Perivascular adipose tissue in autoimmune rheumatic diseases.

Perivascular adipose tissue (PVAT) resides at the outermost boundary of the vascular wall, surrounding most conduit blood vessels, except for the cerebral vessels, in humans. A growing body of evidence suggests that inflammation localized within PVAT may contribute to the pathogenesis of cardiovascular disease (CVD). Patients with autoimmune rheumatic diseases (ARDs), e.

Swiss cheese interventricular septum presenting with catastrophic stroke: the potential role of ECG-gated CTA.

Ventricular septal defect is a common congenital cardiac condition that presents in a variety of morphologies. Less commonly, when an individual patient is found to have multiple ventricular septal defects, the term "Swiss cheese ventricular septal defect" is applied. Although not routinely utilized in clinical practice, electrocardiogram (ECG)-gated computed tomographic angiography (CTA) has been shown to provide utility in detecting intracardiac shunts, demonstrating promise in preventing acute strokes secondary to a paradoxical embolus from occurring; this is especially important when atypical cardiac septa are suspected.

Three Technologies That Will Guide Revascularization of Chronic Coronary Syndrome Patients into the 21st Century: A Review.

Although medical therapy is the preferred first-line treatment for patients with chronic coronary syndrome (CCS), revascularization remains an important consideration. We present a review that identifies the three diagnostic technologies most important to guiding the decision to revascularize patients with CCS: (1) cardiac computed tomography, (2) intracoronary imaging, and (3) lesion-specific physiological guidance.

Clinical experience with a chlorhexidine-coated PICC: A prospective, multicenter, observational study.

Introduction: This study evaluated a chlorhexidine-coated peripherally inserted central catheter (PICC) and the incidence of associated complications within both inpatient and outpatient populations.

Methods: This IRB-approved, multicenter, prospective observational study was performed at three large teaching hospitals in the US. All adults who required a PICC for ⩾14 days were considered.

Impact of intravenous access site on attenuation for thoracic computed tomographic angiography: A time-matched, nested, case-control study.

Background: The objective of this study was to evaluate whether the choice of intravenous access (IVA) site affects aortic attenuation during thoracic computed tomographic angiography (T-CTA) and any associated risks with intravenous device placement.

Methods: All T-CTA exams performed between 1/1/2013 and 8/14/2015 were retrospectively reviewed to identify those performed with contrast media injection via alternative (i.e.

Perivascular Adipose Tissue and Vascular Perturbation/Atherosclerosis.

Atherosclerosis is orchestrated by complex interactions between vascular and inflammatory cells. Traditionally, it has been considered to be an intimal inflammatory disease, characterized by endothelial dysfunction, inflammatory cell recruitment, lipid oxidation, and foam cell formation. This inside-out signaling paradigm has been accepted as dogma for many years, despite the fact that inflammatory cells are far more prevalent in the adventitia compared with the intima.

Coronary Artery Involvement in Segmental Arterial Mediolysis: A Case Report.

Segmental arterial mediolysis (SAM) is an increasingly recognized disorder affecting small- to medium-sized muscular arteries. A patient with SAM involving the visceral arteries who was also found to have multivessel coronary artery involvement is described. The patient underwent a battery of biochemical, imaging, and genetic tests to exclude other vasculitides and connective tissue disorders.

Congenital intravascular abdominal aortic band initially thought to be a metallic foreign body: Characterization using microanatomical CT reconstruction technique.

We present a patient with the initial misdiagnosis of a metallic foreign body in the abdominal aorta. Computed tomographic angiography utilizing microanatomical reconstruction technique revealed the structure to instead be a partially calcified abdominal aortic congenital fibrous band. Most congenital fibrous bands spanning the aortic lumen are proximal within the aorta and are thought to be supportive structures of the aortic valve leaflets.

The augmented role of pancreatic imaging in the era of endoscopic necrosectomy: an illustrative and pictorial review.

Endoscopic cystogastrostomy for mature pancreatic collections has long been recognized. However, FDA approval of newer lumen-apposing metallic stents in 2014 has now brought pancreatic necrosectomy to the endoscopic realm. Endoscopic drainage of Walled-off necrosis and direct endoscopic necrosectomy are technically challenging procedures with higher rates of complications.

Early TIPS failure in association with left mesenterico-gonadal spontaneous portosystemic venous shunt; a case report.

Transjugular intrahepatic portosystemic shunt (TIPS) periprocedural thrombosis rates have fallen significantly since the introduction of polytetrafluoroethylene-covered stent grafts. We present a case of a cirrhotic patient with portal hypertension presenting with early TIPS thrombosis in association with an underlying competing spontaneous left mesenterico-gonadal venous shunt, an uncommon variant of spontaneous portal systemic shunt (SPSS). The patient presented with bleeding distal duodenal varices refractory to endovascular therapy, and although a successful TIPS procedure was performed for this indication, early thrombosis was determined by follow-up abdominopelvic computed tomographic angiography (CTA) scan.

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans.

Coronary artery calcification (CAC) provides an objective measure of coronary artery disease and can readily be identified on non-gated computed tomography (CT) scans with a high correlation with gated cardiac CT scans. This standardized protocol takes a step-wise approach to not only optimizing an image for the identification of calcification but also to distinguishing CAC from other common causes of calcification in the cardiac silhouette. Recognition of CAC on non-gated CT scans helps to identify a very powerful prognostic factor that can influence therapeutic interventions or downstream diagnostic testing without requiring a gated cardiac scan.

Genome-wide analysis suggests a differential microRNA signature associated with normal and diabetic human corneal limbus.

Small non-coding RNAs, in particular microRNAs (miRNAs), regulate fine-tuning of gene expression and can impact a wide range of biological processes. However, their roles in normal and diseased limbal epithelial stem cells (LESC) remain unknown. Using deep sequencing analysis, we investigated miRNA expression profiles in central and limbal regions of normal and diabetic human corneas.

Prostate brachytherapy seed migration to the heart seen on cardiovascular computed tomographic angiography.

Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell.

Type IIIb Endoleak Associated With an Infected Thoracoabdominal Endograft.

We present a 63-year-old male patient who presented with vague abdominal pain after an endoluminal thoracoabdominal aneurysm repair. He was found to have an infected endograft and an associated type IIIb endoleak. We believe that the infection contributed to the fabric degradation along the endograft and resulted in an expanding endoleak.

Pseudoaneurysm of the thoracic aorta sustained during exposure to a tornado diagnosed with ECG-synchronized CT aortography.

A case of a tornado victim with a delayed presentation of injury to the aortic isthmus is discussed. Tornado forces resemble the forces of high energy explosions, and the injuries that can occur as a result of these forces can be bizarre. The patient presented with the unique computed tomography (CT) findings of isolated pseudoaneurysm of the thoracic aorta in the absence of other traumatic injury to the thorax.

An ex vivo approach to complex renal artery aneurysm repair.

Ex vivo repair technique for a complex renal artery aneurysm may have several advantages. Smaller incision size and use of minimally invasive techniques may decrease incisional morbidity and improve recovery time, especially in patients with a high body mass index. Improved visualization afforded by back-table methods may also be valuable when repair of aneurysms involving multiple branches is necessary.

Use of noncontrast computed tomography of the inferior vena cava for real-time imaging guidance for the placement of inferior vena cava filters.

Appropriate placement of an inferior vena cava (IVC) filter necessitates imaging of the renal veins because when an IVC filter is deployed its tip should be at or below the inferior aspect of the inferiormost renal vein. Traditionally, imaging during placement of IVC filters has been with conventional cavography and fluoroscopy. Recently, intravascular ultrasound has been used for the same purpose but with additional expense.

A potential role of ECG-gated CT for the diagnosis of pulmonary vein thrombus: an illustrative case report.

The presence of tumor thrombus in patients with lung cancer confers a risk of stroke and other end-organ ischemic events. This case highlights a potential role for electrocardiogram (ECG)-gated computed tomography (CT) in the diagnosis of this pathologic process. In this case, pulmonary vein thrombus was definitively identified by an ECG-CT following discordant results between CT and transthoracic echocardiogram.

Identification of Coronary Artery Calcification and Diagnosis of Coronary Artery Disease by Abdominal CT: A Resident Education Continuous Quality Improvement Project.

Rationale And Objectives: Coronary artery calcium (CAC) scoring is an excellent imaging tool for subclinical atherosclerosis detection and risk stratification. We hypothesize that although CAC has been underreported in the past on computed tomography (CT) scans of the abdomen, specialized resident educational intervention can improve on this underreporting.

Materials And Methods: Beginning July 2009, a dedicated radiology resident cardiac imaging rotation and curriculum was initiated.

Targeting miR-146a to treat delayed wound healing in human diabetic organ-cultured corneas.

Limbal epithelial stem cells (LESC) residing at the corneal periphery are largely responsible for maintaining corneal optical transparency by continuously supplying new corneal epithelial cells, which mature during their radial migration to the central cornea. Diabetes mellitus (DM) affects all the structures of the eye including the cornea. Frequent epithelial erosions, delayed wound healing, and microbial infections are common alterations of the diabetic eye that can result in vision loss.

Differentiation of human limbal-derived induced pluripotent stem cells into limbal-like epithelium.

Limbal epithelial stem cell (LESC) deficiency (LSCD) leads to corneal abnormalities resulting in compromised vision and blindness. LSCD can be potentially treated by transplantation of appropriate cells, which should be easily expandable and bankable. Induced pluripotent stem cells (iPSCs) are a promising source of transplantable LESCs.

A simple alkaline method for decellularizing human amniotic membrane for cell culture.

Human amniotic membrane is a standard substratum used to culture limbal epithelial stem cells for transplantation to patients with limbal stem cell deficiency. Various methods were developed to decellularize amniotic membrane, because denuded membrane is poorly immunogenic and better supports repopulation by dissociated limbal epithelial cells. Amniotic membrane denuding usually involves treatment with EDTA and/or proteolytic enzymes; in many cases additional mechanical scraping is required.