Ultraschallkriterien zur Graduierung von Stenosen der A. carotis interna – Revision der DEGUM-Kriterien und Transfer in NASCET-Stenosierungsgrade

Arning, Christian; Widder, Bernhard; Reutern, G. M. von; Stiegler, H.; Görtler, Michael

doi:10.1055/s-0029-1245336

Cited by 173 publications

(69 citation statements)

References 11 publications

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“…Lesions were defi ned as calcifi cation or inhomogeneous vessel wall deformation and an intima-media thickness (IMT) more than 1.1 mm. Stenoses of the carotid arteries were classifi ed according to revised DEGUM criteria [13]. Stenoses of the femoral arteries were subdivided considering the plaque characteristics, fl ow characteristics (appearance of laminar or non-laminar fl ow), peak systolic velocity and peak velocity ratio corresponding to clinical standards.…”

Section: Ultrasound Examinationsmentioning

confidence: 99%

Increased vascular occlusion in patients with pseudoxanthoma elasticum

Pingel

Pausewang

Passon

et al. 2017

Vasa

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a These authors contributed equally. Summary:Background: Pseudoxanthoma elasticum (PXE) is an autosomal recessive inherited multisystem disorder of the connective tissue caused by a loss-of-function mutation of the ABCC6 gene. It can affect the cardiovascular system, presumably leading to a high prevalence of atherosclerosis. Patients and methods: 46 PXE patients and 18 controls underwent an angiological examination consisting of measurement of ankle-brachial index (ABI), strain-gauge arterial reserve (SGAR), arterial resting perfusion, pulse wave index (PWI), central pulse wave velocity, and ultrasound examination. Results: With an average age of 51.4 ± 12.4 years, 35/46 (76.1 %) of the PXE patients had atherosclerotic lesions, and 10 of them (28.6 %) had a chronic vascular occlusion of one or more peripheral vessels. 34/46 (73.9 %) had a pathologic ABI < 0.9, 15/42 (35.7 %) had a pathological SGAR < 10 mL/100 mL tissue/min, and 23/38 (60.5 %) had a pathological PWI > 180. The differences between the groups were statistically signifi cant for ABI, arterial reserve, and PWI. Conclusions: In PXE patients atherosclerosis was found with a much higher prevalence than expected. Moreover, they were at very high risk for total vessel occlusions.Keywords: PXE, ABCC6, atherosclerosis, peripheral artery disease, chronic vascular occlusion ble during childhood or adolescence. The cutaneous manifestations mostly begin as small, asymptomatic, yellowish or skin-coloured papules forming a reticular pattern, which unite to a larger plaque. This usually aff ects the lateral and posterior parts of the neck and fl exural areas. These regions show typically a lax, wrinkled, and redundant skin. [3] The ocular manifestations have characteristic funduscopic fi ndings: angioid streaks, peau d'orange, peripheral comet lesions, and choroidal neovascularization [6]. A thickening and calcifi cation of the Bruch's membrane appears to be the primary ophthalmologic pathology of PXE patients. Some publications describe cardiovascular manifestations of PXE. This inherited multisystem disorder seems to increase the cardiovascular risk and is associated with an increased occurrence of atherosclerotic changes [7][8][9]. However, untill today there is little knowledge about the distribution and the pathomechanism of atherosclerosis in patients with PXE. The aim of our study was to examine and determine the changes specifi cally of the peripheral arterial system in a large German collective.

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Section: Ultrasound Examinationsmentioning

confidence: 99%

Increased vascular occlusion in patients with pseudoxanthoma elasticum

Pingel

Pausewang

Passon

et al. 2017

Vasa

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“…Eingriffen erwarten die Arbeitskreise einen Vorteil durch eine NIRSÜberwachung, auch wenn hierfür zurzeit noch keine ausreichende Evidenz vorliegt Risikopatienten bzw. Risikoeingriffe für eine zerebrale Minderperfusion Patienten mit einem Zustand nach Apoplex und bestehenden neurologischen Defiziten Patienten mit einer mittelschweren (Grad 2) oder schweren (Grad 3) arteriellen Hypertonie -Entsprechend einem systolischen Blutdruck ≥160 mmHg[102] Patienten mit hochgradige(n) Karotisstenose(n) -D. h. ≥70%-Stenosegrad gemäß NASCET-Kriterien[103] …”

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Neuromonitoring in der Kardioanästhesie

2014

Z Herz- Thorax- Gefäßchir

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“…PE imaging together with spectral Doppler), and most carotid artery surgery now takes place based on the ultrasound examination alone. The grading of the stenosis is based on the maximum velocities recorded in the arteries rather than the geometry recorded by PE imaging [1]. Although the technique works extremely well, velocity estimates are based on the assumption that blood flow is parallel to the artery wall, whereas in practice, flow patterns in the carotid artery can be very complex (see [2]), and it is possible that these measurements can be refined further in the future using vector velocity techniques such as those described in §4.3.…”

Section: Carotid Artery Stenosismentioning

confidence: 99%

Ultrasonic colour Doppler imaging

2011

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Ultrasonic colour Doppler is an imaging technique that combines anatomical information derived using ultrasonic pulse-echo techniques with velocity information derived using ultrasonic Doppler techniques to generate colour-coded maps of tissue velocity superimposed on grey-scale images of tissue anatomy. The most common use of the technique is to image the movement of blood through the heart, arteries and veins, but it may also be used to image the motion of solid tissues such as the heart walls. Colour Doppler imaging is now provided on almost all commercial ultrasound machines, and has been found to be of great value in assessing blood flow in many clinical conditions. Although the method for obtaining the velocity information is in many ways similar to the method for obtaining the anatomical information, it is technically more demanding for a number of reasons. It also has a number of weaknesses, perhaps the greatest being that in conventional systems, the velocities measured and thus displayed are the components of the flow velocity directly towards or away from the transducer, while ideally the method would give information about the magnitude and direction of the three-dimensional flow vectors. This review briefly introduces the principles behind colour Doppler imaging and describes some clinical applications. It then describes the basic components of conventional colour Doppler systems and the methods used to derive velocity information from the ultrasound signal. Next, a number of new techniques that seek to overcome the vector problem mentioned above are described. Finally, some examples of vector velocity images are presented.

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Ultraschallkriterien zur Graduierung von Stenosen der A. carotis interna – Revision der DEGUM-Kriterien und Transfer in NASCET-Stenosierungsgrade

Cited by 173 publications

References 11 publications

Increased vascular occlusion in patients with pseudoxanthoma elasticum

Increased vascular occlusion in patients with pseudoxanthoma elasticum

Neuromonitoring in der Kardioanästhesie

Ultrasonic colour Doppler imaging

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