scholarly journals Simulation of superselective catheterization for cerebrovascular lesions using a virtual injection software

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Sri Hari Sundararajan ◽  
Srirajkumar Ranganathan ◽  
Vaishnavi Kishore ◽  
Raphael Doustaly ◽  
Athos Patsalides
Keyword(s):  
Mycotic Aneurysm ◽  
Vascular Lesions ◽  
Intracranial Arteriovenous Malformation ◽  
Cerebrovascular Lesions ◽  
Multiplanar Reconstructions ◽  
Contrast Enhanced ◽  
Aneurysm Embolization ◽  
Cerebrovascular Lesion ◽  
Average Utility ◽  
Procedural Planning

Abstract Background This report addresses the feasibility of virtual injection software based on contrast-enhanced cone-beam CTs (CBCTs) in the context of cerebrovascular lesion embolization. Intracranial arteriovenous malformation (AVM), dural arteriovenous fistula (AVF) and mycotic aneurysm embolization cases with CBCTs performed between 2013 and 2020 were retrospectively reviewed. Cerebrovascular lesions were reviewed by 2 neurointerventionalists using a dedicated virtual injection software (EmboASSIST, GE Healthcare; Chicago, IL). Points of Interest (POIs) surrounding the vascular lesions were first identified. The software then automatically displayed POI-associated vascular traces from vessel roots to selected POIs. Vascular segments and reason for POI identification were recorded. Using 2D multiplanar reconstructions from CBCTs, the accuracy of vascular traces was assessed. Clinical utility metrics were recorded on a 3-point Likert scale from 1 (no benefit) to 3 (very beneficial). Results Nine cases (7 AVM, 1 AVF, 1 mycotic aneurysm) were reviewed, with 26 POIs selected. Three POIs were in 2nd order segments, 8 POIs in 3rd order segments and 15 POIs in 4th order segments of their respective arteries. The reviewers rated all 26 POI traces – involving a total of 90 vascular segments – as accurate. The average utility score across the 8 questions were 2.7 and 2.8 respectively from each reviewer, acknowledging the software’s potential benefit in cerebrovascular embolization procedural planning. Conclusion The operators considered CBCT-based virtual injection software clinically useful and accurate in guiding and planning cerebrovascular lesion embolization in this retrospective review. Future prospective studies in larger cohorts are warranted for validation of this modality.

scholarly journals CT angiography and MRI of hand vascular lesions: technical considerations and spectrum of imaging findings

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Alain G. Blum ◽  
Romain Gillet ◽  
Lionel Athlani ◽  
Alexandre Prestat ◽  
Stéphane Zuily ◽  
...  
Keyword(s):  
Doppler Ultrasonography ◽  
Spindle Cell ◽  
State Of The Art ◽  
Vascular Malformations ◽  
Vascular Lesions ◽  
Systemic Diseases ◽  
Contrast Enhanced ◽  
Vascular Compromise ◽  
Exposure To Trauma ◽  
Technical Considerations

AbstractVascular lesions of the hand are common and are distinct from vascular lesions elsewhere because of the terminal vascular network in this region, the frequent hand exposure to trauma and microtrauma, and the superficial location of the lesions. Vascular lesions in the hand may be secondary to local pathology, a proximal source of emboli, or systemic diseases with vascular compromise. In most cases, ischaemic conditions are investigated with Doppler ultrasonography. However, computed tomography angiography (CTA) or dynamic contrast-enhanced magnetic resonance angiography (MRA) is often necessary for treatment planning. MR imaging is frequently performed with MRA to distinguish between vascular malformations, vascular tumours, and perivascular tumours. Some vascular tumours preferentially affect the hand, such as pyogenic granulomas or spindle cell haemangiomas associated with Maffucci syndrome. Glomus tumours are the most frequent perivascular tumours of the hand. The purpose of this article is to describe the state-of-the-art acquisition protocols and illustrate the different patterns of vascular lesions and perivascular tumours of the hand.

scholarly journals Successful endovascular stenting of a bleeding external iliac vein mycotic aneurysm in an oncologic patient: a case report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Rupal S. Parikh ◽  
Shiyi Li ◽  
Christopher Shackles ◽  
Tamim Khaddash
Keyword(s):  
Mycotic Aneurysm ◽  
Case Reports ◽  
Treatment Options ◽  
Iliac Vein ◽  
Pelvic Abscess ◽  
Vascular Lesions ◽  
Endovascular Stenting ◽  
Oncologic Patient ◽  
External Iliac Vein ◽  
Effective Option

Abstract Background Mycotic aneurysms are rare vascular lesions, occurring in 0.6–2% of arterial aneurysms but with no reported venous cases. Venous aneurysms unrelated to an underlying infectious process have been previously described and are typically surgically repaired due to risk of thromboembolic events. Case presentation This case reports a bleeding external iliac vein mycotic aneurysm secondary to erosion of a chronic pelvic abscess, successfully treated with endovascular stenting, in an oncologic patient without alternative therapeutic options. Conclusion Venous aneurysms are uncommon vascular lesions which have historically been treated with open surgical repair. Given the lower degree of procedural morbidity, endovascular management of these lesions may be an effective option in the appropriate setting, particularly as a last resort in patients without surgical treatment options.

Studies on Hypertension in Spontaneously Hypertensive Rats

1973 ◽  
Vol 45 (s1) ◽  
pp. 11s-14s
Author(s):  
Kozo Okamoto ◽  
Yukio Yamori ◽  
Shoichiro Nosaka ◽  
Akira Ooshima ◽  
Fumitada Hazama
Keyword(s):  
Spontaneously Hypertensive Rats ◽  
Genetic Factors ◽  
Vascular Lesions ◽  
Hypertensive Rats ◽  
Cerebrovascular Lesions ◽  
Spontaneously Hypertensive

1. The pathogenesis and complications occurring in spontaneously hypertensive rats (SHR) have been studied. 2. Genetic factors are important both in the development of hypertension and in determining susceptibility to vascular lesions. 3. Selective substrains of SHR may be particularly prone to develop cerebrovascular lesions.

scholarly journals Cavernous Breast Hemangioma Mimicking an Invasive Lesion on Contrast-Enhanced MRI

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Menelaos Zafrakas ◽  
Panayiota Papasozomenou ◽  
Panayiotis Eskitzis ◽  
Demetrios Zouzoulas ◽  
Glyceria Boulogianni ◽  
...  
Keyword(s):  
Cavernous Hemangioma ◽  
Breast Ultrasound ◽  
Vascular Lesions ◽  
Small Lesion ◽  
Gadolinium Contrast ◽  
Full Field ◽  
Enhanced Mri ◽  
First Case ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

Hemangiomas are vascular lesions, which are only rarely located in the breast. Larger breast hemangiomas may be detected by clinical examination, mammography, and breast ultrasound, whereas smaller lesions are usually incidental findings. We present a rare case of a 43-year-old woman with a cavernous hemangioma of the breast, presenting only on MRI and evading mammographic and ultrasonographic imaging. On breast MRI, a small lesion with irregular margins was detected in the right breast, and following gadolinium contrast medium administration, a type 3 curve, with rapid initial rise, followed by reduction in enhancement (washout) in the delayed phase was noted, raising suspicion for malignancy. The lesion could not be visualized on second-look targeted breast ultrasound and full-field digital mammography. A wide local excision was performed after 3 T MRI-guided hook wire localization and diagnosis of cavernous hemangioma was established histologically. Cavernous hemangioma is a rare breast lesion, with only few cases reported in the literature, and this is the first case with a presentation mimicking an invasive tumor on contrast-enhanced MRI.

Frameless neuronavigation based only on 3D digital subtraction angiography using surface-based facial registration

2014 ◽  
Vol 121 (3) ◽  
pp. 745-750 ◽  
Author(s):  
David A. Stidd ◽  
Joshua Wewel ◽  
Ali J. Ghods ◽  
Stephan Munich ◽  
Anthony Serici ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Anatomy ◽  
Water Soluble ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Cerebrovascular Lesions ◽  
Data Set ◽  
Surface Anatomy ◽  
Neuronavigation System ◽  
Image Set

Object Cerebrovascular lesions can have complicated abnormal anatomy that is not completely characterized by CT or MR angiography. Although 3D rotational angiography provides superior spatial and temporal resolution, catheter angiograms are not easily registered to the patient, limiting the use of these images as a source for neuronavigation. However, 3D digital subtraction angiography (DSA) contains not only vascular anatomy but also facial surface anatomy data. The authors report a novel technique to register 3D DSA images by using only the surface anatomy contained within the data set without having to fuse the DSA image set to other imaging modalities or use fiducial markers. Methods A cadaver model was first created to assess the accuracy of neuronavigation based on 3D DSA images registered by facial surface anatomy. A 3D DSA scan was obtained of a formalin-fixed cadaver head, with acquisitions of mask and contrast runs. The right common carotid artery was injected prior to the contrast run with a 45% contrast solution diluted with water-soluble red liquid latex. One week later, the head was registered to a neuronavigation system loaded with the 3D DSA images acquired earlier using facial surface anatomy. A right pterional craniotomy was performed and 10 different vascular landmarks were identified and measured for accuracy using the neuronavigation system. Neuronavigation based only on 3D DSA was then used to guide an open clipping procedure for a patient who presented with a ruptured distal lenticulostriate aneurysm. Results The accuracy of the measurements for the cadaver model was 0.71 ± 0.25 mm (mean ± SE), which is superior to the 1.8–5 mm reported for neuronavigation. The 3D DSA–based navigation-assisted surgery for the distal lenticulostriate aneurysm aided in localization, resulting in a small craniotomy and minimal brain dissection. Conclusions This is the first example of frameless neuronavigation based on 3D catheter angiography registered by only the surface anatomy data contained within the 3D DSA image set. This is an easily applied technique that is beneficial for accurately locating vascular pathological entities and reducing the dissection burden of vascular lesions.

scholarly journals Successful Endovascular Stenting of a Bleeding External Iliac Vein Mycotic Aneurysm: A Case Report

2021 ◽  
Author(s):  
Rupal Parikh ◽  
Shiyi Li ◽  
Christopher Shackles ◽  
Tamim Khaddash
Keyword(s):  
Mycotic Aneurysm ◽  
Case Reports ◽  
Iliac Vein ◽  
Pelvic Abscess ◽  
Vascular Lesions ◽  
Endovascular Stenting ◽  
External Iliac Vein ◽  
Effective Option ◽  
Mycotic Aneurysms ◽  
Arterial Aneurysms

Abstract Background: Mycotic aneurysms are rare vascular lesions, occurring in 0.6-2% of arterial aneurysms but with no reported venous cases. Venous aneurysms unrelated to an underlying infectious process have been previously described and are typically surgically repaired due to risk of thromboembolic events. Only a few reported cases have been successfully treated with endovascular repair. Case presentation: This case reports a bleeding external iliac vein mycotic aneurysm secondary to erosion of a chronic pelvic abscess, successfully treated with endovascular stenting. Conclusion: Venous aneurysms are uncommon vascular lesions which have historically been treated with open surgical repair. Given the lower degree of procedural morbidity, endovascular management of these lesions may be an effective option in the appropriate setting.

Miscellaneous Lesions of the Mediastinum

Chest Imaging ◽  
2019 ◽  
pp. 505-510
Author(s):  
Brett W. Carter
Keyword(s):  
Clinical History ◽  
Extramedullary Hematopoiesis ◽  
Vascular Lesions ◽  
Esophageal Hiatus ◽  
Malignant Neoplasms ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Enhanced Computed Tomography ◽  
Omental Fat

A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.

scholarly journals Pedunculated Hepatic Hemangioma - A case report

2014 ◽  
Vol 1 (1) ◽  
pp. 26-28
Author(s):  
Mostafa Elhajjam ◽  
Mohamed Lahkim ◽  
Mohamed Karji Al-Marzouqi ◽  
Pascal Lacombe
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Magnetic Resonance ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Hepatic Hemangioma ◽  
Spiral Computed ◽  
Thin Sections ◽  
Multiplanar Reconstructions ◽  
Contrast Enhanced

Pedunculated hemangioma is a rare and atypical hepatic angioma. We report the case of a pedunculated hepatic hemangioma presenting as an abdominal sub-hepatic mass incidentally discovered in a 66-year-old woman with anal cancer. The diagnosis was strongly suggested by the vascular features of the lesion on spiral computed tomography (CT) and magnetic resonance (MR) imaging. A surgical removal of the mass was decided to prevent potential risk of ischemic volvulus along the pedicle. Histo-pathological examination confirmed this diagnosis. Contrast enhanced thin sections and subsequent multiplanar reconstructions on CT and MR are very helpful to show the angioma features and the pedicle linking the lesion with the liver.

scholarly journals Cardio-cephalic neural crest syndrome: A novel hypothesis of vascular neurocristopathy

2017 ◽  
Vol 23 (6) ◽  
pp. 572-576 ◽  
Author(s):  
M Komiyama
Keyword(s):  
Neural Crest ◽  
Ductus Arteriosus ◽  
Vascular Diseases ◽  
Coarctation Of The Aorta ◽  
Vascular Lesions ◽  
Therapeutic Approaches ◽  
Persistent Truncus Arteriosus ◽  
Cerebrovascular Lesions ◽  
Artery Disease ◽  
Future Direction

A novel hypothesis proposes that “cardio-cephalic neural crest (NC) syndrome,” i.e. cephalic NC including cardiac NC, contributes to the concurrent occurrence of vascular diseases in the cardio- and cerebrovascular regions. NC is a transient structure present in early embryogenesis. Cephalic NC provides mesenchymal cells to the vascular media in these regions. Concurrent cardio- and cerebrovascular lesions have been reported in PHACE syndrome, ACTA2 mutation syndrome, and less frequently in the spontaneous occlusion of the circle of Willis (so-called moyamoya disease). Cardiovascular lesions in these syndromes include coarctation of the aorta, persistent truncus arteriosus, patent ductus arteriosus, and coronary artery disease, and cerebrovascular lesions include agenesis and stenosis/occlusion of the internal carotid arteries, and moyamoya phenomenon. These concurrent vascular lesions both in the cardio- and cerebrovascular regions might be related to cephalic NC. This hypothesis, although not proven, may facilitate a better understanding of the above-mentioned NC-related vascular pathologies and lead to appropriate diagnostic and therapeutic approaches for clinicians and chart future direction for researchers.

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