Diagnostic and interventional radiology最新文献

{"title":"Staged angioplasty using a full-length balloon catheter to achieve maturation of arteriovenous fistulas.","authors":"Miju Bae, Chang Ho Jeon, Sung Woon Chung, Chung Won Lee, Up Huh, Jongwon Kim, Hyuncheol Jeong","doi":"10.4274/dir.2024.232607","DOIUrl":"10.4274/dir.2024.232607","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of staged full-length balloon-assisted maturation (BAM) for the maturation of arteriovenous fistulas (AVFs) on entire segmental veins, including stenosis, causing primary AVF failure.</p><p><strong>Methods: </strong>This study included patients who underwent AVF surgery using an autogenous vein between February 2020 and June 2021 and received staged angioplasty with a full-length balloon catheter. To minimize balloon overlap and the risk of barotrauma to the immature vein, serial-staged upsizing balloon angioplasty with a long balloon catheter covering the entire vein segment was employed approximately 2 weeks apart.</p><p><strong>Results: </strong>Twenty-three patients (mean age, 69.50 years; mean follow-up, 620.62 days) with average diameters of the radial artery and cephalic vein at 2.14 ± 0.5 mm and 2.43 ± 0.5 mm, respectively, were enrolled. In the first procedure, the average AVF diameter and flow were 4.03 ± 0.57 mm and 438.08 ± 220.95 mL/min, respectively, with juxta-anastomotic stenosis (JAS) present in 61.5% of cases. After staged full-length BAM, the average fistula diameter and flow improved to 5.95 ± 0.86 mm and 717.52 ± 305.95 mL/min, respectively. Maturation was achieved in 87% of the cases. No hematomas or ruptures occurred around the arterialized veins. Despite successful maturation and cannulation, 65.2% of the patients required additional percutaneous transluminal angioplasty (PTA) during the follow-up period. The necessity for PTA was determined by the presence of JAS prior to the first staged full-length BAM, with an odds ratio of 11.74 (95% confidence interval: 1.31-104.96, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>Staged full-length BAM can be safely used in patients with small veins requiring further maturation. Most patients achieved successful cannulation following maturation without post-procedural complications.</p><p><strong>Clinical significance: </strong>Staged full-length BAM is a safe and effective method for enhancing maturation in patients with underdeveloped small veins.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"45-51"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting checklists as compulsory supplements to artificial intelligence manuscript submissions.","authors":"Michail E Klontzas","doi":"10.4274/dir.2024.242849","DOIUrl":"10.4274/dir.2024.242849","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"17-18"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of guided reporting: quality and reading time of automatically generated radiology report in breast magnetic resonance imaging using a dedicated software solution.","authors":"Martin H Maurer, Daniel Lorenz, Maximilian Clemens Otterbach, Igor Toker, Alexander Huppertz","doi":"10.4274/dir.2024.242702","DOIUrl":"10.4274/dir.2024.242702","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Unstructured, free-text dictation (FT), the current standard in breast magnetic resonance imaging (MRI) reporting, is considered time-consuming and prone to error. The purpose of this study is to assess the usability and performance of a novel, software-based guided reporting (GR) strategy in breast MRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighty examinations previously evaluated for a clinical indication (e.g., mass and focus/non-mass enhancement) with FT were reevaluated by three specialized radiologists using GR. Each radiologist had a different number of cases (R1, n = 24; R2, n = 20; R3, n = 36). Usability was assessed by subjective feedback, and quality was assessed by comparing the completeness of automatically generated GR reports with that of their FT counterparts. Errors in GR were categorized and analyzed for debugging with a final software version. Combined reading and reporting times and learning curves were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Usability was rated high by all readers. No non-sense, omission/commission, or translational errors were detected with the GR method. Spelling and grammar errors were observed in 3/80 patient reports (3.8%) with GR (exclusively in the discussion section) and in 36/80 patient reports (45%) with FT. Between FT and GR, 41 patient reports revealed no content differences, 33 revealed minor differences, and 6 revealed major differences that resulted in changes in treatment. The errors in all patient reports with major content differences were categorized as content omission errors caused by improper software operation (n = 2) or by missing content in software v. 0.8 displayable with v. 1.7 (n = 4). The mean combined reading and reporting time was 576 s (standard deviation: 327 s; min: 155 s; max: 1,517 s). The mean times for each reader were 485, 557, and 754 s, and the respective learning curves evaluated by regression models revealed statistically significant slopes (&lt;i&gt;P&lt;/i&gt; = 0.002; &lt;i&gt;P&lt;/i&gt; = 0.0002; &lt;i&gt;P&lt;/i&gt; &lt; 0.0001). Overall times were shorter compared with external references that used FT. The mean combined reading and reporting time of MRI examinations using FT was 1,043 s and decreased by 44.8% with GR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;GR allows for complete reporting with minimized error rates and reduced combined reading and reporting times. The streamlining of the process (evidenced by lower reading times) for the readers in this study proves that GR can be learned quickly. Reducing reporting errors leads to fewer therapeutic faults and lawsuits against radiologists. It is known that delays in radiology reporting hinder early treatment and lead to poorer patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;While the number of scans and images per examination is continuously rising, staff shortages create a bottleneck in radiology departments. The IT-based GR method can be a major boon, improving radiologist efficiency, report quality, and the ","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"19-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow-diverting stents in the management of extracranial carotid artery aneurysms.","authors":"Celal Cinar, Erol Akgul, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Hasan Bilen Onan, Irem Islek, Mohammad Naim Forogh, Mohammad Nawas Nasiri, Ismail Oran","doi":"10.4274/dir.2024.242946","DOIUrl":"https://doi.org/10.4274/dir.2024.242946","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow- up assessments included digital subtraction angiography or computed tomography angiography at 6-12 months and clinical evaluations to monitor symptom resolution and complications.</p><p><strong>Results: </strong>Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period.</p><p><strong>Conclusion: </strong>The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes.</p><p><strong>Clinical significance: </strong>The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal for training: the educational value of a musculoskeletal embolization patellar tendinopathy model.","authors":"Emeric Gremen, Julien Ghelfi, Marylène Bacle, Julien Frandon","doi":"10.4274/dir.2024.243005","DOIUrl":"https://doi.org/10.4274/dir.2024.243005","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries.","authors":"Muhammed Said Beşler, Asiye Sözeri, Murat Canyiğit","doi":"10.4274/dir.2024.243022","DOIUrl":"https://doi.org/10.4274/dir.2024.243022","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the optimal balloon diameter for intravascular ultrasound (IVUS)-guided balloon angioplasty in calcified below-the-knee (BTK) tibial artery lesions.</p><p><strong>Methods: </strong>Between February 2024 and April 2024, a retrospective review was conducted on 17 patients with Rutherford category 4-6 severely calcified tibial arteries with >70% stenosis, treated with IVUS-guided balloon angioplasty. Sequentially, 3 mm and then 3.5 mm diameter balloons were inflated. The minimum lumen diameter and area were measured before and after the procedure in the proximal, mid, and distal segments of the tibial arteries. One- and three-month follow-ups were conducted using Doppler ultrasound.</p><p><strong>Results: </strong>Significant increases in lumen diameter (<i>P</i> < 0.001 for all) and lumen area (<i>P</i> < 0.001, <i>P</i> = 0.003, <i>P</i> = 0.002, respectively) were observed in the proximal, mid, and distal segments of the BTK arteries following IVUS-guided 3.5 mm balloon angioplasty. Ultra-low iodinated contrast media was used [median 2 mL (range, 1-4 mL)]. Lumen area increase ratios were similar among the proximal, mid, and distal segments (<i>P</i> = 0.905). No target vessel revascularization, major amputation, or mortality was observed during follow-up. Wound healing was seen in 62.5% of the cases with foot ulcers.</p><p><strong>Conclusion: </strong>In the treatment of calcified BTK tibial arteries, a gradual balloon diameter increase up to 3.5 mm in IVUS-guided balloon angioplasty is safe and effective.</p><p><strong>Clinical significance: </strong>Gradual balloon diameter increase up to 3.5 mm under IVUS guidance in calcified BTK lesions demonstrates significant potential. It enables ultra-low contrast usage, provides low complication rates, and achieves high patency and limb salvage, along with satisfactory wound healing in the short term.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of multiparametric magnetic resonance imaging in the differentiation of low- and high-grade non-muscle invasive bladder cancer.","authors":"Merve Nur Taşdemir, Uluhan Eryürük, Ural Oğuz, Birgül Tok, Serdar Aslan","doi":"10.4274/dir.2024.243004","DOIUrl":"https://doi.org/10.4274/dir.2024.243004","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic efficacy of apparent diffusion coefficient (ADC) measurements and semi-quantitative dynamic contrast enhancement (DCE) parameters in predicting the differentiation between low- and high-grade tumors in non-muscle invasive bladder cancers (NMIBC).</p><p><strong>Methods: </strong>Patients with NMIBC, who were histopathologically confirmed between August 2020 and July 2023, were analyzed by 2 radiologists with different levels of experience. DCE semi-quantitative parameters such as wash-in rate (WiR), wash-out ratio (WoR), time to peak (TTP), and peak enhancement (PE) were calculated. ADC measurements were performed using the three-region-of-interest (ADCt) and whole volume (ADCw) methods; ADCt ratio (ADCtR) and ADCw ratio (ADCwR) were also calculated. Receiver operating characteristic curve analysis was performed to demonstrate the cut-off values of ADCt, ADCw, ADCtR, and ADCwR to differentiate low- and high-grade tumors. The intraclass correlation coefficient was used to evaluate inter-reader agreement.</p><p><strong>Results: </strong>A total of 89 patients were included in this study. Of these patients, 48 had low-grade NMIBC, and 41 had high-grade NMIBC. There was no significant difference in mean WoR, WiR, TTP, and PE values between low- and high-grade NMIBC (<i>P</i> > 0.05). The ADCt, ADCw, ADCtR, and ADCwR values of high-grade NMIBC were significantly lower than those of low-grade NMIBC (<i>P</i> < 0.001). With cut-off values of 0.449 and 0.435, ADCtR had the best diagnostic value for both readers, showing better accuracy, sensitivity, specificity, and area under the curve (85.4%-83.1%, 87.5%-85.4%, 82.9%-80.4%, and 0.879-0.857, respectively, with confidence intervals). Additionally, ADCtR and ADCt showed acceptable diagnostic performance for both readers, with cut-off values of 0.439 and 0.431, respectively, for differentiating Ta- and T1-stages. The inter-reader agreement was almost perfect for ADC measurements.</p><p><strong>Conclusion: </strong>While DCE semiquantative parameters did not yield significant outcomes in distinguishing between low and high grades, ADCtR holds promise for enhancing patient management in NMIBC cases and stands as a potential preoperative radiological asset.</p><p><strong>Clinical significance: </strong>Individuals diagnosed with NMIBC may require different treatment approaches; therefore, it is very important to distinguish between low- and high-grade cases preoperatively. The differentiation between the Ta- and T1-stages is recognized as crucial in patient treatment strategies. Furthermore, ADCtR shows promise for improving patient management in NMIBC cases.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the prognostic impact of inflammatory markers on treatment outcomes in patients with intrahepatic cholangiocarcinoma undergoing radioembolization.","authors":"Sinan Sözütok, Ferhat Can Pişkin, Hüseyin Tuğsan Ballı, Berkay Dik","doi":"10.4274/dir.2024.242929","DOIUrl":"https://doi.org/10.4274/dir.2024.242929","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive malignancy with limited treatment options, often diagnosed at advanced stages. Radioembolization has emerged as a promising therapy, but its efficacy varies among patients, necessitating reliable biomarkers to predict treatment response. This study evaluates the prognostic impact of systemic inflammatory response markers on treatment outcomes in patients with iCCA undergoing radioembolization.</p><p><strong>Methods: </strong>This retrospective study included 70 patients with iCCA treated with radioembolization between January 2016 and December 2023. Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were measured from peripheral blood samples. Treatment response was assessed using the modified RECIST criteria, and survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards regression.</p><p><strong>Results: </strong>Patients with lower NLR, PLR, and SII values exhibited significantly higher objective response rates (<i>P</i> = 0.032, <i>P</i> = 0.016, and <i>P</i> = 0.001, respectively). High levels of NLR, PLR, and SII were associated with shorter overall survival (12 vs. 16 months, <i>P</i> = 0.007; 12 vs. 16 months, <i>P</i> = 0.004; and 10 vs. 22 months, <i>P</i> < 0.001, respectively) and progression-free survival (3 vs. 7 months, <i>P</i> = 0.046 for SII). Multivariate analysis identified high SII (<i>P</i> = 0.040), lymph node metastasis (<i>P</i> = 0.042), and high serum total bilirubin (<i>P</i> = 0.013) as significant independent prognostic factors.</p><p><strong>Conclusion: </strong>Systemic inflammatory markers such as NLR, PLR, and SII are valuable prognostic indicators for patients with iCCA undergoing radioembolization. These markers can aid in identifying patients likely to benefit from personalized treatment strategies, potentially improving clinical outcomes.</p><p><strong>Clinical significance: </strong>The clinical significance of this study lies in its demonstration that systemic inflammatory markers (NLR, PLR, and SII) serve as valuable prognostic indicators for predicting treatment outcomes in patients with iCCA undergoing radioembolization, thus aiding in the identification of patients who may benefit from personalized treatment strategies and potentially improving clinical outcomes.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of the flare sign in predicting extracapsular extension in metastatic axillary lymph nodes and nodal status on breast magnetic resonance imaging.","authors":"Cihan Özgür, Baran Serdar Sunal, Savaş Hereklioğlu, Meltem Öznur, Sibel Özkan Gürdal","doi":"10.4274/dir.2024.242906","DOIUrl":"10.4274/dir.2024.242906","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in predicting extracapsular extension (ECE) and axillary nodal status in the axillary metastatic lymph nodes of patients with breast cancer.</p><p><strong>Methods: </strong>The preoperative MRI scans of 92 patients with breast cancer and axillary metastases who did not receive neoadjuvant treatment between January 2018 and January 2024 were retrospectively examined. The presence of an increased signal in the axillary fatty tissue surrounding the lymph node (flare sign) on T2-weighted images, irregular nodal contour (shaggy margin), axillary asymmetry (difference in the number and size of lymph nodes compared with the unaffected axilla), loss of the fatty hilum in the most suspicious lymph node, and morphological features on T1-weighted images were assessed. Each dissected axillary lymph node was examined for ECE, and the histopathological results were recorded.</p><p><strong>Results: </strong>Axillary flare sign was significantly associated with the presence of ECE (<i>P</i> < 0.001), number of lymph nodes with ECE (<i>P</i> < 0.001), the presence of ≥4 axillary metastatic lymph nodes (<i>P</i> < 0.001), size of the primary tumor (<i>P</i> = 0.033), lymphovascular invasion in the primary tumor (<i>P</i> < 0.001), and presence of perineural invasion (<i>P</i> = 0.001). The flare sign exhibited 65.7% sensitivity, 96% specificity, 97.8% positive predictive value, 51.1% negative predictive value, and 73.9% accuracy in predicting ECE. Additionally, the receiver operating characteristic curve analysis revealed an area under the curve of 0.808 (95% confidence interval: 0.719-0.898).</p><p><strong>Conclusion: </strong>The flare sign has high performance in predicting ECE and axillary nodal status and is associated with primary tumor aggressiveness, indicating its potential utility in preoperative evaluation.</p><p><strong>Clinical significance: </strong>The flare sign on breast MRI may play a crucial role in preoperative planning, surgical decision-making, and axillary status assessment by accurately predicting ECE.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental study of a canine model for a newly designed adjustable prefenestration aortic stent graft","authors":"Lei Zhang, Chang Shu, Yuchen Qiu, Zeliang Fu, Pengcheng Guo, Xin Li","doi":"10.4274/dir.2023.232440","DOIUrl":"10.4274/dir.2023.232440","url":null,"abstract":"<p><strong>Purpose: </strong>When performing thoracic aortic endovascular repair (TEVAR) on lesions of the aortic arch, physician-modified fenestration or <i>in situ</i> fenestration is often used to maintain patent branches. We designed a new adjustable prefenestration aortic stent graft that can both isolate pathologies in the aortic arch and obtain patent branches simultaneously. In this study, we use this new type of stent to perform fenestrated TEVAR in a canine’s aorta. This study aims to evaluate the safety and feasibility of the new device, which may provide preliminary data for potential human application.</p><p><strong>Methods: </strong>Eight Labrador Retriever canines underwent fenestrated TEVAR using the new stent device. Digital subtract angiography (DSA) was performed before and after fenestrated TEVAR to evaluate the safety and feasibility of the procedure. For the device deployment, at the “large curvature” side in the endograft, there is a rectangular prefenestration area (2 × 5 cm) without the polytetrafluoroethylene membrane, and at both longer side edges of the fenestration, there are two slide rails. A moveable membrane that covers the same area as the prefenestration area is initially set at the prefenestration position. A stay line is connected from the distal site of the moveable membrane that controls it to the distal position along the slide rail, which releases the fenestration. After the positioning of the prefenestration is determined, the outer sheath of the delivery system is released, and the stay line at the end of the delivery system is pulled outside the body. The animals were divided into a 1-month group (n = 4) and a 3-month group (n = 4) after the fenestrated TEVAR. Computed tomography (CT) was performed before euthanasia, and video of the DSA during the procedures and CT angiography (CTA) images were then studied.</p><p><strong>Results: </strong>The procedure success rate was 100%, but the total survival rate was only 87.5%. There were no aortic-related deaths during follow-up, and during the operation, there were no stent-graft-related accidents. In addition, no stent-graft migrations were observed in the CTA, and all branch arteries were kept patent by the adjustable fenestration. Finally, histological examination and electron microscope results showed no obvious vascular injury or inflammation.</p><p><strong>Conclusion: </strong>Based on the results of this study, we judge the safety and feasibility of the use of the newly designed adjustable prefenestration aortic stent graft in a fenestrated-TEVAR canine model to be acceptable. Our preliminary data may serve as an initial reference for evaluating the potential application of the new stent in humans.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"402-408"},"PeriodicalIF":1.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}