Objectives To discuss Doppler ultrasonographic and clinical features of middle aortic syndrome (MAS). Materials and methods Doppler ultrasonographic images and clinical dates of 11 patients with MAS confirmed by angiography were retrospectively analyzed from January 2004 to September 2016. Results The median age of 11 patients was 10 years (1‐39 years). Ten patients presented with hypertension, only 2 cases presented with symptomatic intermittent claudication, and 1 case presented with abdominal pain. The ultrasonographic features of 11 patients with MAS included: (a) Gray‐scale image showed significant segmental narrowing of the aorta in 9 cases. (b) Color Doppler demonstrated aliasing in the suspicious narrowed vessels of all cases. (c) On Spectral Doppler image, peak systolic velocity in the location of aorta coarctation was significantly elevated (range, 2.3~4.8 m/s). When infrarenal aorta was involved, a tardus‐parvus waveform was only seen in the distal aorta. When suprarenal or inter‐renal aorta was involved, a tardus‐parvus pattern was seen in the distal aorta as well as renal artery. Conclusions Significant segmental narrowing and a tardus‐parvus waveform are the important ultrasonographic features in patients with MAS, the latter may be more reliable. Doppler ultrasound can be used as a simple screening method, especially for children and adolescents suspected of having a vascular cause of refractory hypertension.
ObjectiveTo investigate the safety and effectiveness of implanting temporary pacemakers using ultrasound‐guidance at the bedside for rescuing patients in case of cardiac emergencies.MethodsWe enrolled 194 patients with cardiac emergencies requiring temporary pacemakers in this study, and randomly assigned them to either a bedside ultrasound‐guided installation group or an electrocardiogram‐guided installation group. There were 105 cases in the bedside ultrasound‐guided installation group, aged approximately 66.3 ± 10.2 years, and 89 cases in the electrocardiogram‐guided installation group, aged approximately 65.8 ± 9.5 years old, and disease composition was similar between the two groups. We then compared the duration of the procedure, success rates, and occurrence of adverse events between the two groups.ResultsThe two groups showed similar clinical characteristics. The success rates of venipuncture and temporary pacemaker electrode placement were both 100% in the bedside ultrasound‐guided installation group, compared to 87.8% and 96.7% respectively, in the electrocardiogram‐guided installation group, with a statistically significant difference between the two groups. The duration of puncture was significantly shorter in the bedside ultrasound‐guided installation group than in the electrocardiogram‐guided installation group, with statistically significant differences. Moreover, no adverse events such as hematoma, pneumothorax and electrode dislodgement occurred in the bedside ultrasound‐guided installation group, while 13 cases in the electrocardiogram‐guided installation group experienced adverse events, and the difference was statistically significant.ConclusionsThe bedside installation of temporary pacemakers using ultrasound guidance is a simple, safe, effective, and cost‐efficient procedure that boasts a high success rate, does not involve radiation, and enables accurate placement of the electrode catheter.
Background and AimsVulnerable plaques are closely related to ischemic stroke. To investigate the diagnostic value of multimodal plaque vulnerability ultrasound scoring system (PV‐USS) using histopathology as the gold standard.MethodsA total of 45 subjects who would be underwent carotid endarterectomy were recruited. The postoperative specimens were examined by histopathology. All responsible plaques were scanned dynamically in multiple sections by carotid ultrasound to measure maximum thickness and lumen stenotic degree, as well as, the echo, homogeneity, surface morphology, and echo type were observed. The above two‐dimensional (2D) ultrasonic features were systematically scored, that is, PV‐USS2D. Combined with contrast‐enhanced ultrasonography (CEUS), neovascularization grade in plaque was scored, which is PV‐USS2D+CEUS.ResultsAccording to the pathological results, 45 subjects were divided into vulnerable plaque group (27 cases, 60%) and non‐vulnerable plaque group (18 cases, 40%). PV‐USS2D and PV‐USS2D+CEUS in vulnerable plaque group were higher than those in non‐vulnerable plaque group (PV‐USS2D: 9.44 ± 2.10 vs 7.22 ± 1.73; PV‐USS2D+CEUS: 12.37 ± 2.10 vs 8.28 ± 1.81, P < .001). ROC curve analysis showed that the AUC of PV‐USS2D and PV‐USSCEUS was 0.783 and 0.929, respectively (P < .001). The best cutoff values of PV‐USS2D and PV‐USS2D+CEUS were, respectively, 9.5 (the maximum Youden index was 0.425, the sensitivity was 48.1%, the specificity was 94.4%) and 10.5 (the maximum Youden index was 0.667, the sensitivity was 77.8%, the specificity was 88.9%).ConclusionsUltrasound scoring system may be used as an effective method to evaluate the vulnerability of plaque. The diagnostic efficiency of PV‐USS2D+CEUS is more higher than PV‐USS2D.
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