Assessment of intramyocardial hemorrhage by T1-weighted cardiovascular magnetic resonance in reperfused acute myocardial infarction.

Background: Intramyocardialhemorrhage (IMH) reflects severe reperfusion injury in acute myocardial infarction. Non-invasive detection of IMH by cardiovascular magnetic resonance (CMR) may serve as a surrogate marker to evaluate the effect of preventive measures to reduce reperfusion injury and hence provide additional prognostic information. We sought to investigate whether IMH could be detected by CMR exploiting the T1 shortening effect of methemoglobin in an experimental model of acute myocardial infarction.

Wall shear stress and local plaque development in stenosed carotid arteries of hypercholesterolemic minipigs.

Background: Wall shear stress is thought to play a critical role in the local development of atherosclerotic plaque and to affect plaque vulnerability. However, current models and hypotheses do not fully explain the link between wall shear stress and local plaque development. We aimed to investigate the relation between wall shear stress and local plaque development in surgically induced common carotid artery stenoses of hypercholesterolemic minipigs.

Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs.

Background: Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis.

Methods: An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs.

Determination of acute vascular injury and edema in porcine carotid arteries by T2 weighted cardiovascular magnetic resonance.

Inflammation plays an essential role for destabilization and rupture of carotid atherosclerotic plaques causing embolic ischemic stroke. Inflammation of the vessel wall may result in the formation of edema. This study investigated whether edema in the carotid artery wall induced by acute balloon injury could be detected by cardiovascular magnetic resonance (CMR) using a T2-weighted short-tau inversion recovery sequence (T2-STIR).

Long-term incidence of myocardial infarct, stroke, and mortality in patients operated on for abdominal aortic aneurysms.

Objective: The risks of myocardial infarction (MI) and stroke after abdominal aortic aneurysm (AAA) resection are not known. Prophylaxis with aspirin and statins is not generally recommended, although patients with AAAs have an increased prevalence of cardiovascular atherosclerosis. We report the incidences of MI, stroke, and death in an unselected national cohort of patients operated on for AAAs, with the general population as the control group.

Determination of edema in porcine coronary arteries by T2 weighted cardiovascular magnetic resonance.

Background: Inflammation plays a pivotal role in all stages of atherosclerosis. Since edema is known to be an integral part of inflammation, a noninvasive technique that can identify edema in the coronary artery wall may provide unique information regarding plaque activity. In this study, we aimed to determine whether edema induced in porcine coronary arteries by balloon injury could be reliably detected by cardiovascular magnetic resonance (CMR) using a water sensitive T2-weighted short tau inversion recovery sequence (T2-STIR).

CMR assessment of endothelial damage and angiogenesis in porcine coronary arteries using gadofosveset.

Background: Endothelial damage and angiogenesis are essential for atherosclerotic plaque development and destabilization. We sought to examine whether contrast enhanced cardiovascular magnetic resonance (CMR) using gadofosveset could show endothelial damage and neovessel formation in balloon injured porcine coronary arteries.

Methods And Results: Data were obtained from seven pigs that all underwent balloon injury of the left anterior descending coronary artery (LAD) to induce endothelial damage and angiogenesis.

Duplication of the superficial femoral artery.

A computed tomographic angiogram for pseudoaneurysm after previous puncture in the groin showed duplication of the superficial femoral artery in a 52-year-old man without symptoms or signs of arterial insufficiency. It is doubtful whether this very rare anatomic variant has clinical relevance, but it should be known by vascular specialists.

Hemodynamic effects of closure of residual arteriovenous fistulae during in situ graft procedures.

The objective was to study the intraoperative hemodynamic effects of closure of residual arteriovenous fistulae during in situ saphenous vein graft procedures. Data on 60 residual arteriovenous fistulae in nine patients (five men) with a median age of 74 years (range 64-83 years) with critical lower limb ischemia were obtained. Direct measurements of proximal and distal blood pressures in the graft were taken and simultaneous determinations of volume blood flow proximally and distally in the graft with ultrasound transit time technique before and after closure of residual fistulae were made.

Familial hypercholesterolaemic downsized pig with human-like coronary atherosclerosis: a model for preclinical studies.

Aims: A manageable and reproducible large animal model of human-like coronary atherosclerosis is lacking but highly needed for translational research in percutaneous coronary interventions and imaging. Farm pigs with familial hypercholesterolaemia develop advanced atherosclerosis in two to three years but then weigh >200 kg making them impractical and costly. We aimed at down-sizing this pig and accelerating coronary plaque development to make the model more useful and affordable.

Unreliable assessment of necrotic core by virtual histology intravascular ultrasound in porcine coronary artery disease.

Background: Intravascular ultrasound-derived virtual histology (VH IVUS) is used increasingly in clinical research to assess composition and vulnerability of coronary atherosclerotic lesions. However, the ability of VH IVUS to quantify individual plaque components, in particular the size of the destabilizing necrotic core, has never been validated. We tested for correlation between VH IVUS necrotic core size and necrotic core size by histology in porcine coronary arteries with human-like coronary disease.

Longitudinal distribution of mechanical stresses in carotid plaques of symptomatic patients.

Background And Purpose: Mechanical stress may contribute to plaque rupture in patients with carotid atherosclerosis. We determined longitudinal mechanical stresses in carotid atherosclerotic plaques and compared them with known markers of plaque vulnerability.

Methods: Nineteen symptomatic patients scheduled for carotid endarterectomy underwent carotid MRI with a multicontrast protocol to characterize plaque morphology and geometry.

Left ventricular longitudinal strain for perioperative cardiac monitoring in aortic aneurysm surgery using transthoracic 2-dimensional echocardiography: a feasibility and repeatability study.

Objective: This study investigated perioperative echocardiographic image quality, the feasibility, and intra- and interobserver repeatability of left ventricular longitudinal two-dimensional strain echocardiography (2DSE) in aortic aneurysm surgery.

Design: A prospective, descriptive method evaluation.

Setting: A single-center study.

Mechanical stresses in carotid plaques using MRI-based fluid-structure interaction models.

Risk assessment in patients with carotid atherosclerosis relies on the degree of luminal stenosis. Incorporating morphological information on plaque composition obtained noninvasively through the use of magnetic resonance imaging (MRI) could include other variables besides the degree of stenosis into carotid plaque risk assessment. Knowledge of the morphologic composition of the plaque allows determination of mechanic stresses exerted on the protective fibrous cap, which may be of importance in the assessment of plaque vulnerability.

Plaque in superficial femoral arteries indicates generalized atherosclerosis and vulnerability to coronary death: an autopsy study.

Objectives: Risk factors for atherosclerosis have limited ability to identify persons at high risk of coronary heart disease. Assessment of subclinical atherosclerosis in peripheral arteries might improve this limitation. We studied the relationship between atherosclerotic plaques in peripheral arteries, coronary plaques, and coronary death.

Artery-related differences in atherosclerosis expression: implications for atherogenesis and dynamics in intima-media thickness.

Background And Purpose: Information about the expression of atherosclerosis in different arteries is important. The impact of cardiovascular risk factors is artery-related, and the assessment of arterial structure and function in peripheral arteries are increasingly used as surrogate markers for coronary atherosclerosis and the risk of developing heart attack.

Methods: In an autopsy study, we analyzed the coronary, carotid and superficial femoral arteries from 100 individuals (70 men; 20 to 82 years of age) of which 27 died from coronary atherosclerosis.

The status of vascular surgery as an independent specialty in Europe: are the relationships with general and cardiothoracic surgery a problem?

Vascular surgery has established a clear clinical and scientific profile in Europe over the last decade, but it presents a highly complex, disorganized, and unplanned pattern. It is a specialty in the majority of the present member states of the European Union (EU), but in the United Kingdom, Germany, the Netherlands, and Sweden this is not the case. With the current expansion of the EU with 13 countries, mainly from the former Eastern Bloc, it will be even more necessary to ensure at least some level of convergence in the standards of training, certification, quality assured practice, continuing medical education, recertification, access to and quality of care, etc, because free migration of doctors, and patients, is a derivative of the cornerstones of the EU treaties, namely free movement of the citizens (and capital).

Acoustic inhomogeneity of carotid arterial plaques determined by GHz frequency range acoustic microscopy.

Characterization of the structure and composition of carotid arterial plaques is important to predict the risk of embolic and thrombotic events. In clinical echography, echolucent lesions seem to be more associated with stroke than echogenic lesions, and a low grey-scale median is associated with a fivefold increase in the incidence of silent infarcts. In the present study, five fixed human carotid atherosclerotic lesions were observed by GHz-range scanning acoustic microscopy (SAM).