• Title/Summary/Keyword: Catheter angiography

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CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

  • Jiahui Li;Rui Wang;Christian Tesche;U. Joseph Schoepf;Jonathan T. Pannell;Yi He;Rongchong Huang;Yalei Chen;Jianan Li;Xiantao Song
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.697-705
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    • 2021
  • Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

"Misery Collaterals" as Poor Angiographic Findings - Definition, Classification, and Practical Application -

  • Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.159-163
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    • 2006
  • Objective : Unique Internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage[SAH] patients before and during the endovascular coiling. The author investigates their patterns and classifies them into lour subtypes. Methods : Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. Results : The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. Conclusion : These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.

Automatic Segmentation of the Catheter in X-ray Angiography Images using Gradient Information and Mode (X-선 혈관조영영상에서 기울기 정보와 최대 빈도수를 이용한 카테터 자동 분할)

  • Baek, Jung-A;Lee, Min-Jin;Hong, He-Len
    • Proceedings of the Korean Information Science Society Conference
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    • 2010.06c
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    • pp.458-462
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    • 2010
  • 본 논문은 X-선 혈관조영영상에서 기울기 정보 및 최대 빈도수를 이용한 카테터 자동 분할 방법을 제안한다. 제안방법은 세 단계로 이루어진다. 첫째, 분할하고자 하는 카테터 관심영역을 설정하고, 영상의 대조대비를 높이기 위한 밝기값 스트레칭을 수행한다. 둘째, 카테터 후보 경계점을 추출하기 위하여 카테터 방향을 고려한 경계 강조 마스크를 영상에 적용한다. 셋째, 카테터 후보 경계점에서 기울기가 크고 최대 빈도수 직경을 갖는 카테터 경계점을 추출하고 이들을 선형 보간하여 최종 카테터 경계를 분할한다. 제안 방법의 평가를 위하여 육안 평가 및 전문가가 수동 분할한 결과와 본 제안방법을 적용하여 얻은 중복 영역 비율과 평균 거리 차이를 측정한 정확성 평가를 수행하였고, 수행시간을 측정하였다. 실험결과 중복 영역 비율은 93.9%${\pm}$2.7%, 평균 거리 차이는 0.116-픽셀, 수행시간은 평균 0.011초로 측정되었다.

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Basic Arterial Anatomy and Interpretation of CT Angiography for Intra-Abdominal or Gastrointestinal Bleeding: Correlation with Conventional Angiographic Findings for Beginners (복강 내 혹은 소화기계 출혈을 이해하기 위한 기본적인 혈관해부학과 혈관조영술의 해석: 입문자를 위하여)

  • Dong Yoon Han;Ji Hye Hwang;Hye Jin Kang;Jehong Yoon;Se Hwan Kwon;Tae-Seok Seo;Joo Hyeong Oh
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.119-134
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    • 2020
  • It is essential to identify the causative artery in case of active intra-abdominal or gastrointestinal bleeding. A thorough understanding of the basic arterial anatomy is required to identify the causative artery on contrast-enhanced CT angiography and conventional catheter angiography. If one is familiar with the basic arterial anatomy, obtaining access to the bleeding artery will be easier, despite the variations in the origin and course of the vessels. We describe the basic arterial anatomy that will help beginners in diagnostic radiology to identify the blood vessels that can cause active intra-abdominal or gastrointestinal bleeding.

Extraction of Vessel Width in Coronary Angiography Images (관상동맥 조영영상에서의 혈관 폭 추출)

  • Kim, Seong-Hu;Lee, Ju-Won;Kim, Joo-Ho;Choi, Dae-Seob;Lee, Gun-Ki
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.16 no.11
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    • pp.2538-2543
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    • 2012
  • The Percutaneous Coronary intervention is a typical way of testing which could be performance to treat a stenosed region by inserting a stent using catheter. In this case, choosing the best stent amongst various kinds of stent for performing an intervention is the most difficult process. For the reason, a width of the blood vessel which is stenosed must be correctly measured to help an operator choose right size of stent. So based on pixel, a width of the blood vessel measured by using the way of Euclidean distance after designing a center-line of vessel from a certain point assigned by operator is shown as a profile in this study. This study would be used as a goof reference for operators when choosing right size of stent.

Long Term Outcome of In-Stent Stenosis after Stent Assisted Coil Embolization for Cerebral Aneurysm

  • Kim, Sung Jin;Kim, Young-Joon;Ko, Jung Ho
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.536-544
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    • 2019
  • Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.

Budd-Chiari Syndrome Resulting from a Membranous Obstruction of the Inferior Vena Cava -8 Case Report- (하공정맥 막성폐쇄에 의한 Budd-Chiari증후군의 치료)

  • Kim, Dong-Won;Kim, Jun-U;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.268-273
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    • 1995
  • Budd- chiari syndrome resulting from a membranous obstruction of the inferior vena cava[IVC is a rare congenital anomaly. From January 1989 to December 1993, 8 cases of IVC obstruction was treated in Kyung Hee Univ. Hospital. There were 2 male and 6 female patients between 34 and 66 years of age[mean 47.3$\pm$11.9 years of age . 4 patients were treated with angioplasty by balloon catheter and 4 patients were treated with operative correction using cardiopulmonary bypass, profound hypothermia and total circulatory arrest. These 4 patients were repaired the constricted IVC with autologous pericardial patch. In surgically treated patients, all of the specimens were confirmed to be membranous web histopathologically. Postoperative outcome in operative correcting patients was uneventful and postoperative angiography showed unobstructed flow through the IVC with filling of the hepatic veins.The above 8 patients were followed up from 10 months to 56 months [ mean 36.43 17.24 months and recurrent IVC obstruction or stenosis was not seen.

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A Large Ruptured Anterior Communicating Artery Aneurysm Presenting with Bitemporal Hemianopsia

  • Seung, Won-Bae;Kim, Dae-Yong;Park, Yong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.291-293
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    • 2015
  • Anterior communicating artery (ACoA) aneurysms sometimes present with visual symptoms when they rupture or directly compress the optic nerve. Giant or large ACoA aneurysms producing bitemporal hemianopsia are extremely rare. Here we present an unusual case of bitemporal hemianopsia caused by a large intracranial aneurysm of the ACoA. A 41-year-old woman was admitted to our neurosurgical department with a sudden-onset bursting headache and visual impairment. On admission, her vision was decreased to finger counting at 30 cm in the left eye and 50 cm in the right eye, and a severe bitemporal hemianopsia was demonstrated on visual field testing. A brain computed tomography scan revealed a subarachnoid hemorrhage at the basal cistern, and conventional cerebral catheter angiography of the left internal carotid artery demonstrated an $18{\times}8mm$ dumbbell-shaped aneurysm at the ACoA. Microscopic aneurysmal clipping was performed. An ACoA aneurysm can produce visual field defects by compressing the optic chiasm or nerves. We emphasize that it is important to diagnose an aneurysm through cerebrovascular study to prevent confusing it with pituitary apoplexy.

Conversion Arterial Switch Operation for Failed Sensing Procedure in TGA with VSD -One Case Report- (심방교체수술을 시행한 대혈관 전위증환자에서의 동맥전환술-1례 보고-)

  • 조유원;서동만
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.86-89
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    • 1996
  • This is a report of successful conversion arterial switch operation for failed Sunning procedure in transposition of the great arteries(TGA) with ventricular septal defect(VSD). A 15 month-male patient was admitted due to intractable congestive heart failure after Sunning operation was done at the age of 8 months. Angiography revealed marked dysfunction of the morphologic right ventricle with tricuspid regurgitation and residual VSD. The pulmonary ventricle 1 systemic ventricle pressure ratio' of 75/85 at catheter study enabled us to do the take down of denning repair, patch closure of VSD and arterial switch without pulmonary artery banding. After the operation, the baby showed good growth with normal ventricular function.

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Interventional Therapy for Renal Artery Pseudoaneurysms

  • Ji, Wen-Bin;Wang, Wei-Zheng;Sun, Song;Mi, Yu-Cheng;Xu, Qiong;Chen, Yi-Er;Yang, Song;Tao, Dan;Xu, Wei;Xu, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1595-1598
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    • 2012
  • The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.