In this review, we aimed to outline the clinical and pathological conditions for which multidetector computed tomography coronary angiography (MDCT-CA) should be the preferred method because of its advantages over conventional coronary angiography (CCA). A consistent body of literature suggests that MDCT-CA is more than just complementary to CCA and ...

We describe 10-month-old identical female twin infants, one with primary left-sided pulmonary agenesis and the other with primary left-sided pulmonary hypoplasia. They came to our outpatient clinic complaining of persistent dry cough. The clinical examination revealed decreased air entry over the left hemithorax. Chest x-rays showed complete left-sided radio-opacity in ...

Introduction of stentless valves into clinical practice has not replaced stented valve prosthesis as expected a decade ago. With respect to clinical parameters such as transvalvular pressure differences, left ventricular mass regression as well as a possible survival benefit, there are many contradictory studies published. The overall dilemma is the ...

BACKGROUND: Cerebral vasospasm is the main cause of neurological mortality and morbidity following subarachnoid hemorrhage. Basilar artery vasospasm (BAVS) is associated with a high morbidity and may have multiple clinical presentations. METHODS: We report the case of a 43 years-old man with BAVS presenting as a reversible locked-in syndrome (LIS) after ...

Atherosclerotic disease of the carotid bifurcation is associated with an increased risk of both stroke and transient ischaemic attack. Carotid artery stenting (CAS) offers an alternative approach to carotid endarterectomy (CEA) in both symptomatic and asymptomatic individuals. The National Institute for Health and Clinical excellence (NICE) guidance for CAS in ...

Based on the natural mathematical relationships between the components of the human tri-leaflet aortic valve, new calibrated cusp sizers were developed in order to facilitate aortic valve assessment in the operating room and enhance the chance for a perfect restoration of aortic valve competence. These sizers were used clinically to ...

Stent retrievers are increasingly used for flow restoration and thrombectomy in acute embolic stroke. First clinical results support the potential of these new devices, in particular the ability to rapidly restore flow and effectively retrieve clots from large intracranial arteries, with favorable clinical results in preliminary patient series. This article ...

PURPOSE: The medial tentorial artery (MTA) of Bernasconi-Cassinari has been associated with many neurosurgical pathologies, including tentorial and petroclival meningiomas, dural arteriovenous fistulae, hemangioblastomas, moyamoya disease, arteriovenous malformations, trigeminal neuromas, and malignant gliomas. This vessel may function as a source of collateral blood supply for the posterior circulation. Our goal ...

Dacron® (polyethylene terephthalate) and Goretex® (expanded polytetrafluoroethylene) vascular grafts have been very successful in replacing obstructed blood vessels of large and medium diameters. However, as diameters decrease below 6 mm, these grafts are clearly outperformed by transposed autologous veins and, particularly, arteries. With approximately 8 million individuals with peripheral arterial ...

Background:  Despite widespread penetration of drug-eluting stents (DES) in clinical practice, a relevant percentage of patients with coronary artery disease are still treated with bare-metal stents (BMS). Contemporary BMS, however, are less well investigated and comparative data on clinical outcome are lacking. Methods and Results:  This single-center registry aimed to ...

Atherosclerotic renal artery stenosis is a common clinical problem for which the optimal therapeutic strategy remains to be defined. However, renal artery stenting procedures have significantly increased as one approach to treat this clinical problem. Despite improvements in device design and technical performance of the procedure, the benefits and results ...

The use of drug-coated balloons (DCB) for preventing restenosis in both coronary and peripheral arteries has received increasing attention. The first successful clinical outcomes in inhibiting restenosis have been reported for paclitaxel-coated balloons. Paclitaxel is a lipophilic substance characterized by rapid intracellular uptake and irreversible binding to microtubules. In this ...

The aim of this paper is the description of a novel and completely automated technique for carotid artery recognition, far (distal) wall segmentation, and intima-media thickness (IMT) measurement, a strong clinical tool for risk assessment for cardiovascular diseases. The architecture of Completely Automated Multi-resolution Edge Snapper (CAMES) consists of two ...

The extensive use of stents during percutaneous coronary intervention (PCI) is associated with concerns about their potential adverse effects. In-stent restenosis and stent thrombosis definitely significantly affect the PCI outcome. However, review of recent relevant studies suggests that stent-related problems may have been somewhat overestimated when compared to coronary artery ...

OBJECTIVE: To correlate a Dual Energy (DE)-based visual perfusion defect scoring system with established CT-based and clinical parameters of pulmonary embolism (PE) severity. METHODS: In 63 PE patients, DE perfusion maps were visually scored for perfusion defects (P-score). Vascular obstruction was quantified using the Mastora score. Both scores were correlated ...

The purpose of this study was to determine the diagnostic accuracy of the 64-slice multidetector computed tomography (MDCT) in detecting active pelvic arterial bleeding associated with blunt pelvic fractures. We hypothesized that this modality yields high accuracy. We conducted a retrospective review of all MDCT detected pelvic fractures over an ...

This report describes imaging in a patient with a unique unnamed carotid-basilar anastomosis, where the entry into the skull was via the jugular foramen. There were associated findings of absent right and hypoplastic left vertebral arteries and an aberrant right subclavian artery. We speculate that the persistent anastomosis is developmentally ...

The management of carotid stenosis is in evolution. Carotid endarterectomy has been the gold standard for the treatment of carotid stenosis for many years. However, recently, carotid angioplasty and stenting has emerged as a feasible and relatively safe management alternative. The appropriate clinical setting for its preferential use over carotid ...

The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm ...

We present a rare case of a single coronary artery originating from the right sinus of Valsalva. The incidence of this anomaly is 0.004%.

BACKGROUND:: Long-term angiographic and clinical outcome following stenting by flow reversal technique (FRT) for chronic occlusions (COs) of the cervical internal carotid artery (ICA) or vertebral artery (VA) is unknown. OBJECTIVE:: The aim of our retrospective study was to investigate the feasibility, safety and long-term outcome of stenting by FRT ...

Coronary artery bypass grafting (CABG) has been considered the standard therapy for unprotected (nonrevascularized) left main coronary disease (ULM). However, increasing experience with ULM percutaneous coronary intervention (PCI) has resulted in high procedural success and favorable early and late clinical outcomes. In particular, reduction in clinical restenosis with drug-eluting stents, ...

Aortic dissection is an uncommon and often life-threatening condition. It usually presents with classic symptoms, such as severe tearing chest pain radiating to the back associated with acute hemodynamic compromise. Painless aortic dissection is often an under-recognized entity. Its incidence is low, but represents an important clinical dilemma that requires ...

Critical limb ischemia (CLI) represents the most severe clinical manifestation of peripheral arterial disease, defined as the presence of chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease. The dominant pathology underlying CLI is atherosclerosis, distributed at multiple levels along the length of the lower ...

Chronic mesenteric ischemia (CMI) is the most common vascular disorder involving the intestines, however it is unusual in clinical practice. The redundancy of the visceral circulation with multiple interconnections between the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) is the most likely explanation for the infrequent occurrence ...

Thoracic venous aneurysm is an extremely rare condition. This report describes the case of a 70-year-old woman with a left brachiocephalic venous aneurysm that caused recurrent nerve paralysis. Contrast-enhanced computed tomography and venography revealed a venous aneurysm, 4 cm in size, located adjacent to the venous angle. Anticoagulation therapy was ...

PURPOSE: To evaluate the influence of heavy calcification on iliac arterial stent expansion and patency and to define the spatial relationship between the stent and heavy calcifications on computed tomography (CT). MATERIALS AND METHODS: Thirteen patients (11 men, two women; mean age, 66.5 y) with 14 heavily calcified iliac arteries ...

The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length ...

OPINION STATEMENT: During the past few years, the branch syndromes have been ascribed to pontine lesions, and the development of neuroimaging techniques has renewed the interest in exploring their clinical-radiological correlation. Brain imaging via MRI has helped in the diagnosis and accurate localization of lesions. From classic studies it is ...

The occurrence of a vascular perforation during an endovascular procedure is an unexpected and feared complication which can be fatal. However, the incidence, risk or the mechanism of vascular perforation which can occur in the endovascular management of aneurysms remains unclear. The purpose of the present study was to evaluate ...

Anomalous branching pattern of the left external carotid artery (ECA) was detected in an old man. The ECA branched into high submental artery and large transverse facial artery ending as angular artery compensating for concurrent agenesis of ipsilateral facial artery. The lingual artery gave direct branch to the submandibular gland, ...

The use of 3-dimensional computed tomography angiography (3D-CTA) for clipped aneurysms is limited. Usefulness of 3D-CTA with elimination of bone and clips was evaluated in patients with clipped cerebral aneurysms. Forty-three clipped cerebral aneurysms were included. As review of digital subtraction angiography after surgery is the current gold standard, the ...

BRIEF SUMMARY: We describe the use of adenosine-induced cardiac arrest to facilitate intracranial aneurysm clip ligation. Cerebral aneurysms are highly variable which may result in difficult surgical exposure for clip ligation in select cases. Secure clip placement is often not feasible without temporarily decompressing the aneurysm. This can be accomplished ...

We describe the use of multiple Amplatzer vascular plugs which were intentionally placed so as to isolate a large azygous vein aneurysm with intraluminal thrombosis, which had resulted in a previous pulmonary embolus. This technique avoided the need for an invasive thoracotomy and aneurysm resection or attempting to directly fill ...

In subclavian steal phenomenon (SSP), the subclavian artery develops a stenoocclusive disease proximal to the origin of the vertebral artery, leading to pronounced hemodynamic changes such as arterial flow reversal. Although SSP is a common echographic finding in humans, the phenomenon occurs only rarely in animals; consequently its physiologic features ...

Unruptured intracranial artery aneurysms (IAs) can be revealed by cerebral ischemia. Little is known on the clinical course and outcome of patients with this condition. We report our findings in a consecutive series of 15 such patients. We retrospectively analyzed patients with ischemic stroke (IS) or transient ischemic attack (TIA), ...

Arntzen KA, Mathiesen EB. Subclinical carotid atherosclerosis and cognitive function. Acta Neurol Scand: 2011: 124 (Suppl. 191): 18-22. © 2011 John Wiley & Sons A/S. Carotid artery atherosclerosis is a major risk factor for stroke and subsequent cognitive impairment. Recent studies indicate that carotid atherosclerosis without clinical stroke may also ...

In recent years, there has been a revival in the use of bioprosthetic valves as aortic substitutes. For example, during 2008 in Germany, among 12,397 patients who underwent isolated aortic valve procedures, 78% received a biological prosthesis and 21% a mechanical valve, while only 1% underwent valve repair. However, whilst ...

Macular edema is a common cause of visual loss in patients with retinal vein occlusions. Ozurdex(®), a dexamethasone intravitreal implant, has been shown in randomized controlled trials to reduce macular edema and improve visual acuity in patients with either branch retinal vein occlusions or central retinal vein occlusions. It was ...

The authors report a case of a posterior inferior cerebellar artery origin aneurysm causing brainstem compression and swallowing difficulty. The patient had an ipsilateral microvascular decompression of cranial nerve VII for hemifacial spasm 27 years prior to the discovery of the aneurysm. The aneurysm was successfully treated endovascularly. A discussion ...

Although hypoxic pulmonary vasoconstriction is a well-recognized physiological phenomenon it is unusual to observe and assess its efficiency in clinical practice. Here, we report the case of a 50-year-old female who presented with unilateral incomplete bronchial occlusion due to a carcinoid tumor involving the left main bronchus in the absence ...

An intracranial posterior circulation revascularization procedure in the form of a side-to-side in situ posterior inferior cerebellar artery (PICA)-PICA bypass operation was introduced in 1991. This elegant and apparently low-risk operation is performed infrequently. Thus, the operative nuances used in this procedure have not been well reported, limiting the scope ...

Transient adenosine-induced asystole is a reliable method for producing a short period of relative hypotension during surgical and endovascular procedures. Although the technique has been described in the endovascular treatment of brain arteriovenous malformations, aortic aneurysms, and posterior circulation cerebral aneurysms, little description of its use in anterior circulation aneurysms ...

Unlike posttraumatic temporal artery aneurysm, spontaneous temporal artery aneurysm is an exceptional finding. We report the case of a 34-year-old woman with no history of previous trauma who presented a progressively enlarging right temporal lump. A CT scan revealed a 1.6cm diameter aneurysm arising from the superficial temporal artery. The ...

Fusiform anterior communicating artery (ACoA) aneurysms (ACoAAs) are rare, and a series of these aneurysms has not been reported. Large fusiform ACoAA are easily identifiable, whereas smaller ones can coexist with a saccular component. To provide a clear-cut definition, report the incidence of these aneurysms, present a series with follow-up ...

The incidence of ischemia might be increased in the surgical repair of atherosclerotic unruptured aneurysms compared to non-atherosclerotic aneurysms. The atherosclerotic wall might increase the occurrence of thrombembolic events or its rigidity might endanger the occlusion of perforators within the aneurysm vicinity. 87 patients (53 patients without and 34 patients ...

FD technology enables reconstructive repair of otherwise difficult-to-treat intracranial aneurysms. These stentlike devices may induce progressive aneurysm thrombosis without additional implants and may initiate complete reverse vessel remodeling. The associated vascular biologic processes are as yet only partially understood. From 12 different centers, 13 cases of delayed postprocedural aneurysm rupture ...

Flow-diverting approaches to intracranial aneurysm treatment had many promising early results, but recent apparently successful treatments have been complicated by later aneurysm hemorrhage. We analyzed 7 cases of aneurysms treated with flow diversion to explore the possible rupture mechanisms. CFD analysis of pre- and posttreatment conditions was performed on 3 ...

A 51-year-old hypertensive man presented with subarachnoid haemorrhage. He had a past history of cerebellar infarction due to occlusion of the right posterior inferior cerebellar artery (PICA) 4 years earlier. Digital subtraction angiography showed a saccular aneurysm above an arterial loop extending from the vertebral artery to the distal part of ...

AICA aneurysms are rare and a challenge to treat surgically. We present our experience of the angiographic results and the clinical outcomes for 9 AICA aneurysms treated by EVT. Between 1997 and 2009, EVT was attempted for 9 AICA aneurysms. Six patients presented with SAH, and 3 aneurysms were found ...