Intravascular ultrasound in interventional radiology

Manninen, Hannu; Räsänen, Heikki

doi:10.1007/s003300000574

Cited by 14 publications

(4 citation statements)

References 48 publications

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“…Sensitivity was reported as high as 95%, specificity more than 90%, PPV more than 90% and NPV more than 95% [44]. Moreover, IVUS allows palliative treatment of portal stenosis by stent placement [45]. As regards to laparoscopy, from the vascular point of view, it is not effective to detect vascular invasion, so that Laparoscopic Ultrasonography (LUS) was subsequently developed.…”

Section: Diagnosismentioning

confidence: 97%

Vascular Resection in Pancreaticoduodenectomy: Is it Worthwhile?

Bianco

Sassaroli

Delrio

et al. 2012

CDT

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Pancreaticoduodenectomy (PD) is the gold standard treatment for cancer of pancreatic head in all the cases that are supposed to be resectable. Although the overall survival depends on many heterogeneous factors, the main aim of the treatment must be to achieve a R0 resection with microscopically and macroscopically free margins. As in recent reports vascular involvement does not represent anymore a technical limit, it is mandatory pointing out whether or not vascular resection modifies overall survival and if that is the case vascular invasion should not be considered as an exclusion criterion but as part of a standard resection. The review analysis demonstrated a progressive trend of inversion in the treatment of head pancreatic cancer over the last years. Recently, provided that a R0 resection may be performed, a more aggressive surgical approach has led to consider the possibility of venous and arterial resections. The basis for this new approach has been that the superior mesenteric vein or spleno-portal mesenteric vein invasion is not a measure of the tumor malignancy but merely a consequence of the tumor location. On the contrary, the controversial results in terms of overall survival and local recurrences achieved with major arterial resections are more likely due to a biological aggressivity than to the tumor site. The "artery first" technique seems to be the most promising approach to the problem although it needs further trials to determine whether or not this approach may be beneficial for patients in terms of overall survival and local recurrences.

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Section: Diagnosismentioning

confidence: 97%

Vascular Resection in Pancreaticoduodenectomy: Is it Worthwhile?

Bianco

Sassaroli

Delrio

et al. 2012

CDT

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“…The preferred approach for CTO lesions without stumps, with ill-defined positive entrances, or with occlusion after branch vessel emanation is to use intravascular ultrasound -guided true lumen tracing technique. [16][17][18][19][20][21] Of course, in addition to finding the true cavity with the support of imaging, the occlusion of blood vessels can also be opened by "ADR, BASE, Carlino, and other" forward techniques. If the conditions of the reverse collateral are good, the operation can also be completed by reverse technology.…”

Section: Discussionmentioning

confidence: 99%

Successful true cavity pathfinding with balloon assisted CTO with bifurcation lesions: Two case reports

Zhang,

Hu,

Zhang

et al. 2024

Medicine

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Background: Coronary artery disease is a prevalent global cardiovascular ailment, with percutaneous coronary intervention (PCI) standing out as a crucial method for relieving symptoms and enhancing the quality of life in patients with coronary heart disease. However, the presence of concurrent chronic total occlusion (CTO) and bifurcation lesions within coronary arteries elevates the complexity and treatment risks, especially when the entry point of the CTO is ambiguous. Objective: This study aims to present an innovative approach for treating CTO complicated with bifurcation lesions, focusing on true cavity pathfinding assisted by a balloon. Methods: Two cases of CTO patients with concomitant bifurcation lesions are described. One case involves CTO of the left anterior descending artery) combined with anterior non-angle trigeminal lesions, while the other entails CTO of the posterior left artery combined with posterior angle trigeminal lesions. True lumen identification using a balloon and subsequent opening of the CTO blood vessel were performed in both cases. Results: In both cases, the true lumen was successfully located with the assistance of a balloon, leading to the successful opening of the CTO blood vessel. This approach not only simplified the procedure but also reduced procedural difficulty and associated risks of complications compared to traditional guide wire operations. Conclusion: The application of true cavity pathfinding assisted by a balloon offers a novel and effective strategy for managing CTO complicated with bifurcation lesions. The method simplifies the procedure, decreases procedural difficulty, and lowers the risk of complications associated with guide wire operations. However, further studies and long-term follow-up data are warranted to validate the reliability and long-term efficacy of this innovative approach.

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“…This also increases the yield 8 of detecting the intimal tear [6]. Intravascular ultrasound guidance also provides useful information to distinguish the true from the false lumen [7]. …”

Section: Discussionmentioning

confidence: 99%