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Intravascular Ultrasound and Summary

Joseph M Neal, Michael J Barrington, Michael R Fettiplace, Marina Gitman, Stavros G Memtsoudis, Eva E Mörwald, Daniel S Rubin, Guy Weinberg
The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity...
February 2018: Regional Anesthesia and Pain Medicine
Philipp Nicol, Erion Xhepa, Dmitry Bozhko, Michael Joner
Development of new atherosclerotic lesions within the neointima of stented vessels has been recognized as a novel disease manifestation of atherosclerosis (neoatherosclerosis), often manifesting as in-stent restenosis (ISR) or in-stent thrombosis (ST). The pathobiology of this entity is still not fully understood and definite diagnosis is challenging owing to limitations in resolution of contemporary intravascular imaging modalities and lack of consequent histopathology correlation studies. Yet, intravascular imaging has emerged as the gold standard for the diagnosis of in-stent pathologies, the most routinely used modalities being intravascular ultrasound (IVUS) and optical coherence tomography (OCT)...
November 20, 2017: Minerva Cardioangiologica
Brett Z Fite, Azadeh Kheirolomoom, Josquin L Foiret, Jai W Seo, Lisa M Mahakian, Elizabeth S Ingham, Sarah M Tam, Alexander D Borowsky, Fitz-Roy E Curry, Katherine W Ferrara
Temperature-sensitive liposomal formulations of chemotherapeutics, such as doxorubicin, can achieve locally high drug concentrations within a tumor and tumor vasculature while maintaining low systemic toxicity. Further, doxorubicin delivery by temperature-sensitive liposomes can reliably cure local cancer in mouse models. Histological sections of treated tumors have detected red blood cell extravasation within tumors treated with temperature-sensitive doxorubicin and ultrasound hyperthermia. We hypothesize that the local release of drug into the tumor vasculature and resulting high drug concentration can alter vascular transport rate constants along with having direct tumoricidal effects...
June 28, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
Jae-Sik Jang, Ho-Cheol Shin, Jong Seok Bae, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Kyoung-Im Cho, Bo-Hyun Kim, Yong Hyun Park, Hyung-Gon Je, Dong-Soo Kim
BACKGROUND AND OBJECTIVES: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention frequently results in unnecessary stenting due to the low positive predictive value of IVUS-derived minimal lumen area (MLA) for identification of functionally significant coronary stenosis. We appraised the diagnostic accuracy of IVUS-derived MLA compared with the fractional flow reserve (FFR) to assess intermediate coronary stenosis. SUBJECTS AND METHODS: We searched MEDLINE and Cochrane databases for studies using IVUS and FFR methods to establish the best MLA cut-off values to predict significant non-left main coronary artery stenosis...
September 2016: Korean Circulation Journal
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
Islam Y Elgendy, Ahmed N Mahmoud, Akram Y Elgendy, Anthony A Bavry
BACKGROUND: In the era of drug-eluting stents, it is unknown if intravascular ultrasound (IVUS) guidance for percutaneous coronary intervention should be routinely endorsed. This study aimed to determine if IVUS-guided stent implantation is associated with improved outcomes. METHODS AND RESULTS: Randomized trials that reported clinical outcomes and compared routine IVUS-guided stent implantation with an angiography-guided approach in the era of drug-eluting stents were included...
April 2016: Circulation. Cardiovascular Interventions
Jonathan A Batty, Shristy Subba, Peter Luke, Li Wing Chi Gigi, Hannah Sinclair, Vijay Kunadian
Coronary artery disease is the result of atherosclerotic changes to the coronary arterial wall, comprising endothelial dysfunction, vascular inflammation and deposition of lipid-rich macrophage foam cells. Certain high-risk atherosclerotic plaques are vulnerable to disruption, leading to rupture, thrombosis and the clinical sequelae of acute coronary syndrome. Though recognised as the gold standard for evaluating the presence, distribution and severity of atherosclerotic lesions, invasive coronary angiography is incapable of identifying non-stenotic, vulnerable plaques that are responsible for adverse cardiovascular events...
March 2016: Current Cardiology Reports
Andrzej Ochała, Zbigniew Siudak, Jacek Legutko, Radosław Parma, Zbigniew Chmielak, Stanisław Bartuś, Sławomir Dobrzycki, Marek Grygier, Tomasz Moszura, Tomasz Pawłowski, Dariusz Dudek
INTRODUCTION: The Board of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) publishes annual data from the National PCI Registry (ORPKI) operated by the Jagiellonian University Medical College in Krakow. AIM: For the first time the AISN PTK report is based on the new electronic database implemented in Poland on January 1(st), 2014. MATERIAL AND METHODS: In 2014, there were 155 invasive cardiology centers registered in the ORPKI database (an increase by 1 center in comparison to 2013) and 92% of them had 24/7 percutaneous (PCI) duty...
2015: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Nova L Panebianco, Frances Shofer, Alfred Cheng, Jonathan Fischer, Kenneth Cody, Anthony J Dean
BACKGROUND: Ultrasound of the inferior vena cava (IVC) is a noninvasive and rapidly obtainable method of intravascular volume assessment; however not all patients can lie supine for this procedure. In this study we assess whether patient positioning affects IVC diameter metrics. METHODS: This was a prospective convenience sample of patients in an in-patient dialysis unit at an urban tertiary care center. IVC metrics taken in the supine patient, and then at 45o semi-upright position, pre and post dialysis...
November 2014: American Journal of Emergency Medicine
Michael Gofeld, Kacey A Montgomery
SUMMARY Ultrasound-guided procedures are well established and utilized in the regional anesthesia and radiology practice. Conversely, there have been considerable difficulties in implementation of ultrasound in pain medicine. Ultrasonography has to compete with the more established modalities such as fluoroscopy and computed tomography; however, ultrasound has the advantage of radiation safety and point-of care imaging. It also allows direct visualization of tissue planes, blood vessels and nerves. Ultrasound-guided spine interventions are technically feasible and reasonably accurate when validated with conventional radiological modalities...
July 2012: Pain Management
Jae-Sik Jang, Yeo-Jeong Song, Wook Kang, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Kyoung-Im Cho, Bo-Hyun Kim, Yong Hyun Park, Hyung-Gon Je, Dong-Soo Kim
OBJECTIVES: The aim of this study was to systematically review and perform a meta-analysis of randomized trials and observational studies of intravascular ultrasound (IVUS)-guided versus angiography-guided implantation of drug-eluting stents (DES). BACKGROUND: Although studies in the bare-metal stents era suggested that there were clinical benefits to IVUS guidance, it is still controversial whether percutaneous coronary intervention (PCI) with DES guided by IVUS leads to better clinical outcomes...
March 2014: JACC. Cardiovascular Interventions
Bruno R Nascimento, Marcos R de Sousa, Bon-Kwon Koo, Habib Samady, Hiram G Bezerra, Antônio L P Ribeiro, Marco A Costa
INTRODUCTION: Although intravascular ultrasound minimal luminal area (IVUS-MLA) is one of many anatomic determinants of lesion severity, it has been proposed as an alternative to fractional flow reserve (FFR) to assess severity of coronary artery disease. OBJECTIVE: Pool the diagnostic performance of IVUS-MLA and determine its overall accuracy to predict the functional significance of coronary disease using FFR (0.75 or 0.80) as the gold standard. METHODS: Studies comparing IVUS and FFR to establish the best MLA cutoff value that correlates with significant coronary stenosis were reviewed from a Medline search using the terms "fractional flow reserve" and "ultrasound...
September 1, 2014: Catheterization and Cardiovascular Interventions
Giuseppe Ferrante, Patrizia Presbitero, Robert Whitbourn, Peter Barlis
Optical coherence tomography (OCT) is the 'new kid on the block' in coronary imaging. This technology offers clinicians a high resolution (approximately 15μm), that is ten times higher than the currently accepted gold standard of intravascular ultrasound and has emerged as the ideal imaging tool for the assessment of superficial components of coronary plaques and stent struts. Novel OCT systems can perform quick and safe scanning of coronary arteries with a non-occlusive technique. A brief summary containing the key physical principles of OCT technology with particular attention to the novel Fourier domain system is presented...
April 30, 2013: International Journal of Cardiology
Igor E Adzerikho, Alexander G Mrochek, Vladimir T Minchenya, Vyacheslav V Dmitriev, Anatoly I Kulak
To prevent a distal embolization in the course of ultrasound (US) angioplasty, we combined US thrombus disruption in peripheral artery in vivo with simultaneous administration of streptokinase (SK). Acute thrombosis was induced in the femoral arteries of 23 dogs. Two hours after thrombus formation, thrombus destruction was performed using US (36 kHz) and by a combined US+SK (75,000 U/kg) administration. The results showed that thrombi were disrupted completely by 1.5 ± 0.5 min US. A combined US+SK action resulted in activation of fibrinolysis, as indicated by the increase in the content of fibrinogen and fibrin degradation products and D-dimers by a factor of 1...
October 2011: Ultrasound in Medicine & Biology
François Audibert, Alain Gagnon
OBJECTIVE: To provide a Canadian consensus document with recommendations on prenatal screening for and diagnosis of fetal aneuploidy (e.g., Down syndrome and trisomy 18) in twin pregnancies. OPTIONS: The process of prenatal screening and diagnosis in twin pregnancies is complex. This document reviews the options available to pregnant women and the challenges specific to screening and diagnosis in a twin pregnancy. OUTCOMES: Clinicians will be better informed about the accuracy of different screening options in twin pregnancies and about techniques of invasive prenatal diagnosis in twins...
July 2011: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Salvatore Brugaletta, Hector M Garcia-Garcia, Patrick W Serruys, Sanneke de Boer, Jurgen Ligthart, Josep Gomez-Lara, Karen Witberg, Roberto Diletti, Joanna Wykrzykowska, Robert-Jan van Geuns, Carl Schultz, Evelyn Regar, Henricus J Duckers, Nicolas van Mieghem, Peter de Jaegere, Sean P Madden, James E Muller, Antonius F W van der Steen, Wim J van der Giessen, Eric Boersma
OBJECTIVES: The aim of this study was to compare the findings of near-infrared spectroscopy (NIRS), intravascular ultrasound (IVUS) virtual histology (VH), and grayscale IVUS obtained in matched coronary vessel segments of patients undergoing coronary angiography. BACKGROUND: Intravascular ultrasound VH has been developed to add tissue characterization to the grayscale IVUS assessment of coronary plaques. Near-infrared spectroscopy is a new imaging technique able to identify lipid core-containing coronary plaques (LCP)...
June 2011: JACC. Cardiovascular Imaging
C Greis
Ultrasound contrast agents have considerably expanded the range of ultrasound diagnostics. Up to date ultrasound machines with contrast-specific software allow the selective demonstration and quantification of contrast agents in real-time based on the specific signal signature of oscillating contrast agent microbubbles. After intravenous injection the microbubbles are transported with the bloodstream and distributed purely intravascularly. This allows an artefact-free representation of the vascular architecture and delineation of the vascular lumen, independent of blood flow velocity and with high spatial resolution...
June 2011: Der Radiologe
Fabian Kiessling, Jessica Gaetjens, Moritz Palmowski
Stabilized microbubbles with a size between 1-5 µm are used as ultrasound contrast agents in the clinical routine. They have shown convincing results for the vascular characterization of tissues as well as in echocardiography. Due to their size, microbubbles strictly remain intravascular where they can be detected with high sensitivity and specificity. This qualifies them for intravascular molecular imaging. Many studies have been published reporting on the successful use of microbubbles conjugated to specific ligands for target identification in vivo...
2011: Theranostics
Chi-Hang Lee
Percutaneous coronary intervention (PCI) with stent implantation has become the predominant revascularization therapy for coronary artery disease. However, stent thrombosis and instent restenosis remain 2 major complications. Limitations of stand-alone angiographic guidance play a significant role in the pathogenesis of these complications. Intravascular ultrasound (IVUS) guidance intuitively offers the best chance of optimizing the acute procedural outcomes, which translates to lower incidences of thrombosis and restenosis...
February 2012: Journal of Interventional Cardiology
Gastón A Rodriguez-Granillo, Pierfrancesco Agostoni, Héctor M Garcia-Garcia, Giuseppe G L Biondi-Zoccai, Eugène McFadden, Giovanni Amoroso, Peter de Jaegere, Nico Bruining, Pim de Feyter, Patrick W Serruys
To assess the temporal effect of statin therapy on coronary atherosclerotic plaque volume measured by intravascular ultrasound (IVUS), we searched PubMed for eligible studies published between 1990 and January 2006. Inclusion criteria for retrieved studies were (1) IVUS volume analysis at baseline and follow-up and (2) statin therapy in > or =1 group of patients. All data of interest were abstracted in prespecified structured collection forms. Statistical analysis was performed with Review Manager 4.2. Random-effect weighted mean difference (WMD) was used as summary statistics for comparison of continuous variables...
January 1, 2007: American Journal of Cardiology
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