[Diagnostics and interventional radiology of a bleeding trauma patient].

Ultrasonic examination performed for a hemodynamically unstable patient is a reliable means to find whether free fluid indicating bleeding is present in the abdominal cavity, pleura, or pericardium. Ultrasonic imaging is, however, less suitable for diagnosing visceral injuries, and if clinically possible, computed tomography, CT is the primary imaging technique for a trauma patient. In addition to visceral injuries, CT can be used for detecting active arterial bleeding, which has been found to predict the failure of conservative treatment.

Inferior mesenteric artery embolization before endovascular repair of an abdominal aortic aneurysm: effect on type II endoleak and aneurysm shrinkage.

Purpose: To evaluate the value of preoperative embolization of the inferior mesenteric artery (IMA) before endovascular repair of an abdominal aortic aneurysm.

Materials And Methods: From January 2000 to October 2006, 79 patients (mean age, 72.3 years; 69 men) scheduled for endovascular aneurysm repair (EVAR) were found to have a patent IMA at computed tomography.

Risk prediction in patients undergoing elective endovascular repair of an abdominal aortic aneurysm.

Objectives: The aim of this study was to retrospectively evaluate three risk scoring methods in predicting outcome after elective endovascular repair of an abdominal aortic aneurysm.

Design: A Zenith stent graft was employed in 205 patients during years 2001-2005.

Results: The 30-day postoperative mortality rate was 2.

Type II endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization.

The purpose of this study was to report our experience in treating type II endoleaks after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. Two hundred eighteen patients underwent EVAR with a Zenith stent-graft from January 2000 to December 2005. During a follow-up period of 4.

Finnish multicenter study on the midterm results of use of the Zenith stent-graft in the treatment of an abdominal aortic aneurysm.

Purpose: To assess the midterm results of endovascular repair of abdominal aneurysm (AAA) with a Zenith stent-graft.

Materials And Methods: Between January 2001 and December 2005, a Zenith stent-graft was employed for endovascular repair of an infrarenal AAA in 206 patients. The mean patient age (+/-standard deviation) was 73.

Outcome of symptomatic, unruptured abdominal aortic aneurysms after endovascular repair with the Zenith stent-graft system.

Objective: Symptomatic abdominal aortic aneurysms (AAA) account for up to 20% of patients with unruptured AAA undergoing open repair. This condition is associated with an average postoperative mortality rate after open repair of about 16%. The aim of this study was to evaluate the outcome of a consecutive series of patients who underwent endovascular repair for symptomatic, unruptured AAA.

Three-dimensional respiratory-gated coronary MR angiography with reference to X-ray coronary angiography.

Purpose: To assess the clinical value of three-dimensional coronary MR angiography (CMRA) in the detection of significant coronary artery stenosis using conventional X-ray angiography as the standard reference.

Material And Methods: Sixty-nine patients underwent X-ray coronary angiography and CMRA because of suspected or previously diagnosed coronary artery disease. MRI was performed with a 1.

Infrainguinal revascularization because of claudication: total long-term outcome of endovascular and surgical treatment.

Objective: This study was undertaken to define total long-term outcome achievable with invasive treatment, ie, endovascular or surgical, in patients with claudication with infrainguinal lesions. Priority in primary treatment was given to percutaneous transluminal angioplasty.

Methods: Data were analyzed for 233 consecutive patients with claudication in whom primary infrainguinal revascularization was performed in 304 limbs between 1989 and 1992.

Long-term outcome of patients with claudication after balloon angioplasty of the femoropopliteal arteries.

Purpose: To report the long-term outcome of patients with lifestyle-limiting claudication after percutaneous transluminal angioplasty (PTA) of the femoropopliteal arteries.

Materials And Methods: Between 1989 and 1992, 173 consecutive claudicant patients (mean age, 65 years; age range, 41-90 years) underwent PTA in 218 limbs; all interventions included femoral and/or popliteal arterial segments, and additional iliac (n = 27) and infrapopliteal (n = 11) arterial lesions were also treated. Patients were followed up for 7-10 years.

Increased vascularity detected by digital subtraction angiography after VEGF gene transfer to human lower limb artery: a randomized, placebo-controlled, double-blinded phase II study.

Vascular endothelial growth factor (VEGF) gene therapy may be useful for the treatment of lower-limb ischemia. The objectives of this study were to evaluate safety and angiographic and hemodynamic responses of local catheter-mediated VEGF gene therapy in ischemic lower-limb arteries after percutaneous transluminal angioplasty (PTA). For this study, we recruited patients with chronic lower-limb ischemia and atherosclerotic infrainguinal occlusion or stenosis suitable for PTA.

The final outcome of primary infrainguinal percutaneous transluminal angioplasty in 100 consecutive patients with chronic critical limb ischemia.

Purpose: This study was performed to determine final outcomes in patients treated with infrainguinal percutaneous transluminal angioplasty (PTA) for chronic critical limb ischemia (CLI).

Materials And Methods: The study population consisted of 100 consecutive patients (mean age, 72 y; range, 38-90 y; 40 men and 60 women) with 116 treated limbs. CLI was defined as rest pain or ischemic tissue defect combined with an ankle systolic pressure < or = 50 mm Hg.

Failure of prolonged dilation to improve long-term patency of femoropopliteal artery angioplasty: results of a prospective trial.

Purpose: To determine long-term patency of femoropopliteal artery percutaneous transluminal angioplasty (PTA) in a prospective trial during which prolonged balloon inflation was used for optimization of initial results.

Materials And Methods: Femoropopliteal PTA was performed in 112 limbs of 97 patients. The mean total length of the treated segments was 7.

Brachial arterial access: endovascular treatment of failing Brescia-Cimino hemodialysis fistulas--initial success and long-term results.

Purpose: To evaluate safety and efficacy of endovascular interventions in failing antebrachial Brescia-Cimino hemodialysis fistulas in consecutive patients.

Materials And Methods: Altogether, 103 interventions were performed in 53 Brescia-Cimino shunts in 51 patients by means of antegrade brachial arterial access. Twelve interventions were initiated with pharmacomechanical thrombolysis and/or thromboaspiration.

Prospective trial of infrapopliteal artery balloon angioplasty for critical limb ischemia: angiographic and clinical results.

Purpose: To evaluate the safety and efficacy of infrapopliteal percutaneous transluminal angioplasty (PTA) as a primary treatment of chronic critical limb ischemia in a prospective trial.

Materials And Methods: Infrapopliteal PTA was performed on 72 limbs of 60 patients (mean age, 72 y; range, 38-92 y) and patients were followed for 12-24 months.

Results: The primary angiographic success rate for the stenoses was 84% (102 of 121) and that for the occlusions was 61% (41 of 67) with corresponding restenosis rates of 32% and 52% at follow-up angiography performed a mean of 10 months after primary PTA.

Repeated 3D coronary MR angiography with navigator echo gating: technical quality and consistency of image interpretation.

The purpose of this study was to evaluate the technical quality of 3D coronary MR angiography (CMRA) with navigator echo and the consistency of image interpretation in repeated imaging sessions. Fourteen subjects underwent CMRA, 10 of whom were imaged twice. The coronary arteries (96 segments) were analyzed twice for hemodynamically significant stenoses.

Angiographic characteristics of symptomatic recurrent disease after infrainguinal percutaneous transluminal angioplasty.

Purpose: To evaluate the angiographic patterns of clinically manifest recurrent disease after infrainguinal percutaneous transluminal angioplasty (PTA) of stenoses and total occlusions.

Methods: Among 326 infrainguinal PTAs on 263 consecutive patients, selective angiography was performed on 61 limbs of 52 patients 1-60 months after the primary intervention because of clinically suspected recurrent disease. Lesion-specific and patient-related factors were analyzed for 75 angiographically confirmed recurrent lesions in 57 limbs of 48 patients.

Comparison of iodixanol 270 with iohexol 300 in infrapopliteal arteriography. Digital densitometric analysis of angiographic opacification.

Purpose: To compare iodixanol 270 mg I/ml with iohexol 300 mg I/ml in infrapopliteal arteriography by measuring digital densitometric vessel opacification and by visually assessing angiographic enhancement.

Material And Methods: In a double-blind, dual-balanced, 4-sequence cross-over design, 50 claudicant patients received two contrast media injections (10 min interval) in the superficial femoral artery. Digital angiography was performed at 8 frames/s and time-density curves with a circular region of interest over a distal calf artery were generated.

Complications of lower-limb percutaneous transluminal angioplasty: a prospective analysis of 410 procedures on 295 consecutive patients.

Purpose: To evaluate complications and their predictors in percutaneous transluminal angioplasty (PTA) of lower-limb arteries.

Methods: Complications in 410 angioplasty procedures in 295 consecutive patients (192 claudicants and 103 suffering from chronic critical ischemia) were prospectively analyzed.

Results: The total complication rate was 10.

Angiographic predictors of graft patency and disease progression after coronary artery bypass grafting with arterial and venous grafts.

Background: There are few data about angiographic determinants of functional graft patency and native artery disease progression after coronary artery bypass grafting operation with arterial grafts compared with venous grafts.

Methods: Baseline and follow-up coronary angiograms at a mean of 2 years after operation in 91 patients with 194 arterial and 204 venous graft anastomoses were analyzed.

Results: Ninety-two percent of the arterial and 87% of the venous graft anastomoses were patent at follow-up angiography (p = 0.

Adenovirus-mediated gene transfer to lower limb artery of patients with chronic critical leg ischemia.

Arterial gene transfer offers a promising new approach for the treatment of vascular disorders. However, no data are available about the gene transfer efficiency in human arteries in vivo. The aim of this study was to evaluate the safety and feasibility of catheter-mediated adenoviral gene transfer in human peripheral arteries.

Brachial artery access for percutaneous renal artery interventions.

Purpose: To evaluate the suitability of transbrachial access for endovascular renal artery interventions.

Methods: During 37 consecutive endovascular renal artery interventions, the transbrachial approach was used on nine patients (mean age 63 years; range 41-76 years) for 11 renal artery procedures on native kidneys and one percutaneous transluminal angioplasty (PTA) on a transplanted kidney. The reason for using transbrachial access was a steep aorta-renal angle in five, and severe aorta-iliac atherosclerosis in the remaining patients.

Dissecting aneurysms of all four cervicocranial arteries in fibromuscular dysplasia: treatment with self-expanding endovascular stents, coil embolization, and surgical ligation.

A patient with cervicocranial fibromuscular dysplasia (FMD) presented with subarachnoid hemorrhage. A ruptured dissecting distal vertebral artery aneurysm required clip ligation of the parent artery; a contralateral dissecting proximal vertebral aneurysm was occluded with detachable coils. Progressive dissecting, extracranial aneurysms of the internal carotid artery were treated with self-expanding stents.