Establishment of recurrent exposures reference levels for repeated computed tomography examinations in adult patients on a nationwide level in Slovakia.

Introduction: The study aims were: (1) to assess the incidence in 1 year, the cumulative incidences and the period prevalence in 3/5 years of the condition of patients accruing cumulative effective dose (CED) ≥ 100 mSv in health care centres providing CT examinations in Slovakia; and (2) to quantify their variability among different centres, to test the feasibility of establishing recurrent exposure reference levels (RERL) on a nationwide level.

Materials And Methods: The data were tracked during five consecutive years using the CT dose index and dose-length-product along with the patient's ID. ED was calculated using conversion factors.

Predictors of Outcome after Direct Aspiration of Basilar Artery Occlusion.

: Basilar artery occlusion (BAO) is a serious disease with a poor prognosis if left untreated. Endovascular therapy (EVT) is the most effective treatment that is able to reduce mortality and disability. Treatment results are influenced by a wide range of factors that have not been clearly identified.

Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial.

Background: Recent evidence suggests a beneficial effect of endovascular thrombectomy in acute ischaemic stroke with large infarct; however, previous trials have relied on multimodal brain imaging, whereas non-contrast CT is mostly used in clinical practice.

Methods: In a prospective multicentre, open-label, randomised trial, patients with acute ischaemic stroke due to large vessel occlusion in the anterior circulation and a large established infarct indicated by an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) of 3-5 were randomly assigned using a central, web-based system (using a 1:1 ratio) to receive either endovascular thrombectomy with medical treatment or medical treatment (ie, standard of care) alone up to 12 h from stroke onset. The study was conducted in 40 hospitals in Europe and one site in Canada.

Effects of low-dose ionizing radiation on genomic instability in interventional radiology workers.

Interventional radiologists are chronically exposed to low-dose ionizing radiation (IR), which may represent a health risk. The aim of the present study was to evaluate genomic instability by analyzing chromosomal aberrations, micronuclei, and 53BP1 DNA repair foci in peripheral blood lymphocytes of radiologists. Based on the IAEA guidelines on biodosimetry using dicentrics, the average protracted whole-body dose in radiologists were estimated.

Radiation dose and image quality of CT coronary angiography in patients with high heart rate or irregular heart rhythm using a 16-cm wide detector CT scanner.

Aim of the study was to evaluate the effect of high and irregular heart rate on the image quality and on the radiation exposure using a 256-row, 16-cm wide detector computed tomography (CT) system. Between March and December 2019, 349 patients undergoing CT coronary angiography (CTCA) were prospectively enrolled. Patients were divided into 2 study groups; Group 1 included patients with a regular heart rate of ≤70 bpm, while Group 2 included patients with an irregular heart rhythm or heart rate of >70 bpm.

DIAGNOSTIC REFERENCE LEVELS IN SCREENING MAMMOGRAPHY CENTERS IN SLOVAKIA.

Optimization in mammography remains the most important tool in practice. In the optimization process, we look for a balanced relationship between image quality and patient dose. For mammographic examinations, the diagnostic reference levels (DRLs) are expressed as the average glandular dose (AGD) based on the thickness of the compressed breast.

Dialysis vascular access restoration by a transcollateral approach using the Surfacer® Inside-Out® Access Catheter System.

Chronic thoracic venous occlusion (CTVO) as a result of repeated or prolonged central venous catheter insertion represents a significant problem in catheter-dependent patients. Different endovascular techniques techniques have been utilised for CTVO recanalization. The Surfacer® Inside-out® system represents a new approach to restore right-sided central venous access in CTVO by the inside-out recanalization technique.

Response of minimal operon to UVC and auto-aggregation: pilot study.

Aim: The study of minimal operon as a determinant of tellurium resistance (Te) is important for the purpose of confirming the relationship of these genes to the pathogenicity of microorganisms. The operon is widespread among bacterial species and pathogens, implicated also in phage inhibition, oxidative stress and colicin resistance. So far, there is no experimental evidence for the role of the minimal operon in ultraviolet C (UVC) resistance, biofilm formation and auto-aggregation.

Aspiration Thrombectomy in Patients with Large Vessel Occlusion and Mild Stroke: A Single-Center Experience.

BACKGROUND The purpose of this study was to evaluate outcomes of patients with mild stroke, defined by National Institutes of Health Stroke Scale (NIHSS) score <6, caused by large vessel occlusion treated with aspiration thrombectomy. MATERIAL AND METHODS Data from the endovascular stroke registry of our center were retrospectively analyzed. Anterior or posterior circulation strokes with NIHSS score <6 upon admission were analyzed.

Aspiration thrombectomy as the first-line treatment of M2 occlusions.

Purpose: The aim of the present study was (i) to evaluate the safety and efficacy of aspiration thrombectomy in patients with M2 occlusions and (ii) to compare outcome of treatment of occlusion of different M2 segments.

Materials And Methods: Between March 2016 and June 2019, 82 patients with acute ischemic stroke and isolated M2 occlusions were treated in cerebrovascular stroke center with aspiration thrombectomy as the first-line treatment. Functional outcomes of patients with different types of M2 occlusions were statistically compared.

Endovascular treatment of acute ischemic stroke in patients with recurrent intracranial large vessel occlusion.

Background: Data on the treatment with recurrent mechanical thrombectomy of patients with acute ischemic stroke with recurrent large vessel occlusion are limited. We report our experience with recurrent mechanical thrombectomy for recurrent large vessel occlusion.

Methods: During the period between May 2013 and August 2018, data on patients with recurrent large vessel occlusion were collected.

CT protocols and radiation doses for hematuria and urinary stones: Comparing practices in 20 countries.

Purpose: Patients with hematuria and renal colic often undergo CT scanning. The purpose of our study was to assess variations in CT protocols and radiation doses for evaluation of hematuria and urinary stones in 20 countries.

Method: The International Atomic Energy Agency (IAEA) surveyed practices in 51 hospitals from 20 countries in the European region according to the IAEA Technical cooperation classification and obtained following information for three CT protocols (urography, urinary stones, and routine abdomen-pelvis CT) for 1276 patients: patient information (weight, clinical indication), scanner information (scan vendor, scanner name, number of detector rows), scan parameters (such as number of phases, scan start and end locations, mA, kV), and radiation dose descriptors (CTDI, DLP).

Neurointerventionalist and Patient Radiation Doses in Endovascular Treatment of Acute Ischemic Stroke.

Purpose: To evaluate the patient and the neurointerventionalist radiation dose levels during endovascular treatment of acute ischemic stroke, and to analyze factors affecting doses.

Materials And Methods: From October 2017 to January 2019, we prospectively collected patient radiation data and neurointerventionalist data from real-time dosimetry from all consecutive thrombectomies. Multivariate analysis was performed to analyze patient total dose area product (DAP) and neurointerventionalist dose variability in terms of clinical characteristics and the technical parameters of thrombectomies.

RISK EVALUATION IN THE LOW-DOSE RANGE CT FOR RADIATION-EXPOSED CHILDREN, BASED ON DNA DAMAGE.

One of the most common usages of radiation in current medical diagnosis is computed tomography (CT) using X-rays. The potential health risk of CT scans has been discussed in various studies to determine whether low-dose radiation from CT could enhance the chromosome aberration yields in pediatric patients and increase their risk of carcinogenesis. For this reason, it is of great interest to study the effects of low-dose radiation.

Characteristics of responders to autologous bone marrow cell therapy for no-option critical limb ischemia.

Background: The present study investigated factors associated with therapeutic benefits after autologous bone marrow cell (BMC) therapy in patients with "no-option" critical limb ischemia (CLI).

Methods And Results: Sixty-two patients with advanced CLI (Rutherford category 5 or 6) not eligible for revascularization were randomized to treatment with 40 ml of autologous BMCs (SmartPreP2) by local intramuscular (n = 32) or intra-arterial (n = 30) application. The primary endpoint was limb salvage and wound healing at 12 months.

[Retrospective analysis of short-term and mid-term results of percutaneous endovascular repair in patients with abdominal aortic aneurysm].

Introduction: Endovascular abdominal aortic aneurysm repair (EVAR) is a modern and, compared to conventional open surgery, less invasive therapeutic strategy with short-term lower morbidity and mortality. The aim of our retrospective analysis was the assessment of safety, technical success, short-term and mid-term results of elective patients scheduled for total percutaneous EVAR implantation (PEVAR).

Material And Methods: One hundred and sixteen consecutive patients (M:F 104:12, age 71±9 years, maximum AAA diameter 60±14mm) underwent elective PEVAR between January 2009 and August 2012.

Pharmacomechanical thrombectomy for treatment of acute transplant renal artery thrombosis.

Acute transplant renal artery thrombosis is a rare complication in kidney transplantation that often leads to renal allograft loss. We present the first case of acute renal artery thrombosis 3 months after kidney transplantation, treated with pharmacomechanical thrombectomy with adjunctive catheter-directed thrombolysis and stent placement. The graft was salvaged with restoration of renal function and renal artery patency at the 3-year follow-up point.

Characterization of mesenchymal stem cells of "no-options" patients with critical limb ischemia treated by autologous bone marrow mononuclear cells.

Background: Application of autologous bone marrow mononuclear cells to "no option" patients with advanced critical limb ischemia (CLI) prevented major limb amputation in 73% patients during the 6-month follow-up. We examined which properties of bone marrow stromal cells also known as bone-marrow derived mesenchymal stem cells of responding and non-responding patients are important for amputation-free survival.

Methods And Findings: Mesenchymal stem cells of 41 patients with CLI unsuitable for revascularisation were isolated from mononuclear bone marrow concentrate used for their treatment.

Endovascular treatment of internal carotid and vertebral artery aneurysms using a novel pericardium covered stent.

Intracranial aneurysm is a fairly common (often asymptomatic) condition. Subarachnoid hemorrhage associated with aneurysmal rupture is a potentially lethal event with a mortality rate as high as 50 percent and a high rate of disability among those who survive the initial hemorrhage, such that recently published guidelines support treatment of intracerebral aneurysms. The current treatment options include surgical clipping and endovascular treatment, but these are not without significant problems.

Intra-arterial autologous bone marrow cell transplantation in a patient with upper-extremity critical limb ischemia.

Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

No difference in intra-arterial and intramuscular delivery of autologous bone marrow cells in patients with advanced critical limb ischemia.

Stem cell therapy has been proposed to be an alternative therapy in patients with critical limb ischemia (CLI), not eligible for endovascular or surgical revascularization. We compared the therapeutic effects of intramuscular (IM) and intra-arterial (IA) delivery of bone marrow cells (BMCs) and investigated the factors associated with therapeutic benefits. Forty-one patients (mean age, 66 ± 10 years; 35 males) with advanced CLI (Rutherford category, 5 and 6) not eligible for revascularization were randomized to treatment with 40 ml BMCs using local IM (n = 21) or selective IA infusion (n = 20).

Endovascular treatment of a giant aorto-ostial renal artery pseudoaneurysm.

Vascular complications after lumbar laminectomy are rare, but are potentially life-threatening. A 59-year-old man presented with progressive and worsening abdominal pain over several weeks. Multidetector computed tomography angiography revealed a large aorto-ostial left renal artery pseudoaneurysm 3 years after lumbar laminectomy.

[Successfully combined management of the abberant retroesophageal arteria subcalvia dextra aneurysm (arteria lusoria)].

Introduction: Aberrant right subclavian artery arising from the distal part of the aortic arch and passing behind the oesophagus (arteria lusoria) is a rare congenital vascular anomaly, it is the 4th most common aortic arch anomaly. At the site of the orifice there is the Kommerell's diverticulum, which is the locus minoris resistentiae with the possible arise of the aortic aneurysm. Aneurysmatic dilatation of the anomalous artery and of the aorta may be the cause of distal embolism or rupture.