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A Reappraisal of CT Angiography Derived Duplex Ultrasound Velocity Criteria with a Comparison to Digital Subtraction Angiography in Patients with Carotid Artery Stenosis.

Ann Vasc Surg 2021 Jun 18. Epub 2021 Jun 18.

Division of Vascular Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address:

Background: Traditionally, carotid duplex ultrasound (CDUS) velocity criteria have been derived from angiography. Recent studies support a shift toward computed tomography angiography (CTA) derived velocity criteria; however, they lack a comparison to angiography. The purposes of this study are to validate CTA derived measurements with digital subtraction angiography (DSA) and to update our previous CTA-derived velocity criteria for 50% and 80% stenosis. Read More

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Spontaneous chronic subdural hematoma due to cerebral cortical artery rupture: First case report and review of pertinent literature.

Neuroradiol J 2021 Jun 21:19714009211026891. Epub 2021 Jun 21.

Kaiser Permanente, USA.

Introduction: Chronic subdural hematoma (CSDH) is generally attributed to pathological changes in the dural arterial system, which has led to growing utilization of middle meningeal artery (MMA) embolization in CSDH treatment. There are no case reports of CSDH due to cerebral cortical artery perforation.

Method: We report a case of spontaneous CSDH caused by cortical artery rupture that was identified on digital subtraction angiography and could be visualized on computed tomographic angiography (CTA). Read More

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Major dietary patterns and metabolic syndrome associated with severity of coronary artery disease: A structural equation modeling.

Nutr Health 2021 Jun 21:2601060211020655. Epub 2021 Jun 21.

48439Tehran University of Medical Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Iran.

Background: The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known.

Aim: This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM).

Methods: In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35-65 years, who underwent coronary angiography. Read More

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Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World: The INCAPS-COVID Study.

JACC Cardiovasc Imaging 2021 Jun 10. Epub 2021 Jun 10.

Technion Israel Institute of Technology, Haifa, Israel.

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic.

Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Read More

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Precise, simplified diagnostic criteria and optimised management of initial-onset Vogt-Koyanagi-Harada disease: an updated review.

Eye (Lond) 2021 Jun 18. Epub 2021 Jun 18.

Inflammatory and Retinal Eye Diseases, , Centre for Ophthalmic Specialised care, Lausanne, Switzerland.

Vogt-Koyanagi-Harada (VKH) disease is a primary autoimmune stromal choroiditis. This review aimed to provide a novel perspective of the disease. We took into account recent developments in the understanding of the disease and crucial progress in investigational modalities of the choroid, which has led to new, simpler diagnostic criteria. Read More

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Lipid biomarkers in statin users with coronary artery disease annotated by coronary computed tomography angiography.

Sci Rep 2021 Jun 18;11(1):12899. Epub 2021 Jun 18.

Istituto di Fisiologia Clinica-CNR, via Giuseppe Moruzzi 1, 56124, Pisa, Italy.

Molecular markers are suggested to improve the diagnostic and prognostic accuracy in patients with coronary artery disease (CAD) beyond current clinical scores based on age, gender, symptoms and traditional risk factors. In this context, plasma lipids are emerging as predictors of both plaque composition and risk of future events. We aim to identify plasma lipid biomarkers associated to CAD indexes of stenosis severity, plaque lipid content and a comprensive score of CAD extent and its risk. Read More

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Utility of silent magnetic resonance angiography in the evaluation and characterisation of intracranial dural arteriovenous fistula.

Clin Radiol 2021 Jun 15. Epub 2021 Jun 15.

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.

Aim: To evaluate the utility of silent magnetic resonance angiography (MRA) in the diagnosis, characterisation, and therapeutic planning of intracranial dural arteriovenous fistula (DAVF).

Materials And Methods: Twenty consecutive patients with DAVF were enrolled prospectively and were evaluated using silent MRA and digital subtraction angiography (DSA) as a part of routine work-up. The diagnosis and location of fistula, Borden and Cognard classification, entire arterial feeders, and venous drainage were analysed. Read More

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Can we replace computed tomography angiography by contrast-enhanced ultrasound in the surveillance of patients submitted to aortoiliac aneurysm repair?

Vascular 2021 Jun 18:17085381211027440. Epub 2021 Jun 18.

Department of Vascular and Endovascular Surgery, 37870Santa Casa de Sao Paulo Medical School, 485046Prevent Senior Health Operator, Bela Vista, São Paulo, Brazil.

Objectives: This study was designed for evaluation of CEUS (contrast-enhanced ultrasound) for the detection of endoleaks after EVAR (endovascular aortic aneurysms repair) as an alternative to CTA (computed tomography angiography), the gold standard in post-EVAR surveillance.

Methods: Post-EVAR surveillance of patients who underwent CEUS and CTA was retrospectively analyzed to compare the accuracy of CEUS compared to CTA. For that, the following parameters were analyzed: the largest aneurysm diameter, type of endoleaks, and the time elapsed after EVAR using both surveillance tests. Read More

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Insulin resistance genetic risk score and burden of coronary artery disease in patients referred for coronary angiography.

PLoS One 2021 18;16(6):e0252855. Epub 2021 Jun 18.

Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.

Aims: Insulin resistance associates with development of metabolic syndrome and risk of cardiovascular disease. The link between insulin resistance and cardiovascular disease is complex and multifactorial. Confirming the genetic link between insulin resistance, type 2 diabetes, and coronary artery disease, as well as the extent of coronary artery disease, is important and may provide better risk stratification for patients at risk. Read More

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Intravascular Ultrasound in Branched and Fenestrated Endovascular Aneurysm Repair: Initial Experience in a Single-Center Cohort Study.

J Endovasc Ther 2021 Jun 17:15266028211025014. Epub 2021 Jun 17.

Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy.

Purpose: To evaluate intravascular ultrasound (IVUS) safety and efficacy to detect visceral stenting issues during complex endovascular aneurysm repair through branched and fenestrated repair (B-FEVAR).

Materials And Methods: A single-center retrospective analysis of 33 bridging stents assessed intraoperatively using IVUS between January and September 2020 was performed. Ten aortic aneurysm patients [7 thoracoabdominal / 1 pararenal / 2 juxtarenal; 3 females; mean age 73 years [range 70-77 years]) were included. Read More

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Popliteal artery patency is an indicator of ambulation and healing after below-knee amputation in vasculopaths.

Vascular 2021 Jun 16:17085381211026498. Epub 2021 Jun 16.

Center for Wound Healing and Hyperbaric Medicine, 71541MedStar Georgetown University Hospital, Washington, DC, USA.

Background: The posterior flap is a conventional technique for closing a below-knee amputation (BKA) that uses the gastrocnemius and soleus muscle and relies on the popliteal and posterior compartment arteries. If the prior mentioned arterial blood supply is compromised, this flap likely relies on collateral flow. The purpose of this study is to identify and differentiate any significant associations between preoperative popliteal and tibial arterial flow and BKA outcomes and patient-reported function. Read More

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Analysis of risk factors for anterior communicating artery aneurysm rupture: a single-center study.

World Neurosurg 2021 Jun 13. Epub 2021 Jun 13.

Department of Interventional Radiology & Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing 210000, China.

Background And Purpose: Congenital hypoplasia/aplasia of the A1 segment of the anterior cerebral artery is associated with an increased incidence of berry aneurysms at the anterior communicating artery (ACoA) complex. We analysed the factors contributing to ACoA aneurysm rupture.background MATERIALS AND METHODS: We retrospectively analysed the data of patients with ACoA aneurysms who underwent cerebral angiography between July 2008 and January 2020. Read More

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Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis.

World J Cardiol 2021 May;13(5):144-154

Center for Community Medicine, Jichi Medical University, Shimotsuke-City 329-0498, Tochigi, Japan.

Background: The traditional radial approach (RA) is recommended as the standard method for coronary angiography (CAG), while a distal RA (DRA) has been recently used for CAG.

Aim: To assess the efficacy and safety of the DRA RA during CAG.

Methods: The following databases were searched through December 2020: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials. Read More

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Quantitative analysis of retinal vessel density and thickness changes in diabetes mellitus evaluated using optical coherence tomography angiography: a cross-sectional study.

BMC Ophthalmol 2021 Jun 15;21(1):259. Epub 2021 Jun 15.

Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

Background: Diabetic retinopathy is the most common microvascular complication of diabetes; however, early changes in retinal microvessels are difficult to detect clinically, and a patient's vision may have begun to deteriorate by the time a problem is identified. Optical coherence tomography angiography (OCTA) is an innovative tool for observing capillaries in vivo. The aim of this study was to analyze retinal vessel density and thickness changes in patients with diabetes. Read More

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CT ​EvaLuation ​by ​ARtificial ​Intelligence ​For ​Atherosclerosis, Stenosis and Vascular ​MorphologY ​(CLARIFY): ​A ​Multi-center, international study.

J Cardiovasc Comput Tomogr 2021 Jun 12. Epub 2021 Jun 12.

Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA.

Background: Atherosclerosis evaluation by coronary computed tomography angiography (CCTA) is promising for coronary artery disease (CAD) risk stratification, but time consuming and requires high expertise. Artificial Intelligence (AI) applied to CCTA for comprehensive CAD assessment may overcome these limitations. We hypothesized AI aided analysis allows for rapid, accurate evaluation of vessel morphology and stenosis. Read More

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Successful coil embolization of a large right coronary artery-coronary sinus fistula causing a significant left-to-right shunt: a case report.

Eur Heart J Case Rep 2021 May 3;5(5):ytab121. Epub 2021 May 3.

DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA.

Background: This case reviews a challenging but successful transcatheter coil embolization of a large congenital coronary artery fistula (CAF) causing a significant left-to-right shunt.

Case Summary: A 51-year-old female with no significant prior history presented with symptoms of dyspnoea and chest discomfort. Extensive evaluation revealed a large CAF between a tortuous right coronary artery (RCA) and the coronary sinus (CS) composed of three aneurysmal pseudochambers. Read More

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Optical Coherence Tomography Angiography of Macular Perfusion Changes after Anti-VEGF Therapy for Diabetic Macular Edema: A Systematic Review.

J Diabetes Res 2021 22;2021:6634637. Epub 2021 May 22.

Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: Diabetic macular edema (DME) is a major cause of vision loss in diabetics that is currently mainly treated by antivascular endothelial growth factor (VEGF) agents. The effect of these agents on macular perfusion (MP) is a current concern. Optical coherence tomography angiography (OCTA) is an imaging modality that allows noninvasive high-resolution retinal microvasculature imaging. Read More

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CT angiography evaluation of intracranial aneurysms: Distribution, characteristics, and association with subarachnoid hemorrhage.

Authors:
E Caliskan D Oncel

Niger J Clin Pract 2021 Jun;24(6):833-840

Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey.

Aims: To investigate the distribution, characteristics, and association with subarachnoid hemorrhage (SAH) of aneurysms identified in Turkish adult patients with computed tomography angiography (CTA) performed with suspicion of intracranial aneurysms and/or SAH.

Subjects And Methods: A total of 356 patients (164 male, and 192 female) with a mean age of 55.6 ± 4. Read More

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Low bleeding and thromboembolic risk with continued dabigatran during cardiovascular interventions: the GLORIA-AF study.

Eur J Intern Med 2021 Jun 11. Epub 2021 Jun 11.

Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.

Background: Prospective data on nonvitamin-K-antagonist oral anticoagulant (NOAC) management during cardiovascular interventions are limited. We therefore evaluated the safety and effectiveness of uninterrupted dabigatran therapy as well as dabigatran management during atrial fibrillation (AF)-cardioversions, AF-ablations, pacemaker implantations and coronary angiography and/or stenting procedures.

Method: GLORIA-AF is an international registry programme involving patients with newly diagnosed AF. Read More

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Identification of high risk clinical and imaging features for intracranial artery dissection using high-resolution cardiovascular magnetic resonance.

J Cardiovasc Magn Reson 2021 Jun 14;23(1):74. Epub 2021 Jun 14.

Department of Radiology, Changhai Hospital, Naval Medical University, 10 Building, 168 Changhai Road, Yangpu, Shanghai, 200433, China.

Background: Intracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions. Read More

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Coronary access after TAVR with a cylindrical shaped valve: Learning from LOTUS.

Cardiovasc Revasc Med 2021 Jun 4. Epub 2021 Jun 4.

Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan.

Background/purpose: Data on the feasibility of coronary access (CA) through above or outside of the cylindrical shaped-transcatheter heart valve (THV) are very limited. The aims of the present study were to assess the feasibility of CA after transcatheter aortic valve replacement (TAVR) with the LOTUS using multi detector computed tomography (MDCT) and the reliability of algorithm detecting unfavorable CA.

Methods/materials: Post-TAVR MDCT of 41 patients with 82 coronary arteries were evaluated. Read More

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Transthoracic Echocardiography: Beginner's Guide with Emphasis on Blind Spots as Identified with CT and MRI.

Radiographics 2021 Jun 11:200142. Epub 2021 Jun 11.

From the Departments of Radiology (M.D.G., R.D.M., S.D.K., R.M.B., J.D.M., D.W.G., E.A.R.) and Cardiology (J.M.R.), Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431; and the Uniformed Services University of the Health Sciences, Bethesda, Md (M.D.G., J.M.R., D.W.G., E.A.R.).

Transthoracic echocardiography (TTE) is the primary initial imaging modality in cardiac imaging. Advantages include portability, safety, availability, and ability to assess the morphology and physiology of the heart in a noninvasive manner. Because of this, many patients who undergo advanced imaging with CT or MRI will have undergone prior TTE, particularly when cardiac CT angiography or cardiac MRI is performed. Read More

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Silent embolism of a large thrombus in transit through the patent foramen ovale: a case report.

Eur Heart J Case Rep 2021 Mar 31;5(3):ytab091. Epub 2021 Mar 31.

Cardiovascular Department, Saint Elizabeth's Medical Center, 736 Cambridge Street, Brighton, MA 02135, USA.

Background : Detection of a thrombus in transit through a patent foramen ovale (PFO) is extremely rare due to the transient nature of the process. We report an unusual case of a large, paradoxical embolus in transit seen on echocardiography through a PFO that was not found upon atriotomy.

Case Summary : An 80-year-old woman presented to the emergency room with shortness of breath and right leg pain. Read More

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Severe chronic aortic regurgitation after percutaneous coronary intervention: a case report and literature review.

Eur Heart J Case Rep 2021 Mar 3;5(3):ytab044. Epub 2021 Mar 3.

Department of Cardiothoracic Surgery and Anesthesiology, Entrance 50, 7th Floor, Uppsala University Hospital, SE-75185 Uppsala, Sweden.

Background: Severe aortic regurgitation (AR) is an extremely rare complication after coronary catheterization and percutaneous coronary intervention (PCI), where most reported cases have required relatively urgent surgical intervention due to acute-onset AR and cardiac decompensation.

Case Summary: We report a case of a 60-year-old woman that previously presented with a non-ST-elevation myocardial infarction (NSTEMI) due to an ostial right coronary artery stenosis. During the course of 2 years, she developed five recurrent NSTEMI due to in-stent thrombosis, necessitating either a new coronary stent or balloon. Read More

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Coronary Artery Fistula Aneurysm: Pathological Analysis After Surgery.

Cureus 2021 May 8;13(5):e14903. Epub 2021 May 8.

Cardiology, Kawasaki Municipal Ida Hospital, Kawasaki, JPN.

An asymptomatic 75-year-old woman was identified with a 40-mm-sized, round-shaped lesion beside the pulmonary artery on computed tomography (CT). Coronary angiography showed a coronary artery fistula (CAF) with an aneurysm branching from the left anterior descending artery toward the pulmonary artery. The CAF aneurysm (CAFA) was resected and coronary artery bypass graft surgery using the left internal thoracic artery was performed successfully. Read More

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Comprehensive management of acute pulmonary embolism in primary care using telemedicine in the COVID-era.

BMJ Case Rep 2021 Jun 10;14(6). Epub 2021 Jun 10.

Emergency Medicine, Kaiser Permanente Roseville Medical Center, Roseville, California, USA

A healthy, active woman in her 70s reported intermittent exertional dyspnoea for 2 months, notable during frequent open-water swimming. Symptoms were similar to an episode of travel-provoked pulmonary embolism 3 years prior. She denied chest pain, cough, fever, extremity complaints and symptoms at rest. Read More

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Automated Quantification of Choriocapillaris Lesion Area in Patients with Posterior Uveitis.

Am J Ophthalmol 2021 Jun 6. Epub 2021 Jun 6.

Department of Ophthalmology, University of Washington, Seattle, WA. Electronic address:

Purpose: To validate a custom algorithm for automated identification and quantification of clinically relevant inflammatory choriocapillaris (CC) lesions from en face swept source optical coherence tomography (SS-OCTA) images.

Design: observational case series METHODS: : Twenty eyes of 14 patients with posterior uveitis were imaged using the PLEX® Elite 9000. The machine-generated en face OCTA CC slabs were exported to MATLAB where a custom algorithm performed unsupervised lesion boundary delineation and area quantification. Read More

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Pulmonary embolism severity before and during the COVID-19 pandemic.

Br J Radiol 2021 Jul 9;94(1123):20210264. Epub 2021 Jun 9.

Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK.

Objectives: Early in the coronavirus 2019 (COVID-19) pandemic, a high frequency of pulmonary embolism was identified. This audit aims to assess the frequency and severity of pulmonary embolism in 2020 compared to 2019.

Methods: In this retrospective audit, we compared computed tomography pulmonary angiography (CTPA) frequency and pulmonary embolism severity in April and May 2020, compared to 2019. Read More

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Anatomical Variations of the Vertebral Artery: Analysis by Three-Dimensional Computed Tomography Angiography in Chinese Population.

Orthop Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China.

Objective: To analyze the anatomical variations of V3 and V2 segments of the vertebral artery in the Chinese population.

Methods: The current retrospective study was an observational, anatomical, radiological research. Between 1 January 2018 to 31 December 2019, the data of 589 continuous head-and-neck three-dimensional computed tomography angiography were observed and analyzed using the open-source software of Horos. Read More

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Comparison of the effectiveness of celiac versus common hepatic artery injection for the detection of hepatocellular carcinoma and of the feeding artery on cone-beam computed tomographs obtained during hepatic angiography.

Acta Radiol Open 2021 Feb 22;10(2):2058460121994735. Epub 2021 Feb 22.

Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: Cone-beam computed tomography (CBCT) has been widely used during transcatheter arterial chemoembolization for hepatocellular carcinoma.

Purpose: To evaluate the sensitivity of CBCT for the detection of hepatocellular carcinomas and the tumor feeders by comparing celiac artery (CA) and common hepatic artery (CHA) injection.

Material And Methods: We retrospectively enrolled 30 patients (52 hepatocellular carcinoma lesions) who had undergone CBCT-assisted transcatheter arterial chemoembolization. Read More

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February 2021