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Intravascular ultrasound guidance

Shinzo Ota, Yoshinobu Sekihara, Takahiro Himeno, Yasue Tanaka, Tatsuya Ohtonari
We performed stent placement under intravascular ultrasound (IVUS), without the use of contrast medium, in a male patient in his 70s who had vertebral artery origin stenosis and decreased renal function. Satisfactory dilatation was achieved without complications, and the patient remained asymptomatic at 2 years of follow-up. We now report the details of this procedure. Stent placement under IVUS guidance may be useful in patients in whom contrast medium is contraindicated.
November 28, 2016: Interventional Neuroradiology
Masahiro Yamawaki, Daisuke Terashita, Hachidai Takahashi, Toshiro Shinke, Kenichi Fujii, Yoshihisa Shimada, Yoshihiro Takeda, Shinichiro Yamada, Yoshihisa Kinoshita, Yoshinobu Murasato
OBJECTIVE: To investigate the impact of diabetes mellitus (DM) on provisional coronary bifurcation stenting under the complete guidance of intravascular-ultrasound (IVUS). BACKGROUND: The efficacy of such intervention has not yet been fully elucidated in the DM patients. METHODS: A total of 100 DM and 139 non-DM patients in a prospective multi-center registry of IVUS-guided bifurcation stenting were compared in angiographic results at 9 months...
December 2016: Journal of Interventional Cardiology
Tadayuki Kadohira, Yoshio Kobayashi
Intravascular ultrasound (IVUS) is a reliable imaging tool to guide percutaneous coronary intervention. There has been increasing evidence supporting the clinical utility of IVUS-guided drug-eluting stent (DES) implantation, including randomized trials, observational studies, and meta-analyses of both. IVUS provides cross-sectional views of the coronary artery wall, and allows us to assess stenosis severity, identify plaque morphology, optimize stent implantation, and understand mechanism of stent failure. IVUS guidance can increase DES efficacy and decrease clinical events...
November 7, 2016: Cardiovascular Intervention and Therapeutics
Ziad A Ali, Akiko Maehara, Philippe Généreux, Richard A Shlofmitz, Franco Fabbiocchi, Tamim M Nazif, Giulio Guagliumi, Perwaiz M Meraj, Fernando Alfonso, Habib Samady, Takashi Akasaka, Eric B Carlson, Massoud A Leesar, Mitsuaki Matsumura, Melek Ozgu Ozan, Gary S Mintz, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation...
November 26, 2016: Lancet
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Dong-Ho Shin, Sung-Jin Hong, Gary S Mintz, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: The aim of this study was to evaluate the clinical usefulness of intravascular ultrasound (IVUS)-guided new-generation drug-eluting stent (DES) implantation using a meta-analysis of individual patient-level data from randomized trials. BACKGROUND: Published randomized trials that compare IVUS-guided versus angiography-guided new-generation DES implantation are scarce. METHODS: Searches of the MEDLINE, Embase, and Cochrane databases were performed to find randomized trials that compared IVUS-guided versus angiography-guided new-generation DES implantation...
October 6, 2016: JACC. Cardiovascular Interventions
Shinsuke Mori, Keisuke Hirano, Yoshiaki Ito, Masahiro Yamawaki, Motoharu Araki, Norihiro Kobayashi, Hideyuki Takimura, Yasunari Sakamoto, Masakazu Tsutsumi, Takuro Takama, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai
AIM: To investigate the relationship between intravascular ultrasound (IVUS) findings and restenosis after stent implantation for long occlusive femoropopliteal (FP) lesions using the intraluminal approach. METHODS: This was a single-center retrospective study of 45 patients (49 lesions) with de novo long occlusive FP lesions treated with bare metal stents implanted using the intraluminal approach under IVUS guidance from April 2007 to December 2014. All patients were followed up at least 12 months...
October 1, 2016: Journal of Atherosclerosis and Thrombosis
Masakazu Nagaoka, Naoko Tsumuraya, Masaki Nie, Yuji Ikari
The occurrence of allergy to iodinated contrast in certain patients may prevent the use of percutaneous coronary intervention (PCI) in such cases. We present a 53-year-old male with a history of allergic reaction to iodinated contrast who successfully underwent intravascular ultrasound (IVUS) guided PCI. Stent size was determined based on IVUS. After PCI, stent expansion and a lack of edge dissection or incomplete apposition were confirmed by IVUS. Thus, PCI without contrast injection under IVUS may be feasible in selected patients with allergy to iodinated contrast...
2016: Tokai Journal of Experimental and Clinical Medicine
Suvranu Ganguli, Beau M Hawkins, Farhad Abtahian, Mazen S Abu-Fadel, Thomas G Walker, Cheryl MacKay, Michael R Jaff, Ido Weinberg
OBJECTIVES: To compare utilization, procedural outcomes, complications and long-term patient outcomes associated with bedside placement of inferior vena cava filters (IVCF) using intravascular ultrasound (IVUS) and fluoroscopic placement of IVCF. BACKGROUND: IVCF are usually placed under fluoroscopic-guidance in dedicated angiography suites. Bedside placement of IVCF is possible in patients not suitable for transportation, but data regarding their use are limited...
August 28, 2016: Annals of Vascular Surgery
Toru Naganuma, Antonio Colombo, Maciej Lesiak, Davide Capodanno, Tommaso Gori, Holger Nef, Giuseppe Caramanno, Christoph Naber, Carlo Di Mario, Neil Ruparelia, Piera Capranzano, Jens Wiebe, Aleksander Araszkiewicz, Salvatore Geraci, Hiroyoshi Kawamoto, Stelios Pyxaras, Alessio Mattesini, Thomas Münzel, Corrado Tamburino, Azeem Latib
OBJECTIVES: The aim of this study was to evaluate midterm outcomes of bioresorbable vascular scaffolds (BVS) implanted in bifurcation lesions. BACKGROUND: BVS have emerged as an alternative to conventional metallic drug-eluting stents for the treatment of coronary complex lesions. METHODS: Between November 2011 and January 2014, 1189 patients underwent percutaneous coronary intervention with BVS at 10 European centers (GHOST EU registry). Of these, 289 consecutive patients (302 bifurcation lesions) treated with either single-stenting (n = 260) or double-stenting (n = 42) were evaluated...
July 14, 2016: Catheterization and Cardiovascular Interventions
Donald C Perrine, Gina Votta-Velis, Alain Borgeat
PURPOSE OF REVIEW: The ability of ultrasound to provide detailed anatomic visualization while avoiding radiation exposure continues to make it an appealing tool for many practitioners of chronic pain management. This review will present the most recent evidence regarding the use of ultrasound-guidance for the performance of interventional procedures in the treatment of chronic pain. RECENT FINDINGS: For a variety of different procedures, studies continue to compare ultrasound-guided techniques to commonly used fluoroscopic or landmark-based techniques...
October 2016: Current Opinion in Anaesthesiology
Anil K Pillai, Brice Andring, Nicholas Faulconer, Stephen P Reis, Yin Xi, Ikponmwosa Iyamu, Patrick D Suthpin, Sanjeeva P Kalva
PURPOSE: To compare safety and effectiveness of intravascular ultrasound (US)-guided portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) creation with conventional TIPS technique. MATERIALS AND METHODS: In this retrospective study, TIPS creation using intravascular US guidance in 55 patients was compared with conventional TIPS creation in 54 patients by 10 operators over a 3-year period. Operators were classified as experienced if they had performed ≥ 20 TIPS procedures at the beginning of the study period...
August 2016: Journal of Vascular and Interventional Radiology: JVIR
Gonzalo D Maso Talou, Pablo J Blanco, Ignacio Larrabide, Cristiano Guedes Bezerra, Pedro A Lemos, Raul A Feijoo
OBJECTIVE: Intravascular ultrasound is a fundamental imaging technique for atherosclerotic plaque assessment, interventionist guidance and, ultimately, as a tissue characterization tool. The studies acquired by this technique present the spatial description of the vessel during the cardiac cycle. However, the study frames are not properly sorted. As gating methods deal with the cardiac phase classification of the frames, the gated studies lack motion compensation between vessel and catheter...
June 15, 2016: IEEE Transactions on Bio-medical Engineering
Georges Ephrem, Sireesha Garikipati, Ivan D Hanson
INTRODUCTION: Percutaneous endovascular revascularization requires the use of fluoroscopic guidance and radiopaque contrast. We present a successful intervention without the use of iodinated contrast. CASE: A 92-year-old man with dry gangrene involving the second and fourth left toes had acute on chronic kidney injury. Arterial duplex showed severe stenosis in bilateral superficial femoral arteries (SFAs). Fluoroscopic and ultrasound guidance and intravascular imaging were used to avoid iodinated contrast...
September 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Satoshi Mogi, Yuichiro Maekawa, Keiichi Fukuda, Shigetaka Noma
The major puncture-site complications of the transfemoral approach are retroperitoneal bleeding (RPB), arteriovenous (AV) fistula, and arterial pseudoaneurysm. Although the management of RPB and AV fistula depends on individual cases, our experience shows that the use of a covered stent with intravascular ultrasound (IVUS) guidance can successfully manage percutaneous coronary intervention-associated RPB and AV fistula. IVUS guidance can therefore make it easy to use an optimal-size covered stent.
2016: Internal Medicine
Metha Brattwall, Pether Jildenstål, Margareta Warrén Stomberg, Jan G Jakobsson
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues...
2016: F1000Research
Sung-Jin Hong, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Ae-Young Her, Yong Hoon Kim, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: The aim of this study was to investigate whether a 6-month dual-antiplatelet therapy (DAPT) duration was comparable with a 12-month duration in patients who underwent everolimus-eluting stent implantation. BACKGROUND: Well-designed studies that determine optimal DAPT strategies after everolimus-eluting stent implantation are limited. METHODS: A total of 1,400 patients (implanted mean total stent length >45 mm) were randomly assigned to receive 6-month (n = 699) or 12-month (n = 701) DAPT between October 2010 and July 2014 at 20 centers in Korea...
July 25, 2016: JACC. Cardiovascular Interventions
Sakura Nagumo, Kohei Wakabayashi, Miki Tsujiuchi, Chisato Sato, Takenori Yamauchi, Toshio Nakadate, Hiroshi Suzuki
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the standard treatment in patients with ST-elevation myocardial infarction (STEMI). However, some patients still develop ST re-elevation during PCI, resulting in further myocardial damage and a poor outcome. An undersized-stenting approach may prevent ST re-elevation. We aimed to determine the association between final stent area and ST re-elevation during primary PCI for STEMI. METHODS: Overall, 102 consecutive STEMI patients who underwent primary PCI under integrated backscatter intravascular ultrasound guidance were enrolled...
September 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Arie Steinvil, Yao-Jun Zhang, Sang Yeub Lee, Si Pang, Ron Waksman, Shao-Liang Chen, Hector M Garcia-Garcia
The use of intravascular ultrasound (IVUS) guidance for drug-eluting stent (DES) optimization is limited by the number of adequately powered randomized control trials (RCTs). We performed an updated meta-analysis, including data from recently published RCTs and observational studies, by reviewing the literature in Medline and the Cochrane Library to identify studies that compared clinical outcomes between IVUS-guided and angiography-guided DES implantation from January 1995 to January 2016. This meta-analysis included 25 eligible studies, including 31,283 patients, of whom 3192 patients were enrolled in 7 RCTs...
August 1, 2016: International Journal of Cardiology
Steven D Kao, Maud M Morshedi, Kazim H Narsinh, Thomas B Kinney, Jeet Minocha, Andrew C Picel, Isabel Newton, Steven C Rose, Anne C Roberts, Alexander Kuo, Hamed Aryafar
PURPOSE: To assess whether intravascular ultrasound (US) guidance impacts number of needle passes, contrast usage, radiation dose, and procedure time during creation of transjugular intrahepatic portosystemic shunts (TIPS). MATERIALS AND METHODS: Intravascular US-guided creation of TIPS in 40 patients was retrospectively compared with conventional TIPS in 49 patients between February 2010 and November 2015 at a single tertiary care institution. Patient sex and age, etiology of liver disease (hepatitis C virus, alcohol abuse, nonalcoholic steatohepatitis), severity of liver disease (mean Model for End-Stage Liver Disease score), and indications for TIPS (variceal bleeding, refractory ascites, refractory hydrothorax) in conventional and intravascular US-guided cases were recorded...
August 2016: Journal of Vascular and Interventional Radiology: JVIR
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