Value of Posterior circulation ASPECTS and Pons-Midbrain Index on non-contrast CT and CT Angiography Source Images in patients with basilar artery occlusion recanalized after mechanical thrombectomy. / Valor de la escala ASPECTS de circulación posterior y del índice puente-mesencéfalo en imágenes de TC sin contraste y angiografía por TC en pacientes con oclusiones de la arteria basilar recanalizados tras trombectomía mecánica.

PURPOSE: Endovascular treatment with mechanical thrombectomy devices demonstrated high recanalization rates but functional outcome did not correlate with high rates of recanalization obtained. Patient selection prior to the endovascular treatment is very important in the final outcome of the patient. The primary aim of our study was to evaluate the prognostic value of posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) and Pons-Midbrain Index (PMI) scores in patients with Basilar Artery Occlusion (BAO) treated with successful angiographic recanalization after mechanical thrombectomy. METHODS: Retrospective single-center study including 18 patients between 2008 and 2013 who had acute basilar artery occlusion managed with endovascular treatment within 24hours from symptoms onset and with successful angiographic recanalization. The patients were initially classified into two groups according to clinical outcome and mortality at 90 days. For analysis we also divided patients into groups based on pc-ASPECTS (≥8vs.<8) and PMI (≥3vs.<3) on non-contrast CT (NCCT) and CT Angiography Source Images (CTASI). Imaging data were correlated to clinical outcome and mortality rate. RESULTS: CTASI pc-ASPECTS, dichotomized at <8 versus≥8, was associated with a favorable outcome (RR: 2.6; 95% CI: 1.3-5.2) and a reduced risk of death (RR: 6.5: 95% CI: 7.8-23.3). All patients that survived and were functionally independent had pc-ASPECTS score≥8. None of the 5 patients with CTASI pc-ASPECTS score less than 8 survived. CONCLUSION: PC-ASPECTS on CTASI is helpful for predicting functional outcome after BAO recanalization with endovascular treatment. These results should be validated in a randomized controlled trial in order to decide whether or not to treat a patient with BAO.

RADStation3G: a platform for cardiovascular image analysis integrating PACS, 3D+t visualization and grid computing.

RADStation3G is a software platform for cardiovascular image analysis and surgery planning. It provides image visualization and management in 2D, 3D and 3D+t; data storage (images or operational results) in a PACS (using DICOM); and exploitation of patients' data such as images and pathologies. Further, it provides support for computationally expensive processes with grid technology. In this article we first introduce the platform and present a comparison with existing systems, according to the platform's modules (for cardiology, angiology, PACS archived enriched searching and grid computing), and then RADStation3G is described in detail.

[Treatment with the placement of carotid stent of jugular-carotid fistula after the insertion of hemodialysis catheter]. / Tratamiento mediante implantación de stent carotídeo de fistula yugulocarotídea tras la inserción de catéter para hemodiálisis.

The use of jugular temporary catheters as vascular access for hemodialysis, entails a risk of various complications. The most frequent problems are the arterial puncture and haematoma. However, there are other less frequent potentially serious complications, which constitute a therapeutic and diagnostic challenge for the nephrologists. We present a case of a patient that developed an acute renal failure in the context of cellulites for E. Coli treated with aminoglycosid, who required renal treatment with haemodialysis. After the placement of a polyurethane double-lumen catheter with ultrasound guidance at the level of the internal jugular vein, arterial blood streaming was observed through the lumen of the catheter. The angiographic study showed the tipo of the catheter placed at the level of the aortic arch. Ultrasound exam clearly despicted the track between the internal jugular vein and the internal carotid artery. An effective closing of the fistula was achieved with the placement of a covered stent-graft with the simultaneous withdrawal of the catheter. Reviewing the literature this is the first reported case of an iatrogenic jugulo-carotid fistula secundary to placement of hemodialysis catheter resolved by the implantation of carotid stent-graft.

[Multiple radicular tumors in von Recklinghausen disease assessed by magnetic resonance]. / Tumores radiculares múltiples en la enfermedad de Von Recklinghausen. Valoración mediante resonancia magnética.

We present a case of multiple neurofibromata at lumbar nerve root level in a patient diagnosed as having Von Reckling-hausen's disease or type 1 neurofibromatosis (NF 1), studied using magnetic resonance (MR). We also observed in the same study the presence of dural ectasis, something likewise related to NF 1. We assessed MR possibilities in the study of this type of pathology and its relative advantages with respect to other types of image-forming techniques. MR is nowadays considered as the technique of choice when studying medullar and radicular pathology in patients suffering Von Recklinghausen's disease.

[Carotid cavernous fistula: endovascular therapy]. / Fístulas carótido-cavernosas: tratamiento endovascular.

Abnormal communications between the carotidal artery and the cavernous sinus are known as carotid-cavernous fistulas. We can however distinguish between these fistulas two different evolutive and etiological entities: on the one hand there are the direct types with high flux and normally related to hard traumatisms and on the other hand there are the indirect types lacking clear etiological factors, with slower flux and which correspond to dural malformations with different arterial nutrition. In the last two years in our service we have treated eight carotid-cavernous fistulas, four direct and four indirect, using endovascular techniques with differing emboligenic materials according to the nature of the fistula, flux volume and origin. Complete closure was obtained in all patients with direct fistulas and in two whose fistulas were indirect. Closure was almost (greater than 75%) complete in the remaining two cases. In all cases symptomatology prior to intervention diminished completely a few weeks later with no relapse up until now. We discuss the classification and clinico-pathological characteristics of each fistula type, the comparative usefulness of different diagnostic methods and we review therapeutic symptoms with special emphasis on neuroradiological endovascular techniques, analyzing the usefulness of each emboligenic material type. The recent development of intervention techniques in neuroradiology makes low risk correct closure of carotid-cavernous fistulas a possibility. Endovascular is accepted as the treatment of choice today.