G. Pieter Gerritsen, MD, Elma J. Gussenhoven, MD, Salem H. K

Slides:

Advertisements

Similar presentations

Elastin, collagen, and some mechanical aspects of arterial aneurysms

Advertisements

Feasibility of transgastric ultrasonography of the abdominal aorta

Follow-up of renal artery stenosis by duplex ultrasound

Ultrasound measurement of the luminal diameter of the abdominal aorta and iliac arteries in patients without vascular disease Ole Martin Pedersen, MD,

Arterial rupture without balloon rupture during percutaneous transluminal angioplasty Timothy P. Murphy, M.D., John J. Cronan, M.D., Landy P. Paolella,

Mohammed Al-Omran, MD, MSc Journal of Vascular Surgery

Low-dose direct fibrinolysis in peripheral vascular disease

The accuracy of CT scanning in the diagnosis of abdominal and thoracoabdominal aortic aneurysms George J. Todd, MD, Roman Nowygrod, MD, Alan Benvenisty,

Diagnosis of Atherosclerosis by Imaging

Technique for obtaining proximal intraluminal control when arteries are inaccessible or unclampable because of disease or calcification Frank J. Veith,

Central venous catheter failure is induced by injury and can be prevented by stabilizing the catheter tip Ted R. Kohler, MD, Thomas R. Kirkman, BS Journal.

Intravascular ultrasonography allows accurate assessment of abdominal aortic aneurysm: An in vitro validation study Jeroen A. van Essen, MD, Aad van.

Persistent sciatic artery and vein: An unusual case

The comparative evaluation of three-dimensional magnetic resonance for carotid artery disease Donald K. Wilkerson, MD, Irwin Keller, MD, Reuben Mezrich,

Thermal laser-assisted balloon angioplasty of the superficial femoral artery: A multicenter review of 602 cases David Rosenthal, MD, Felix A. Pesa, MD,

Mycotic axillary artery aneurysm

Efficacy of a filter device in the prevention of embolic events during carotid angioplasty and stenting: An ex vivo analysis Takao Ohki, MD, Gary S.

Feasibility of transgastric ultrasonography of the abdominal aorta

Douglas M. Cavaye, FRACS, William J. French, MD, Rodney A

In vivo human comparison of intravascular ultrasonography and angiography Marwan Tabbara, MD, Rodney White, MD, Douglas Cavaye, FRACS, George Kopchok,

Ryan A. Helmick, MD, Charles L. Mesh, MD Journal of Vascular Surgery

Malcolm O. Perry, MD, Richard Kempczinski, MD

The potential for lower extermity revascularization without contrast arteriography: Experience with magnetic resonance angiography Richard P. Cambria,

Intimal angiosarcoma presenting with common femoral artery aneurysm

Remodeling in peripheral vein graft revisions: Serial study with three-dimensional ultrasound imaging Daniel F. Leotta, PhD, Jean F. Primozich, BS, Kirk.

M. R. Sapoval, MD, B. Beyssen, MD, J. Y. Pagny, MD, E

Turbulence occurring after carotid bifurcation endarterectomy: A harbinger of residual and recurrent carotid stenosis Dennis F. Bandyk, M.D., Hermann.

William W. Lin, BA, Gregory S. McGee, MD, Bruce K

Failed percutaneous transluminal renal angioplasty: Experience with lesions requiring operative intervention Richard H. Dean, M.D., James T. Callis,

Ruptured ovarian artery aneurysm: A case report

Ex vivo human carotid artery bifurcation stenting: Correlation of lesion characteristics with embolic potential Takao Ohki, MD, Michael L. Marin, MD,

Joseph L. Mills, MD, Spence M. Taylor, MD, Roy M. Fujitani, MD

Dissection of the external iliac artery in highly trained athletes

Local photodynamic action of methylene blue favorably modulates the postinterventional vascular wound healing response Joerg Heckenkamp, MD, Farzin Adili,

In vitro evaluation of multiple arterial stenoses using three-dimensional power Doppler angiography Zhenyu Guo, PhD, Louis-Gilles Durand, PhD, Louis.

Douglas M. Cavaye, FRACS, Rodney A. White, MD, George E

Presidential address: Vascular surgery—The third generation

Objective tinnitus resulting from internal carotid artery stenosis

Aortic dissection: Percutaneous management of ischemic complications with endovascular stents and balloon fenestration Suzanne M. Slonim, MD, Ulf Nyman,

First experience using intraoperative contrast-enhanced ultrasound during endovascular aneurysm repair for infrarenal aortic aneurysms Reinhard Kopp,

Criteria for defining significant central vein stenosis with duplex ultrasound Nicos Labropoulos, PhD, DIC, RVT, Marc Borge, MD, Kenneth Pierce, MD, Peter.

David C. Taylor, M. D. , Mark D. Kettler, M. D. , Gregory L. Moneta, M

Successful treatment tailored to each splanchnic arterial lesion due to segmental arterial mediolysis (SAM): Report of a case Takuya Hashimoto, MD, Juno.

Intermittent claudication in a professional rugby player

Increased collagenase activity in early aneurysmal dilatation

John F. Eidt, MD, Mark B. Kahn, MD, Gary W. Barone, MD, James M

Human percutaneous and intraoperative laser thermal angioplasty: Initial clinical results as an adjunct to balloon angioplasty Timothy A. Sanborn, M.D.,

Proximal bleeding control obtained by a balloon catheter in the surgical repair of a left supraclavicular traumatic arteriovenous fistula A. Nemes, L.

Alternative techniques for management of distal anastomoses of aortofemoral and iliofemoral endovascular grafts Reese A. Wain, MD, Ross T. Lyon, MD,

Martin E. Harrington, MD, Myron E. Schwartz, MD, Timothy A

Ruptured abdominal aortic aneurysm: A population-based study

Evaluation of carotid artery stenosis: Is duplex ultrasonography sufficient? Paula M. Muto, MD, Harold J. Welch, MD, William C. Mackey, MD, Thomas F.

Low-dose direct fibrinolysis in peripheral vascular disease

Ramesh Lokanathan, MD, FRCS(C), David C. Taylor, MD, FRCS(C)

Limitations of ultrasonic duplex scanning for diagnosing lower limb arterial stenoses in the presence of adjacent segment disease Louis Allard, MSc,

Plaque area increase and vascular remodeling contribute to lumen area change after percutaneous transluminal angioplasty of the femoropopliteal artery:

Peter F. Lawrence, MD, Ke Li, MD, Steven W. Merrell, MD, Greg R

Research and research funding in vascular surgery

A multicenter study of popliteal aneurysms

Excimer laser—assisted femoral angioplasty: Early results

Carotid biaxillary bypass: A new operation

Spontaneous thrombosis of iatrogenic femoral artery pseudoaneurysms: Documentation with color Doppler and two-dimensional ultrasonography Joseph P. Johns,

Kim J. Hodgson, M.D., David S. Sumner, M.D.

Recognition and treatment of arterial insufficiency from Cafergot

Intramural dissection of superior mesenteric artery

Nancy A. Diettrich, MD, John C. Cacioppo, MD, David P.W. Ying, MD

Thigh claudication due to profunda femoris artery occlusion

Prevention of stenosis after vascular reconstruction: Pharmacologic control of intimal hyperplasia—A review Alexander W. Clowes, MD, Michael A. Reidy,

Arterial fibrodysplasia: Rapid progression complicated by rupture of a visceral aneurysm into the gastrointestinal tract G. den Butter, M.D., J.H. van.

Endovascular repair of two abdominal aortic aneurysms

Presentation transcript:

Intravascular ultrasonography before and after intervention: In vivo comparison with angiography G.Pieter Gerritsen, MD, Elma J. Gussenhoven, MD, Salem H.K. The, MD, Herman Pieterman, MD, Aad v.d. Lugt, MD, Wenguang Li, MSc, Nicolaas Bom, PhD, Lukas C. van Dijk, MD, Nico A.J.J. Du Bois, MD, Hero van Urk, MD Journal of Vascular Surgery Volume 18, Issue 1, Pages 31-40 (July 1993) DOI: 10.1067/mva.1993.41957 Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Intravascular ultrasound catheter together with diagram. Ultrasound crystal inside dome rotates so that cross-sectional image of artery can be obtained. (Reprinted with permission of the European Journal for Vascular Surgery from Gussenhoven WJ, Essed CE, Frietman P, et al. Eur J Vasc Surg 1989; 3:571-6.) Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Angiographic and intravascular ultrasonographic cross sections obtained from superficial femoral artery before and after balloon angioplasty. Under fluoroscopy radiopaque ruler is used to mark position of ultrasound catheter. Before intervention normal arterial segment is seen proximally (at level 24). From level 26 to 32, 6 cm long stenosis is observed. At level 26 stenosis seen angiographically is 50% to 90%; with ultrasonography stenosis is greater than 90%. At level 32 angiography and ultrasonography classify obstruction as 50% to 90% stenosis. Aneurysm is seen at level 33. At level 34 obstruction is classified as less than 50% by both angiography and ultrasonography. Lesions seen at levels 26, 32, and 35 are classified as eccentric soft lesions. After balloon angioplasty, normal cross-sectional site is seen at level 24 angiographically and on ultrasonography. At level 26 dissection is seen with both techniques, but degree of stenosis is discordant: less than 50% on angiography and 50% to 90% on ultrasonography. Obstruction is related to large lesion dissected from arterial wall. At level 32 similar discordant analysis is found: on angiography less than 50% and on ultrasonography 50% to 90%. At level 34 aneurysm is seen. Note echogenicity of blood inside aneurysm in postinterventional photograph compared with other cross sections in which saline is used to replace blood. At level 35 both angiography and ultrasonography reveal residual stenosis of less than 50%. Plus sign indicates catheter; calibration, 1 mm. Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Intravascular ultrasonographic cross sections of superficial femoral artery before and after balloon angioplasty showing traced contours of free lumen and media-bounded lumen area. Region enclosed by two contours is lesion area. Quantitative results before and after intervention are provided. (Reprinted in part with permission of Circulation from The SHK, Gussenhoven EJ, Zhong Y, et al. Circulation 1992; 86:483-93.) Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Angiographic and intravascular ultrasonographic cross section of superficial femoral artery after balloon angioplasty. At level 33 both techniques reveal dissection. Semiquantitative and quantitative analyses with respect to degree of stenosis were not possible echographically given inadequate ultrasound information seen beyond dissection (arrow). Plus sign indicates catheter; calibration, 1 mm. Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Angiographic and intravascular ultrasonographic cross section obtained before intervention showing discrepancy in classification of stenosis. At level 11 angiography judges stenosis less than 50% (arrow). On ultrasongoraphy large eccentric soft lesion is seen classified as 50% to 90% stenosis. Plus sign indicates catheter; calibration, 1 mm. Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Intravascular ultrasonographic cross sections obtained from superficial femoral artery at corresponding levels before (left) and after (right) balloon angioplasty with 6 mm diameter balloon. No angiogram was available before intervention because of origin obstruction of superficial femoral artery. Before laser angioplasty, ultrasound catheter was advanced blinded proximally to distally through lesion. Ultrasound catheter is seen to be completely surrounded by soft concentric lesion. Hypoechoic media is circumferentially seen, indicating diameter of vessel of 3.5 mm (between arrows). After intervention, lesion for major part has disappeared; diameter of vessel increased to 4.5 mm. Internal elastic lamina rupture is seen at 9 o'clock position evidenced as interruption of internal elastic lamina echoes (small arrows). Plus sign indicates catheter; calibration, 1 mm. (Reprinted in part with permission of Circulation from The SHK, Gussenhoven EJ, Zhong Y, et al. Circulation 1992; 86:483-93.) Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Angiographic and intravascular ultrasonographic cross sections obtained from superficial femoral artery before and after balloon angioplasty. Before intervention, concordant classification is obtained from angiography and ultrasonography. At level 18 stenosis of greater than 90% was observed. Lesion is classified as concentric soft. After intervention, dissection is seen both angiographically and on ultrasonography. Angiography judges stenosis as less than 50%; ultrasonography, however, reveals 50% to 90% stenosis. Lesion is seen dissected from arterial wall. Plus sign indicates catheter; calibration, 1 mm. Journal of Vascular Surgery 1993 18, 31-40DOI: (10.1067/mva.1993.41957) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions