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1.
Rofo ; 185(2): 153-9, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23196837

ABSTRACT

PURPOSE: Comparison of dose area products (DAP) in diagnostic angiography procedures between an image intensifier (II) and a flat panel detector (FPD) angiography system and the evaluation of DAP/body mass index (BMI) dependency. MATERIALS AND METHODS: An image intensifier system or a flat panel detector system was used to perform 571 diagnostic angiographies (n = 328 and n = 243, respectively) of 5 different types: peripheral arterial, venous, single leg, abdominal and upper extremity. The results were retrospectively analyzed. The DAP, fluoroscopy time (t) and the number of series of the respective interventions as calculated by the respective machines was compared for all interventions and for the respective subtypes and machines. The BMI dependency was calculated separately for both machines for all interventions by subdividing the patients into 6 BMI classes defined by the WHO. RESULTS: The average DAP for all diagnostic interventions was 1958.9 cGy×cm2 (t = 384.6 s, n = 7.85 series) for the II and 2927.4 cGy×cm2 (t = 267.4 s, n = 7.02 series) for the FPD. Group-dependent differences ranged between + 21 and + 252 % when using the FPD system. After time standardization, the respective increases were found to be 120 % for the FPD system. The DAPs increased considerably in patients with higher BMIs (766.7 cGy × cm2 - 6892.6 cGy × cm2, II machine, 950.5 cGy × cm2 - 12 487.7 cGy × cm2, FPD machine) with a greater DAP gain seen for the FPD. The average duration of the interventions was higher using the II machine. CONCLUSION: The use of an FPD system led to higher DAP values compared to the II system in diagnostic angiographic procedures. In addition, increased BMI values led to higher DAPs, especially for the FPD machine. However, the average fluoroscopy times were shorter.


Subject(s)
Angiography/instrumentation , Angiography/statistics & numerical data , Body Mass Index , Peripheral Arterial Disease/diagnostic imaging , Radiation Protection/instrumentation , Radiographic Image Enhancement/instrumentation , X-Ray Intensifying Screens/statistics & numerical data , Equipment Design , Equipment Failure Analysis , Humans , Radiation Dosage , Radiation Protection/statistics & numerical data , Reproducibility of Results , Sensitivity and Specificity
2.
Langenbecks Arch Surg ; 394(3): 569-71, 2009 May.
Article in English | MEDLINE | ID: mdl-19089446

ABSTRACT

BACKGROUND: Early portal vein impairment or thrombosis after liver transplantation is a significant risk factor for graft failure. CASE: Here, we describe a case of severe portal hypoperfusion after thrombectomy during liver transplantation that was treated with percutaneous stenting on the first postoperative day. Stenting was combined with embolization of varices and normalized portal inflow. RESULT: Liver function and portal flow were normal after 1 year of follow-up. CONCLUSION: This case demonstrates that percutaneous stenting is a safe and feasible therapeutic option even in the initial days after liver transplantation.


Subject(s)
Liver Transplantation , Portal Vein , Postoperative Complications/surgery , Stents , Venous Thrombosis/surgery , Female , Humans , Ligation , Middle Aged , Postoperative Complications/diagnosis , Stomach/blood supply , Thrombectomy , Venous Thrombosis/diagnosis
3.
J Radiol ; 88(9 Pt 2): 1230-7, 2007 Sep.
Article in French | MEDLINE | ID: mdl-17878867

ABSTRACT

Magnetic resonance (MR) imaging is well established for the diagnosis of musculoskeletal diseases. The excellent tissue contrast and the multiplanar imaging capability have both contributed to the improvement of this technique. The development of fast acquisition techniques, sufficient patient access obtained with open magnet configurations and advances in the technology of MR compatible instruments allow a new approach to interventional radiology. These recently commercially available open-bored high-field magnets allow standard interventions such as biopsies or intra-articular infiltrations. Moreover, new interventions e.g. preoperative marking of soft tissue or bone marrow tumors are now possible with the better tissue contrast of MR imaging.


Subject(s)
Bone Diseases/diagnosis , Magnetic Resonance Imaging, Interventional , Muscular Diseases/diagnosis , Biopsy , Bone Neoplasms/surgery , Contrast Media , Equipment Design , Humans , Image Processing, Computer-Assisted , Injections, Intra-Articular , Injections, Spinal , Magnetic Resonance Imaging, Interventional/instrumentation , Monitoring, Physiologic , Muscle Neoplasms/surgery
4.
Rofo ; 179(10): 1009-15, 2007 Oct.
Article in English | MEDLINE | ID: mdl-17879173

ABSTRACT

PURPOSE: Mesenchymal stem cells (MSC) seem to be a promising cell source for cellular cardiomyoplasty. We recently developed a new aptamer-based specific selection of MSC to provide "ready to transplant" cells directly after isolation. We evaluated MRI tracking of newly isolated and freshly transplanted MSC in the heart using one short ex vivo selection step combining specific aptamer-based isolation and labeling of the cells. MATERIALS AND METHODS: Bone marrow (BM) was collected from healthy pigs. The animals were euthanized and the heart was placed in a perfusion model. During cold ischemia, immunomagnetic isolation of MSC from the BM by MSC-specific aptamers labeled with Dynabeads was performed within 2 h. For histological identification the cells were additionally stained with PKH26. Approx. 3 x 10(6) of the freshly aptamer-isolated cells were injected into the ramus interventricularis anterior (RIVA) and 5 x 10(5) cells were injected directly into myocardial tissue after damaging the respective area by freezing (cryo-scar). 3 x 10(6) of the aptamer-isolated cells were kept for further characterization (FACS and differentiation assays). 20 h after cell transplantation, MRI of the heart using a clinical 3.0 Tesla whole body scanner (Magnetom Trio, Siemens, Germany) was performed followed by histological examinations. RESULTS: The average yield of sorted cells from 120 ml BM was 7 x 10(6) cells. The cells were cultured and showed MSC-like properties. MRI showed reproducible artifacts within the RIVA-perfusion area and the cryo-scar with surprisingly excellent quality. The histological examination of the biopsies showed PKH26-positive cells within the areas which were positive in the MRI in contrast to the control biopsies. CONCLUSION: Immunomagnetic separation of MSC by specific aptamers linked to magnetic particles is feasible, effective and combines a specific separation and labeling technique to a "one stop shop" strategy.


Subject(s)
Aptamers, Nucleotide , Cardiomyoplasty , Magnetic Resonance Imaging , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Animals , Bone Marrow Cells , Cardiomyoplasty/methods , Cell Separation , Feasibility Studies , Fluorescent Dyes , Immunomagnetic Separation , Mesenchymal Stem Cells/cytology , Myocardial Ischemia , Organic Chemicals , Staining and Labeling , Swine , Time Factors
6.
Eur J Med Res ; 11(12): 527-33, 2006 Dec 14.
Article in English | MEDLINE | ID: mdl-17182365

ABSTRACT

OBJECTIVE: To estimate performance of MRI for differentiating malignant from benign solitary pulmonary nodules (SPN) using morphological characteristics. MATERIAL AND METHODS: MRI in 46 patients with SPN (mean diameter: 19 mm) was carried out on 1.0 Tesla scanner using ECG-gated, gradient echo sequence. Morphological signs of SPN were determined and compared with previously performed helical-CT, where final diagnosis served as reference with 52% frequency of malignancy. Furthermore, three observers evaluated all images. RESULTS: Significant differences between the two groups were found for nodules shape, margin, inhomogeneity and the vessel-sign in MRI, nodules shape, margin, the vessel-sign, and presence of spicules in CT. Using these signs, AUC were 0.746 for MRI and 0.765 for CT. The mean sensitivity, specificity, and accuracy of observers for MRI/CT were 89%/95%, 42%/41%, 66%/68%, respectively. CONCLUSIONS: Despite discrepancies in morphologic appearance, no significant difference of accuracy between MRI and CT was determined. Further investigations are necessary to demonstrate the clinical use in combination with functional parameters, establishing MRI as a comprehensive diagnostic modality for SPN.


Subject(s)
Lung Neoplasms/diagnosis , Solitary Pulmonary Nodule/diagnosis , Adult , Aged , Carcinoid Tumor/diagnosis , Carcinoid Tumor/diagnostic imaging , Carcinoma/diagnosis , Carcinoma/diagnostic imaging , Diagnosis, Differential , Female , Hamartoma/diagnosis , Hamartoma/diagnostic imaging , Humans , Lung Neoplasms/diagnostic imaging , Magnetic Resonance Imaging , Male , Middle Aged , Protons , Retrospective Studies , Solitary Pulmonary Nodule/diagnostic imaging , Tomography, X-Ray Computed , Tuberculoma/diagnosis , Tuberculoma/diagnostic imaging
7.
MAGMA ; 19(2): 71-7, 2006 May.
Article in English | MEDLINE | ID: mdl-16779562

ABSTRACT

In the current study the effect of increasing concentrations of superparamagnetic iron oxide labeled cells on the MRI signal decay at magnetic field strengths of 0.2, 1.5, and 3 T was evaluated. The spin echo and gradient echo cellular transverse relaxivity was systematically studied for various concentrations (N = 1, 5, 10, 20, 40, and 80 cells/microl(gel)) of homogeneously suspended SH U 555A labeled SK-Mel28 human melanoma cells. For all field strengths investigated a linear relationship between cellular transverse relaxation enhancement and cell concentration was found. In the spin echo case, the cellular relaxivities [i.e., d(deltaR2)/dN] were determined to 0.12 s(-1) (cell/microl)(-1) at 0.2 T, 0.16 s(-1) (cell/microl)(-1) at 1.5 T, and 0.17 s(-1) (cell/microl) at 3 T. In the gradient echo case, the calculated cellular relaxivities (i.e., d(deltaR2*)/dN) were 0.51 s(-1) (cell/microl)(-1) at 0.2 T, 0.69 s(-1) (cell/microl)(-1) at 1.5 T, and 0.71 s(-1) (cell/microl)(-1) at 3 T. The proposed preparation technique has proven to be a simple and reliable approach to quantify effects of magnetically labeled cells in vitro. On the basis of this quantification well suited tissue specific models can be derived.


Subject(s)
Echo-Planar Imaging , Image Processing, Computer-Assisted , Iron , Magnetic Resonance Imaging , Oxides , Artifacts , Calibration , Cells, Cultured , Contrast Media , Dextrans , Ferric Compounds/chemistry , Ferrosoferric Oxide , Humans , Magnetite Nanoparticles , Melanoma/pathology , Staining and Labeling
8.
Minerva Cardioangiol ; 54(1): 83-93, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16467744

ABSTRACT

The superficial femoral artery (SFA) is a frequent target of atherosclerotic disease predominantly in the proximal section near the bifurcation to the deep femoral artery and in the distal section where the adductor muscles tend to compress the artery. In the past, SFA revascularization was the domain of vascular surgery (femoropopliteal and femorodistal bypasses). However, with the development of endovascular treatment and advancing techniques as well as more sophisticated stenting material and balloons, endovascular treatment is nowadays not just a treatment option but, in most cases, preferable at least as initial revascularization procedure in the treatment of peripheral artery vascular disease. In the last years, many efforts have been made to fight restenosis in revascularized artery segments after stenting and/or angioplasty. This article aims to give a review on this topic including the most recent experience with the various latest revascularization techniques such as drug eluting stents, coated stent grafts, brachytherapy, cryoplasty, cutting balloons, and drug coated balloons.


Subject(s)
Angioplasty, Balloon/methods , Arterial Occlusive Diseases/therapy , Femoral Artery , Leg/blood supply , Angioplasty, Balloon/instrumentation , Angioplasty, Balloon/trends , Arterial Occlusive Diseases/diagnosis , Atherosclerosis/therapy , Brachytherapy , Clinical Trials as Topic , Coronary Artery Disease/therapy , Humans , Popliteal Artery , Sirolimus/administration & dosage , Stents , Vascular Patency
9.
Biomed Tech (Berl) ; 50(6): 174-80, 2005 Jun.
Article in German | MEDLINE | ID: mdl-16003918

ABSTRACT

UNLABELLED: PURPOSE. This work aims to present a preparation technique for ex-vivo MR examination of SPIO (superparamagnetic iron oxide) containing solutions or SPIO labeled cells. Accumulations of SPIO particles and labeled cells were prepared in different concentrations using agar gel phantoms. Signal extinction around accumulations of magnetic material was examined systematically by gradient echo sequences with variable echo times and spatial resolution. The correlation between local iron concentration and diameter of signal extinction in MR gradient echo images was investigated. METHODS: Resovist, (SHU 555A) was used as superparamagnetic contrast medium. Different concentrations of SPIO-containing solutions (0.75 - 15 mg Fe/10 ml) and magnetically labeled SK-Mel28 cells (25,000-1,000,000 cells/10 ml) were accommodated inside a defined volume in an agar matrix. Diameters of signal void were assessed in dependence on local iron concentration, echo time (5-25 ms) and isotropic spatial resolution (length of voxel 0.25 - 0.60 mm). Measurements were performed on a clinical MR whole body scanner (3 Tesla) using a spoiled gradient echo sequence (FLASH). RESULTS: For the present experimental conditions sensitivity to detect the magnetic label was maximized using TE 25 ms. In contrast, the area of signal cancellation was minimized using TE 5 ms and isotropic resolution of 0.25 mm. In the latter case the image indicated the area of magnetic material most precisely. Diameter of signal cancellation was a logarithmic function on local iron concentration. In the presented set-up detection of concentrations as low as 0.75 mg Fe/10 ml in SPIO-containing solution or 1.25 mg Fe/10 ml in SPIO-labeled SK-Mel28 cells was certainly possible. CONCLUSION: The proposed preparation strategy with a well defined spatial distribution of the magnetic material in an agar gel phantom produced reliable results and appears clearly superior compared to set-ups with randomly distributed material in glass tubes. The diameter of the signal extinction in gradient echo images was significantly affected by the choice of echo time and spatial resolution. The calibration of signal cancellation versus iron concentrations may be valuable to assess SPIO concentrations and possibly numbers of labeled cells under specific conditions in vitro or even in vivo.


Subject(s)
Complex Mixtures/analysis , Contrast Media/chemistry , Image Enhancement/methods , Iron/chemistry , Magnetic Resonance Imaging/methods , Melanoma/pathology , Oxides/chemistry , Cell Line, Tumor , Complex Mixtures/chemistry , Contrast Media/analysis , Contrast Media/chemical synthesis , Ferrosoferric Oxide , Humans , Iron/analysis , Materials Testing , Oxides/analysis , Oxides/chemical synthesis , Solutions , Staining and Labeling/methods
10.
Rofo ; 176(12): 1770-5, 2004 Dec.
Article in German | MEDLINE | ID: mdl-15573288

ABSTRACT

PURPOSE: To evaluate the diagnostic accuracy of direct multidetector CT arthrography (CTA) and direct MR arthrography (MRA) in patients suffering from chronic shoulder instability. MATERIALS AND METHODS: Twenty-nine patients suffering from chronic shoulder instability were included into a prospective study. In all cases, the indication for direct CTA and arthroscopy was set by the orthopedic surgeon. Prior to the imaging procedures, 10 to 20 ml of a special combination of contrast media (including saline, Isovist(R) and Magnevist(R) in a relation of 125 : 125 : 1) was injected into the joint under sterile conditions. First, CTA was performed with a multidetector CT, with images reconstructed in the axial, semi-coronal and semi-sagittal planes. Thereafter, MRA was performed. Axial images were obtained using a T1-weighted, fat-saturated spin echo sequence and semi-coronal images using a T1-weighted FLASH-3D GRE sequence. The results of CTA and MTA were compared with results obtained from arthroscopy or arthrotomy. RESULTS: MRA was superior to CTA in the detection of labral lesions. The sensitivity of MRA was 96 % and the specificity 96 %, compared to a sensitivity of 76 % (p < 0.05) and specificity of 92 % for CTA. Both methods showed the same effectiveness concerning the assessment of capsule distension (sensitivity for both techniques: 91 %). CONCLUSIONS: MRA seems to be superior to CTA in the diagnostic workup of chronic shoulder instability even when using a multidetector CT technique.


Subject(s)
Arthrography/methods , Joint Instability/diagnosis , Magnetic Resonance Imaging/methods , Shoulder Joint , Tomography, X-Ray Computed , Adolescent , Adult , Chronic Disease , Contrast Media , Female , Humans , Joint Instability/diagnostic imaging , Male , Middle Aged , Scapula/diagnostic imaging , Scapula/pathology , Sensitivity and Specificity , Shoulder Joint/diagnostic imaging , Shoulder Joint/pathology
11.
Rofo ; 176(10): 1485-92, 2004 Oct.
Article in German | MEDLINE | ID: mdl-15383983

ABSTRACT

PURPOSE: To evaluate the effect of dexamethasone on the growth of cultured human aortic smooth muscle cells in an in-vitro model depending on the dose applied. MATERIALS AND METHODS: Commercially available human aortic smooth muscle cells (haSMC) were incubated with different doses of dexamethasone (10(-6), 10(-8), 10(-10) mol/l). For 20 days, the dose-depending effects of dexamethasone on cell growth were studied by analyzing cell proliferation, clonogenic activity as well as cell cycle distribution. In addition, the migratory ability of haSMC was evaluated using a two compartment in-vitro model. RESULTS: Cell growth was reduced in a dose dependent manner. An applied dose of 10(-6) M dexamethasone effectively inhibited cell growth for the follow-up period of 20 days. Cell cycle analysis revealed a G1-phase block which was dose dependent and significant for a dose of 10(-6) M. Also a reduction of haSMC clonogenic activity could be found in the colony formation assays. Finally, dexamethasone reduced the migratory ability of the treated cells significantly for doses of 10(-6) and 10(-8) M. CONCLUSION: Depending on the dose applied, incubation with dexamethasone results in a significant growth reduction of cultured haSMC, which may be due to a drug induced G1-phase block. Dexamethasone also reduces the clonogenic activity as well as the migratory ability of cultured haSMC.


Subject(s)
Angioplasty, Balloon , Anti-Inflammatory Agents/pharmacology , Aorta/drug effects , Constriction, Pathologic/prevention & control , Dexamethasone/pharmacology , Muscle, Smooth, Vascular/cytology , Muscle, Smooth, Vascular/drug effects , Stents , Anti-Inflammatory Agents/administration & dosage , Aorta/cytology , Arteriosclerosis/prevention & control , Cell Cycle , Cell Movement/drug effects , Cells, Cultured , Colony-Forming Units Assay , Culture Media , Dexamethasone/administration & dosage , Follow-Up Studies , Graft Occlusion, Vascular , Humans , Hyperplasia , Recurrence , Time Factors , Tunica Intima/pathology
12.
Radiologe ; 44(4): 347-57, 2004 Apr.
Article in German | MEDLINE | ID: mdl-15042292

ABSTRACT

The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI], transarterial chemoembolisation [TACE]) in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases.


Subject(s)
Catheter Ablation/instrumentation , Catheter Ablation/methods , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Catheter Ablation/trends , Humans , Patient Selection , Practice Patterns, Physicians' , Treatment Outcome
13.
Rofo ; 176(3): 398-403, 2004 Mar.
Article in German | MEDLINE | ID: mdl-15026954

ABSTRACT

PURPOSE: Thrombomodulin (TM), an integral endothelial receptor, is known for its anticoagulant functions. Moreover, there is evidence of growth-modulating effects of this cell surface -protein. The aim of our study was to establish by in vitro transfection a stable cell line of vascular smooth muscle cells with overexpression of TM for further investigations concerning the influence of TM on cellular proliferation and its potential role during the formation of restenosis. METHODS: Aortic smooth muscle cells of the rat were transfected with cDNA of mouse TM or one of its three mutants (M1, M2, M4) by a liposome-mediated technique. The expression of mouse TM mRNA in the selected clones was proven with the help of RT-PCR. Changes of cell proliferation were determined by proliferation kinetics over 24 days. The quantification of the total protein TM was made by Western blots. RESULTS: In 44 of 100 cases the RT-PCR confirmed a successful transfection of mouse-TM. The clones with transfected TM, M1 or M2 showed an inhibited cell growth, whereas M4 demonstrated an increased proliferation compared with controls. The comparison of amounts of total TM with cell growth of individual clones resulted in a negative correlation between proliferation and TM-expression (coefficient of correlation for TM -0.87, for M1 -0.59). CONCLUSIONS: It is possible to reproduce stable cell-lines of vascular smooth muscle cells with overexpression of TM by the presented model of in vitro transfection. Thus, a basis exists for detailed examinations of growth-regulating mechanisms by TM.


Subject(s)
Constriction, Pathologic/prevention & control , Genetic Therapy , Muscle, Smooth, Vascular/cytology , Thrombomodulin/genetics , Transfection , Analysis of Variance , Angioplasty, Balloon , Animals , Aorta/cytology , Blotting, Western , Cell Count , Cell Division , Cell Line , Culture Media , DNA Replication , DNA, Complementary/genetics , Gene Expression , Kinetics , Liposomes , Mice , RNA, Messenger/analysis , Rats , Recurrence , Reverse Transcriptase Polymerase Chain Reaction , Time Factors
14.
Rofo ; 176(3): 404-8, 2004 Mar.
Article in German | MEDLINE | ID: mdl-15026955

ABSTRACT

PURPOSE: To evaluate the dose of (188)Re that completely suppresses growth and clonogenic activity of human aortic smooth muscle cells (haSMC) since these cells are mainly responsible for restenosis occurring after PTA. For comparison, growth and clonogenic activity of endothelial cells (EC) were investigated with corresponding doses. MATERIALS AND METHODS: Two days after plating, haSMC and EC were incubated with (188)Re for five days. The doses applied ranged from 4 to 16 Gy. Cell growth was observed for a period of 20 days (EC) or 30 days (haSMC), respectively. Clonogenic activity was monitored over a period of 20 days for both cell lines. RESULTS: Irradiation caused dose-depend-ent inhibition of cell growth and clonogenic activity both in haSMC and in EC. HaSMC growth was completely blocked with 8 Gy, while EC still showed some proliferation even with 16 Gy. The clonal activity of haSMC was also completely blocked with 8 Gy while EC still showed little clonal activity even with 16 Gy. CONCLUSION: Cell growth of both haSMC and EC can be effectively suppressed in a dose-dependent manner. Only haSMC showed a complete growth arrest with 8 Gy while EC were able to proliferate even with 16 Gy. HaSMC colony formation was completely suppressed after application of 8 Gy, while the EC still showed colony formation activity with 16 Gy. (188)Re has some advantageous properties for intravascular irradiation in comparison to other radionuclides making it an interesting radionuclide for stent coating to prevent restenosis.


Subject(s)
Angioplasty, Balloon , Endothelial Cells/radiation effects , Muscle, Smooth, Vascular/cytology , Muscle, Smooth, Vascular/radiation effects , Radioisotopes/pharmacology , Rhenium/pharmacology , Stents , Aorta/radiation effects , Cell Division/radiation effects , Cell Line , Colony-Forming Units Assay , Constriction, Pathologic/prevention & control , Dose-Response Relationship, Radiation , Endothelial Cells/cytology , Humans , Muscle, Smooth, Vascular/growth & development , Radiation Dosage , Recurrence , Time Factors
15.
Rofo ; 175(4): 484-8, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12677502

ABSTRACT

AIM: The primary objective of this study was to evaluate the impact of radiopaque markers on stent visibility. The secondary objective was to investigate the impact of such radiopaque markers on localized corrosion at the stent corpus-marker interfaces. MATERIAL AND METHODS: The radiopacity of the following stents was evaluated at different fluoroscopy modes (spotfilm, continuous fluoroscopy, 15 p/s, 7.5 p/s, 3 p/s): Memotherm Flexx (FX), Memotherm Luminexx (LX)(Bard), SMART (SM), SMARTeR (SMR)(Cordis). Four readers evaluated a total of 3200 images (160 per stent per fluoro mode) according to the following radiopacity score (RS): 0 = no stent visible, 1 = poor, 2 = acceptable, 3 = good, and 4 = very good stent visibility. LX and SMR stents (n = 5/group) were subjected to potentiodynamic polarization testing in de-aerated Hanks salt solution at 37 degrees C using a potentiostat. Palmaz-Schatz stents (n = 3) were used as the control group for comparative evaluation. The corrosion current density (I corr ) and the breakdown value (E bd ) were compared parameters of interest. RESULTS: At the spotfilm mode the LX, the SM and the SMR were rated well to very well visible in 99 %, 96 %, 96 %, and the FX only in 64 %. At 7.5 p/s (standard fluoro mode) the LX was considered to be well to very well visible in 77 %, followed by the SMR in 12.5 %, the SM in 1 %, and the FX in 0 %. The SMR stents exhibited the highest E bd values (802 +/- 112 mV vs SCE), while the LX stents exhibited the lowest E bd values (155 +/- 38 mV vs SCE). Also, the average E bd values for the SMR stents were better than those exhibited by the PS stents (503 +/- 107 mV vs SCE). CONCLUSION: Stent radiopacity can be increased significantly with the help of radiopaque markers (p < 0,0001 LX vs. FX). However, the surface condition of the stent corpus and the mode of attachment of the marker onto the corpus may have a significant impact on the uniformity of the final corrosion behavior. It is not feasible to determine the clinical impact of this localized corrosion behavior from this in vitro study. Further experimentation is recommended to ascertain the same.


Subject(s)
Coated Materials, Biocompatible , Contrast Media , Equipment Failure Analysis , Fluoroscopy , Stents , Corrosion , Equipment Failure Analysis/statistics & numerical data , Humans , Mathematical Computing , Microscopy, Electron, Scanning , Phantoms, Imaging , Prosthesis Design , Stents/statistics & numerical data
16.
Rofo ; 173(9): 810-4, 2001 Sep.
Article in German | MEDLINE | ID: mdl-11582560

ABSTRACT

OBJECTIVE: To evaluate the feasibility of signal enhancement in the deep veins by means of manual compression of the calf (flow augmentation) as a new approach to MR venography in open configuration, low-field systems. METHODS: 10 healthy volunteers underwent MR venography of the calf unconstrained and during short localized manual compression. Gradient recalled echo sequences (FLASH, FISP) with repeated single slice acquisition and first-order gradient motion refocussing were tested in four protocols with and without arterial presaturation slabs (scan time 2.2 - 5.0 s per slice). The effect on flow enhancement was rated by means of a signal score. Interventional accessories, particularly an in-room LCD screen, were required for interactive application of compression manoeuvres. RESULTS: Sequences with arterial presaturation slabs were superior to those without regardless of the longer acquisition times. Careful targeting of compression to the mid-time of data acquisition was crucial to obtain marked flow acceleration. Enhancement was best in the case of proximally applied calf compression. Signal improvement was consistently achieved in the proximal parts of the posterior tibial and peroneal veins, but was only seen in 4/10 volunteers in the distal part of the anterior tibial vein. CONCLUSION: Flow augmentation by means of manual calf compression is a simple and effective complementary approach to MR venography in open configuration, low field MR systems.


Subject(s)
Image Enhancement/instrumentation , Magnetic Resonance Angiography/instrumentation , Phlebography/instrumentation , Venous Pressure/physiology , Venous Thrombosis/diagnosis , Adult , Blood Flow Velocity/physiology , Female , Humans , Male , Pulsatile Flow/physiology , Sensitivity and Specificity , Venous Thrombosis/physiopathology
17.
J Invasive Cardiol ; 13(6): 456-9, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11385170

ABSTRACT

PURPOSE: To assess the feasibility and initial clinical results of Closer (Perclose, Redwood City, California), a new device for percutaneous suture-mediated closure of arterial puncture sites. METHODS: Vascular interventions were performed using 6 and 7 French sheaths in 22 consecutive patients. All patients underwent suture-mediated percutaneous closure with the new device. Patients were followed by physical examination the day after the procedure. RESULTS: Immediate hemostasis was achieved in 20/22 patients (91%). In 3 out of 5 antegrade closures, only one suture was captured. In two cases, this was managed by reinsertion of a second device. In another patient, hemostasis was not achieved by the device due to knot entrapment. No major complications were observed. The overall rate of minor complications was 9% (2/22) due to hematomas without the need for blood transfusions. CONCLUSION: Percutaneous suture with this new device is an acceptably safe and effective method to achieve immediate hemostasis of the arterial access site after interventional procedures with minimized manipulation of the puncture track.


Subject(s)
Arteries/surgery , Needles/statistics & numerical data , Punctures/instrumentation , Sutures , Adult , Aged , Aged, 80 and over , Equipment Design , Female , Hemostasis/physiology , Humans , Male , Middle Aged
18.
Int J Radiat Oncol Biol Phys ; 49(3): 809-15, 2001 Mar 01.
Article in English | MEDLINE | ID: mdl-11172964

ABSTRACT

PURPOSE: To evaluate dose-dependent growth-modulating effects of the beta-gamma emitter Rhenium-188 on cultured human aortic smooth muscle cells (haSMC). METHODS AND MATERIALS: HaSMC were plated in 25 cm(2) flasks. Two days after plating, cells were incubated with the Re-188 (beta E(max) 2.12 MeV, tissue range(max) < 10 mm, T(1/2) 17 h) for five days. The doses administered were 0.2 Gy, 1, 4, 6, 8, 16, and 32 Gy. After five days, the radionuclide was removed. Cell growth, cell cycle distribution, and clonogenic activity were analyzed for the following 25 days. RESULTS: The 0.2 and 1 Gy groups did not show relevant growth-inhibiting effects compared to the control groups. The 4 to 32 Gy groups presented dose-dependent growth inhibition, with a complete growth arrest of the 16 and 32 Gy groups. Clonogenic activity of the smooth muscle cell was strongly inhibited from doses > or =8 Gy. Flow cytometry showed a lasting dose-dependent G2/M phase block. CONCLUSION: Smooth muscle cell (SMC) growth can be controlled effectively with Re-188 for at least 25 days after radiation in vitro. As the first four weeks after arterial angioplasty are crucial concerning neointimal formation, Re-188 may be a valuable radionuclide to inhibit restenosis after arterial angioplasty.


Subject(s)
Aorta/radiation effects , Cell Division/radiation effects , Muscle, Smooth, Vascular/radiation effects , Radioisotopes/pharmacology , Rhenium/pharmacology , Aorta/cytology , Dose-Response Relationship, Drug , Humans , Interphase/radiation effects , Muscle, Smooth, Vascular/cytology , Radiobiology
19.
Rofo ; 173(1): 72-6, 2001 Jan.
Article in German | MEDLINE | ID: mdl-11225421

ABSTRACT

PURPOSE: The aim of this study was to evaluate the capability of human aortic smooth musc e cells (HaSMC) and endothelial cells (EC) to recover after incubation with the combined beta/gamma emitter 186rhenium. MATERIALS AND METHODS: Two days after plating, HaSMC and EC were incubated for five days with 186Re (total doses applied 4 Gy-32 Gy). Cell counts were performed for a period of 30 days (haSMC) and 22 days (EC). To detect possible growth recovery, colony formation assays were plated for both cell types on day 5, 10, and 20 (and lay 30 for haSMC). RESULTS: Both cell types presented a dose-dependent growth inhibition which was maximum at a dose of 32 Gy. Human endothelial cells presented with total growth recovery at 4 and 8 Gy, and a partial growth recovery at 16 Gy. Smooth muscle cells only presented partial growth recovery at 4 and 8 Gy. At 16 Gy and more no recovery was detected. CONCLUSION: HaSMC as well as EC growth can be modulated effectively with 186Re over a period of 30 days in vitro. Compared to smooth muscle cells human endothelial cellls seem to possess a higher potential to recover at doses of 8 to 16 Gy. 186Re may be a valuable radionuclide to prevent restenosis.


Subject(s)
Endothelium, Vascular/cytology , Endothelium, Vascular/radiation effects , Muscle, Smooth, Vascular/cytology , Muscle, Smooth, Vascular/radiation effects , Radioisotopes/pharmacology , Rhenium/pharmacology , Angioplasty, Balloon , Angioplasty, Balloon, Coronary , Aorta/cytology , Cell Count , Cell Division , Cells, Cultured , Humans , Radiation Dosage , Recurrence , Time Factors
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