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Shin SM, Lee JY, Nam Hun H, Choo SW, Jeon YP, Chung J, Ko JH, Koo HW, Shin DS, Lee MR, Oh JS. Efficacy and safety of a new torque-controlled angiographic catheter in cerebral angiography: A multicenter, randomized, open-label trial. Heliyon 2024; 10:e35205. [PMID: 39157386 PMCID: PMC11328082 DOI: 10.1016/j.heliyon.2024.e35205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024] Open
Abstract
Objective We aimed to examine the effectiveness and safety of a novel torque-controlled catheter for cerebral angiography. Methods A total of 417 patients who underwent routine transfemoral cerebral angiography were enrolled in a randomized controlled study to compare the new torque-controlled and control group catheters. Device success was assessed on parameters such as the assessment of the common carotid artery, device rotation force, and success rate with the crossover group after the failed procedure. Four neurointerventionalists investigated the degree of satisfaction of using the new device. Superiority and non-inferiority tests of satisfaction scores were estimated for the new torque-controlled and the control group catheters. Results The new torque-controlled catheter showed improved performance in terms of technical device success (92.79 vs. 98.09 %, P = 0.010), crossover after technical device failure (0 vs. 86.67 %, P = 0.004), and common carotid artery access (92.79 vs. 98.56 %, P = 0.004). The flexibility and rotational force of the new torque-controlled catheter were higher than those of the control group catheters (75.48 vs. 100 %, P < 0.001). No marked adverse cerebrovascular accidents or vessel damage occurred in either group during the procedure. The differences between the two groups in terms of the device rotational force and operator satisfaction were 1.836 (1.765-1.907) and 2.092 (2.000-2.183), respectively. The new torque-controlled catheter showed superior device rotational force satisfaction, operator satisfaction, and manufacturer satisfaction, with statistical significance. Conclusion The new torque-controlled catheter was effective, safe, and convenient compared to the control group catheters for diagnostic cerebrovascular angiography.
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Affiliation(s)
- Seung Min Shin
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ji Young Lee
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Heo Nam Hun
- Clinical Trial Center, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | | | | | - Jaewoo Chung
- Department of Neurosurgery, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jung Ho Ko
- Department of Neurosurgery, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hae-Won Koo
- Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Republic of Korea
| | - Dong Seoung Shin
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, Republic of Korea
| | - Man Ryul Lee
- Soonchunhyang, Institute of Medi-Bio Science (SIMS), Soonchunhyang University, Cheonan, Republic of Korea
| | - Jae Sang Oh
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
- Department of Neurosurgery, Uijeonbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeonbu, Republic of Korea
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Celikyurt U, Acar B, Agacdiken A, Vural A. Comparison of selective coronary angiography through the ablation catheter versus conventional coronary angiography to guide ablation of premature ventricular contractions originating from aortic cusp. J Interv Card Electrophysiol 2022; 65:711-715. [PMID: 35930127 DOI: 10.1007/s10840-022-01324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Intraprocedural coronary angiography (CA) is recommended in patients undergoing ablation in aortic cusps to assess the relation of catheter tip and coronary ostia. In this report, we aimed to compare selective coronary angiography (SCA) through the contact force (CF)-sensing radiofrequency catheter with conventional coronary angiography (CCA) to guide ablation of premature ventricular contractions (PVC). METHODS This was a retrospective observational cohort study of prospectively collected data of 87 consecutive patients undergoing PVC ablation at a single institution between February 2016 and June 2021. Forty-six patients (53%) underwent SCA and forty-one patients (47%) underwent CCA. Data were consecutively collected case-by-case and entered into a computerized database. Procedural characteristics, complications, and clinical outcomes were compared between the SCA and CCA groups. RESULTS Successful ablation was achieved in seventy-seven (89%) patients. Total procedure and fluoroscopy time and radiation dose were significantly lower in SCA group (93 ± 22 min vs 102 ± 20 min, p = 0.042; 12 ± 3 min vs 14 ± 4 min, p = 0.030; 3292 ± 1221 μGy m2 vs 3880 ± 1229 μGy m2, p = 0.028, respectively). Median ambulation time was significantly longer in CCA group (6.8 ± 1 h vs 17.8 ± 1.8 h, p = 0.006). CONCLUSIONS Selective coronary angiography through the CF-sensing ablation catheter to assess the relation between the ablation site and the coronary ostia is feasible and safe. This technique precludes the requirement of an additional arterial access and decreases the total procedure and fluoroscopy time and radiation dose.
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Affiliation(s)
- Umut Celikyurt
- Arrhythmia, Electrophysiology, Pacemaker Research and Management Center, Kocaeli University Medical Faculty, Umuttepe Yerleskesi, 41380, Kocaeli, Turkey.
| | - Burak Acar
- Arrhythmia, Electrophysiology, Pacemaker Research and Management Center, Kocaeli University Medical Faculty, Umuttepe Yerleskesi, 41380, Kocaeli, Turkey
| | - Aysen Agacdiken
- Arrhythmia, Electrophysiology, Pacemaker Research and Management Center, Kocaeli University Medical Faculty, Umuttepe Yerleskesi, 41380, Kocaeli, Turkey
| | - Ahmet Vural
- Arrhythmia, Electrophysiology, Pacemaker Research and Management Center, Kocaeli University Medical Faculty, Umuttepe Yerleskesi, 41380, Kocaeli, Turkey
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Crowhurst JA, Campbell D, Raffel OC, Whitby M, Pathmanathan P, Redmond S, Incani A, Poon K, James C, Aroney C, Clarke A, Walters DL. Using DynaCT for the assessment of ilio-femoral arterial calibre, calcification and tortuosity index in patients selected for trans-catheter aortic valve replacement. Int J Cardiovasc Imaging 2013; 29:1537-45. [PMID: 23925712 DOI: 10.1007/s10554-013-0221-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 04/16/2013] [Indexed: 11/26/2022]
Abstract
Adequate vascular access for femoral trans-catheter aortic valve replacement is fundamental to the success of the procedure. Assessment of vascular calibre, tortuosity and calcification is performed by angiography and multi-slice computed tomography (MSCT). Can DynaCT provide the same information as MSCT? 15 Patients underwent MSCT, angiography and DynaCT. Vessel diameter measurements were taken in three positions of the left and right ilio-femoral arteries. Tortuosity was assessed using an index of the direct distance and the distance taken by the artery between two points. Calcification was assessed in MSCT and DynaCT using a simple scoring system. Concordance correlation coefficient of arterial calibre between angiography and MSCT was 0.96 (95 % CI 0.94-0.97). DynaCT and angiography was 0.94 (95 % CI 0.91-0.96) and Dyna CT and MSCT, 0.95 (95 % CI 0.92-0.97). Bland-Altman tests demonstrate a mean difference between the angiogram and the MSCT of 0.06 mm (+0.97, -1.42), angiogram and DynaCT, 0.13 mm, (+1.00, -0.87), DynaCT and MSCT, 0.2 mm, (+1.15, -0.76). Tortuosity comparisons gave a median tortuosity index for MSCT 1.29 and DynaCT 1.23 (p = 0.472). Calcification comparisons of MSCT and DynaCT using correlation coefficients demonstrate a correlation of 0.245 (p = 0.378). Effective radiation doses were: DynaCT; 3.63 ± 0.65 mSv and angiography; 0.57 ± 0.72 mSv, MSCT; 7.15 ± 2.58 mSv. DynaCT is equal to MSCT and angiography in assessing femoral artery calibre. Like MSCT, it can assess tortuosity and can produce 3D images but is inferior in the assessment of calcification.
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Affiliation(s)
- James A Crowhurst
- Cardiac Investigations Unit, The Prince Charles Hospital, Rode Road, Chermside, QLD, 4032, Australia,
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Gabriel M, Pawlaczyk K, Waliszewski K, Krasiński Z, Majewski W. Location of femoral artery puncture site and the risk of postcatheterization pseudoaneurysm formation. Int J Cardiol 2007; 120:167-71. [PMID: 17250906 DOI: 10.1016/j.ijcard.2006.09.018] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 07/29/2006] [Accepted: 09/20/2006] [Indexed: 11/22/2022]
Abstract
Iatrogenic causes constitute increasingly frequent sources of pseudoaneurysms due to endovascular interventions. However, till now, all analyses focused on evaluating different risk factors contributing to the development of pseudoaneurysm, overlooking the issue of localization of femoral puncture. The aim of this study was to assess the influence of position of femoral artery puncture on the risk of pseudoaneurysm formation. 116 patients were evaluated for the site of catheter insertion into femoral arteries. Another group of 273 patients, suspected of vascular complications after endovascular procedures, were diagnosed with pseudoaneurysms which were analyzed for the location of arterial wall disruption. Puncture sites of groin arteries, i.e. EIA (2.7%), CFA (77.5%), SFA and DFA (19.8%), correlated with pseudoaneurysm location reaching 7.6% (EIA), 54.3% (CFA) and 38.1% (SFA, DFA). Type of procedure influenced these values. Duplex ultrasound mapping of CFA before the endovascular intervention eliminated discrepancies between the incidence of pseudoaneurysm formation and the frequency of arterial puncture in the selected vascular segments. Pseudoaneurysms formed in 4.5% of patients undergoing traditional palpation-guided vessel cannulation and in 2.6% of patients after ultrasound-guided puncture of the femoral artery. Upon further analysis, we concluded that the likelihood of the development of pseudoaneurysm depends on the artery punctured in the groin. This risk increases dramatically for external iliac artery, superficial and deep femoral arteries. A simple means of prevention of this dangerous complication of femoral artery puncture is duplex ultrasound mapping of the groin arteries.
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Affiliation(s)
- Marcin Gabriel
- Department of Vascular Surgery, University of Medical Sciences, Poznan, Poland.
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Kiss P, Suranyi P, Simor T, Saab-Ismail NH, Elgavish A, Hejjel L, Elgavish GA. In vivo R1-enhancement mapping of canine myocardium using ceMRI with Gd(ABE-DTTA) in an acute ischemia-reperfusion model. J Magn Reson Imaging 2007; 24:571-9. [PMID: 16892191 DOI: 10.1002/jmri.20661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To demonstrate the usefulness of normalized DeltaR1 (DeltaR1(n)) mapping in myocardial tissue following the administration of the contrast agent (CA) Gd(ABE-DTTA). MATERIALS AND METHODS Ischemia-reperfusion experiments were carried out in 11 dogs. The method exploited the relatively long tissue lifetime of Gd(ABE-DTTA), and thus no fast R1 measurement technique was needed. Myocardial perfusion was determined with colored microspheres (MP). RESULTS With varying extent of ischemia, impaired wall motion (WM) and lower DeltaR1(n) values were detected in the ischemic sectors, as opposed to the nonischemic sectors where normal WM and higher DeltaR1(n) were observed. Based on the DeltaR1(n), data from the myocardial perfusion assay and the DeltaR1(n) maps were compared in the ischemic sectors. A correlation analysis of these two parameters demonstrated a significant correlation (R = 0.694, P < 0.005), validating the DeltaR1(n)-mapping method for the quantitation of ischemia. Similarly, pairwise correlations were found for the MP, DeltaR1(n), and wall thickening (WT) values in the same areas. Based on the correlation between DeltaR1(n) and MP, DeltaR1(n) maps calculated with a pixel-by-pixel resolution can be converted to similarly high-resolution myocardial perfusion maps. CONCLUSION These results suggest that the extent of the severity of ischemia can be quantitatively represented by DeltaR1(n) maps obtained in the presence of our CA.
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Affiliation(s)
- P Kiss
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Alabama 35294-0005, USA
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Barrera-Ramírez CF, Pineda-Pompa LR, Guzmán CE. Prevención de las complicaciones vasculares en el intervencionismo coronario. ¿Cambio de acceso o sellado de la vía? Rev Esp Cardiol (Engl Ed) 2004. [DOI: 10.1016/s0300-8932(04)77272-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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