutes a seductive alternative for surgery when performed early after symptoms onset. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  4. Ascending aortic injuries following blunt trauma.

    Science.gov (United States)

    Sun, Xiumei; Hong, Jenny; Lowery, Robert; Goldstein, Steven; Wang, Zuyue; Lindsay, Joseph; Hill, Peter C; Corso, Paul J

    2013-11-01

    The diagnosis and the management of traumatic thoracic aortic injuries have undergone significant changes due to new technology and improved prehospital care. Most of the discussions have focused on descending aortic injuries. In this review, we discuss the recent management of ascending aortic injuries. We found 5 cohort studies on traumatic aortic injuries and 11 case reports describing ascending aortic injuries between 1998 to the present through Medline research. Among case reports, 78.9% of cases were caused by motor vehicle accidents (MVA). 42.1% of patients underwent emergent open repair and the operative mortality was 12.5%. 36.8% underwent delayed repair. Associated injuries occurred in 84.2% of patients. Aortic valve injury was concurrent in 26.3% of patients. The incidence of ascending aortic injury ranged 1.9-20% in cohort studies. Traumatic injuries to the ascending aorta are relatively uncommon among survivors following blunt trauma. Aortography has been replaced by computed tomography and echocardiography as a diagnostic tool. Open repair, either emergent or delayed, remains the treatment of choice. © 2013 Wiley Periodicals, Inc.

  5. Coil embolization of a false aneurysm with aorto-cutaneous fistula after prosthetic graft replacement of the ascending aorta

    International Nuclear Information System (INIS)

    Miguel, Bruno; Camilleri, Lionel; Gabrillargues, Jean; Macheda, Bruno; Kubota, Hiroshi; Ravel, Anne; Riberolles, Charles de; Boyer, Louis

    2000-01-01

    Aim: To report palliative embolization of a false aneurysm over the distal suture line of an ascending aorta graft replacement. Material and Method: A 78-year-old male patient was admitted for increasing bleeding of a chronic Manubrium ulceration, 20 months after coronary artery bypass complicated by perioperative ascending aorta dissection requiring prosthetic graft replacement. One month later, he underwent epiploplasty for a mediastinitis followed by long-term antibiotic therapy. Five months later, he presented with a Manubrium ulceration of the sternotomy. Spiral computerized tomography (CT) and aortography revealed a 20 mm anterior peri-prosthetic false aneurysm with a wide neck. Advanced age, active mediastinitis and patient's objection led us to perform percutaneous occlusion according to the Moret remodeling technique while protecting the coils release with balloon catheter inflation. Results: No post-operative complication was observed and at 1-year follow-up the patient was doing well with no recurrent bleeding. Magnetic resonance imaging (MRI) and spiral CT controls confirmed coils stability without any internal flow. Conclusion: Percutaneous coils embolization of a large false aneurysm in the ascending aorta can be a palliative treatment in a surgically unsuited patient

  6. Operated DeBakey type III dissecting aortic aneurysm: review of 12 cases

    International Nuclear Information System (INIS)

    Moon, Hi Eun; Lee, Ghi Jai; Oh, Sang Joon; Yoon, Sei Ra; Shim, Jae Chan; Kim, Ho Kyun; Han, Chang Yul

    1995-01-01

    We evaluated the indications of operation and radiologic findings in 12 operated DeBakey type III aortic dissections. We retrospectively reviewed radiologic findings of 12 operated DeBakey type III aortic dissections, using CT, MRI, or aortography, and correlations were made with clinical course of the patients. Three cases were uncomplicated dissections. There were aneurysm rupture in 4 cases, impending rupture in 4 cases, occlusion of common iliac artery in 2 cases, occlusion of renal artery in 1 case, and compression of bronchus and esophagus by dilated aorta in 1 case. Associated clinical sign and symptoms were chest and back pain in 12 cases, claudication in 3 cases, dyspnea and dysphagia in 1 case, hoarseness in 1 case, and hemoptysis in 1 case. Post-operative complications were death from aneurysm rupture in 1 case, paraplegia in 2 cases, acute renal failure in 3 cases, and hemopericardium in 1 case. Although medical therapy is preferred in management of DeBakey type III aortic dissection, surgical treatment should be considered in patients with radiological findings of aortic rupture, impending rupture, occlusion of aortic major branches

  7. Pelvic Arterial Embolisation in a Trauma Patient with a Pre-Existing Aortobifemoral Graft

    International Nuclear Information System (INIS)

    Abulaban, Osama; Hopkins, Jonathan; Willis, Andrew P.; Jones, Robert G.

    2011-01-01

    Pelvic fractures secondary to blunt trauma are associated with a significant mortality rate due to uncontrolled bleeding. Interventional radiology (IR) can play an important and central role in the management of such patients, offering definitive minimally invasive therapy and avoiding the need for high-risk surgery. Rapid access to whole-body computed tomography has been shown to improve survival in polytrauma patients and allows rapid diagnosis of vascular injury and assessment of suitability for endovascular therapy. IR can then target and treat the specific area of bleeding. Embolisation of bleeding pelvic arteries has been shown to be highly effective and should be the treatment of choice in this situation. The branches of the internal iliac artery (IIA) are usually involved, and these arteries are accessed by way of IIA catheterisation after abdominal aortography. Occasionally these arteries cannot be accessed by way of this conventional route because of recent IIA ligation carried out surgically in an attempt to stop the bleeding or because (in the rare situation we describe here) these vessels are excluded secondary to previous aortoiliac repair. In this situation, knowledge of pelvic arterial collateral artery pathways is important because these will continue to supply pelvic structures whilst making access to deep pelvic branches challenging. We describe a rare case, which has not been previously reported in the literature, in which successful embolisation of a bleeding pelvic artery was carried out by way of the collateral artery pathways.

  8. Three Different Imaging Modalities of a Patient with the Aortic Coarctation

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    Ramin Khameneh Bagheri

    2017-03-01

    Full Text Available The patient was a 19 year-old woman with the diagnosis of resistant hypertension, although she was under treatment of three classes of anti-hypertensive drugs (beta blocker, angiotensin receptor blocker, diuretic for more than one year. In physical examination there was only a significant difference between the systolic blood pressure of upper and lower extremities (200 vs. 120 mmHg, without any other remarkable finding. Three different imaging modalities (echocardiography (Figure 1, CT angiography (Figure 2, conventional aortography (Figure 3 confirmed the aortic coarctation at 30 mm after left subclavian artery origin, with the 3.5-4 mm diameter of the narrowest segment. She underwent implantation of a self-expanding aortic stent and therefore the systolic pressure gradient decreased from 90 to 15 mmHg. After three months, her blood pressure was stable on 110/80 mmHg, while she received only metoprolol 25 mg twice daily and follow-up echocardiography showed 15-20 mmHg pressure gradient through the stent.

  9. Ovarian Artery: Angiographic Appearance, Embolization and Relevance to Uterine Fibroid Embolization

    International Nuclear Information System (INIS)

    Pelage, J.P.; Walker, W.J.; Le Dref, O.; Rymer, R.

    2003-01-01

    Purpose: To describe the angiographic appearance of the ovarian artery and its main variations that may be relevant to uterine fibroid embolization. Methods: The flush aortograms of 294 women who had been treated by uterine artery embolization for fibroids were reviewed. Significant arterial supply to the fibroid, and the origin and diameter of identified ovarian arteries were recorded. In patients with additional embolization of the ovarian artery, the follow-up evaluation also included hormonal levels and Doppler imaging of the ovaries. Results: A total of 75 ovarian arteries were identified in 59 women (bilaterally in 16 women and unilaterally in 43 women). All ovarian arteries originated from the aorta below the level of the renal arteries with a characteristic tortuous course. Fifteen women had at least one enlarged ovarian artery supplying the fibroids. Fourteen women (14/15, 93%) presented at least one of the following factors: prior pelvic surgery, tubo-ovarian pathology or large fundal fibroids. Conclusion: We advocate the use of flush aortography in women with prior tubo-ovarian pathology or surgery or in cases of large fundal fibroids. In the case of an ovarian artery supply to the fibroids, superselective catheterization and embolization of the ovarian artery should be considered

  10. Fate of coronary ostial anastomoses after the modified Bentall procedure.

    Science.gov (United States)

    Milano, Aldo D; Pratali, Stefano; Mecozzi, Gianclaudio; Boraschi, Piero; Braccini, Giovanni; Magagnini, Enrico; Bortolotti, Uberto

    2003-06-01

    Introduction of the modified Bentall procedure with the button technique has reduced but not eliminated anastomotic complications in patients receiving a composite aortic conduit. Particularly the true incidence of coronary ostial complications such as stenosis, kinking or pseudoaneurysm formation needs to be assessed. We reviewed 71 patients receiving a composite aortic conduit from November 1993 to November 1999 for chronic aneurysms (n = 51) or aortic dissection (n = 20), 12 of whom had Marfan syndrome. Patients were divided into two groups according to variations in the surgical technique. In group 1 (30 patients; 42%) the classic modified Bentall operation with the button technique was employed whereas in group 2 (41 patients; 58%) some technical modifications were added mainly consisting of a reinforcement suture joining the cut edge of the aortic wall and the prosthetic sewing ring and suture of the coronary buttons with an "endo-button" technique. To detect potential procedure-related complications particularly at the coronary ostia anastomoses follow-up included transthoracic two-dimensional echocardiography every 6 months and computerized tomographic angiography at 12 months or whenever indicated; in 20 patients a magnetic resonance imaging angiography and standard aortography with selective coronary angiography were also added. At a mean follow-up of 49 +/- 19 months anastomotic complications occurred in 4 patients (6%): in 2 a pseudoaneurysm developed at the distal aortic suture line and in 1 a pseudoaneurysm developed at the right coronary ostium after repair of acute aortic dissection; in 1 Marfan patient an aneurysm of the left coronary ostium developed. Such complications were unrelated to the two surgical techniques used in this series for reimplantaion of the coronary ostia. The modified Bentall operation is associated with an extremely low incidence of anastomotic complications particularly at the coronary ostia. More extensive use of new imaging

  11. Urgent carotid stenting before cardiac surgery in a young male patient with acute ischemic stroke caused by aortic and carotid dissection

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    Popović Rade

    2016-01-01

    Full Text Available Introduction. Acute aortic dissection (AD is the most common life-threatening disorder affecting the aorta. Neurological symptoms are present in 17-40% of cases. The management of these patients is controversial. Case report. We presented a 37-year-old man admitted for complaining of left-sided weak-ness. Symptoms appeared two hours before admission. The patient had no headache, neither thoracic pain. Neurological examination showed mild confusion, left-sided hemiplegia, National Institutes of Health Stroke Scale (NIHSS score was 10. Ischemic stroke was suspected, brain multislice computed tomography (MSCT and angiography were performed and right intrapetrous internal carotid artery dissection noted. Subsequent color Doppler ultrasound of the carotid arteries showed dissection of the right common carotid artery (CCA. The patient underwent thoracic and abdominal MSCT aortography which showed ascending aortic dissection from the aortic root, propagating in the brachiocephalic artery and the right CCA. Digital subtraction angiography was performed subsequently and two stents were successfully implanted in the brachiocephalic artery and the right CCA prior to cardiac surgery, only 6 hours after admission. The ascending aorta was reconstructed with graft interposition and the aortic valve re-suspended. The patient was hemodynamically stable and with no neurologic deficit after surgery. Unfortinately, at the operative day 6, mediastinitis developed and after intensive treatment the patients died 35 days after admission. Conclusion. In young patients with suspected stroke and oscillatory neurological impairment urgent MSCT angiography of the brain and neck and/or Doppler sonography of the carotid and vertebral artery are mandatory to exclude carotid and aortic dissection. The prompt diagnosis permits urgent carotid stenting and cardiosurgery. To the best of our knowledge, this is the first published case of immediate carotid stenting in acute ischemic

  12. Unilateral renal agenesia in the angiographic material and renovascular hypertension

    International Nuclear Information System (INIS)

    Stojanov, D.; Lovasic, I.; Dujmovic, M.; Bobinac, D.

    1987-01-01

    Analysis of 1216 abdominal aortographies and selective renovasographies undertaken at the Institute of Radiology, Clinical Hospital Centre Rijeka during the period 1979-1985, was performed. 39 (3,2%) unilateral renal agenesias were established, a percentage that is significantly higher than reported by other authors. Analysis of all angiographic parameters of a single kidney was also worked out. A significanlty high percentage (66,7%) of hypertension was diagnosed in this group. Congenital renal failures make their appearance in the early embryological development and are discovered, if compatible with life, most frequently at an advanced age. Statistical data on the frequency during a lifetime are less reliable because a great number of anomalies are never discovered during a person's life. The etiology of variations and congenital failure of renal arteries is unknown in 90% of the cases, and most of the malformations are without characteristic symptomatology. Since the anatomic relations in anomalous kidney are disturbed, the sign of the disease can develop atypical forms causing frequent errors in diagnosis. The kidney is supplied by numerous lateral branches of the medial sacral artery, i.e. the aorta, during embryological development. Later, some of them degenerate or mutually connect themselves, and the definitive kidney has been usually penetrated by only one artery and one vein on the same side (1). If this is not so, i.e. when the obliterations of caudal metanephogenic arteries are only partially present, then the renal arteries emerge from the iliac or lumbar arteries (2,3). Bilateral renal agenesia is extreme and incompatible with life, and hence of small clinical importance. Unilateral agenesia makes its appearance according to various statistics and authors from the obductional materials in ratio 1:1000 (4,5), clinical ones 1:5000 (6, 7, 8) and the angiographically 1:76(9), more exactly 1:35 cases (10). (orig.)

  13. Circulação coronária dependente do ventrículo direito na atresia pulmonar com septo interventricular íntegro. Ausência da origem das artérias coronárias da aorta Right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum. Absence of origin of the coronary arteries from the aorta

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    Ivan Romero Rivera

    1998-08-01

    Full Text Available São descritos os aspectos clínicos, ecocardiográficos e angiográficos de um neonato de sexo masculino, com cinco dias de vida e diagnóstico de atresia pulmonar com septo interventricular íntegro. Tanto o ecocardiograma como a aortografia mostraram ausência da origem das artérias coronárias da aorta. O ecocardiograma bidimensional e, posteriormente, a ventriculografia direita identificaram as artérias coronárias, originando-se no ventrículo direito. Não houve contrastação retrógrada da aorta ou do tronco pulmonar quando contrastadas as artérias coronárias. Este é o primeiro caso relatado com diagnóstico ecocardiográfico pré angiografia, e é um exemplo da necessidade de se avaliar as artérias coronárias em pacientes com atresia pulmonar e septo ventricular íntegro.This report describes the clinical, echocardiographic and angiographic aspects of a five-day old boy with pulmonary atresia and intact ventricular septum. Both the echocardiogram and the aortography did not show any coronary arteries arising from the aorta. Two-dimensional echocardiography was able to identify the coronary arteries originating from the right ventricle and so did the right ventricular angiogram. No retrograde flow into the aorta or pulmonary trunk was identified after opacification of the coronary arteries. As far as we know this is the first case diagnosed by echocardiography, and is a vivid example of the necessity of identifying the coronary arteries in patients with pulmonary atresia and intact ventricular septum.

  14. Hemodynamic evaluation before and after the STA-MCA anastomosis

    International Nuclear Information System (INIS)

    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Yamada, Keisuke; Shibamoto, Keiji

    1990-01-01

    Twenty-seven patients with minor completed and major stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The regional cerebral blood flow (rCBF), using inhalation of stable xenon and computed tomographic scanning (Xe s CT-CBF study), and the mode of transit time (MTT) in the MCA territory using intra-arterial digital aortography were measured. Activated rCBF and MTT was measured 20 minutes after the administration of acetazolamide (10 mg/kg) in 14 patients. Nineteen of the 23 patients with minor stroke (Group 1) showed immediate improvement in their neurological state within a few days of the operation, while four patients with minor stroke (Group 2) and four patients with major stroke (Group 3) showed no improvement. Based on the rCBF obtained with the Xe s CT-CBF study, affected side rCBF/unaffected side rCBF and %f [(peak DSA number/affected side MTT)/(peak DSA number/unaffected side MTT)] were compared. There was a significant positive correlation. Affected side MTT in Group 1 was 6.41±1.16 sec, preoperatively, and significantly decreased to 5.13±0.91 sec after the operation. On the other hand, preoperative MTT in Group 2 was 4.40±0.81 sec and 4.76±0.89 sec, postoperatively. Preoperative %f in Group 1 was 0.514±0.143 and significantly increased to 0.739±0.154, postoperatively. Group 2 showed no change. Vasodilatory capacity with acetazolamide showed a marked improvement in Group 1, postoperativery. Our study indicated that if MTT is moderately lengthened, %f is moderately decreased, and vasodilatory capacity is impaired, in patients with minor ischemic stroke will benefit from STA-MCA anastomosis. (author)

  15. Hybrid repair of a very late, post-aortic coarctation surgery thoracic aneurysm: a case report

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    Tilea Ioan

    2012-08-01

    Full Text Available Abstract Introduction Local aneurysms after surgical repair of coarctation of the aorta occur mainly in patients surgically treated by Dacron patch plasty during adulthood. The management of these patients is always problematic, with frequent complications and increased mortality rates. Percutaneous stent-graft implantation avoids the need for surgical reintervention. Case presentation We report a case involving the hybrid treatment by stent-graft implantation and transposition of the left subclavian artery to the left common carotid artery of an aneurysmal dilatation of the thoracic aorta that occurred in a 64-year-old Caucasian man, operated on almost 40 years earlier with a Dacron patch plasty for aortic coarctation. Our patient presented to our facility for evaluation with back pain and shortness of breath after minimal physical effort. A physical examination revealed stony dullness to percussion of the left posterior thorax, with no other abnormalities. The results of chest radiography, followed by contrast-enhanced computed tomography and aortography, led to a diagnosis of giant aortic thoracic aneurysm. Successful treatment of the aneurysm was achieved by percutaneous stent-graft implantation combined with transposition of the left subclavian artery to the left common carotid artery. His post-procedural recovery was uneventful. Three months after the procedure, computed tomography showed complete thrombosis of the excluded aneurysm, without any clinical signs of left lower limb ischemia or new onset neurological abnormalities. Conclusions Our patient’s case illustrates the clinical outcomes of surgical interventions for aortic coarctation. However, the very late appearance of a local aneurysm is rather unusual. Management of such cases is always difficult. The decision-making should be multidisciplinary. A hybrid approach was considered the best solution for our patient.

  16. Radiological evaluation of ventricular septal defect with aortic insufficiency - An analysis of cineangiography in 15 cases -

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1981-01-01

    Fifteen cases of ventricular septal defect with aortic insufficiency were diagnosed radiographically and confirmed after operation at Seoul National University Hospital in recent two half years since 1979. Cineangiographies of ascending aorta and left ventricle were done in those cases and revealed some characteristic findings. The results of the analysis are as follow: 1. Among the 15 cases, 14 cases were male and 1 case was female. Age distribution was from 7 years to 23 years. 2. Those 15 cases were corresponded to 8% among total 193 cases of ventricular septal defect, to 11% among total 135 cases of aortic insufficiency and especially to 48% among 48 cases of aortic insufficiency below age of 20 years. 3. After operation, 11 cases were confirmed as subpulmonary type ventricular septal defect and 4 cases as subcristal type. The sizes of the ventricular septal defects were ranged between 0.6 and 2.5 cm in diameter. 4. Regurgitation of contrast media was noticed in cine aortography of all cases, and the grades of regurgitation were II-III/IV in 13 cases. 5. Various types of herniated aortic cusp through ventricular septal defect were seen. In the cases of subpulmonary ventricular septal defect characteristic saccular aneurysm was found in 7 cases. Asymmetry or mild bulging of aortic sinus was found in the cases of subcristal ventricular septal defect. 6. Infundibular stenosis was found in 3 cases with right ventriculography and those were caused by the herniated saccular aneurysm of aortic cusp. 7. It is essential for the diagnosis of ventricular septal defect with aortic insufficiency to undertake biplane cineangiography of ascending aorta and left ventricle in long axial view and right ventriculography should be done in suspicion of infundibular pulmonary stenosis

  17. Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration

    Energy Technology Data Exchange (ETDEWEB)

    Koganemaru, Masamichi, E-mail: mkoganemaru@med.kurume-u.ac.jp; Nonoshita, Masaaki, E-mail: z2rs-1973@yahoo.co.jp; Iwamoto, Ryoji, E-mail: iwamoto-ryouji@kurume-u.ac.jp; Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Nabeta, Masakazu, E-mail: nabeta-masakazu@med.kurume-u.ac.jp; Kusumoto, Masashi, E-mail: kusumoto-masashi@med.kurume-u.ac.jp; Kugiyama, Tomoko, E-mail: kugiyama-tomoko@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan); Kozuma, Yutaka, E-mail: kouduma-yutaka@kurume-u.ac.jp [Kurume University School of Medicine, Department of Obstetrics and Gynecology (Japan); Nagata, Shuji, E-mail: sn4735@med.kurume-u.ac.jp; Abe, Toshi, E-mail: toshiabe@med.kurume-u.ac.jp [Kurume University School of Medicine, Department of Radiology (Japan)

    2016-08-15

    PurposeWe evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration.Materials and MethodsWe reviewed seven cases of patients (mean age 30.9 years; range 27–35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery’s architecture, technical and clinical success rates, and complications.ResultsThe vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases.ConclusionPostpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.

  18. Clinical Assessment of a New Stereoscopic Digital Angiography System

    International Nuclear Information System (INIS)

    Moll, Thierry; Douek, Philippe; Finet, Gerard; Turjman, Francis; Picard, Catherine; Revel, Didier; Amiel, Michel

    1998-01-01

    Purpose: To assess the clinical feasibility of an experimental modified angiographic system capable of real-time digital stereofluoroscopy and stereography in X-ray angiography, using a twin-focus tube and a stereoscopic monitor. Methods: We report the experience obtained in 37 patients with a well-documented examination. The patients were examined for coronary angiography (11 cases), aortography (7 cases), pulmonary angiography (6 cases), inferior vena cava filter placement (2 cases), and cerebral angiography (11 cases). Six radiologists were asked to use stereoscopic features for fluoroscopy and angiography. A questionnaire was designed to record their subjective evaluation of stereoscopic image quality, ergonomics of the system, and its medical interest. Results: Stereofluoroscopy was successfully used in 25 of 37 cases; diplopia and/or ghost images were reported in 6 cases. It was helpful for aortic catheterization in 10 cases and for selective catheterization in 5 cases. In stereoangiography, depth was easily and accurately perceived in 27 of 37 cases; diplopia and/or ghost images were reported in 4 cases. A certain gain in the three-dimensional evaluation of the anatomy and relation between vessels and lesions was noted. As regards ergonomic considerations, polarized spectacles were not considered cumbersome. Visual fatigue and additional work were variously reported. Stereoshift tuning before X-ray acquisition was not judged to be a limiting factor. Conclusion: A twin-focus X-ray tube and a polarized shutter for stereoscopic display allowed effective real-time three-dimensional perception of angiographic images. Our clinical study suggests no clear medical interest for diagnostic examinations, but the field of interventional radiology needs to be investigated

  19. Sangramento espontâneo de artéria lombar em paciente com doença de Von Recklinghausen: tratamento endovascular Spontaneous lumbar artery bleeding in patient with Von Recklinghausen’s disease: endovascular treatment

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    Felipe Nasser

    2008-12-01

    Full Text Available Os sangramentos no retroperitônio são, em sua grande maioria, secundários a eventos traumáticos envolvendo grande energia cinética, com poucos relatos na literatura caracterizados como espontâneos. No presente relato, descrevemos paciente gestante, portadora de doença de Von Recklinghausen e com volumoso hematoma retroperitoneal diagnosticado durante o parto cesariano, secundário a ruptura espontânea de artéria lombar. A doença de Von Recklinghausen apresenta manifestações vasculares bem descritas, caracterizando-se principalmente por estenoses que são secundárias a tumores intramurais (proliferação das células de Schwann e raramente dilatações aneurismáticas, assintomáticas em sua maioria. No presente caso, foi realizada a aortografia com cateterização seletiva e embolização da artéria sangrante com sucesso.Retroperitoneal bleeding is mainly due to traumatic events with a high amount of kinetic energy, with few reported cases of spontaneous events in the literature. We report on a case of a pregnant woman with Von Recklinghausen"s disease and bulky retroperitoneal hematoma diagnosed during cesarean delivery secondary to spontaneous lumbar artery rupture. Von Recklinghausen"s disease has well-described vascular manifestations, mainly characterized by stenoses related to intramural tumors (Schwann cell proliferation and rarely asymptomatic aneurysmal dilatations. In this case, aortography was performed with successful selective catheterization and embolization of the bleeding artery.

  20. Comparative analysis of lower extremities tissue perfusion by the use of perfusion scintigraphy method after hyperbaric oxygenation and lumbar sympathectomy

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    Zoranović Uroš

    2009-01-01

    Full Text Available Background/Aim. Lumbar syphatectomy (LS increases pheripheral blood flow primarily by the arteriolar vasodilatation within the skin vascular net. Increase in tissue nutrition takes place only in the distal blood vessels of the skin. Nevertheless, in some patients sympathectomy brings about improvement in ischemic ulcerations healing. Hyperbaric oxigenation (HBO is a medical treatment in which a patient breathes 100% oxygen under pressure higher than atmospheric implemented in special units allowing the whole body be in a chamber. The aim of the study was to determine efficacy of the applied therapies for the treatment of inoperable occlusive lower extremities (LE arteries diseases according to the obtained results. Methods. The study included 30 patients divided into two groups (15 patients each in which stenosis level of the lower extremities arteries had been determined using aortography due to further treatment with HBO and LS. All the patients were clinically examined, their objective condition evaluation based on claudication distance, pain in rest, skin and skin adnexa atrophy, and temperature and LE functionality, as well as exposed to perfusion scintigraphy prior to the treatment and within 30 days after the treatment finishing. Results. Analyzing patients' status prior to and after the treatments applied the number of patients with obvious improvement was higher in those treated by HBO than those treated by LS. Measuring claudication distance revealed significantly greater changes in patients treated by HBO (from 178.57 m to 754.76 m than in those treated by LS (from 229 m to 253 m. Other clinical symptoms, such as parasthesia, status of the skin adnexes (hair, nails, skin colour and temperature were also improved after the treatment by HBO. Conclusion. The results obatined in this study confirm the advantages of HBO over LS in therapy of inoperable occlusive LE disease, so LS could be definitely abandoned as a choice for treating such

  1. Syphilitic aortic regurgitation. An appraisal of surgical treatment.

    Science.gov (United States)

    Grabau, W; Emanuel, R; Ross, D; Parker, J; Hegde, M

    1976-12-01

    During the 10 years from 1964 to 1973, fifteen patients with severe syphilitic aortic regurgitation were treated surgically at the National Heart Hospital. In thirteen the valve was replaced and in two it was repaired. In addition four had replacement of an aneurysmal ascending aorta with a Dacron graft and seven some form of plastic repair to the coronary ostia. Three patients died within 1 month of surgery and a further six during the follow-up period which varied from 1 to 55 months (mean 25-5). The six survivors have been followed-up for an average of 33 months. Factors contributing to this high mortality were analysed and it was found that the mean duration of effort dyspnoea was 22 months in the survivors compared with 48 months in those who had died. Similarly the average duration of nocturnal dyspnoea was 4 months in the survivors compared with a mean of 8 months in those who had died. Only six out of the fifteen patients had angina; this was present in two of the survivors and in four of the fatalities. The pulse pressure, heart size, and haemodynamic findings were similar in the two groups. The prognostic value of an elevated erythocyte sedimentation rate was also examined. It was concluded that preoperative investigations should include aortography, coronary arteriography, an assessment of left ventricular function, and whenever possible myocardial biopsy. These data were interpreted as suggesting that patients should be referred for surgery at an earlier stage in the disease--certainly before the onset of cardiac failure and--and that if this more aggresive attitude was adopted, as it has been in non-syphilitic cases of aortic valve disease, the present high mortality in this group would be reduced.

  2. Hidden (end-on) patent ductus arteriosus: recognition and device closure.

    Science.gov (United States)

    Garg, Naveen; Madan, Bevunahalli Kantharaj

    2016-02-01

    Sometimes, it is difficult to visualize a patent ductus arteriosus and deploy a device in the standard lateral view because of an end-on orientation. The right anterior oblique view may be helpful by separating the ductus arteriosus from the aorta. This study was undertaken to evaluate the incidence of end-on patent ductus arteriosus and the utility of the right anterior oblique view during device closure. Aortography was performed in lateral and right anterior oblique views before, during, and after successful device deployment in 117 consecutive patients. When a ductus arteriosus was not clearly visible in the lateral view due to overlapping by the aorta, it was termed "right anterior oblique view useful". The types of patent ductus arteriosus were A, B, C, and E in 86 (73.5%), 20 (17.1%), 4 (3.4%), and 7 (6.0%) patients, respectively. An end-on ductus arteriosus was present in 24 (20.5%) patients (14 type B, 10 type A). The right anterior oblique view was useful during device closure in 15 (12.8%) cases (all end-on type). Among all cases of end-on patent ductus arteriosus, it was useful in 62.5% (most type B and a few type A). In all of these, the device appeared obliquely oriented and foreshortened in the lateral view but fully profiled in the right anterior oblique view. Recognizing an end-on patent ductus arteriosus and utilizing the right anterior oblique view simplified device closure. For ducts well-profiled in the lateral view, the right anterior oblique view is unnecessary and avoidable. © The Author(s) 2016.

  3. Endoluminal Treatment of Ruptured Abdominal Aortic Aneurysm with Small Intestinal Submucosa Sandwich Endografts: A Pilot Study in Sheep

    International Nuclear Information System (INIS)

    Yamada, Katsuyuki; Pavcnik, Dusan; Uchida, Barry T.; Timmermans, Hans A.; Corless, Christopher L.; Yin, Qiang; Yamakado, Koichiro; Wha Park, Joong; Roesch, Josef; Keller, Frederick S.; Sato, Morio; Yamada, Ryusaku

    2001-01-01

    Purpose: To evaluate efficacy of small intestinal submucosa (SIS) Sandwich endografts for the treatment of acute rupture of abdominal aortic aneurysms (AAA) and to explore the short-term reaction of the aorta to this material.Methods: In eight adult sheep, an infrarenal AAA was created transluminally by dilation of a short Palmaz stent. In six sheep, the aneurysm was then ruptured by overdilation of the stent with a large angioplasty balloon. Two sheep with AAAs that were not ruptured served as controls. A SIS Sandwich endograft, consisting of a Z stent frame with 5 bodies and covered inside and out with SIS, was used to exclude the ruptured and non-ruptured AAAs. Follow-up aortography was done immediately after the procedure and before sacrifice at 4, 8, or 12 weeks. Autopsy and histologic studies followed.Results: Endograft placement was successful in all eight sheep. Both ruptured and non-ruptured AAAs were successfully excluded. Three animals with AAA rupture developed hind leg paralysis due to compromise of the arterial supply to the lower spinal cord and were sacrificed 1 day after the procedure. In five animals, three with rupture and two controls, follow-up aortograms revealed no aortic stenoses and no perigraft leaks. Gross and histologic studies revealed incorporation of the endografts into the aortic wall with replacement of SIS by dense neointima that was completely endothelialized in areas where the endograft was in direct contact with the aortic wall. In central portions of the endograft, in contact with the thrombosed aneurysm, endothelialization was incomplete even at 12 weeks.Conclusion: The SIS Sandwich endografts effectively excluded simple AAAs and ruptured AAAs. They were rapidly incorporated into the aortic wall. A detailed long-term study is warranted

  4. Cineangiographic analysis of T.O.F

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyung Mo; Kim, Jong Chul; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1985-06-15

    2 cases, and anterior descending artery from right coronary artery in 1 case, etc. 8. Selective biplane cinecardioangiography with axial projection is essential to evaluate the size of left ventricle and to localize the ventricular septal defects and pulmonary stenosis, and to detect associated cardiac anomalies in T.O.F. Sometimes aortography is necessary when anomaly of coronary arteries is suspected.

  5. Renal Scintiscanning with Hg209-Neohydrin in Urologic Diseases

    International Nuclear Information System (INIS)

    Bollini, V.; Tori, G.

    1964-01-01

    compensatory hypertrophy should be distinguished from the dishomogeneous and irregular ones. These last pictures suggest the presence of large hydronephroses, tumours or multiple cysts. In renal vascular disease, the character of the uptake in the two kidneys can be of significant value in assessing the reduced function and in differentiating unilateral from bilateral diseases. Renal scintiscanning thus shows promise of proving a useful clinical technique, particularly if combined with radiological examination of the kidneys by traditional means (urography, ascending pyelography, retropneumoperitoneum, tomography, aortography, etc.). (author) [fr

  6. Surgical treatment of Dunbar syndrome Tratamento cirúrgico da síndrome de Dunbar

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    Luís Henrique Gil França

    2013-03-01

    Full Text Available Dunbar syndrome or celiac artery compression syndrome is an infrequently described clinical condition with poorly defined diagnostic criteria and an obscure pathophysiology. It is usually associated with an extrinsic compression upon the celiac axis near its takeoff from the aorta by fibrous diaphragmatic bands or sympathetic neural fibers. The authors report the case of a 70-year-old male patient presenting with nausea, epigastric pain, and weight loss. An aortography showed a compression of the celiac trunk. A preliminary attempt at percutaneous transluminal angioplasty and stenting proved unsuccessful. The patient became asymptomatic and his clinical condition improved after surgical release of the celiac trunk by partial section of the arcuate ligament of the diaphragm and with resection of the neural, fibrotic, and lymphatic tissues surrounding the aortic and visceral vessels. The purpose of this report is to discuss the indications and the therapeutic options of this syndrome.A síndrome de Dunbar ou compressão do tronco celíaco é uma condição clínica infrequente, com poucos critérios para diagnóstico e com patofisiologia obscura. Está usualmente associada à compressão extrínseca do tronco celíaco por banda fibrosas do diafragma e fibras neurais simpáticas, próximo a sua emergência da aorta. Os autores relatam um caso de um paciente de 70 anos de idade com quadro de náuseas, dor epigástrica e perda de peso. Uma arteriografia mostrou compressão do tronco celíaco. Uma primeira tentativa de angioplastia com stent foi realizada em outro serviço, mas sem sucesso. Após o tratamento cirúrgico que consistiu de secção parcial do ligamento arqueado do diafragma com ressecção dos tecidos fibróticos, neurais e linfáticos que circundavam a aorta e as artérias viscerais, o paciente obteve melhora clínica e tornou-se assintomático. O objetivo deste estudo é discutir as indicações e opções terapêuticas desta síndrome.

  7. Surgical outcome of traumatic rupture of the thoracic aorta.

    Science.gov (United States)

    Tatou, E; Steinmetz, E; Jazayeri, S; Benhamiche, B; Brenot, R; David, M

    2000-01-01

    The aim of this study was to point out the results of different techniques of spinal cord protection in surgically-treated patients with traumatic thoracic aorta (TTA). A multicentric study was carried out involving 182 patients with TTA. Four patients died before surgery. Two patients were operated on without any investigation and 2 had no aortic tear at thoracotomy. The remaining 174 patients had aortic isthmus disruption and were included in the study. The mean age was 32.3+/-14.29 years with 126 men (72.4%) and 48 women (27.6%). Road accidents were causal in 163 patients (93.66%); polytraumatism was frequent. A standard chest roentgenogram led to a diagnosis which was confirmed with aortography in 94.8% of cases. Surgical repair of visceral lesions was performed in 52 patients (29.9%) for traumatic spleen, liver, diaphragm, mesentery, and gut. These operations were done before or after aortic operation in 21.3% and 8.6% of cases, respectively. Thirty-three patients (19%) died and 9 (5.2%) had paraplegia. Sixty-nine patients had clamp and sew technique (group 1). Ninety-three patients had different types of extracorporeal circulation (group 2), and 12 patients had Gott shunt (group 3). No difference appeared between the 3 groups according to mortality and paraplegia. But the sex ratio, age, visceral lesions, craniocerebral lesions, the type of aortic repair, and cross-clamp time were discriminative. The univariate analysis point out age, cross-clamp time, hemothorax, and anatomical type of aortic injury as the risk factors of death. This was confirmed by a multivariable test which retained age, cross-clamp time, and hemothorax as risk factors. When not diagnosed in time, TTA is serious and has a bad prognosis. In spite of a high mortality and morbidity, the surgical management has improved. Immediate operation and medullar protection are the stumbling block in this operation. Operation can be delayed in some cases, but one must take care of hemodynamic

  8. Sutura arterial com técnicas contínua e de pontos separados, utilizando-se os fios polipropilene e polidioxanone: estudo experimental em coelhos Arterial suture with continuous and interrupted techniques, using polypropylene and polydioxanone threads: experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Nelson Leonardo Kerdahi Leite de Campos

    2003-10-01

    following itens were assessed: weight, arterial diameters and pulse, stenosis, thrombosis, tissue adherence at the suture line, aortography, suture material visibility, suture line healling visibility and microscopic study. RESULTS: a after 60 days, the suture line site had a significant growing in all groups; b interrupted technique result less suture line stenosis in surgical act and in euthanasia c the difference between groups showed in the microscopic study, was transitory, not pesisting after 60 days post surgery; CONCLUSION: Polydioxanone is better than polypropylene for suture in growing artery, not causing (or causing little restriction to the growing of the suture line, even though using continuous technique.

  9. Tratamento cirúrgico da coarctação de aorta pela aortoplastia trapezoidal Surgical treatment of coarctation of the aorta using trapezoidal aortoplasty

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    Jarbas Jakson Dinkhuysen

    2004-01-01

    the images of aortography showed good anatomical continuity in the region of the anastomosis, and the morphometric study of the aorta revealed the beneficial effects of the technique indicated by the increase in the caliber of the aorta in the distal segment of the arch, isthmus, and descending portion. CONCLUSION: Trapezoidal aortoplasty showed satisfactory clinical results that allow its application in all cases indicated for end-to-end anastomosis.

  10. TRATAMIENTO PERCUTÁNEO CON PRÓTESIS ENDOVASCULAR DE COARTACIÓN DE AORTA ABDOMINAL EN UN ADULTO / Percutaneous treatment with endovascular prosthesis of abdominal aortic coarctation in an adult

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    Luis Felipe Vega Fleites

    2010-12-01

    balloon catheter dilatation, surgical treatment and, finally, as a more novel option, the implantation of stents. In this paper we present the case of a 45-year-old female, ex-smoker with a history of rheumatoid arthritis and hypertension who presented claudication of lower limbs during gait. There was a marked bilateral decrease of the femoral and Doppler pulses, and showed a damping factor in both femoral and popliteal arteries. The CT angiography found a significant stenosis of the distal third of the infrarenal abdominal aorta with marked hypoplasia of the right iliac. Aortography confirmed the diagnosis (gradient of 80 mmHg. Using two arterial sheaths, two-balloon catheters MATCH-35, 5.0x80 mm were introduced through femoral arteries, simultaneously inflated and subsequently a MEDTRONIC "Bridge Assurant" stent of 10x30 mm was implanted in the stenotic segment; with no complications. The residual gradient was 10 mmHg. The patient improved and was discharged form the hospital 24 hours after the procedure.

  11. Resultados a médio prazo do tratamento cirúrgico da dissecção aguda de aorta tipo A com o emprego da prótese intraluminal Surgical treatment of type a aortic dissection using intraluminal prosthesis medium term follow up

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    Jefferson Francisco de OLIVEIRA

    2001-06-01

    of 8 patients (without total circulatory arrest, due to selective perfusion of the right subclavian artery. The replacement of the aortic valve was necessary in just 6 patients. The global mortality was of 10.3% and there was no death among the patients which it was possible the treatment with the double ring. As the postoperative evaluation of these patients the echocardiography and the aortography were made. We did not observe pseudoaneurysm formation or migration and the maximum gradient was of 16 mmHg. Conclusion: The employment of the intraluminal prosthesis in the treatment of the type A acute aortic dissection, provides us fast, safe and haemostatic anastomosis, reducing the mortality. In a medium term follow-up we found no complication related to the employment of the intraluminal ring.

  12. Prevalência de estenose das artérias renais em 1.656 pacientes que realizaram cateterismo cardíaco Prevalence of renal artery stenosis in 1,656 patients who have undergone cardiac catheterization

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    Rogério Tadeu Tumelero

    2006-09-01

    Full Text Available OBJETIVO: Determinar a prevalência de estenose da artéria renal (EAR em pacientes submetidos a cineangiocoronariografia. MÉTODOS: Estudo prospectivo, considerando 1.656 cinean-giocoronariografias seguidas de aortografia, entre janeiro/2002 e fevereiro/2004, de pacientes encaminhados à cineangiocoronariografia diagnóstica com história ou não de hipertensão arterial sistêmica (HAS. RESULTADOS: Dos 1.656 pacientes, a idade média foi de 61,6 ± 11,8 anos, 53,8% eram do sexo masculino, 10,2% eram diabéticos, 63,8% apresentavam coronariopatia obstrutiva. A presença de EAR maior que 50% foi observada em 228 (13,8% pacientes, e em 25 (1,5% destes, ocorreu bilateralmente. A coronariopatia obstrutiva foi definida como estenose que causa redução do lúmen do vaso em 50% ou mais, em um, dois ou três vasos principais, denominados uniarterial, biarterial ou triarterial, respectivamente.A quantificação era realizada através da análise visual da angiografia. Comparando os grupos com e sem EAR > 50%, observou-se diferença estatisticamente significativa quanto a gênero, idade, ocorrência de diabete melito, PA e função ventricular esquerda. Não houve diferença significativa, no entanto, quanto à ocorrência de obstrução coronariana > 50%. Quando, porém, a EAR considerada é > 70%, observa-se diferença significativa quanto a PA, associação à obstrução coronariana > 50% e à disfunção ventricular esquerda, maiores no grupo com EAR. CONCLUSÃO: A prevalência de EAR neste estudo foi comparável àquela das grandes casuísticas da literatura e, em razão de sua importância pela associação com HAS e doença renal terminal (DRT e suas seqüelas, devemos estar atentos para seu diagnóstico angiográfico.OBJECTIVE: To determine the prevalence of renal artery stenosis (RAS in patients who have undergone cineangiocoronariography. METHODS: Prospective study of cineangiocoronariography and aortography examinations conducted between

  13. Saphenous vein graft true aneurysms: Report of nine cases and review of the literature

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    Davidović Lazar B.

    2004-01-01

    due to occlusive disease and renovascular hypertension. An translumbar aortography showed occlusion of the aortic bifurcation associated with fusiform aneurysm formation of ASVG (Figures 8, 9 and 10. During the same operation an aorto-bifemoral bypass and repairing of ASVG aneurysm with Dacron grafts, were performed. A pathohistological examination showed atherosclerotic origin of the ASVG aneurysm. One year latter both grafts are patent. DISCUSSION The table 1 shows 45 true aneurysmal formation at ASVG after F-P bypass surgery in cases with occlusive diseases [1-25]. In his famous paper Szilagyi [3] reported a study of the biologic fate of ASVG in 260 patients with F-P bypass procedures, and he found 10 (3.8% aneurysms. In 1973 De Weese [5] found 4 (1.2% ASVG aneurysms after 350 F-P reconstructions, while in 1975 Vanttinen [6] found 1 (0.9% such case after these procedures. In 1987 Yuanagyia [26], and in 1989 Martin [27] described cases of ASVG aneurysmal formation after subclavian artery aneurysm replacement. Yanagyia's patient had a Behcet disease. We also had one case of ASVG aneurysm after subclavian artery aneurysm repair, manifested with hand ischemia due to distal embolization. Gemperle[12]in 1986 decribed ASVG aneurysm which developed 18 years after replacement of the injured brachial artery. Carrasaquilla [28] has in 1972 described a case of ASVG aneurysm formation after replacement of the common carotid artery, while in 1998 Tekeuchi et al [29] described a case of an ASVG aneurysm after subclavian to vertebral artery bypass due to stenotic lesions of the both vertebral arteries. Four years later a giant ASVG aneurysm was found, and successfully resected. In 1990 Peer et al [30] reported two ASVG aneurysms seven and eight years after popliteal artery aneurysm replacement. In 1991 Kogel et al [31] described one such case 10 years after primary operation. In 1997 Loftus [32] described 10 new cases of the ASVG aneurysms after popliteal artery aneurysm repair