ABSTRACT
OBJECTIVE: To compare the mortality rates of patients with claudication and de novo femoropopliteal lesions treated with and without paclitaxel coated devices (PCD). BACKGROUND: A recent meta-analysis, mostly including patients with claudication and de novo femoropopliteal lesions but also with recurrent stenoses and critical limb ischemia, has shown a significant excess mortality in patients treated with PCD. METHODS: Comparison of two historical cohorts of patients presenting with claudication and de novo femoropopliteal lesions treated with and without PCD between 2008 and 2018. RESULTS: After review of 5219 arteriograms in patients presenting with peripheral artery disease, 700 consecutive patients were included consisting in 72.6% of male (n = 508). Mean age was 68.1 ± 8.5 years. 45.7% of the patients (n = 320) had a treatment including a PCD. Mean femoropopliteal lesion length was 123 ± 91 mm including 44.6% of occlusions. Patients of the control group were censored at crossover to paclitaxel when applicable. Mortality rates at 1, 2 and 5 years were 4.6%, 7.5%, 19.4% and 1.6%, 6.2%, 16.6% in the non-PCD and PCD groups respectively. The relative risks of death when using PCD were 0.35 (p = 0.03), 0.83 (p = NS) and 0.86 (p = NS) at 1, 2 and 5 years respectively. CONCLUSION: There was no excess mortality in patients with claudication and de novo femoropopliteal lesions treated with paclitaxel coated devices at 1, 2 and 5 years of follow-up in this cohort. The current study suggests that additional prospective randomized studies properly powered to study mortality are necessary.
Subject(s)
Alloys , Angioplasty, Balloon/instrumentation , Arteriovenous Shunt, Surgical/adverse effects , Graft Occlusion, Vascular/therapy , Kidney Failure, Chronic/therapy , Renal Dialysis , Stents , Upper Extremity/blood supply , Aged , Collateral Circulation , Female , Graft Occlusion, Vascular/diagnostic imaging , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/physiopathology , Humans , Kidney Failure, Chronic/diagnosis , Prosthesis Design , Treatment Outcome , Vascular PatencyABSTRACT
Hemorrhagic extension along the pulmonary arteries should be recognized as a complication of Stanford type A aortic dissection. Radiologists and other physicians with an interest in cardiothoracic imaging should be aware of this rare but life-threatening pathology. The anatomical concept of the pathology is outlined in this text, through high-quality electrocardiogram-gated computerized tomography images.
Subject(s)
Aortic Aneurysm/complications , Aortic Aneurysm/diagnostic imaging , Aortic Dissection/complications , Aortic Dissection/diagnostic imaging , Electrocardiography , Hematoma/diagnostic imaging , Hematoma/etiology , Pulmonary Artery , Tomography, X-Ray Computed/methods , Aged, 80 and over , Fatal Outcome , Female , Humans , Pulmonary Artery/diagnostic imaging , Treatment RefusalSubject(s)
Angioplasty, Balloon/instrumentation , Ischemia/therapy , Lower Extremity/blood supply , Peripheral Arterial Disease/therapy , Stents , Veins , Chronic Disease , Female , Humans , Ischemia/diagnostic imaging , Ischemia/physiopathology , Middle Aged , Peripheral Arterial Disease/diagnostic imaging , Peripheral Arterial Disease/physiopathology , Prosthesis Design , Regional Blood Flow , Treatment Outcome , Veins/diagnostic imaging , Veins/physiopathology , Wound HealingABSTRACT
During the past decade, cardiac magnetic resonance has gained increasing popularity in the diagnosis of hypertrophic cardiomyopathy because of its greater accuracy and better characterization of cardiac morphology compared with other imaging modalities. In this pictorial essay, a global clinical portrait of hypertrophic cardiomyopathy will be drawn. The various radiologic findings associated with each variant of hypertrophic cardiomyopathy, and the clinical edge offered by cardiac magnetic resonance will be discussed.
Subject(s)
Hypertrophy, Left Ventricular/diagnosis , Magnetic Resonance Imaging , Diagnosis, Differential , Echocardiography , Gadolinium , Humans , Hypertrophy, Left Ventricular/classification , Hypertrophy, Left Ventricular/physiopathology , Hypertrophy, Left Ventricular/therapy , Magnetic Resonance Imaging/methodsABSTRACT
This article reviews the basic and clinical features of heart disease associated with carcinoid syndrome, with an emphasis on its principal imaging modalities.
