Correlation of muscle BOLD MRI with transcutaneous oxygen pressure for assessing microcirculation in patients with systemic sclerosis.

Purpose: To prospectively compare calf muscle BOLD MRI with transcutaneous oxygen pressure (TcPO2 ) measurement in patients with systemic sclerosis (SSc) and healthy volunteers and thereby get insight into the pathogenesis of vasculopathy in this connective tissue disorder.

Materials And Methods: Twelve patients with SSc (6 women and 6 men, mean age 53.5 ± 10.

Assessment of cutaneous microcirculation in unaffected skin regions by transcutaneous oxygen saturation monitoring and Laser Doppler flowmetry in systemic sclerosis.

We assessed the cutaneous microcirculatory reactivity of a clinically unaffected skin region in patients with systemic sclerosis (SSc) compared to healthy controls by measuring transcutaneous oxygen saturation (TcPO2) and Laser Doppler flowmetry (LDF).Twelve consecutive patients with SSc and twelve healthy controls were subjected to TcPO2 monitoring and LDF during cuff-induced ischemia and reactive hyperemia in order to measure the skin oxygen tension and the microcirculatory blood flow. Mean minimal and maximal values of oxygen tension and blood flow, time to peak (TTP), and declining slopes after peaking (slope) were compared between patients with SSc and controls.

Effect of aspirin versus clopidogrel on walking exercise performance in intermittent claudication-a double-blind randomized multicenter trial.

Background: This study sought to determine possible effects of different antiplatelet therapies on walking exercise performance in intermittent claudication. Aspirin, in contrast to clopidogrel, interferes with processes that increase collateral conductance in an ischemic animal model.

Methods And Results: Patients with stable intermittent claudication were recruited from 21 centers in Switzerland and Germany and randomized to either aspirin or clopidogrel treatment.

Central venous pressure and impaired renal function in patients with acute heart failure.

Aims: To determine the relationship between central venous pressure (CVP) and renal function in patients with acute heart failure (AHF) presenting to the emergency department.

Methods And Results: Central venous pressure was determined non-invasively using compression sonography in 140 patients with AHF at presentation. Worsening renal function (WRF) was defined as an increase in serum creatinine ≥ 0.

Correlation of carotid artery atherosclerotic lesion echogenicity and severity at standard US with intraplaque neovascularization detected at contrast-enhanced US.

Purpose: To correlate echogenicity and severity of atherosclerotic carotid artery lesions at standard ultrasonography (US) with the degree of intraplaque neovascularization at contrast material-enhanced (CE) US.

Materials And Methods: This HIPAA-compliant study was approved by the local ethics committee, and all patients provided informed consent. A total of 175 patients (113 [65%] men, 62 [35%] women; mean age, 67 years ± 10 [standard deviation]) underwent standard and CE US of the carotid artery.

Vascular involvement in patients with giant cell arteritis determined by duplex sonography of 2x11 arterial regions.

Objective: To define the specificity and extent of duplex sonography (DS) findings suggestive of vessel wall inflammation in patients with giant cell arteritis (GCA).

Methods: Patients admitted between December 2006 and April 2009 to the University Hospital Basel with a suspicion of GCA were eligible for the study. DS of 2x11 arterial regions was performed in all study participants, and American College of Rheumatology criteria were applied to classify patients into GCA or non-GCA groups.

Central venous pressure at emergency room presentation predicts cardiac rehospitalization in patients with decompensated heart failure.

Aims: To investigate the relationship between central venous pressure (CVP) at presentation to the emergency room (ER) and the risk of cardiac rehospitalization and mortality in patients with decompensated heart failure (DHF).

Methods And Results: Central venous pressure was determined non-invasively using high-resolution compression sonography at presentation in 100 patients with DHF. Cardiac hospitalizations and cardiac and all-cause mortality were assessed as a function of continuous CVP levels and predefined CVP categories (low <6 cm H(2)O, intermediate 6-23 cm H(2)O, and high >23 cm H(2)O).

Vasa vasorum and plaque neovascularization on contrast-enhanced carotid ultrasound imaging correlates with cardiovascular disease and past cardiovascular events.

Background And Purpose: Histological data associate proliferation of adventitial vasa vasorum and intraplaque neovascularization with vulnerable plaques represented by symptomatic vascular disease. In this observational study, the presence of carotid intraplaque neovascularization and adventitial vasa vasorum were correlated with the presence and occurrence of cardiovascular disease (CVD) and events (CVE).

Methods: The contrast-enhanced carotid ultrasound examinations of 147 subjects (mean age 64+/-11 years, 61% male) were analyzed for the presence of intraluminal plaque, plaque neovascularization (Grade 1=absent; Grade 2=present), and degree of adventitial vasa vasorum (Grade 1=absent, Grade 2=present).

Non-invasive central venous pressure measurement by compression ultrasound--a step into real life.

Aim Of The Study: Information on central venous pressure (CVP) is helpful in clinical situations like cardiac failure and sepsis. Compression ultrasound (CU) of a forearm vein has been shown to be a reliable method for CVP measurement when assessed by experienced personal under study conditions. To test the hypothesis, that CU can be reliably used for CVP measurement after a training program and using a portable ultrasound system, we investigated feasibility and accuracy of CU, comparing the results of vascular experts vs.

Rapid adaptation of the intrarenal resistance index after living donor kidney transplantation.

Background: Limited data exist concerning changes of renal perfusion directly after kidney transplantation. Colour-coded duplex sonography is the accepted method to assess kidney perfusion after transplantation. A widely used, although unspecific, Doppler parameter is the intrarenal resistance index (RI).

Effect of prolonged treatment with compression stockings to prevent post-thrombotic sequelae: a randomized controlled trial.

Objective: Compression stockings are widely applied after acute proximal deep vein thrombosis, but their efficacy in preventing the post-thrombotic syndrome remains controversial. This study assessed the effect of prolonged compression therapy after a standard treatment of 6 months after acute deep vein thrombosis.

Methods: Of 900 patients screened, we randomly allocated 169 patients with a first or recurrent proximal deep vein thrombosis after receiving 6 months of standard treatment to wear compression stockings or not.

Noninvasive central venous pressure measurement by controlled compression sonography at the forearm.

Objectives: We sought to validate a new noninvasive technique to determine central venous pressure (CVP) using high-resolution compression sonography.

Background: Information concerning CVP is crucial in clinical situations, including cardiac failure, volume overload, and sepsis. The measurement of CVP, however, requires puncture of a vein with attendant risk of complication.

Calf muscles imaged at BOLD MR: correlation with TcPO2 and flowmetry measurements during ischemia and reactive hyperemia--initial experience.

Purpose: To prospectively compare the blood oxygen level-dependent (BOLD) magnetic resonance (MR) signal intensity of calf muscle during ischemia and reactive hyperemia with laser Doppler flowmetry (LDF) and transcutaneous oxygen pressure (TcPo2) measurements, two parameters routinely used to evaluate peripheral arterial occlusive disease.

Materials And Methods: The study was institutional review board approved; all volunteers gave informed consent. Fifteen healthy volunteers (eight male, seven female; mean age, 33.

Intraarterial versus IV gadolinium injections for MR angiography: quantitative and qualitative assessment of the infrainguinal arteries.

Objective: Our purpose was to quantitatively and qualitatively compare 3D intraarterial (IA) gadolinium-enhanced MR angiography (IA MRA) versus the standard of reference of MR angiography, 3D IV gadolinium-enhanced MR angiography (IV MRA), in patients with peripheral arterial occlusive disease (PAOD) for use during catheter-based MR-guided endovascular interventions.

Conclusion: IA MRA provides image quality of the infrainguinal arteries in PAOD patients comparable to IV MRA with a significantly improved assessment of the infrapopliteal arteries due to reduced venous contamination. Further benefits of IA MRA include usage of only very low doses of gadolinium and simplified bolus timing.

Lower extremity: low-dose contrast agent intraarterial MR angiography in patients--initial results.

Institutional review board approval and patient consent were obtained. A low-dose injection protocol for intraarterial three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography was derived from femoral flow phantom studies and prospectively evaluated in patients with peripheral arterial occlusive disease (PAOD). All MR angiograms were obtained at 1.

Dialysis access-associated steal syndrome: the intraoperative use of duplex ultrasound scan.

Dialysis access-associated steal syndrome (DASS) is an uncommon but serious complication after the creation of an arteriovenous shunt for hemodialysis and is related to an excess perfusion of the fistula. Several surgical options have been described for DASS correction. To achieve an adequate distribution of the blood flow towards the fistula and the hand, intraoperative duplex ultrasound scan monitoring was used in this preliminary communication to control the surgical reduction of volume flow through the fistula.

Physical training for intermittent claudication: a comparison of structured rehabilitation versus home-based training.

In a non-randomized, open-label study results after a structured institution-based peripheral arterial occlusive disease (PAD) rehabilitation program were compared with the results of training at home. Three groups were compared: group 1 (n = 19) PAD rehabilitation; group 2 (n = 19) PAD rehabilitation + clopidogrel 75 mg once daily; group 3 (n = 21) home-based training. The training period was 3 months for all groups, which was followed by a 3-month observation phase (without prescribed training).

Reproducibility of constant-load treadmill testing with various treadmill protocols and predictability of treadmill test results in patients with intermittent claudication.

Background: Most trials on the reliability of constant-load treadmill testing use one pair of treadmill settings (speed, grade) only. The question of whether the results can be applied to tests with different settings is left open. Also, claudication distances measured with differing settings are not comparable, rendering the comparison of the results from different trials difficult.