The Role of IVUS for Evaluation & Treatment Optimisation

Slides:

Advertisements

Similar presentations

Study Design 121 Relapsing-remitting MS patients randomized to –Stress Management Therapy MS active treatment* 16 individual sessions conducted over 24.

Advertisements

Jennifer Cohen, MD, Heather Costa, PhD, Robert Russo, MD, PhD, Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA The MagnaSafe Registry:

Vasculature Physiologic Disturbances. Blood Flow Studies Heart And Vessels X-ray plain film for pulmonary vessels only Nuclear Medicine – V/Q Scan Angiography.

Short-term outcomes after endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI) in patients with multiple sclerosis Kenneth Mandato,

Endovascular management of CCSVI: Single Center Experience Hector Ferral, MD, George Behrens, MD, Yanki Tumer, MD, Tameem Souman, MD.

Granja Miguel et al. Hospital Italiano de Buenos Aires. Argentina. Percutaneous Treatment of Severe Aortic Coarctation with PTFE-covered Stent ENDOVASCULAR.

ASNR 2015 Poster# EP-19 Effect of Chemotherapy on Brain Structure and Cognition in Older Women with Breast Cancer: a Brain MRI Study 1 Bihong T. Chen MD.

TRI vs TFI in STEMI Shenyang Northern Hospital Wang Shouli Han Yalin.

Neurological Consequences of Diabetic Ketoacidosis at Initial Presentation of Type 1 Diabetes in a Prospective Cohort Study of Children Featured Article:

We retrospectively analyzed 58 patients with ONSM treated between on a dedicated 6 MV stereotactic LINAC. All cases were discussed in a multidisciplinary.

DR AMER JAFAR ‘STROKE’ October Ethnicity and recurrence of stroke Population-based study Compared poststroke recurrence and survival in Mexican.

Departments of Neurosurgery 1, Cardiology 2, Radiology 3, Gifu University Graduate School of Medicine, Gifu, Japan. Kiyofumi Yamada 1, Shinichi Yoshimura.

Long-term clinical outcome following emergency MR-based reperfusion therapy for acute middle cerebral artery occlusion Department of Stroke Treatment,

Friedrich-Schiller-University, Jena, Germany

Ted Feldman MD, FACC, FESC, FSCAI Disclosure Information The following relationships exist: Grant support: Abbott, BSC, Edwards, St Jude, WL Gore Consultant:

Imaging of radiosurgical planning and follow-up of arteriovenous malformations treated by gamma knife: ten years experience. P.David*, N.Massager**, N.Sadeghi*,

IVUS in Peripheral Procedures

POLISH EXPERIENCE IN CCSVI TREATMENT Marian Simka EuroMedic Department of Vascular & Endovascular Surgery Katowice Poland.

Cerebral Sinus Venous Thrombosis

Imaging and atrial fibrillation: the role of multimodality imaging in patient evaluation and management of atrial fibrillation by Laurens F. Tops, Martin.

Risk of stroke at 3 months6 Expected Strokes at 3 months

NEDA epoch analysis of patients with relapsing multiple sclerosis treated with ocrelizumab: Results from the OPERA I and OPERA II, phase III studies G.

Eric Van Belle MD-PhD, Nicolas Debry MD et al. Heart Institute

CCSVI: can we justify the procedure at this time?

Treatment of iliac vein obstruction

30-Day Safety and Echocardiographic Outcomes Following Transcatheter Aortic Valve Replacement with the Self-Expanding Repositionable Evolut PRO System.

CCSVI Richard F. Neville, MD Professor of Surgery

Treatment of iliac vein obstruction

Marian Simka, MD PhD Katowice, Poland

Introduction Methods Results Conclusions

Copyright © 2010 American Medical Association. All rights reserved.

To compare demographic and clinical characteristics of those with and without diabetes that undergo a lower extremity amputation in Glasgow, UK Fiona.

Restenosis in Peripheral Arteries

Copyright © 2007 American Medical Association. All rights reserved.

Cognitive changes after surgery vs stenting for carotid artery stenosis Brajesh K. Lal, MD, Maha Younes, PhD, Gina Cruz, APN, Indu Kapadia, PA, Zafar.

How the Latest Data in MDD Can Guide Treatment Decisions:

Figure 1 Perivenous distribution of multiple sclerosis lesions

Figure EDSS, FS scores, and Modified MSFC scores

Late Follow-Up from the PARTNER Aortic Valve-in-Valve Registry

Neurology Resident and Fellow Section

Figure 2 ALSFRS-R changes (A) Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) slope after 6 months of treatment without (left)

Nat. Rev. Cardiol. doi: /nrcardio

Angiography-guided PCI

Endovascular treatment of internal iliac artery obstructive disease

Predictors of response to percutaneous ethanol sclerotherapy (PES) in patients with venous malformations: Analysis of patient self-assessment and imaging

Incidence and Mechanisms of Cerebral Ischemia After Transcatheter Aortic Valve Implantation Compared With Surgical Aortic Valve Replacement Aiman Alassar,

Figure Brain MRI of the patient throughout the disease course(A) Brain MRI at the time of cerebral toxoplasmosis diagnosis (a) and after 1 month of toxoplasmosis.

Treating to Target in MS

Figure 1 Patient flow diagram

The Mitral Valve Patient Learning Objectives

ENDOVASCULAR TREATMENT OF COMPLETE INTERRUPTION OF THORACIC AORTA POST SURGICAL REPAIR OF AORTIC COARCTATION Percutaneous treatment of atretic segment.

Proceedings of the 2017 Santa Fe Bone Symposium: Insights and Emerging Concepts in the Management of Osteoporosis E. Michael Lewiecki, John P. Bilezikian,

Figure 2 Primary and secondary outcomes reported in multiple sclerosis (MS) disease-modifying therapy (DMT) clinical trials Primary and secondary outcomes.

Figure 2 7T MRI can differentiate between early PML and MS lesions Two different patterns of brain lesions were observed using 7T MRI: ring-enhancing lesions.

Brian D. Williamson et al. JACEP 2017;3:

Figure 2 A case of early-onset PSD

Multimodality imaging of aortic stenosis.

Figure 1 Patterns of study retention The proportion of individuals actively participating in the study is displayed over the course of the study. Patterns.

Left Atrial Appendage Occlusion for The Unmet Clinical Needs of Stroke Prevention in Nonvalvular Atrial Fibrillation David R. Holmes, MD, Mohamad Alkhouli,

New brain lesions after carotid revascularization are not associated with cognitive performance Katrin Wasser, MD, Sara M. Pilgram-Pastor, MD, Sonja.

Left Atrial Fibrosis Assessed with Cardiac MRI in Patients with Paroxysmal and Those with Persistent Atrial Fibrillation More than two left atrial segments.

A Complication of Vein Graft Aneurysm Following the Use of Cutting Balloon Angioplasty in Recurrent Infrainguinal Venous Conduit Stenosis M. Kumar, J.

Mean Pulmonary Artery Pressure Change Post-Thrombectomy Average pre-procedural mean pulmonary artery pressure (mPAP) in patients with pulmonary hypertension.

Michael J. Gough, ChM, FRCS Journal of Vascular Surgery

Abdominal magnetic resonance imaging of a patient with tuberous sclerosis complex lymphangioleiomyomatosis and multiple small renal angiomyolipomas (arrows)

Antitumor activity. Antitumor activity. A, maximum change in target lesion size from baseline assessed according to RECIST 1.0 (n = 26). Six patients had.

A 63-year-old female with a giant left internal carotid artery, cavernous segment aneurysm undergoing treatment with PED. Angiography from a catheter positioned.

(A) Pre-embolization right external carotid lateral view angiograms demonstrating a large blush consistent with a hypervascular glomus jugulare tumor.

Magnetic resonance imaging (MRI) of the right leg shows a 1. 1 × 0

Figure 4 Illustration of a practice effect by examining longitudinal performance measures in patients with MS and cohabitants (A) Response time for each.

Presentation transcript:

The Role of IVUS for Evaluation & Treatment Optimisation The Venoplasty Programme The Venoplasty Programme, The Edinburgh Clinic, Scotland

CAROTID IVUS

CAROTID IVUS Irshad K, Reid D, Miller P et al. 2001 J Endovasc Ther ; 8 : 329 - 338

Percutaneous Femoral Vein Access

Percutaneous Femoral Vein Access

IVUS

IVUS

Abnormal Valve

Abnormal Valve

Abnormal Valve

A Prospective Study of Clinical Effectiveness & Safety 322 CCSVI Patients with MS undergoing venoplasty

MS SPECIFIC FUNCTIONAL COMPOSITE SCORING SYSTEM National MS Society

MS SPECIFIC QUALITY OF LIFE QUESTIONAIRE National MS Society

Magnetic Resonance Imaging

Assessment before treatment & at 6 months Doppler Scan MRI Independent neurological examination scoring (MSFC) Quality of Life scoring

322 CCSVI Patients with Multiple Sclerosis Results 322 CCSVI Patients with Multiple Sclerosis 99 % Technical Success

322 CCSVI Patients with Multiple Sclerosis Results 322 CCSVI Patients with Multiple Sclerosis Complications : 1 transient atrial fibrillation 1 rash 2 extravasation of contrast

MSFC SCORE {Z arm average + Z leg average + Z cognitive}/3.0 Pre-treatment score -0.128 Post treatment score +1.542 A decrease or an increase in the MSFC score represents, respectively, deterioration or improvement in neurological functions.

MSQoL QoL Pre Rx(Physical) ± SD 43.06 ± 17.93 QoL Post Rx(Physical) ± SD 53 ± 22.17 QoL Pre Rx(Mental) ± SD 57.77 ± 24.01 QoL Post Rx(Mental) ± SD 68 ± 21.57

NATIONAL INSTITUE FOR CLINICAL EXCELLENCE DRAFT GUIDELINES

Conclusions CCSVI is associated with Multiple Sclerosis Endovascular treatment is feasible as day case Balloon angioplasty has limitations IVUS is helpful but not essential

Venoplasty Programme Donald Reid Khalid Irshad Raj Velu Martin Errington David Kean Barun Majumber Thomas Gilhooly David Pugh Fiona Hassel