Assessment of Feasibility and Patency of below the Knee Atherectomy Using the 1.5 mm Phoenix Catheter-A Retrospective Study.

Background and Objectives: Peripheral arterial disease (PAD) contains a significant proportion of patients whose main pathology is located in the infragenicular arteries. The treatment of these patients requires a deliberate consideration due to the threat of possible complications of an intervention. In this retrospective study, the feasibility of a below-the-knee atherectomy (BTKA) via a 1.5 mm Phoenix atherectomy catheter and the patient outcome over the course of 6 months are investigated. Materials and Methods: The data of patients suffering from PAD with an infragenicular pathology treated via 1.5 mm Phoenix™ atherectomy catheter between March 2021 and February 2022 were retrospectively analyzed. Prior to the intervention, after 2 weeks and 6 months, the PAD stages were graded and ankle-brachial-indeces (ABI) were measured. Results: The study shows a significant improvement of ABI, both after 2 weeks and 6 months. Additionally, the number of PAD stage IV patients decreased by 15.2% over the course of 6 months, and 18.2% of the patients improved to PAD stage IIa. Only one bleeding complication on the puncture side occurred over the whole study, and no other complications were observed. Conclusions: Phoenix™ atherectomy usage in the BTKA area seems to be feasible and related to a favorable outcome in this retrospective study.&nbsp.

MRI of the prostate: interobserver agreement compared with histopathologic outcome after radical prostatectomy.

BACKGROUND: The purpose of this study was to evaluate interobserver agreement of prostatic MRI in assessing the performance of staging prostate carcinoma in comparison with histopathologic step section prostate specimens. METHODS: We retrospectively evaluated 46 patients who underwent prostatic MRI examination at 1.5 T MRI and "subsequently" radical prostatectomy. All MR-images were reevaluated by two different experienced radiologists (15 and 1.5 years of experience) with special focus on T2/T3 differentiation. Both radiologists were not aware of the patient's clinical data, except that the patient had prostate cancer. These findings were compared with histopathologic whole mount step section prostate specimens, which served as the "gold standard". Fourfold tables were created to calculate sensitivity, specificity, positive and negative predictive values and efficiency for T2/T3 differentiation. Cohen's kappa was calculated to measure inter-rater agreement. RESULTS: Twenty-eight patients were diagnosed with organ defined cancer (T2), 18 patients were staged with extracapsular extension (T3), and thereof 7 patients were staged with seminal vesicle invasion (T3b) by the pathologists. The experienced reader reached a sensitivity of 77.78% (95%-CI 52.36%; 93.59%) and specificity of 92.86% (95%-CI 76.50%; 99.12%) for T2/T3 differentiation, the less experienced reader however achieved a sensitivity of 33.33% (95%-CI 13.34%; 59.01%) and specificity of 71.43% (95%-CI 51.33%; 86.78%). The Cohen's kappa for inter-rater reliability for differentiation between T2 and T3 stage was κ=0.0129. CONCLUSIONS: Evaluation of prostatic MR imaging requires lengthy experience for accurate interpretation and staging. While a highly experienced reader can achieve good correlation with histopathology even without utilization of functional MR imaging, a less experienced reader with theoretical knowledge falls short of expectation.