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Computed Tomography
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Computed Tomography is a specialized X-ray imaging technique. It may be performed "plain" or after the injection of a "Contrast Agent". CT creates the image by using an array of individual small X-Ray sensors and a computer. By spinning the X-Ray source and the sensor/detectors around the patient, data is collected from multiple angles. A computer then processes this information to create an image on the video screen.
Image Guidance of Percutaneous Coronary and Structural Heart Disease Interventions Using a Computed Tomography and Fluoroscopy Integration
Standard angiography (SA) of the coronary vasculature and heart structures is limited by its two-dimensional (2-D) projection of complex three-dimensional (3-D) structures. The use of angiography and fluoroscopy results in imaging artifacts and procedural limitations that makes some interventions difficult. The introduction of 3-D imaging technologies paves the way to a more precise and thorough evaluation of complex structures. Computerized tomographic angiography (CTA) and X-ray based innovative 3-D reconstruction fusion software are major advances in cardiovascular imaging. These imaging techniques provide a 3-D vessel representation and enable the subsequent analysis of 3-D properties with important clinical implications. This review will focus on novel X-ray/CT image fusion techniques that allow for guidance of percutaneous coronary and structural heart disease interventions off- and online.
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De Novo Periaortitis Following Endovascular Aneurysm Repair: A report of two cases
De Novo Periaortitis Following Endovascular Aneurysm Repair: A report of two cases Feature: De Novo Periaortitis Following Endovascular Aneurysm Repair: A report of two cases - Vasana Cheanvechai, MD and Steve Busuttil, MD Endovascular aneurysm repair (EVAR) has emerged as a routine and viable alternative in the treatment of abdominal aortic aneurysms (AAA). CT scan at this time demonstrated significant thickening of the aneurysm sac, resembling an inflammatory abdominal aortic aneurysm. ...
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Automated Contrast Injection and Targeted Renal Therapy: Strategies to Prevent Contrast-Induced Nephropathy and Treat Renal Insufficiency in Patients wth Peripheral Arterial Disease
Automated Contrast Injection and Targeted Renal Therapy: Strategies to Prevent Contrast-Induced Nephropathy and Treat Renal Insufficiency in Patients wth Peripheral Arterial Disease Feature: Automated Contrast Injection and Targeted Renal Therapy: Strategies to Prevent Contrast-Induced Nephropathy and Treat Renal Insufficiency in Patients wth Peripheral Arterial Disease - David E. Allie, MD, Chris J. Herbert, RT, RCIS, and Craig M. Walker, MD It is currently estimated that in the United ...
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Diagnosis and Non-Surgical Management of Mesenteric Ischemia
Diagnosis and Non-Surgical Management of Mesenteric Ischemia Feature: Diagnosis and Non-Surgical Management of Mesenteric Ischemia - Jaffar Ali Raza, MD, Michael Miller, MD, ?Robert S. Dieter, MD, RVT, ?? Acute mesenteric ischemia (AMI) is further subdivided into occlusive and nonocclusive mesenteric ischemia. 52 Patients with peritoneal signs and documented thrombosis with mesenteric ischemia, infarction, bowel ischemia and bowel infarction require laparotomy for possible thrombectomy and ...
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Case Study: Endovascular Management of Double Fusiform Aneurysms of the Extra-Cranial Internal Carotid Artery with Covered Stents
A 39-year-old woman presented with a double fusiform aneurysm of extracranial internal carotid artery (EICA), which was successfully treated. The clinical features, imaging and details of endovascular treatment are discussed along with a relevant review of the literature. Endovascular treatment using covered stent grafts has recently been considered a suitable alternative to surgery for the treatment of EICA aneurysms. Vascular Disease Management 2005;2(5):102?104 Keywords: Endovascular management, fusiform aneurysm, extra-cranial internal carotid artery, covered stent
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Duplex Ultrasound Surveillance after Carotid Stent Angioplasty: When to Follow-up and What to Look for
medical therapy for stroke prevention in patients with severe atherosclerotic ICA stenosis in both the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the Asymptomatic Carotid Atherosclerosis Study (ACAS),3,4 and is currently being compared to carotid stent-assisted angioplasty (CAS) in the Carotid Revascularization Endovascular Stent Trial (CREST). Angiography confirmed > 75% DR CAS stenosis in all 6 patients, resulting in balloon angioplasty (n = 3), stent angioplasty (...
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Reversal of Refractory Hypertension due to the Goldblatt Kidney Phenomena from a Descending Aortic Dissection Using a Stent and Filter Device
1Mohan Nandalur, MD 2Bruce Abramowitz, MD, 2Surendra Avula, MD, 2Nausheen Akhter, MD"> Reversal of Refractory Hypertension due to the Goldblatt Kidney Phenomena from a Descending Aortic Dissection Using a Stent and Filter Device Case Study and Review: Reversal of Refractory Hypertension due to the Goldblatt Kidney Phenomena from a Descending Aortic Dissection Using a Stent and Filter Device - 1Mohan Nandalur, MD 2Bruce Abramowitz, MD, 2Surendra Avula, MD, 2Nausheen Akhter, MD Introduction ...
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Renal Sub-capsular Hemorrhage: Unique Imaging Findings and Role of Interventional Management
We present two patients with sub-capsular renal hemorrhage treated with arterial embolization. One patient developed the hemorrhage secondary to a presumed perforation of the renal cortex by a guidewire during renal artery stenting, while hemorrhage was spontaneous in the other patient. Anticoagulation was a common factor in both. Computer tomography (CT) of the abdomen with arterial phase scans was useful in defining the sites of hemorrhage and planning intervention. The radiological findings and intervention are discussed with review of the relevant literature. Key words: sub-capsular renal hemorrhage, guidewire perforation, interventional management
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Witnessed Rupture of a Sinus of Valsalva Aneurysm into the Right Ventricle Presenting as Cardiogenic Shock
Sinus of Valsalva aneurysms (SVA) are extremely rare, seen more often in Asian populations and males. They typically produce few or no symptoms and therefore go undiagnosed until the third and fourth decades of life, when rupture can manifest as acute heart failure. Surgical repair has a low operative mortality rate (5%), and subsequent survival approaches the healthy population, making prompt diagnosis and treatment of this condition essential. We report the unique experience of witnessing the rupture of a right SVA into the right ventricle, causing immediate severe cardiogenic shock in a 33-year-old male successfully treated with medical stabilization and surgical repair. We include transthoracic, transesophageal and angiographic images of this unusual case. Key words: aneurysm, sinus of Valsalva, rupture, cardiogenic shock, heart failure
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Endoscopic Vein Harvest for Infrainguinal Vascular Reconstruction and Limb Salvage in Chronic Critical Limb Ischemia
Endoscopic Vein Harvest for Infrainguinal Vascular Reconstruction and Limb Salvage in Chronic Critical Limb Ischemia Original Contribution: Endoscopic Vein Harvest for Infrainguinal Vascular Reconstruction and Limb Salvage in Chronic Critical Limb Ischemia - Michael C. Trotter, MD, Charles L. Kock, PA-C, Craig M. Walker, MD Introduction Autogenous greater saphenous vein is the preferred conduit for infrainguinal vascular reconstruction, and the most commonly utilized venous conduit for ...
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