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1.
Methods Mol Biol ; 2319: 93-104, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34331247

RESUMO

Lightsheet microscopy is a form of fluorescence microscopy that can be used to visualize specimen with high resolution, a large depth-of-field, and minimal photodamage and photobleaching as compared to traditional confocal microscopy. As this technology becomes much more readily available, it will be useful in revealing new findings in the cardiovascular development field that may be hidden or difficult to image. In this manuscript, we describe an approach for mounting and culturing postimplantation mouse embryos to visualize blood vessel development with a lightsheet microscope.


Assuntos
Angiografia/métodos , Vasos Sanguíneos/diagnóstico por imagem , Técnicas de Cultura/métodos , Embrião de Mamíferos/diagnóstico por imagem , Desenvolvimento Embrionário , Microscopia de Fluorescência/métodos , Neovascularização Fisiológica , Animais , Vasos Sanguíneos/crescimento & desenvolvimento , Vasos Sanguíneos/metabolismo , Meios de Cultura/química , Dissecação/métodos , Embrião de Mamíferos/irrigação sanguínea , Camundongos , Camundongos Transgênicos , Microscopia Confocal
2.
J Plast Reconstr Aesthet Surg ; 74(8): 1703-1717, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33931326

RESUMO

INTRODUCTION: Indocyanine Green Angiography (ICG-A) is an imaging technique used to visualize tissue perfusion in real time. The aim of this systematic review and meta-analysis is to evaluate all published papers on breast reconstruction using ICG-A, which provides information on complication rates and to investigate whether the use of this peroperative method decreases the risk of complications. MATERIALS AND METHODS: MEDLINE/PubMed, EMBASE, Cochrane, and UpToDate were searched using relevant terms. The literature was assessed using the PRISMA guidelines. Inclusion criteria were: original articles written in English assessing ICG-angiography in breast reconstruction. The individual studies were evaluated according to Cochrane guidelines. RESULTS: The search yielded 243 papers on ICG-A and breast reconstruction. Twenty-six of these were included for analysis. The risk of overall major complications ([OR] = 0.53, 95% confidence interval (CI) = 0.43-0.66, p = 0.00001) and overall loss of reconstruction ([OR] = 0.58, 95% CI = 0.37-0.92, and p = 0.020) was significantly lower when peroperative ICG-A was used. When using ICG-A to evaluate mastectomy flaps, a statistically lower risk of major complications ([OR] = 0.56 and p = 0.0001) and the loss of reconstruction was found ([OR] = 0.46, p = 0.006). ICG-A used in autologous breast reconstruction significantly reduced the risk of minor ([OR] = 0.62 and p = 0.001) and major complications ([OR] = 0.53 and p = 0.0028). CONCLUSIONS: This is the first systematic review to analyze the use of ICG-A on both mastectomy flaps and autologous reconstruction. The results obtained in the current study indicate that the use of ICG-A in breast reconstructive procedures reduces the complications as well as the loss of reconstruction.


Assuntos
Angiografia/métodos , Implantes de Mama , Neoplasias da Mama/cirurgia , Corantes/administração & dosagem , Verde de Indocianina/administração & dosagem , Mamoplastia/métodos , Complicações Pós-Operatórias/prevenção & controle , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos
3.
Biomed Res Int ; 2021: 5564462, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33977105

RESUMO

A 125 cm long catheter makes it possible to perform renal arteriography via radial artery, but its feasibility and safety remain unclear. Our study recruited 1,323 patients grouped by two different vascular accesses to renal arteriography, i.e., femoral artery access and radial artery access. The success rate of angiography was 100% in both groups. Differential analysis showed that the overall complication incidence of radial artery access group was significantly lower (2.5% for radial artery access vs. 4.8% for femoral artery access, p = 0.03). From this study, we suggest that using the 125 cm angiographic catheter to perform renal arteriography via radial artery access is feasible and safe.


Assuntos
Angiografia , Cateteres/efeitos adversos , Rim , Artéria Radial/cirurgia , Artéria Renal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia/efeitos adversos , Angiografia/instrumentação , Angiografia/métodos , Feminino , Artéria Femoral/cirurgia , Humanos , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Eur J Vasc Endovasc Surg ; 62(1): 82-88, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33896727

RESUMO

OBJECTIVE: A well functioning arteriovenous fistula (AVF) is essential for haemodialysis. Despite regular duplex ultrasound (DUS) a significant number of AVFs fail. Tomographic 3D ultrasound (tUS) creates a 3D image of the AVF that can be interpreted by the clinician. DUS, tUS, and fistulograms were compared for the identification and measurement of flow limiting stenosis. METHODS: Patients with AVF dysfunction on routine Transonic surveillance, defined as (1) > 15% reduction in flow on two consecutive occasions, (2) > 30% reduction in flow on one occasion, (3) flow of < 600 mL/sec, (4) presence of recirculation, underwent DUS. AVF tUS imaging was performed prior to fistulography. All fistulograms were reported by the same consultant radiologist and tUS images by the same vascular scientist blinded to the fistulogram results. Maximum diameter reduction in all stenoses were measured using all three imaging techniques. RESULTS: In 97 patients with 101 stenoses, the mean (± standard deviation [SD]) severity of stenosis was 63.0 ± 13.9%, 65.0 ± 11.6%, and 64.8 ± 11.7% for the fistulograms, DUS, and tUS respectively. The mean (± SD) time between ultrasound and fistulography imaging was 15.0 ± 14.5 days. Assuming the fistulogram as the "gold standard", Bland-Altman agreement for DUS was -1.9 ± 15.5% (limit of agreement [LOA] -32.2 - 28.4) compared with -1.7 ± 15.4% (LOA -31.9 - 28.4) for tUS. Median (± interquartile range) time to complete the investigation was 09:00 ± 03:19 minutes for DUS and 03:13 ± 01:56 minutes for tUS (p < .001). CONCLUSION: DUS and tUS were equally accurate at detecting AVF complications but tUS investigation requires less skill and was significantly quicker than DUS.


Assuntos
Angiografia/métodos , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Oclusão de Enxerto Vascular/diagnóstico , Imageamento Tridimensional/métodos , Diálise Renal/efeitos adversos , Velocidade do Fluxo Sanguíneo , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Oclusão de Enxerto Vascular/etiologia , Humanos , Imageamento Tridimensional/estatística & dados numéricos , Fluxo Sanguíneo Regional , Diálise Renal/métodos , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia/métodos , Tomografia/estatística & dados numéricos , Ultrassonografia Doppler Dupla/métodos , Ultrassonografia Doppler Dupla/estatística & dados numéricos , Grau de Desobstrução Vascular
6.
J Cardiovasc Surg (Torino) ; 62(4): 364-368, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33829742

RESUMO

BACKGROUND: Endovascular balloon angioplasty is a common practice to treat femoropopliteal arterial lesions. The precise balloon inflation duration to obtain the best lesion dilatation is unclear. The aim of this study was to assess angiographic images after 3- and 5-minute balloon inflation in femoropopliteal de-novo atherosclerotic lesions. METHODS: We randomly assigned 61 femoropopliteal arterial lesions to undergo balloon angioplasty for 3 and 5 minutes. The primary endpoint was the rate of favorable angiographic images after balloon angioplasty. The correlation between angiographic image and degree of calcification was studied. The secondary endpoint was the need of additional ballooning or stenting of the dilated lesion. RESULTS: Thirty-two (52%) lesions were randomized to a 3-minute inflation time and 29 (48%) lesions to a 5-minute inflation time. Median lesion length was 83±32mm in the 3-minute group and 89±31mm in the 5-minute inflation group (P=0.47). After deflation, vessel recoil was significantly higher in the 3-minute group compared to the 5-minute group (P=0.04), in mild to moderate calcified lesions, 18 (56%) and 9 (31%) cases, respectively. The angiographic result after balloon angioplasty was significantly more favorable (P=0.007) in the 5-minute group with 20 (69%) cases compared to 10 (31%) cases in the 3-minute group. An increase of vessel recoil of 62% has been seen in severe calcified lesions in the 5-minute group. Additional intervention rate was significantly higher (P=0.007) in the 3-minute group compared to the 5-minute group. CONCLUSIONS: A prolonged inflation time of 5 minutes has an overall better angiographic image in the femoropopliteal segment and especially in non- or mildly calcified lesions.


Assuntos
Angiografia/métodos , Angioplastia com Balão/métodos , Arteriopatias Oclusivas/cirurgia , Artéria Femoral/cirurgia , Artéria Poplítea/cirurgia , Idoso , Arteriopatias Oclusivas/diagnóstico , Feminino , Artéria Femoral/diagnóstico por imagem , Seguimentos , Humanos , Masculino , Artéria Poplítea/diagnóstico por imagem , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Dispositivos de Acesso Vascular
7.
J Cardiovasc Surg (Torino) ; 62(4): 369-376, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33829745

RESUMO

BACKGROUND: The aim of this study was to retrospectively analyze early and late outcomes of infrainguinal revascularization performed with the Omniflow-II® (LeMaitre Vascular, Inc., Burlington, MA, USA) biosynthetic vascular graft (BVG) for complex femoro-popliteal obstructive disease. METHODS: Over a 10-year period, this BVG was used in 110 patients who underwent infrainguinal femoro-popliteal or femoro-distal bypass. Early (intraoperative and <30 days) results were analyzed in terms of death, thrombosis, amputations and reinterventions. Follow-up results were analyzed in terms of primary and secondary graft patency, and amputation-free survival. RESULTS: We performed 87 (79.1%) above-the-knee bypass, 20 (18.2%) below-the-knee bypass, and 3 (2.7%) tibial artery bypass. In-hospital mortality was not observed. Mean follow-up was 66±37 months (range, 3-150). Estimated primary patency rate at 1, 2 and 5-years of follow-up was 77%±4 (95%CI: 68-84), 73%±5 (95%CI: 63.5-83), and 59%±6 (95%CI: 47-70.5) respectively. Predictors of primary patency loss were the presence of critical limb ischemia (P=0.048; HR: 2.1; 95%CI: 1.01-4.28), and the necessity of below-the-knee bypass (P=0.012; HR: 2.4; 95%CI: 1.22-4.75). Aneurysmal degeneration of the BVG was detected in 4 (3.6%) patients, an infected BVG occurred in 3 (2.7%) patients. The amputation-free survival was 96%±2 (95%CI: 91-99), 93%±3 (95%CI: 86-96), and 76%±5 (95%CI: 66-84) at 1, 2 and 5-years respectively. CONCLUSIONS: In our experience, Omniflow-II® is a valid first-line alternative for infrainguinal revascularization when the ipsilateral autologous saphenous vein is not available. Aneurysmal degeneration was lower than previously reported with alternative BVGs, and the incidence of BVG infection was acceptably low.


Assuntos
Angiografia/métodos , Bioprótese , Implante de Prótese Vascular/métodos , Prótese Vascular , Artéria Femoral/cirurgia , Artéria Poplítea/cirurgia , Veia Safena/transplante , Idoso , Idoso de 80 Anos ou mais , Feminino , Artéria Femoral/diagnóstico por imagem , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/diagnóstico por imagem , Desenho de Prótese , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia Doppler Dupla/métodos
8.
Phys Med Biol ; 66(6): 065020, 2021 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-33709957

RESUMO

Conventional detector-dose driven exposure controls (DEC) do not consider the contrasting material of interest in angiography. Considering the latter when choosing the acquisition parameters should allow for optimization of x-ray quality and consecutively lead to a substantial reduction of radiation exposure. Therefore, the impact of a material-specific, contrast-to-noise ratio (CNR) driven exposure control (CEC) compared to DEC on radiation exposure was investigated. A 3D-printed phantom containing iron, tantalum, and platinum foils and cavities, filled with iodine, barium, and gas (carbon dioxide), was developed to measure the CNR. This phantom was placed within a stack of polymethylmethacrylate and aluminum plates simulating a patient equivalent thickness (PET) of 2.5-40 cm. Fluoroscopy and digital radiography (DR) were conducted applying either CEC or three, regular DEC protocols with parameter settings used in abdominal interventions. CEC protocols where chosen to achieve material-specific CNR values similar to those of DEC. Incident air kerma at the reference point(Ka,r), using either CEC or DEC, was assessed and possible Ka,r reduction for similar CNR was estimated. We show that CEC provided similar CNR as DEC at the same or lower Ka,r. When imaging barium, iron, and iodine Ka,r was substantially reduced below a PET of 20 cm and between 25 cm and 30 cm for fluoroscopy and Dr When imaging platinum and tantalum using fluoroscopy and DR and gas using DR, the Ka,r reduction was substantially higher. We estimate the Ka,r reduction for these materials between 15% and 84% for fluoroscopy and DR between 15% and 93% depending on the PET. The results of this study demonstrate a high potential for skin dose reduction in abdominal radiology when using a material-specific CEC compared to DEC. This effect is substantial in imaging materials with higher energy K-edges, which is beneficial, for example, in long-lasting embolization procedures with tantalum-based embolization material in young patients with arterio-venous malformations.


Assuntos
Angiografia/métodos , Meios de Contraste , Imagens de Fantasmas , Intensificação de Imagem Radiográfica/métodos , Bário , Fluoroscopia/métodos , Humanos , Imageamento Tridimensional/métodos , Iodo , Ferro , Tomografia por Emissão de Pósitrons , Doses de Radiação , Exposição à Radiação , Radiografia , Pele/efeitos da radiação , Raios X
9.
J Comput Assist Tomogr ; 45(3): 359-366, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33661153

RESUMO

OBJECTIVES: This study aimed to compare the accuracy of assessing the arterial hypervascularity of hepatocellular carcinoma (HCC) on dynamic computed tomography (CT) scans and gadoxetic acid (EOB)-enhanced magnetic resonance imaging (MRI) scans performed with radial sampling. METHODS: We studied the images of 40 patients with hypervascular HCC. A radiologist recorded the standard deviation of the attenuation (or the signal intensity [SI]) in subcutaneous fat tissue as the image noise (N) and calculated the contrast-to-noise ratio (CNR) as follows: (CNR) = (n-ROIT - n-ROIL)/N, where n-ROIT is the mean attenuation (or SI) of the tumor divided by the mean attenuation (or SI) of the aorta and n-ROIL is the mean attenuation (or SI) of the liver parenchyma divided by the mean attenuation (or SI) of the aorta. RESULTS: The CNR was significantly higher on EOB-enhanced MRI than on dynamic CT scans. CONCLUSIONS: For the assessment of HCC vascularity, EOB-enhanced MRI scans acquired with radial sampling were more accurate than dynamic CT images.


Assuntos
Angiografia/métodos , Carcinoma Hepatocelular/irrigação sanguínea , Gadolínio DTPA/administração & dosagem , Artéria Hepática/diagnóstico por imagem , Neoplasias Hepáticas/irrigação sanguínea , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/diagnóstico por imagem , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Razão Sinal-Ruído , Tomografia Computadorizada por Raios X
10.
J Cardiothorac Surg ; 16(1): 60, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33781306

RESUMO

BACKGROUND: Anatomic variation may increase the difficulty and risk of anatomic segmentectomy. The preoperative three-dimensional computed tomography bronchography and angiography (3D-CTBA) can provide a detailed model of the segmental structure, and contribute to precise and safe segmentectomy. CASE PRESENTATION: This is a case of anomalous bronchi and pulmonary vessels in the right upper posterior segment (RS2). Under the guidance of 3D-CTBA, anatomic RS2 segmentectomy was performed accurately and safely. The postoperative condition was uneventful. CONCLUSIONS: This rare case highlights the importance of 3D-CTBA to guild accurate segmentectomy with anatomic variation.


Assuntos
Brônquios/irrigação sanguínea , Pulmão/irrigação sanguínea , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Malformações Vasculares/cirurgia , Adulto , Angiografia/métodos , Feminino , Humanos , Período Pós-Operatório , Tomografia Computadorizada por Raios X/métodos , Malformações Vasculares/diagnóstico
11.
Curr Opin Ophthalmol ; 32(3): 275-279, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33653980

RESUMO

PURPOSE OF REVIEW: The aim of this study was to provide a comprehensive summary of in-vivo imaging techniques of the aqueous outflow system and discuss its role in improving our understanding of glaucoma pathogenesis and management. RECENT FINDINGS: Our understanding of the aqueous outflow system is largely derived from ex-vivo studies. Recent innovations in imaging technology and techniques enable in-vivo evaluation of the conventional outflow system in real-time. Optical coherence tomography allows for noninvasive, high-resolution, volumetric imaging of ocular tissues. Dynamic structural changes have been observed at the trabecular meshwork and Schlemm's canal. In parallel, aqueous angiography using injected tracers show a similar dynamism with variable and pulsatile flow signals. SUMMARY: In-vivo imaging enable real-time evaluation of the conventional aqueous outflow pathway. This emerging field shows great promise to expand our understanding of the pathogenesis and treatment of glaucoma.


Assuntos
Humor Aquoso/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Limbo da Córnea/diagnóstico por imagem , Malha Trabecular/diagnóstico por imagem , Angiografia/métodos , Glaucoma/diagnóstico por imagem , Humanos , Tomografia de Coerência Óptica/métodos
12.
Medicine (Baltimore) ; 100(11): e23855, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33725926

RESUMO

ABSTRACT: The application of transcatheter angiographic embolization (TAE) is controversial in the treatment of ulcer bleeding. This study aims to determine rebleeding risk factors and evaluate the efficacy of prophylactic TAE (p-TAE) following endoscopic hemostasis in rebleeding prevention of Forrest lla ulcers.The medical records of Forrest lla ulcer patients who underwent endoscopic hemostasis (E group) and endoscopic hemostasis plus p-TAE (E + p-TAE group) in West China Hospital from May 2009 to May 2018 were retrospectively reviewed. Baseline characteristics, clinical efficacy, and rebleeding risk factors were analyzed.As a result, a total of 102 patients were included, with 75 and 27 patients in E and E + p-TAE group, respectively. Most of the baseline data in E and E + p-TAE group were similar except for the proportion of protruded non-bleeding visible vessel (NBVV) (E group vs E + p-TAE group, 50.7% vs 74.1%, P = .035). The rebleeding rate of E + p-TAE group (3.7%) was significantly lower than E group (24.0%) (P = .02). The protruded NBVV (OR: 6.896, 95% confidence interval [CI]: 1.532-30.642, P = .01) and employment of p-TAE (OR: 0.038, 95% CI: 0.003-0.448, P = .009) were identified as independent risk factors for Forrest IIa ulcer rebleeding. Additionally, log-rank test indicated the rebleeding occurrence was greatly reduced by p-TAE in patients with protruded NBVVs (P = .006).In conclusion, the protruded NBVV and employment of p-TAE were the independent risk factors tightly associated with rebleeding of Forrest IIa ulcer. P-TAE following endoscopic hemostasis could effectively prevent Forrest IIa ulcer from rebleeding.


Assuntos
Embolização Terapêutica/métodos , Hemostase Endoscópica/métodos , Úlcera Péptica Hemorrágica/terapia , Prevenção Secundária/métodos , Adulto , Idoso , Angiografia/métodos , Cateterismo/métodos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
15.
PLoS One ; 16(2): e0246469, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33571215

RESUMO

PURPOSE: OCT-angiography (OCT-A) offers a non-invasive method to visualize retinochoroidal microvasculature. As glaucoma disease affects retinal ganglion cells in the macula, macular microcirculation is of interest. The purpose of the study was to investigate regional macular vascular characteristics in patients with ocular hypertension (OHT), pre-perimetric primary open-angle glaucoma (pre-POAG) and controls by OCT-A in three microvascular layers. MATERIAL AND METHODS: 180 subjects were recruited from the Erlangen Glaucoma Registry, the Department of Ophthalmology, University of Erlangen and residents: 38 OHT, 20 pre-POAG, 122 controls. All subjects received an ophthalmological examination including measurements of retinal nerve fibre layer (RNFL), retinal ganglion cell layer (RGC), inner nuclear layer (INL), and Bruch's Membrane Opening-Minimum Rim Width (BMO-MRW). Macular vascular characteristics (vessel density, VD, foveal avascular zone, FAZ) were measured by OCT-A (Spectralis OCT II) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). RESULTS: With age correction of VD data, type 3 tests on fixed effects showed a significant interaction between diagnosis and sectorial VD in SVP (p = 0.0004), ICP (p = 0.0073), and DCP (p = 0.0003). Moreover, a significance in sectorial VD was observed within each layer (p<0.0001) and for the covariate age (p<0.0001). FAZ differed significantly between patients' groups only in ICP (p = 0.03), not in SVP and DCP. For VD the AUC values of SVP, ICP, and DCP were highest among diagnostic modalities (AUC: 0.88, 95%-CI: 0.75-1.0, p<0.001). CONCLUSION: Regional reduced macula VD was observed in all three retinal vascular layers of eyes with OHT and pre-POAG compared to controls, indicating localized microvascular changes as early marker in glaucoma pathogenesis.


Assuntos
Angiografia/métodos , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Macula Lutea/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Idoso de 80 Anos ou mais , Angiografia/normas , Feminino , Humanos , Macula Lutea/irrigação sanguínea , Macula Lutea/inervação , Masculino , Pessoa de Meia-Idade , Nervo Óptico/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/normas
16.
PLoS One ; 16(2): e0247399, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630902

RESUMO

The aim of the study is to evaluate the progression of visual field (VF) defects over 16 years of observation and to assess abnormalities in vessels and retinal nerve fibre layer (RNFL) thickness in patients with optic disc drusen (ODD). Both static automated perimetry (SAP) and semi-automated kinetic perimetry (SKP) were performed in 16 eyes of 8 patients (mean age 54 years) with ODD among 26 eyes of 13 patients examined 16 years before. The area of I2e, I4e, III4e, and V4e isopters was measured in deg2. The MD and PSD parameters were estimated using SAP. Optical coherence tomography angiography (OCT-A) was additionally performed in 16 ODD eyes and 16 eyes of 8 healthy subjects to estimate the RNFL thickness and vessel density of the optic nerve disc and the macula. The differences in all isopter areas of SKP and SAP parameters after 16 years were not significant. The analysis of OCT-A showed a significant reduction of the vessel density and RNFL of the peripapillary area in each segment in patients with ODD, compared with the control group. The highest reduction of RNFL was observed in the superior segment of the optic disc area (92.56µm vs 126.63µm) also the macular thickness was decreased in ODD patients, compared with the control group. In the macula, there was a significant vascular defect in the whole superficial layer and in the parafoveal deep layer. A strong significant correlation of the parafoveal deep plexus with MD and PSD parameters was detected. In conclusion, VF loss due to ODD after 16 years of the follow-up was not significant both in SKP and SAP. ODD caused a reduced vessel density and RNFL, as well as macular thickness in OCT-A. SAP parameters were influenced by parafoveal deep plexus.


Assuntos
Macula Lutea/fisiopatologia , Drusas do Disco Óptico/fisiopatologia , Disco Óptico/fisiopatologia , Transtornos da Visão/fisiopatologia , Adulto , Idoso , Angiografia/métodos , Estudos de Casos e Controles , Feminino , Humanos , Macula Lutea/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/fisiologia , Disco Óptico/irrigação sanguínea , Estudos Prospectivos , Células Ganglionares da Retina/fisiologia , Vasos Retinianos/fisiopatologia , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Adulto Jovem
17.
Pediatr Cardiol ; 42(4): 926-933, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33590323

RESUMO

The aim of the study is to evaluate the impact of multimodality imaging technology during percutaneous pulmonary valve implantation (PPVI). Among percutaneous procedures, PPVI traditionally has one of the highest patient radiation exposures. Different protocol modifications have been implemented to address this problem (i.e., improvements in guidance systems, delivery systems, valve design, post-implantation evaluation). Although the effectiveness of individual modifications has been proven, the effect of an approach which combines these changes has not been reported. We performed a retrospective chart review of 76 patients who underwent PPVI between January 2018 and December 2019. Patients were classified in "Traditional protocol," using routine biplane angiography and/or 3D rotational angiography (3DRA); and "Multimodality protocol" that included the use of VesselNavigator for guidance, selective 3DRA for coronary evaluation, Long DrySeal Sheath for valve delivery, and Intracardiac Echocardiography for valve evaluation after implantation. Radiation metrics, procedural time, and clinical outcomes were compared between groups. When the traditional protocol group was compared with the multimodality protocol group, a significant reduction was described for total fluoroscopy time (31.6 min vs. 26.2 min), dose of contrast per kilogram (1.8 mL/Kg vs. 0.9 mL/Kg), DAP/kg (26.6 µGy·m2/kg vs. 19.9 µGy·m2/kg), and Air Kerma (194 mGy vs. 99.9 mGy). A reduction for procedure time was noted (140 min vs. 116.5 min), but this was not statistically significant. There was no difference in clinical outcomes or the presence of complications between groups. The combination of novel technology in PPVI caused a significant reduction in radiation metrics without increasing the complication rate in our population.


Assuntos
Cardiopatias Congênitas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Valva Pulmonar/cirurgia , Exposição à Radiação/prevenção & controle , Adolescente , Angiografia/métodos , Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia/métodos , Feminino , Fluoroscopia/métodos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Imagem Multimodal/efeitos adversos , Imagem Multimodal/métodos , Insuficiência da Valva Pulmonar/cirurgia , Exposição à Radiação/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
18.
Medicine (Baltimore) ; 100(4): e23635, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530166

RESUMO

BACKGROUND: As a novel ultrasound technique, superb microvascular imaging (SMI) can quickly, simply, and noninvasively study the microvascular distribution in the tumor and evaluate the microvascular perfusion. Studies suggested that SMI is helpful for the differentiation between benign and malignant parotid tumors. However, the results of these studies have been contradictory. Therefore, the present meta-analysis aimed at determining the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to September 30, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis. RESULTS: This systematic review will determine the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. CONCLUSION: Its findings will provide helpful evidence for the accuracy of SMI in the differential diagnosis between benign and malignant parotid tumors. SYSTEMATIC REVIEW REGISTRATION: INPLASY2020100093.


Assuntos
Angiografia/estatística & dados numéricos , Microvasos/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico por imagem , Ultrassonografia/estatística & dados numéricos , Angiografia/métodos , Diagnóstico Diferencial , Humanos , Metanálise como Assunto , Reprodutibilidade dos Testes , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Ultrassonografia/métodos
19.
BMC Surg ; 21(1): 71, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33530973

RESUMO

BACKGROUND: Hemobilia due to rupture of hepatic artery pseudoaneurysm and recurrent hemorrhage caused by hepatic artery collateral circulation are both rare complications after liver trauma. There have been a number of separate reports of both complications, but no cases have been reported in which the two events occurred in the same patient. Here we report a recurrent hemorrhage in the bile duct due to hepatic artery pseudoaneurysm secondary to collateral circulation formation after hepatic artery ligation in a patient with liver trauma. CASE PRESENTATION: A 52-year-old male patient was admitted to our hospital for liver trauma (Grade IV according to the American Association for the Surgery of Trauma (AAST) grading system) with active bleeding after a traffic accident. Hepatic artery ligation was performed for hemostasis. Three months after the surgery, the patient was readmitted for melena and subsequent hematemesis. Selective angiography examination revealed the formation of collateral circulation between the superior mesenteric artery and right hepatic artery. Moreover, a ruptured hepatic artery pseudoaneurysm was observed and transcatheter arterial embolization (TAE) was performed for hemostasis at the same time. After the treatment, the patient recovered very well and had an uneventful prognosis until the last follow-up. CONCLUSION: For patients with hepatic trauma, the selection of the site of hepatic artery ligation and the diagnosis and treatment methods of postoperative biliary hemorrhage are crucial for the prognosis of the disease.


Assuntos
Falso Aneurisma , Aneurisma Roto , Hemobilia , Artéria Hepática , Ligadura/efeitos adversos , Fígado , Traumatismos Abdominais/complicações , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Aneurisma Roto/etiologia , Aneurisma Roto/terapia , Angiografia/métodos , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/lesões , Circulação Colateral , Embolização Terapêutica , Hematemese/etiologia , Hematemese/terapia , Hemobilia/etiologia , Hemobilia/terapia , Artéria Hepática/diagnóstico por imagem , Artéria Hepática/lesões , Artéria Hepática/cirurgia , Humanos , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Fígado/lesões , Masculino , Melena/etiologia , Melena/terapia , Pessoa de Meia-Idade , Recidiva , Circulação Esplâncnica
20.
Am J Otolaryngol ; 42(2): 102751, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33485567

RESUMO

OBJECTIVE: Preoperative planning, design, and perioperative monitoring of microsurgical free flaps is of paramount importance to successful reconstruction. Infrared Thermography provides an indirect method by which vascular perfusion may be monitored and has previously shown efficacy in detection of cutaneous perforators. In a proof-of-concept study, we assessed the utility of infrared thermography in delineating angiosomes and monitoring for adequate tissue perfusion in the preoperative, intraoperative, and postoperative setting. This technology was compared to conventional indocyanine green fluorescence angiography (ICG-FA). METHOD: Four patients undergoing locoregional pedicled or free flap reconstruction were assessed using ICG-FA and Forward-looking infrared (FLIR) thermography in standardized conditions. Monitoring of flap angiosomes and tissue perfusion using both fluorescent pixel intensity and thermography was then performed implementing proprietary software. CONCLUSION: Our study is unique in that tissue perfusion intraoperatively was assessed with both thermography and indocyanine green fluorescence angiography (ICG-FA), which represents a previously established system. We demonstrate that smartphone compatible thermal cameras may be used as an adjunct to clinical exam, as well as other monitoring technologies, providing further information in not only selection of perforators, in the operative setting, but also in the early detection of poor flap viability secondary to microvascular compromise allowing for timely salvage.


Assuntos
Angiografia/métodos , Retalhos de Tecido Biológico/irrigação sanguínea , Hemodinâmica , Verde de Indocianina , Raios Infravermelhos , Lasers , Microcirurgia/métodos , Monitorização Fisiológica/métodos , Imagem Óptica/métodos , Perfusão , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Termografia/métodos , Gravação em Vídeo/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Perioperatório
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