Interpretation of Upper Extremity Arteriography

Wong, Victor W.; Katz, Ryan D.; Higgins, James P.

doi:10.1016/j.hcl.2014.09.009

Cited by 21 publications

(8 citation statements)

References 63 publications

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“…Utilizing a transducer array with a wider lateral dimension, we could potentially image the entire breast at the same imaging speed. This experiment together with the arm and palm experiments clearly demonstrate the clinical imaging capability of the compact laser, indicating its potential in screening upper extremity vascular disorders [41,42] and breast cancer [43]. Our results demonstrate that a compact laser approach is well suited for PACT applications.…”

Section: Human Imagingsupporting

confidence: 53%

Deep tissue photoacoustic computed tomography with a fast and compact laser system

Wang

et al. 2016

Biomed. Opt. Express

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Photoacoustic computed tomography (PACT) holds great promise for biomedical imaging, but wide-spread implementation is impeded by the bulkiness of flash-lamp-pumped laser systems, which typically weigh between 50 -200 kg, require continuous water cooling, and operate at a low repetition rate. Here, we demonstrate that compact lasers based on emerging diode technologies are well-suited for preclinical and clinical PACT. The diodepumped laser used in this study had a miniature footprint (13 × 14 × 7 cm 3 ), weighed only 1.6 kg, and outputted up to 80 mJ per pulse at 1064 nm. In vitro, the laser system readily provided over 4 cm PACT depth in chicken breast tissue. In vivo, in addition to high resolution, non-invasive brain imaging in living mice, the system can operate at 50 Hz, which enabled high-speed cross-sectional imaging of murine cardiac and respiratory function. The system also provided high quality, high-frame rate, and non-invasive three-dimensional mapping of arm, palm, and breast vasculature at multi centimeter depths in living human subjects, demonstrating the clinical viability of compact lasers for PACT.

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Section: Human Imagingsupporting

confidence: 53%

Deep tissue photoacoustic computed tomography with a fast and compact laser system

Wang

et al. 2016

Biomed. Opt. Express

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“…AC alone has been suggested as primary therapy, 268 but a review of 23 studies suggested that poor functional outcomes were reported more often after a conservative approach. 269…”

Section: Surgical Decision Makingmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Björck

Earnshaw

Acosta

et al. 2020

European Journal of Vascular and Endovascular Surgery

312

222

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“…Angiography remains the gold standard diagnostic tool, particularly for hand and digit ischemia, and permits therapeutic intervention. 48 Treatment strategies continue to evolve with the introduction of novel endovascular devices and targeted pharmacologics. 25 As confirmed in this review, a majority of AULI cases are due to thromboembolic disease that often localizes to proximal arm vessels and are amenable to embolectomy techniques.…”

Section: Discussionmentioning

confidence: 99%

Nonoperative Management of Acute Upper Limb Ischemia

Wong

Major

Higgins

2016

Hand (New York, N,Y.)

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Background: Acute upper limb ischemia (AULI) is an uncommon emergency warranting immediate evaluation and treatment. The role of nonsurgical therapies including endovascular techniques, thrombolytics, and anticoagulation remains undefined. The authors systematically reviewed the current literature on the nonsurgical treatment of acute ischemia of the upper extremity. Methods: A PubMed and Embase search was conducted, and articles were screened using predetermined criteria. Data collected included patient demographics, cause of upper limb ischemia, type of nonsurgical treatment used, treatment outcomes, and complications. Patients were divided into 4 treatment groups: catheter embolectomy, catheter-directed thrombolysis, endovascular stenting, and anticoagulation/medical therapy alone. Results: Twenty-three retrospective studies met the search criteria. Of 1326 reported occlusions, 92% (1221) were attributed to thromboembolic disease. The second most common cause was iatrogenic (1.5%). Overall limb salvage rates were excellent with catheter embolectomy (862 of 882 cases, 97.7%) and catheter-directed thrombolysis (110 of 114 cases, 96.5%). Limb salvage rates were also high with anticoagulation/medical therapy (158 of 165 cases, 95.8%), but poor functional outcomes were more often reported. Conclusions: High-quality evidence to guide the nonsurgical treatment of AULI is lacking. Retrospective studies support the utility of catheterbased embolectomy and thrombolysis for distal ischemia. Whether a surgical or nonsurgical approach is taken, anticoagulation therapy remains a mainstay of both treatment and prevention of AULI. Because AULI patients often have underlying cardiac and/or systemic disease, a multidisciplinary approach is essential to minimize complications and prevent future occurrences.

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Interpretation of Upper Extremity Arteriography

Cited by 21 publications

References 63 publications

Deep tissue photoacoustic computed tomography with a fast and compact laser system

Deep tissue photoacoustic computed tomography with a fast and compact laser system

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Nonoperative Management of Acute Upper Limb Ischemia

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