- Real-time magnetic resonance imaging - guided coronary intervention in a porcine model. [Journal Article]
- SRSci Rep 2019 Jun 17; 9(1):8663
- X-ray fluoroscopy is the gold standard for coronary diagnostics and intervention. Magnetic resonance imaging is a radiation-free alternative to x-ray with excellent soft tissue contrast in arbitrary …
X-ray fluoroscopy is the gold standard for coronary diagnostics and intervention. Magnetic resonance imaging is a radiation-free alternative to x-ray with excellent soft tissue contrast in arbitrary slice orientation. Here, we assessed real-time MRI-guided coronary interventions from femoral access using newly designed MRI technologies. Six Goettingen minipigs were used to investigate coronary intervention using real-time MRI. Catheters were custom-designed and equipped with an active receive tip-coil to improve visibility and navigation capabilities. Using modified standard clinical 5 F catheters, intubation of the left coronary ostium was successful in all animals. For the purpose of MR-guided coronary interventions, a custom-designed 8 F catheter was used. In spite of the large catheter size, and therefore limited steerability, intubation of the left coronary ostium was successful in 3 of 6 animals within seconds. Thereafter, real-time guided implantation of a non-metallic vascular scaffold into coronary arteries was possible. This study demonstrates that real-time MRI-guided coronary catheterization and intervention via femoral access is possible without the use of any contrast agents or radiation, including placement of non-metallic vascular scaffolds into coronary arteries. Further development, especially in catheter and guidewire technology, will be required to drive forward routine MR-guided coronary interventions as an alternative to x-ray fluoroscopy.
- Imaging characteristics of acute type A aortic dissection and candidacy for repair with ascending aortic endografts. [Journal Article]
- JVJ Vasc Surg 2019 May 27
- CONCLUSIONS: A minority of patients suffering ATAD would currently qualify for ascending aortic endografting on the basis of anatomic criteria alone. Future device designs should take into account these common anatomic exclusion criteria so that more versatile devices may be developed and commercially available to treat a larger number of patients.
- Retrograde coronary intervention for chronic total occlusion of RCA ostium with anomalous origin: A case report. [Case Reports]
- JCJ Cardiol Cases 2019; 19(6):182-185
- Chronic total coronary occlusion (CTO) remains one of the most technically challenging clinical scenarios in which to perform interventions. Although the antegrade approach is a general approach for …
Chronic total coronary occlusion (CTO) remains one of the most technically challenging clinical scenarios in which to perform interventions. Although the antegrade approach is a general approach for CTO recanalization, a retrograde attempt improves the success rate and its usage has been increasingly adopted in recent years. Congenital coronary anomaly represents another technically challenging factor especially when accompanied with CTO lesions. We report the case of a 43-year-old man with no relevant cardiac history who presented for evaluation of exertional chest discomfort with palpitation. Coronary angiography revealed the existence of CTOs at just ostial of anomalously originating right coronary artery (RCA) with no angiographic ostial dimple in Valsalva sinus. Because it was not possible to engage with the antegrade guiding catheter (GC) at the inlet of the RCA, we decided to perform revascularization using the retrograde approach. Percutaneous coronary intervention (PCI) of such an anomalous RCA, which is chronically occluded, is difficult and is rarely described. Retrograde approach has been used to overcome the impossible placement of antegrade GC to RCA ostium. After successful CTO-PCI, his chest discomfort promptly disappeared. <Learning objective: Percutaneous coronary intervention for chronic total coronary occlusion of anomalous origin of right coronary artery (RCA) patients is difficult and is rarely described. Retrograde approach has been used to overcome the impossible placement of antegrade guiding catheter to RCA ostium.>.
- Intraseptal Mucocele as a Long-term Complication of Revision Septorhinoplasty: A Case Report and Review of a Rare Entity. [Case Reports]
- ARAllergy Rhinol (Providence) 2019 Jan-Dec; 10:2152656719845325
- Paranasal sinus mucoceles are benign, expansive, cystic lesions which arise from retention of mucus secretions. They arise primarily in the setting of cystic degeneration of the sinus mucosa or secon…
Paranasal sinus mucoceles are benign, expansive, cystic lesions which arise from retention of mucus secretions. They arise primarily in the setting of cystic degeneration of the sinus mucosa or secondarily in the setting of obstruction of the sinus ostium due to mucosal trauma or chronic inflammation. Septal mucoceles are rare. Only 10 cases to our knowledge have previously been reported. Patients are exclusively male, in their middle years, usually with a history of nasal trauma or nasal surgery. Nasal obstruction followed by headache present for 3 months to a year are the most common presenting symptoms. Here, we present a case of septal mucocele with dystrophic bone formation in a 57-year-old man arising 35 years after open septorhinoplasty treated successfully with total excision via an endoscopic, endoseptal approach. A review of the available literature was conducted to provide a consolidated update on diagnosis and management.
- [Preliminary efficacy of penetrating canaloplasty in primary angle-closure glaucoma]. [Journal Article]
- ZYZhonghua Yan Ke Za Zhi 2019 Jun 11; 55(6):448-453
- CONCLUSIONS: Preliminary study shows penetrating canaloplasty is safe and effective in the treatment of PACG, but needs a longer follow-up. (Chin J Ophthalmol, 2019, 55: 448-453).
- Morphology of the Vieussens valve and its imaging in cardiac multislice computed tomography. [Journal Article]
- JCJ Cardiovasc Electrophysiol 2019 Jun 11
- CONCLUSIONS: The VV is a common heart structure, present in over 60% of humans, located mainly on the anterior and superior circuit of the coronary sinus, with relatively high morphological variability. Large VVs, which pose a significant obstacle in catheterization procedures, may be visualized using standard-protocol contrast-enhanced cardiac MSCT.
- Anomalous origin of the coronary artery coursing between the great vessels presenting with a cardiovascular event (J-CONOMALY Registry). [Journal Article]
- EHEur Heart J Cardiovasc Imaging 2019 Apr 25
- CONCLUSIONS: In patients with AOCA, age ≤40 years, male sex, sporting activity, and an acute take-off angle appear to be risk factors for SCA. Appropriate management can be beneficial. Confirmation in a large-scale study is warranted.
- 'Crochetage' Sign of Atrial Septal Defect. [Journal Article]
- QJMQJM 2019 Jun 10
- Dacryocystorhinostomy: Evolution of endoscopic techniques after 498 cases. [Journal Article]
- EJEur J Ophthalmol 2019 Jun 10; :1120672119854582
- CONCLUSIONS: Our results confirm that endoscopic dacryocystorhinostomy can be considered as a valid surgical approach to primary nasolacrimal duct obstruction and revision cases. The key aspects in achieving functional and anatomical results are meticulous surgical procedure and precise follow-up.
New Search Next
- Anomalies of coronary artery origin: Evaluation on multidetector CT angiography. [Review]
- CIClin Imaging 2019 May 23; 57:87-98
- Anomalies of origin of coronary arteries are an uncommon occurrence and found in approximately 1-2% of the general population. While a large proportion of these anomalies are clinically silent, a few…
Anomalies of origin of coronary arteries are an uncommon occurrence and found in approximately 1-2% of the general population. While a large proportion of these anomalies are clinically silent, a few might be hemodynamically significant and may even result in sudden cardiac death. Comprehensive knowledge of the normal as well as variant anatomies of the coronary artery origin and familiarity with imaging appearances and clinical significance of these anomalies is imperative for precise diagnosis and subsequent planning of treatment, whenever required. Multidetector computed tomography angiography, on account of its non-invasiveness, faster scan times and multiplanar reconstruction capabilities, is increasingly being utilized for characterization of coronary artery origin anomalies and their three-dimensional spatial relations. It shows a superior rate of detection of these anomalies compared to conventional angiography, providing more accurate delineation of the ostium as well as course. With the advent of newer generation CT scanners and use of advanced dose reduction techniques, images can be obtained rapidly having excellent spatial resolution and with minimal radiation dose. In this review article, we present the multidetector CT angiography imaging findings of the spectrum of anomalous coronary artery origin, using a third-generation dual-source CT scanner.