The first measure performed in the treatment of pseudoaneurysms should be reapplication of a compression bandage, followed, if necessary, by UGCR. After failure of UGCR, spontaneous healing occurs in the majority of patients. Operation can be reserved for progressive and complicated lesions.
Background and Purpose-Embolic events are a major cause for procedure-related strokes after carotid endarterectomy (CEA). Transcranial Doppler sonography can reveal embolic events as microembolic signals (MES) during CEA. MES during declamping and shunting are frequently detected. MES during shunting are rare and known to be correlated with the neurological outcome of the patient. In the present study, we analyzed the occurrence of MES within different stages of CEA and whether MES within those stages were correlated with cerebral ischemia, as detected by diffusion-weighted imaging (DWI), and brain infarction, as detected by contrast-enhanced MRI. Methods-Thirty-three patients were monitored intraoperatively for MES using transcranial Doppler sonography. DWI was performed within 24 hours before and after surgery. Positive postoperative DWI led to reexamination with contrast-enhanced T1-MRI 7 to 10 days after CEA for detection of cerebral infarction. Results-MES were detected in 32 of 33 patients. The highest number of MES was found during shunting and declamping.A significant correlation was found between MES and DWI-lesions during dissection. A significant correlation was found between MES during dissection and shunting, and nonsignificant correlation was found between MES and the occurrence of cerebral infarction.
Conclusion-MES
Background This study was undertaken to expand the understanding of ultrasound-guided compression repair (UGCR) of postcatheterization femoral artery injuries.Methods and Results In a series of 62 patients with pseudoaneurysms (n=53) or arteriovenous (AV) fistulas (n=9), UGCR was performed as a nonsurgical method in the treatment of postcatheterization femoral artery injuries. When the communicating channel could be visualized (43 cases), pressure was focused on it; otherwise (10 cases) the extraluminal cavity itself was compressed. In 45 cases, the elimination of flow in the pseudoaneurysm and/or the communicating channel could be achieved only with simultaneous temporary complete occlusion of the femoral artery. UGCR was success-
There is a significant overall improvement in tissue perfusion of the foot immediately after tibial angioplasty. The effect shown in this study, however, was found to be global and was not restricted to certain borders, such as defined by angiosomes.
Figure 1: Reconstructed volume of a 3D scene in a fish tank with diluted milk. While in the floodlit image (b) only the front objects are recognizable, confocal imaging (c) partially removes the haze. Using our novel descattering algorithm combined with confocal imaging more global scattering is removed and objects at even larger distances become visible (d). The image is sharper and features more saturated colors. In (e), the recovered 3D structure is visualized for a different view. Images (c)-(e) have been created by computing a confocal or descattered confocal volume followed by maximum intensity projection.
AbstractIn translucent objects, light paths are affected by multiple scattering, which is polluting any observation. Confocal imaging reduces the influence of such global illumination effects by carefully focusing illumination and viewing rays from a large aperture to a specific location within the object volume. The selected light paths still contain some global scattering contributions, though. Descattering based on high frequency illumination serves the same purpose. It removes the global component from observed light paths. We demonstrate that confocal imaging and descattering are orthogonal and propose a novel descattering protocol that analyzes the light transport in a neighborhood of light transport paths. In combination with confocal imaging, our descattering method achieves optical sectioning in translucent media with higher contrast and better resolution.
DWI is a sensitive method of demonstrating ischemic events after CEA. The number and volume of DWI lesions after CEA are highly predictive of brain infarction.
We conducted tests on six healthy volunteers and six pacemaker patients. With the aid of three straight line frequency acceleration pickups attached to the body, the mechanical signals were recorded on the three axes during different activities. Along with standardized exercise on bicycle and treadmill ergometers, we tested the influence of household activities and interference influences. The results were analyzed in terms of the amplitude and frequency content of the signals. For walking activities, we found a signal amplitude increasing in a largely linear fashion with the walking speed, the signal amplitudes being approximately twice as high on the vertical axis as on the other two axes. Exercise on the bicycle ergometer produced mechanical signals of clearly lower amplitude than comparable walking activities. The Fast-Fourier analysis showed amplitude peaks in the low frequency range of 1 to 4 Hz for all forms of physiological exercise, while interference influences showed amplitude peaks mainly in the range above 8 Hz. The use of a straight line-frequency acceleration pickup and a corresponding low pass filter might be a way of reducing the effect of unphysiological interference influences on an activity controlled pacemaker system. A sensor measuring on the horizontal axis appears to be the most favorable compromise for the various types of exercise. However, due to the considerable difference in signal amplitude for different types of exercise of the same intensity, an activity controlled pacemaker system cannot entirely meet metabolic conditions and requirements.
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