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chronic total occlusion mri

José P S Henriques, Loes P Hoebers, Truls Råmunddal, Peep Laanmets, Erlend Eriksen, Matthijs Bax, Dan Ioanes, Maarten J Suttorp, Bradley H Strauss, Emanuele Barbato, Robin Nijveldt, Albert C van Rossum, Koen M Marques, Joëlle Elias, Ivo M van Dongen, Bimmer E P M Claessen, Jan G Tijssen, René J van der Schaaf
BACKGROUND: In 10% to 15% of patients with ST-segment elevation myocardial infarction (STEMI), concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery is present and is associated with increased morbidity and mortality. OBJECTIVES: The EXPLORE (Evaluating Xience and Left Ventricular Function in Percutaneous Coronary Intervention on Occlusions After ST-Elevation Myocardial Infarction) trial evaluated whether patients with STEMI and concurrent CTO in a non-infarct-related artery benefit from additional percutaneous coronary intervention (PCI) of CTO shortly after primary PCI...
October 11, 2016: Journal of the American College of Cardiology
Seung Chai Jung, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
PURPOSE: The aim of this article is to present high-resolution magnetic resonance imaging (HR-MRI) findings of chronic stage spontaneous and unruptured intracranial artery dissection (ICAD). MATERIAL AND METHODS: From March 2012 to April 2016 a total of 29 patients (15 male and14 female, age range 37-68 years) with chronic stage spontaneous and unruptured ICAD (vertebral artery 27, posterior inferior cerebellar artery 1 and middle cerebral artery 1) were retrospectively enrolled...
September 27, 2016: Clinical Neuroradiology
Trisha Roy, Garry Liu, Noor Shaikh, Andrew D Dueck, Graham A Wright
PURPOSE: To test and validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization and relate the MRI characteristics to the amount of force required for a guidewire to puncture peripheral chronic total occlusions (CTOs) as a surrogate for immediate failure of endovascular therapy. METHODS: Diseased superficial femoral, popliteal, and tibial artery segments containing 55 atherosclerotic lesions were excised from the amputated limbs of 7 patients with critical limb ischemia...
September 22, 2016: Journal of Endovascular Therapy
Ahmed Chebil, Yosra Falfoul, Rym Limaiem, Leila El Matri
BACKGROUND: Chronic corneal ulcers still pose etiological and therapeutic challenge. They are serious complications and often associated with poor functional prognosis. AIM: We report the case of a patient with bilateral and chronic corneal ulcer revealing a rare   familial   form   of   bilateral   agenesis   of   the   lacrimal   gland. CASES REPORT: A 39-year-old man was referred to our department for bilateralchronic and sterile ulcer...
January 2016: La Tunisie Médicale
Makoto Araki, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Eisuke Usui, Takayuki Niida, Sadamitsu Ichijo, Rikuta Hamaya, Tsunekazu Kakuta
The reverse CART technique provides the potential to modify the retrograde procedure by improving the controlled movement of the retrograde wire and improve the success rates of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Development of interventricular hematoma is a rare complication of CTO PCI. A 63-year-old man with effort angina with a right coronary artery CTO lesion underwent PCI by retrograde approach from the LAD to a septal branch. A contrast "stain" was demonstrated surrounding the septal collateral channel used for the retrograde approach at the end of the procedure without symptom...
2016: Case Reports in Medicine
Sung Mok Kim, Jin-Ho Choi, Yeon Hyeon Choe
PURPOSE: To compare the success rates of percutaneous coronary interventions (PCIs) for chronic total occlusion (CTO) lesions according to the different signal intensity (SI) patterns seen at coronary magnetic resonance (MR) angiography. MATERIALS AND METHODS: Institutional review board approval was obtained, and all patients gave written informed consent. This study included 95 CTO lesions in 93 consecutive patients who underwent steady-state free-precession coronary MR angiography with a 1...
April 2016: Radiology
Philipp Chadid, Sinisa Markovic, Peter Bernhardt, Vinzenz Hombach, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Successful recanalization of true chronic total occlusion (CTO) has been linked to a decrease in cardiac mortality. We evaluated the effect of CTO recanalization on LVEF and regional wall motion using paired cardiac magnetic resonance imaging (cMRI) studies. METHODS AND RESULTS: 43 patients underwent contrast enhanced cMRI prior to and 9 months after successful recanalization of a true CTO defined as thrombolysis in myocardial infarction flow 0 and duration of occlusion of more than 3 months...
June 2015: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Yue-Qi Zhu, Jue Wang, Hua-Qiao Tan, Hai-Tao Lu, Fang Liu, Ying-Sheng Cheng, Li-Ming Wei, Pei-Lei Zhang, Jun-Gong Zhao
PURPOSE: To compare the feasibility and efficacy of recanalizing below-the-knee (BTK) chronic total occlusions (CTOs) between patients with good or poor distal runoff based on magnetic resonance angiography (MRA) scans. METHODS: Two hundred long-segment BTK CTOs in 171 limbs of 113 diabetic patients (58 men; mean age 69.8±1.9 years) were divided into good distal runoff (GDR: 119 lesions, 98 limbs) or poor distal runoff groups (PDR: 81 lesions, 73 limbs) based on baseline MRA findings...
April 2015: Journal of Endovascular Therapy
David P Ripley, Oliver E Gosling, Loke Bhatia, Charles R Peebles, Angela C Shore, Nick Curzen, Nick G Bellenger
BACKGROUND: A collateral circulation which supplies a myocardial territory, subtended by a chronic total occlusion (CTO), may be observed at invasive coronary angiography. The prognostic and protective role of such collateralisation is well demonstrated suggesting that a good collateral circulation may be a predictor of myocardial viability, but current evidence is discrepant. The aim of this study is to assess the relationship between collateralisation from the contralateral epicardial vessels and myocardial viability by cardiovascular magnetic resonance (CMR)...
December 15, 2014: International Journal of Cardiology
P H Gao, L Yang, G Wang, L Guo, X Liu, B Zhao
PURPOSE: Isolated middle cerebral artery dissection (MCAD) is a rare but important clinical entity. The purpose of this study is to demonstrate the clinical and magnetic resonance imaging (MRI) features of symptomatic unruptured isolated MCAD. METHODS: We retrospectively analyzed clinical characteristics and MRI features of eight consecutive ischemic stroke patients diagnosed with unruptured isolated MCAD over a 1-year period. RESULTS: All the patients had symptoms of cerebral infarction, whereas one patient was presented as transient ischemic attack...
March 2016: Clinical Neuroradiology
Yasuaki Tanaka, Martin Genet, Lik Chuan Lee, Alastair J Martin, Richard Sievers, Edward P Gerstenfeld
BACKGROUND: Standard electroanatomic mapping systems use a single catheter to perform left ventricular substrate mapping. A new mapping system uses a 64-electrode mini-basket catheter to perform rapid automated acquisition of chamber geometry, voltage, and activation. OBJECTIVE: The aim of this study was to compare the accuracy of electroanatomic mapping using the basket catheter with that of mapping using a standard linear catheter in a swine model of chronic myocardial infarction...
January 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Burcu Zeydan, Gulcin Benbir, Derya Uluduz, Birsen Ince, Baki Goksan, Civan Islak
A 37-year-old male, previously diagnosed with GAPO syndrome, was admitted to our hospital complaining of recurrent episodes of transient weakness and numbness in his left arm for 3 months, and severe headache with progressive dysphagia for 15 days. His cranial magnetic resonance (MR) images showed multiple ischemic foci in the bilateral periventricular and supraventricular white matter. Cerebral MR-angiography showed total occlusion of the right internal carotid artery and moderate stenosis in the left internal carotid...
May 2014: American Journal of Medical Genetics. Part A
Jiayin Zhang, Yuehua Li, Minghua Li, Jingwei Pan, Zhigang Lu
PURPOSE: To assess the correlation between the filling pattern of distal coronary vessels in patients with chronic total occlusion (CTO) observed at coronary computed tomographic (CT) angiography and the extent of downstream myocardial infarction (MI). MATERIALS AND METHODS: All patients gave written informed consent, and the institutional review board approved the study protocol. A total of 97 patients (mean age, 68.5 years ± 11.5 [standard deviation]; age range, 38-87 years; 77 men, 20 women) with 106 CTOs were prospectively enrolled...
June 2014: Radiology
Sung-Ha Hong, Ludmila Belayev, Larissa Khoutorova, Andre Obenaus, Nicolas G Bazan
Recently we demonstrated that docosahexaenoic acid (DHA) is highly neuroprotective when animals were allowed to survive during one week. This study was conducted to establish whether the neuroprotection induced by DHA persists with chronic survival. Sprague-Dawley rats underwent 2h of middle cerebral artery occlusion (MCAo) and treated with DHA or saline at 3h after MCAo. Animals received neurobehavioral examination (composite neuroscore, rota-rod, beam walking and Y maze tests) followed by ex vivo magnetic resonance imaging and histopathology at 3 weeks...
March 15, 2014: Journal of the Neurological Sciences
Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Meike Coldewey, Thomas Munzel, Wolfgang Dippold, Philipp Wild
We report about a 56-year-old man with dyspnoea and leg pain diagnosed with Leriche syndrome and chronic heart failure caused by dilated cardiomyopathy (DCM) with acute cardiac decompensation. Optimising of chronic heart failure therapy with diuretic and antihypertensive drugs leaded to recompensation. A defibrillator was implanted, and afterwards surgical therapy of Leriche syndrome was planned.Leriche syndrome is an uncommon variant of atherosclerotic occlusive disease characterised by total occlusion in abdominal aorta and/or both iliac arteries...
March 2014: Wiener Klinische Wochenschrift
Sandra Pujadas, Victoria Martin, Xavier Rosselló, Francesc Carreras, Antonio Barros, Ruben Leta, Xavier Alomar, Juan Cinca, Manel Sabate, Guillem Pons-Llado
BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of a coronary artery can provide benefits in terms of myocardial function and survival but the procedure is complex and the success rate is relatively low. To assess these benefits, myocardial function, ischemia and viability should be clearly determined by means of a reliable diagnostic test. This study aimed to assess ventricular function and myocardial ischemia before and after PCI for CTO using cardiac magnetic resonance (CMR)...
October 30, 2013: International Journal of Cardiology
Idan Roifman, Gideon A Paul, Mohammad I Zia, Lynne K Williams, Stuart Watkins, Harindra C Wijeysundera, Andrew M Crean, Bradley H Strauss, Alexander J Dick, Graham A Wright, Kim A Connelly
BACKGROUND: Percutaneous coronary intervention (PCI) is frequently attempted to open chronic total occlusions (CTOs) and restore epicardial coronary flow. Data suggest adverse outcomes in the case of PCI failure. We hypothesized that failure to open a CTO might adversely affect regional cardiac function and promote deleterious cardiac remodelling, and success would improve global and regional cardiac function assessed using cardiac magnetic resonance and velocity vector imaging. METHODS: Thirty patients referred for PCI to a CTO underwent cardiac magnetic resonance examination before and after the procedure...
November 2013: Canadian Journal of Cardiology
David Sicong Fan, Serge Alexander Sorser, Roberto Mauro Gamarra
Sclerosing cholangitis is a chronic cholestatic liver disease defined by both inflammatory and fibrotic changes of the biliary tract leading to diffuse stricture formation. This entity exists in both a primary and secondary form. Here we present a rare case of secondary sclerosing cholangitis due to direct metastasis from a gallbladder adenocarcinoma. A 55-year-old morbidly obese male presented electively with a 2-week history of low back pain and scleral icterus for 2 days. He also described severe epigastric pain that worsened postprandially and a 13 kg weight loss over the previous month...
January 2013: Case Reports in Gastroenterology
David E Kandzari
While the challenges associated with chronic total coronary occlusions may appear formidable, our evolving understanding of the benefits of revascularization has contributed to increasing interest in this lesion subset, reflected in an increasing number of chronic total occlusion (CTO) procedures, the development of novel technologies and the design of trials dedicated to CTO revascularization. Although studies examining the efficacy of stenting following CTO recanalization have consistently demonstrated improved outcomes than angioplasty alone, rates of restenosis and reocclusion remain unacceptably higher compared with those observed for treatment of non-occlusive lesions...
February 2004: Journal of Invasive Cardiology
Aaron A Teitelbaum, Xiuling Qi, Azriel B Osherov, Ashley R Fraser, Michelle Ladouceur-Wodzak, Nigel Munce, Beiping Qiang, Max Weisbrod, Daniel Bierstone, Ilana Erlich, John D Sparkes, Graham A Wright, Bradley H Strauss
AIMS: Percutaneous revascularisation of chronic total occlusions (CTO) is limited by failure of guidewire crossing. Neovascularisation within the proximal CTO segment may be important for guidewire crossing and dramatically declines in CTO beyond six weeks of age. The aims of the current study were to determine whether local delivery of a pro-angiogenic growth factor increases neovascularisation in mature CTO and facilitates guidewire crossings. METHODS AND RESULTS: CTO (n=51) were created in the femoral arteries of 44 New Zealand white rabbits using the thrombin injection model...
January 22, 2013: EuroIntervention
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