Low-Dose vs High-Dose Paclitaxel-Coated Balloons for Femoropopliteal Lesions: 2-Year Results From the COMPARE Trial.

Background: So far only 1-year data have been reported for direct comparisons of paclitaxel-coated balloons (PCBs) using different coating technologies.

Objectives: The aim of this study was to report the 24-month results on the efficacy and safety of low-dose vs high-dose PCBs with nominal paclitaxel densities of 2.0 and 3.

COMPARE: prospective, randomized, non-inferiority trial of high- vs. low-dose paclitaxel drug-coated balloons for femoropopliteal interventions.

Aims: Drug-coated balloons (DCBs) for femoropopliteal interventions have not been tested against each other. We aimed to directly compare efficacy and safety of a high-dose (In.Pact™) vs.

Smaller-Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents Are Associated With Increased Survival.

Background & Aims: We studied the effects of diameter of covered, self-expandable, nitinol stents on survival times of patients with a transjugular intrahepatic portosystemic shunt (TIPS).

Methods: We collected data from 185 patients (median age, 55 y; 30% female) who received a covered nitinol stent, from February 2006 through September 2010, using the online multicenter German TIPS registry. TIPS were given to 107 patients for refractory ascites and to 78 patients for variceal bleeding.

Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI.

Objectives: To assess changes in portal and splanchnic arterial haemodynamics in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) using four-dimensional (4D) flow MRI, a non-invasive, non-contrast imaging technique.

Methods: Eleven patients undergoing TIPS implantation were enrolled. K-t GRAPPA accelerated non-contrast 4D flow MRI of the liver vasculature was applied with acceleration factor R = 5 at 3Tesla.

Distal aortic reintervention after surgery for acute DeBakey type I or II aortic dissection: open versus endovascular repair.

Objectives: Aortic dissection DeBakey type I and II may require distal reinterventions after initial proximal repair. We evaluated outcomes following open versus endovascular approaches to distal aortic pathologies after surgery for acute dissection.

Methods: One hundred and forty-one consecutive patients underwent 152 distal reinterventions after previous type I or II dissection repair [63 (first quartile, 55; third quartile, 72) years old; initially 86% DeBakey type I; 54% hemiarch, 39% isolated ascending, 7% total arch replacement] at two tertiary centres in the USA and Europe over the last 14 years.

Standard intra-aortic counterpulsation balloon may cause temporary occlusion of mesenterial and renal arteries.

The study was to test the hypothesis that mesenteric and renal arteries may be occluded by intra-aortic balloon pumps (IABPs), despite correct positioning. Computed tomography scans of 107 patients (34.6% women and 65.

Reproducibility study of four-dimensional flow MRI of arterial and portal venous liver hemodynamics: influence of spatio-temporal resolution.

Purpose: To evaluate influence of variation in spatio-temporal resolution and scan-rescan reproducibility on three-dimensional (3D) visualization and quantification of arterial and portal venous (PV) liver hemodynamics at four-dimensional (4D) flow MRI.

Methods: Scan-rescan reproducibility of 3D hemodynamic analysis of the liver was evaluated in 10 healthy volunteers using 4D flow MRI at 3T with three different spatio-temporal resolutions (2.4 × 2.

A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls.

Purpose: To evaluate the feasibility of time-resolved flow-sensitive four-dimensional (4D) MRI for the visualization and quantification of splanchnic arterial and portal venous hemodynamics in patients with cirrhosis and in controls.

Materials And Methods: We applied flow-sensitive 4D MRI to evaluate arterial and portal venous three-dimensional blood flow in patients with advanced liver cirrhosis (n=5) and in healthy controls (n=10) using 3T MRI (spatial resolution=1.7×2.

Results of high-risk endovascular procedures in patients with non-dissected thoracic aortic pathology: intermediate outcomes.

Objectives: To investigate mid-term outcome in patients undergoing thoracic endovascular aortic repair (TEVAR) for non-dissected aortic pathology with favourable and unfavourable landing zone and aortic anatomy.

Methods: Between 2000 and 2011, TEVAR was performed in 208 patients with descending thoracic aortic disease. Of 105 patients with non-dissected thoracic aortic pathology, 69 presented with unfavourable anatomy as defined by short length (<15 mm), large diameter (>42 mm), angulation of >60° of the proximal or distal landing zone or extreme aortic tortuosity.

Late complications and distal growth rates of Marfan aortas after proximal aortic repair.

Objectives: Conflicting results have been reported on late aortic growth and complication rates of the descending thoracic aorta in patients with Marfan syndrome (MFS) after proximal aortic surgery.

Methods: Of 198 Marfan patients followed up regularly, 121 (43% David-I, 7% David-II, 11% supracoronary replacement, 52% mechanical conduit, 8% arch replacement) were analysed after proximal aortic surgery retrospectively. 97% had MFS1, 3% MFS2 (Loeys-Dietz-Syndrome); 56% were male and the mean age was 35 ± 13 years.

Peripheral vessel scout imaging based on continuously moving table acquisition of projection data.

A fast and spatially seamless peripheral vessel scout is desirable for subsequent planning of magnetic resonance (MR) angiography. We implemented a continuously moving table sequence providing projection data with time-of-flight contrast of the entire lower extremities in less than 2 minutes. Variation of arterial signal during the cardiac cycle and autocorrelation were exploited to enhance vessel-to-background contrast.

Prosthesis oversizing in balloon-expandable transcatheter aortic valve implantation is associated with contained rupture of the aortic root.

Background: To retrospectively investigate the potential cause of contained rupture of the aortic root in balloon-expandable transcatheter aortic valve implantation (TAVI) by means of pre- and postinterventional multislice computed tomography.

Methods And Results: Seventy-two patients (mean age 82±7 years, mean aortic valve area 0.69±0.

Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type a aortic dissection.

Purpose: One current method of anastomosis in aortic dissection type A is the adventitial inversion technique. To improve hemostasis at the anastomotic site, we have developed a novel technique for distal anastomosis involving adventitial inversion employing graft telescopic insertion.

Methods: The adventitia was inverted into the aortic lumen and the anastomosis with a Dacron tube-graft was made in a telescopic method, covering the inverted adventitia.

Chronic critical limb ischemia.

Background: Some 40 000 lower limb amputations are performed in Germany each year, 70% of them in diabetics. About 80% of all major amputations may be preventable with the use of new interventional and vascular surgical procedures, particularly on the arteries of the leg and foot. We present the current state of the art in revascularization techniques and evaluate their usefulness for preservation of the lower limb.

Normal and altered three-dimensional portal venous hemodynamics in patients with liver cirrhosis.

Purpose: To compare time-resolved three-dimensional (3D) phase-contrast magnetic resonance (MR) imaging with three-directional velocity encoding (flow-sensitive four-dimensional [4D] MR imaging), with Doppler ultrasonography (US) as standard of reference, for investigating alterations in 3D portal venous hemodynamics in patients with liver cirrhosis compared with healthy age-matched control subjects and healthy young volunteers.

Material & Methods: This prospective study was approved by the local ethics committee, and written informed consent was obtained from all participants. Three-dimensional portal venous hemodynamics was assessed, employing flow-sensitive 4D MR imaging with a 3-T MR system (spatial resolution, approximately 2 mm(3); temporal resolution, approximately 45 msec) in 20 patients with hepatic cirrhosis, 20 healthy age-matched control subjects, and 21 healthy young volunteers.

Treatment of unresectable cholangiocarcinoma: conventional transarterial chemoembolization compared with drug eluting bead-transarterial chemoembolization and systemic chemotherapy.

Background: Unresectable cholangiocarcinoma (CCC) has a poor prognosis. Patients with intrahepatic CCC have a very limited benefit from systemic chemotherapy (ChT). The aim of this prospective study was to evaluate the feasibility, safety, and efficacy of conventional transarterial chemoembolization (cTACE) with mitomycin-C and of irinotecan-eluting beads (iDEB-TACE), and to retrospectively compare them with ChT with oxaliplatin and gemcitabine.

Endovascular treatment of multiple HIV-related aneurysms using multilayer stents.

Complex peripheral aneurysm anatomy with major artery branches in the immediate vicinity and mycotic aneurysm often impede endovascular management using covered stent grafts. The Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) is a recently approved innovative stent system for peripheral aneurysm management. Its multilayer design aims at decreasing mean velocity and vorticity within the aneurysm sac to cause thrombus formation while maintaining patency of branching vessels due to laminar flow.

Combined assessment of aortic root anatomy and aortoiliac vasculature with dual-source CT as a screening tool in patients evaluated for transcatheter aortic valve implantation.

Objective: The objective of our study was to investigate the feasibility, image quality, and clinical implications of a combined dual-source CT angiography (CTA) protocol to assess aortic root anatomy and aortoiliac vasculature in patients with severe aortic stenosis evaluated for transcatheter aortic valve implantation.

Subjects And Methods: Eighty consecutive patients (47 women and 33 men; mean age, 82.3 ± 7.

MR-based visualization and quantification of three-dimensional flow characteristics in the portal venous system.

Purpose: To evaluate the feasibility of time-resolved flow-sensitive MRI for the three-dimensional (3D) visualization and quantification of normal and pathological portal venous (PV) hemodynamics.

Materials And Methods: Portal venous hemodynamics were evaluated in 18 healthy volunteers and 5 patients with liver cirrhosis. ECG- and adaptive respiratory navigator gated flow-sensitive 4D MRI (time-resolved 3D MRI with three-directional velocity encoding) was performed on a 3 Tesla MR system (TRIO, Siemens, Germany).

Thoracic aorta: prospective electrocardiographically triggered CT angiography with dual-source CT--feasibility, image quality, and dose reduction.

Purpose: To prospectively investigate the feasibility, image quality, and radiation dose for prospective electrocardiographically (ECG) triggered sequential dual-source computed tomographic (CT) angiography of the thoracic aorta in comparison to retrospective ECG-gated helical dual-source CT angiography.

Materials And Methods: This study was approved by the institutional review board; informed consent was obtained. One hundred thirty-nine patients referred for ECG-assisted dual-source CT angiography of the thoracic aorta were prospectively enrolled.

Aorto-caval fistula from acute rupture of an abdominal aortic aneurysm treated with a hybrid approach.

Ruptured abdominal aneurysm is a life-threatening disease requiring immediate treatment. The outcome is even worse in cases complicated by aorto-caval fistula. Treatment is usually attempted by open surgery using direct closure of the venous tear and graft placement in the aorta.

Endovascular treatment for thoracoabdominal aneurysms: outcomes and results.

Objective: Endovascular treatment of thoracoabdominal aortic aneurysms (TAAA) in combination with selective open surgical revascularization may be an alternative to conventional surgical repair. We analyzed our patient outcomes after elective and emergent endovascular TAAA repair.

Methods: Mortality and outcome data from 21 consecutive patients treated with endovascular TAAA repair between 2000 and 2006 were reviewed.

Thoracic endovascular stent grafting inhibits aortic growth: an experimental study.

Objective: Dilatation of the aorta at the landing zone site may be exaggerated by the radial force of stent grafts potentially limiting long-term results of endovascular therapy. We evaluated growth patterns and morphology of the thoracic aorta in young piglets after thoracic stent-graft placement.

Methods: Eight domestic piglets (37+/-2 kg) had an endovascular stent graft placed in the proximal descending thoracic aorta using retroperitoneal access.

Incidence of neurological complications following overstenting of the left subclavian artery.

Objective: Aortic endovascular stent-graft implantation is associated with low morbidity and mortality rates. Overstenting of the left subclavian artery may be necessary to create a satisfactory proximal 'landing zone' for the stent-graft. Few cases have been published reporting adverse neurological events after overstenting of the left subclavian artery.