Feasibility study of needle placement in percutaneous vertebroplasty: cone-beam computed tomography guidance versus conventional fluoroscopy.

Objective: To investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy.

Materials And Methods: On 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy.

Remote endarterectomy versus supragenicular bypass surgery for long occlusions of the superficial femoral artery: medium-term results of a randomized controlled trial (the REVAS trial).

Background: To investigate the optimal surgical treatment, remote superficial femoral artery endarterectomy (RSFAE) or supragenicular bypass, for Transatlantic Inter-Society Consensus (TASC) C and D lesions of the superficial femoral artery. Medium-term results will be presented.

Methods: The study randomized 116 patients, 61 to RSFAE and 55 to supragenicular bypass surgery.

Initial results of concomitant cryoplasty after remote endarterectomy of the superficial femoral artery: a feasibility study (cryoplasty following remote endarterectomy).

Objective: Remote endarterectomy is a less invasive technique compared with supragenicular bypass surgery for superficial femoral artery (SFA) occlusive disease. Early restenosis remains one of the drawbacks of this procedure. To prevent restenosis following remote endarterectomy, concomitant cryoplasty of the desobstruct SFA was introduced.

Percutaneous embolization on hereditary hemorrhagic telangiectasia patients with severe epistaxis.

Objectives: To evaluate the results of embolization in patients with hereditary hemorrhagic telangiectasia (HHT) because of severe epistaxis.

Methods: All HHT patients who underwent an embolization (between 1992 and 2006) were asked to participate in this retrospective study. Twelve patients who had in total 19 embolization procedures were interviewed.

Carotid angioplasty and stenting: treatment of postcarotid endarterectomy restenosis is at least as safe as primary stenosis treatment.

Objectives: This study compared transcranial Doppler (TCD) imaging and outcomes of carotid angioplasty and stenting (CAS) in stenosis after carotid endarterectomy (CEA) vs primary atherosclerotic stenoses.

Methods: A prospectively accumulated database of 812 CAS procedures was analyzed retrospectively. Two groups were created.

Pulmonary arteriovenous malformations associated with migraine with aura.

Migraine with aura (MA) is associated with cardiac right-to-left shunt. We prospectively studied the association between pulmonary arteriovenous malformations (PAVMs) and MA in hereditary haemorrhagic telangiectasia (HHT). All 220 consecutive HHT patients who underwent high-resolution chest computed tomography for PAVM screening were included prospectively.

Treatment of ureteropelvic junction obstruction using a detachable inflatable stent: initial experience.

Objective: We describe a new method for treating ureteropelvic junction (UPJ) obstruction using a detachable inflatable stent positioned via a cystoscopic transvesicular approach.

Conclusion: Eleven patients with UPJ obstruction were treated using a detachable inflatable stent, 64% of whom experienced complete pain relief. In 82% of patients, no obstruction was seen on renograms obtained after the procedure.

Grading of pulmonary right-to-left shunt with transthoracic contrast echocardiography: does it predict the indication for embolotherapy?

Rationale: Pulmonary arteriovenous malformations (PAVMs) are associated with severe neurologic complications in patients with hereditary hemorrhagic telangiectasia (HHT). Therefore, screening is warranted. Transthoracic contrast echocardiography (TTCE) can effectively detect a pulmonary right-to-left shunt (RLS).

Short-term results of a randomized trial comparing remote endarterectomy and supragenicular bypass surgery for long occlusions of the superficial femoral artery [the REVAS trial].

Objective: Techniques for surgical repair of Trans-Atlantic Inter-Society Consensus (TASC) C and D lesions of the superficial femoral artery (SFA) are supragenicular bypass grafting or the less invasive remote endarterectomy (RSFAE). This trial compares the patency rates of both techniques.

Design: Randomized, multicenter trial.

Screening for pulmonary arteriovenous malformations using transthoracic contrast echocardiography: a prospective study.

Pulmonary arteriovenous malformations (PAVMs) are associated with severe neurological complications in patients with hereditary haemorrhagic telangiectasia (HHT). The objective of the present study was to prospectively establish the diagnostic value of transthoracic contrast echocardiography (TTCE) as a screening technique for PAVM using chest high-resolution computed tomography (HRCT) as the gold standard for PAVMs. All consecutive adult patients referred for HHT screening underwent a chest HRCT (n = 299), TTCE (n = 281), arterial blood gas analysis (n = 291), shunt fraction measurement (n = 111) and chest radiography (n = 296).

Long-term single-center results with AneuRx endografts for endovascular abdominal aortic aneurysm repair.

Purpose: To evaluate the long-term single-center results with the AneuRx stent-graft in endovascular abdominal aortic aneurysm (AAA) repair (EVAR).

Methods: Between December 1996 and August 2003, 212 patients (197 men; mean age 71.3+/-7.

Superselective coil embolization of arterial esophageal hemorrhage.

The authors report a case of arterial esophageal bleeding resistant to endoscopic hemostasis in a patient in critical condition after complicated gastrointestinal and pulmonary surgery. Unfit for surgery, the patient's massive hemorrhage was successfully treated with superselective coil embolization of the afferent esophageal branch of the thoracic aorta. In patients with severe arterial bleeding of the esophagus, percutaneous superselective arterial coil embolization may be feasible for control of hemorrhage.

Renal function after endovascular aortic aneurysm repair: a single-center experience with transrenal versus infrarenal fixation.

Purpose: To describe the short-term consequences of endovascular aortic aneurysm repair (EVAR) on renal function after infrarenal (IR) versus transrenal (TR) stent-graft fixation.

Methods: Between December 1996 and January 2006, 369 consecutive patients were treated with EVAR. All patients had an AneuRx or a Talent stent-graft implanted using IR (AneuRx) or transrenal (Talent) fixation.

Carotid angioplasty and stenting for postendarterectomy stenosis: long-term follow-up.

Background: Carotid angioplasty and stenting (CAS) for recurrent stenosis after carotid endarterectomy (CEA) has been proposed as an alternative to redo CEA. Although early results are encouraging, the extended durability remains unknown. We present the long-term surveillance results of CAS for post-CEA restenosis.

Thoracic stent grafting for acute aortic pathology.

Background: Elective endovascular repair of the thoracic aorta has shown reduced morbidity and mortality when compared with open surgery. The number of studies describing the use of thoracic endovascular stent grafts for acute pathology is limited, however. The purpose of this study was to describe our increasing experience with stent grafting for acute thoracic aortic pathology.

[Four patients with aneurysm of the hepatic artery].

Two men aged 73 and 71 years and 2 women aged 76 and 80 years were referred for a false aneurysm (the 3rd patient) or true aneurysm (the other 3 patients) of an extrahepatic portion of the hepatic artery. The first patient was asymptomatic, the third patient had a rupture in the biliary duct and the remaining 2 patients had upper abdominal pain. In the first 2 patients, the aneurysm was removed surgically and replaced with a venous interposition graft.

Endovascular recanalization of chronic long-segment occlusions of the inferior vena cava: midterm results.

Purpose: To report the midterm results of endovascular recanalization of chronic long-segment (> 5 cm) occlusions of the inferior vena cava (IVC) with stent placement.

Methods: Nine patients (5 men; median age 30 years, range 14-58) with disabling complaints for more than 6 months caused by IVC occlusions were treated by endovascular recanalization. Mean occlusion length was 11 cm (range 6-22); some occlusions extended to the iliac (n = 3) or common femoral (n = 2) veins.

Acute leg ischemia: the dark side of a percutaneous femoral artery closure device.

The use of femoral artery closure devices to obtain hemostasis after percutaneous catheterization has become widespread because of their proven feasibility in combination with patient-related advantages. Since 2002 more than 6,500 patients have undergone either diagnostic angiography or therapeutic intervention via the femoral route with an Angioseal closure device in our hospital. We were faced with six cases of limb-threatening complications, which are described here.

Dutch iliac stent trial: long-term results in patients randomized for primary or selective stent placement.

Purpose: To determine long-term results of the prospective Dutch Iliac Stent Trial.

Materials And Methods: The study protocol was approved by local institutional review boards. All patients gave written informed consent.

Clinical outcome and technical considerations of late removal of abdominal aortic endografts: 8-year single-center experience.

During an 8-year period, 355 patients underwent endovascular repair of mainly true (97%) infrarenal aneurysms. After a mean follow-up of 48 months, 11 (3.1%) patients required conversion to open repair and 10 were eligible for open surgical intervention.

Prediction of early cerebral outcome by transcranial Doppler monitoring in carotid bifurcation angioplasty and stenting.

Objective: The outcomes of carotid angioplasty and stenting (CAS) are, in addition to patient baseline characteristics, highly dependent on the safety of the endovascular procedure. During the successive stages of CAS, transcranial Doppler (TCD) monitoring of the middle cerebral artery was used to assess the association of cerebral embolism and hemodynamic changes with transient (amaurosis fugax and transient ischemic attack) and persistent (minor and major stroke) cerebral deficits, and death.

Methods: By use of a prospectively completed database of 550 patients, the association of various TCD emboli and velocity variables with periprocedural cerebral outcome View Article and Find Full Text PDF

Impact of head movements on morphology and flow in the internal carotid artery after carotid angioplasty and stenting versus endarterectomy.

Objective: Because stents can cause vessel angulation during movement, we hypothesized that internal carotid artery (ICA) stents might lead to alterations of cerebropetal blood flow. This study assessed three-dimensional anatomy and volumetric flow rate (VFR) in the ICA in various head positions by comparing patients treated with carotid angioplasty and stenting (CAS) with patients treated with carotid endarterectomy (CEA).

Methods: Three-dimensional time-of-flight magnetic resonance angiography and magnetic resonance flow quantification were performed on six subjects after CAS (median age, 70 years) and on six subjects after CEA (median age, 67 years).