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  • ANGIOGRAPHY  (7)
  • Aorta  (6)
  • EXPERIENCE  (6)
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  • 1
    Keywords: Diagnostic Imaging ; radiology ; MULTISLICE CT ; imaging ; CT ; CT ANGIOGRAPHY ; ANGIOGRAPHY ; arteries
    Type of Publication: Book chapter
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  • 2
    Keywords: Germany ; THERAPY ; CLASSIFICATION ; RISK ; PATIENT ; treatment ; LESIONS ; EXPERIENCE ; REPAIR ; HIGH-RISK ; SELECTION ; RECONSTRUCTION ; MANAGEMENT ; SURGICAL-TREATMENT ; ABDOMINAL AORTIC-ANEURYSM ; aneurysm ; ARTERY ANEURYSMS ; endograft ; endovascular ; ENDOVASCULAR TREATMENT ; GRAFTS ; iliac artery ; MIDTERM EXPERIENCE
    Abstract: Isolated iliac aneurysms (IIA) are uncommon lesions that require surgical repair to prevent rupture. The aim of this article is to give an update on the current surgical management of IIA. This report also evaluates the application of endovascular repair in IIA, based on a recent Pubmed search and on our own experience in the interventional field: Open reconstruction achieves good longterm results and still represents the golden standard in surgical treatment of IIA. Transluminally placed endovascular stent grafts can be successfully used to exclude isolated iliac aneurysms in selected high risk patients with suitable anatomy. A classification based on aneurysm morphology is useful for patient selection. The value of endovascular therapy has yet to be determined
    Type of Publication: Journal article published
    PubMed ID: 16485205
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  • 3
    Keywords: computed tomography ; ANGIOGRAPHY ; ABDOMINAL-AORTA ; Aorta ; Aortic pathologies ; COMPUTED-TOMOGRAPHY AN
    Abstract: Current imaging of the aorta saw an improvement in terms of diversity and quality in recent years. In addition to verifying and documenting a clinical suspicion, it provides the basis for establishing an indication, choosing a therapy (conservative, surgical, interventional), as well as therapy planning and follow-up. Besides B-mode and duplex sonography, as well as transesophageal echocardiography (TEE), contrast-enhanced cross-sectional imaging, computer tomography (CT), with the option for CT angiography (CTA), and magnetic resonance tomography (MRT), with the option for MR angiography (MRA), play a significant role. The present article describes the possibilities offered by CTA and MRA for the diagnosis of aortic pathologies from the point of view of the radiologist in a maximum care hospital
    Type of Publication: Journal article published
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  • 4
    Keywords: Germany ; FOLLOW-UP ; PATIENT ; INFECTION ; EXPERIENCE ; REPAIR ; tomography ; COMPUTED-TOMOGRAPHY ; COMPLICATIONS ; conversion ; PLACEMENT ; AORTIC-ANEURYSMS ; complication ; endovascular repair ; FISTULAS ; GRAFT INFECTION ; material fatigue ; pseudoaneurysm ; stent-graft ; STENT-GRAFTS ; thoracic aortic aneurysm ; wire fracture
    Abstract: Purpose: To report complications from a thoracic endograft wire fracture and early experience with elective conversion after thoracic endografting. Case Report: A 43-year-old man underwent urgent endovascular repair of a symptomatic post-traumatic thoracic aneurysm in 1999. The patient had been involved in a car accident 14 years before. He developed clinical and radiological signs of graft infection 46 months after stent-graft implantation. Multidetector computed tomography confirmed a fracture of the longitudinal support wire in the Excluder thoracic stent-graft. Additionally, radiological signs of suspected endograft infection were described. Due to concerns over a potential chronic infection, the stent-graft was successfully excised, and a polyester graft was implanted 50 months after primary endovascular repair. Conclusions: Recognition or strong suspicion of endograft infection requires conversion with removal of the device. Long-term follow-up after endografting is necessary to assess material fatigue that undermines the durability of these implants
    Type of Publication: Journal article published
    PubMed ID: 15683278
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  • 5
    Keywords: Germany ; chest ; CT ; SYSTEM ; TOOL ; DEATH ; DISEASE ; MORTALITY ; RISK ; SURGERY ; PATIENT ; INJURIES ; MECHANISM ; IMPACT ; CONTRAST ; mechanisms ; treatment ; EXPERIENCE ; DISRUPTION ; REPAIR ; REGION ; ANGIOGRAPHY ; MANAGEMENT ; THORACIC AORTA ; HEIGHT ; wound ; STABILIZATION ; endovascular ; Cause of Death ; BLUNT ; DELAYED TREATMENT ; intracranial ; RUPTURE
    Abstract: Acute traumatic aortic tear (ATAT) is the second most common cause of deaths in trauma patients (about 8,000 deaths/year in the USA). Due to circumferential aortic disruption, up to 90% die at the scene. Responsible trauma mechanisms are: penetrating (gunshot/stab wounds), iatrogenic (interventional catheterization) and, most frequently, blunt chest trauma (high-speed motor vehicles, falls from heights, crushes, explosions) resulting in injury at the aortic isthmus region (loco typico, about 90%). Severe multiple system injuries (polytrauma), especially to intracranial and intraabdominal organs, are characteristic and prognostically predicitive. Immediate transthoracic open repair of ATAT has a mortality risk of 8% to 33% and paraplegia risk of 2% to 26%. Contrast enhanced CT scan has replaced the classical angiography as the diagnostic tool of choice. Patients with life-threatening multisystem injuries are scheduled for delayed repair after initial stabilization. Currently, the use of endovascular stent-grafts (EVAR) is being investigated. Our personal series confirms that EVAR for ATAT is a viable alternative to open repair while minimizing the morbidity and mortality of the open procedure and having a limited impact on trauma destabilization. The assessment of long-term durability of EVAR is one of the key issues to consider EVAR as the first choice of treatment
    Type of Publication: Journal article published
    PubMed ID: 16533692
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  • 6
    Keywords: ANGIOGENESIS ; CANCER ; SURVIVAL ; tumor ; Germany ; THERAPY ; DENSITY ; DIAGNOSIS ; imaging ; liver ; NEW-YORK ; SAMPLE ; SAMPLES ; TISSUE ; TUMORS ; NUCLEAR-MEDICINE ; PATIENT ; BIOMARKERS ; TISSUES ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; BREAST ; immunohistochemistry ; REGION ; REGIONS ; MUSCLE ; PARAMETERS ; NORMAL TISSUE ; SERIES ; CONTRAST-ENHANCED MRI ; nuclear medicine ; ASBESTOS ; mesothelioma ; MALIGNANT MESOTHELIOMA ; LUNG-CARCINOMA ; HETEROGENEITY ; radiology ; RE ; THERAPIES ; monitoring ; dynamic contrast enhanced MRI ; biomarker ; analysis ; methods ; SUBTYPES ; NUCLEAR ; USA ; correlation ; spleen ; Aorta ; microvascular density ; MEDICINE ; quantitative ; PHARMACOKINETIC ANALYSIS ; DCE-MRI ; neoplasm ; CD-34 ; IMAGING BIOMARKER
    Abstract: Rationale and Objectives. Malignant mesothelioma (MM) of the pleura is an aggressive and often fatal neoplasm. Because MM frequently demonstrates marked angiogenesis, it may be responsive to antiangiogenic therapy, but effective methods for selecting and monitoring of patients are further needed. We employed dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and quantitative immunohistochemistry (IHC) to characterize the microvascularity of MM using both a physiologic and ultrastructural method. Materials and Methods. Nineteen patients diagnosed with MM were enrolled and DCE-MRI was performed before antiangiogenic treatment. For each patient, tumor regions were characterized by their DCE-MRI-derived pharmacokinetic parameters (Amp, k(ep), k(el)), which were also compared to those of normal tissue (aorta, liver, spleen, and muscle). In addition, quantitative ITIC of representative samples was performed with CD-34 staining to compare the calculated microvessel density (MVD) results with DCE-MRI results. Results. MM demonstrated markedly abnormal pharmacokinetic properties compared with normal tissues. Among the parameters tested, Amp was significantly different in MM (P :5.001) compared to normal organs. Despite the observation that the MVD of mesotheliomas in this series was high compared to other tumors, DCE-MRI pharmacokinetic parameters had a moderately positive correlation with MVD (r = 0.5). Conclusions. DCE-MRI and IHC can be used in patients with MM to visualize tumor microvascularity and to characterize tumor heterogeneity. DCE-MRI and IHC results positively correlated, though moderately, but these two methods present as essential tumor biomarkers. This multimodal characterization may be useful in selecting possible tumor subtypes that would benefit from antiangiogenic therapy
    Type of Publication: Journal article published
    PubMed ID: 18423312
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  • 7
    Keywords: MODEL ; VISUALIZATION ; DISEASE ; BLOOD-FLOW ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; SURVEILLANCE ; ANGIOGRAPHY ; endovascular repair ; endovascular ; ANEURYSM REPAIR ; Aorta ; stent graft ; phase-contrast flow ; blood flow velocity
    Abstract: PURPOSE: To validate flow measurements within an aortic nickel-titanium (nitinol) stent graft using velocity-encoded cine magnetic resonance imaging (VEC MRI) and to assess intraobserver agreement of repeated flow measurements. MATERIALS AND METHODS: An elastic tube phantom mimicking the descending aorta was developed with the possibility to insert an aortic nitinol stent graft. Different flow patterns (constant, sinusoidal and pulsatile aortic flow) were applied by a gear pump. A two-dimensional phase-contrast sequence was used to acquire VEC perpendicular cross-sections at six equidistant levels along the phantom. Each acquisition was performed twice with and without stent graft, and each dataset was analysed twice by the same reader. The percental difference of the measured flow volume to the gold standard (pump setting) was defined as the parameter for accuracy. Furthermore, the intraobserver agreement was assessed. RESULTS: Mean accuracy of flow volume measurements was -0.45+/- 1.63% without stent graft and -0.18+/- 1.45% with stent graft. Slightly lower accuracy was obtained for aortic flow both without (-2.31%) and with (-1.29%) stent graft. Accuracy was neither influenced by the measurement position nor by repeated acquisitions. There was significant intraobserver agreement with an intraclass correlation coefficient of 0.87 (without stent graft, p〈0.001) and 0.80 (with stent graft, p〈0.001). The coefficient of variance was 0.25% without stent graft and 0.28% with stent graft. CONCLUSION: This study demonstrated high accuracy and excellent intraobserver agreement of flow measurements within an aortic nitinol stent graft using VEC MRI. VEC MRI may give new insights into the haemodynamic consequences of endovascular aortic repair.
    Type of Publication: Journal article published
    PubMed ID: 20888719
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  • 8
    Keywords: POPULATION ; magnetic resonance imaging ; AGE ; NECK ; COMPUTED-TOMOGRAPHY ; ANGIOGRAPHY ; physiology ; CONFORMATIONAL-CHANGES ; THORACIC AORTA ; endovascular repair ; endovascular ; ANEURYSMS ; stent graft ; ARTERIAL STIFFNESS ; WAVE REFLECTION
    Abstract: PURPOSE: To test our hypothesis that distension and displacement in various segments of the healthy thoracic aorta are significant and can be predicted based on clinical characteristics. MATERIALS AND METHODS: Sixty-one Caucasian volunteers without cardiovascular disease (49 +/- 16 years, range 19-82; 28 men, 33 women) divided into two age groups (A: 〈50, B: 〉/= 50 years) underwent 1.5-T MRI. ECG-gated dynamic data sets were acquired at five locations perpendicular to the thoracic aorta. Aortic distension and Centre of Mass (CoM) displacement were determined as percentages of diastolic aortic diameter. A multiple linear regression model including age group, gender, location, mean arterial blood pressure, heart rate and body mass index was tested. RESULTS: Mean aortic distension averaged over all locations was 11.2 +/- 4.1% (age group A) and 6.7 +/- 3.3% (age group B), mean displacement 15.1 +/- 8.3% (A) and 11.0 +/- 6.2% (B). Systolic and diastolic aortic diameter and CoM position significantly differed at all locations (p〈0.001). Distension and displacement could be predicted based on the regression model (p〈0.001). Age group A and women exhibited significantly greater distension and displacement compared to age group B (p〈0.001) and men (p〈0.01), respectively. Distension increased, displacement decreased from proximal to distal. CONCLUSION: Distension and translational displacement are significant at all levels of the thoracic aorta and can be predicted based on clinical characteristics.
    Type of Publication: Journal article published
    PubMed ID: 20850234
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  • 9
    Keywords: brain ; Germany ; PERFUSION ; imaging ; CONTRAST ; CONTRAST AGENT ; MR ; EXPERIENCE ; CENTRAL-NERVOUS-SYSTEM ; intravenous ; CEREBRAL ARTERIOVENOUS-MALFORMATIONS ; CONTRAST AGENTS ; DOUBLE-BLIND ; GADOBENATE-DIMEGLUMINE ; GADODIAMIDE INJECTION ; GADOPENTETATE DIMEGLUMINE ; INTRACRANIAL METASTASES ; MAGNETIC-RESONANCE ANGIOGRAPHY ; MR-ANGIOGRAPHY ; F ; AGENT ; BILE
    Type of Publication: Journal article published
    PubMed ID: 15503381
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  • 10
    Keywords: Germany ; COMMON ; CT ; DIAGNOSIS ; FOLLOW-UP ; imaging ; DISEASE ; MORTALITY ; NEW-YORK ; ACCURACY ; computed tomography ; NUCLEAR-MEDICINE ; PATIENT ; REPAIR ; EFFICIENT ; tomography ; COMPUTED-TOMOGRAPHY ; sensitivity ; specificity ; CT ANGIOGRAPHY ; ANGIOGRAPHY ; ARTERY ; nuclear medicine ; DISSECTION ; radiology ; HIGH-RESOLUTION ; THORACIC AORTA ; MORBIDITY ; PRINCIPLES ; NUCLEAR ; USA ; aneurysm ; Aorta ; MEDICINE ; NOV ; medical imaging ; ANEURYSMS ; German ; aortic dissection ; aortic disease ; INTRAMURAL HEMATOMA ; MULTIDETECTOR-ROW CT ; multisclice computed tomography (MSCT)
    Abstract: Aortic disease is associated with high morbidity and mortality and thus require an efficient and accurate diagnostic approach, especially in the acute setting. Multislice computed tomography (MSCT) with the option of high-resolution CT angiography (CTA) has emerged as the standard of reference in diagnosis and follow-up of patients with acquired aortic disease. Aortic dissection is the most common aortic emergency, but it remains undiscovered in up to 38% of cases. Sensitivity and specificity of MSCT in the assessment of aortic dissection are greater than 99%. The sensitivity of CT in the detection of inflammatory changes is 83%; its specificity is almost 100%; and its diagnostic accuracy is ca. 94%. This article outlines state-of-the-art principles in diagnostic CT imaging of acquired aortic disease
    Type of Publication: Journal article published
    PubMed ID: 17938873
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