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Fernandes JR, Dos Santos LCF, Lamers ML. Applicability of autofluorescence and fluorescent probes in the trans-surgical of oral carcinomas: A systematic review. Photodiagnosis Photodyn Ther 2022; 41:103238. [PMID: 36509404 DOI: 10.1016/j.pdpdt.2022.103238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
Oral cancer represents an important health problem, as it is the sixth most common type of cancer in the world and is associated with high rates of morbidity and mortality. The treatment considered the gold standard for this type of tumor is surgical resection with negative margins, with a distance of at least 5 mm from the tumor. This procedure is strongly associated with local control and disease-specific survival, however, in many cases, large amounts of healthy tissue are removed, resulting in surgical defects, compromising various functions and directly affecting the individual's quality of life. From this perspective, this systematic review aimed to evaluate the use of autofluorescence and fluorescent probes as potential adjuvant techniques to facilitate the delineation of surgical margins for oral cancers. A comprehensive search was performed in Pubmed, Scopus, Web of Science, LIVIVO, Embase, ProQuest Open Access Dissertations & Theses, Open Access Theses and Dissertations, and DART Europe databases, where 1948 articles were found. After the different stages of critical evaluation, 15 articles were selected, eligible for the inclusion criteria. Of these, 7 articles used autofluorescence, 7 used fluorescent probes and 1 article used both methods. As for autofluorescence, the most used device was the VELScope, and indocyanine green was the most used probe. Compared to histopathology, autofluorescence did not obtain significant and/or superiors results. In contrast to fluorescent probes that, most articles showed a good performance of margins during surgical resection, making them a promising alternative. However, it is still necessary to carry out the analysis of more articles, with more significant samples and sensitivity and specificity data to qualify the results.
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Affiliation(s)
- Julia Rodrigues Fernandes
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, Porto Alegre, RS CEP 90035-003, Brazil.
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Saba L, Antignani PL, Gupta A, Cau R, Paraskevas KI, Poredos P, Wasserman B, Kamel H, Avgerinos ED, Salgado R, Caobelli F, Aluigi L, Savastano L, Brown M, Hatsukami T, Hussein E, Suri JS, Mansilha A, Wintermark M, Staub D, Montequin JF, Rodriguez RTT, Balu N, Pitha J, Kooi ME, Lal BK, Spence JD, Lanzino G, Marcus HS, Mancini M, Chaturvedi S, Blinc A. International Union of Angiology (IUA) consensus paper on imaging strategies in atherosclerotic carotid artery imaging: From basic strategies to advanced approaches. Atherosclerosis 2022; 354:23-40. [DOI: 10.1016/j.atherosclerosis.2022.06.1014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 12/24/2022]
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Kiyosawa R, Saito T, Yamada S, Harada K. Efficacy of Post-Dilatation during Carotid Artery Stenting for Unstable Plaque Using a Double-Layer Stent Evaluated by OFDI. JOURNAL OF NEUROENDOVASCULAR THERAPY 2022; 16:395-401. [PMID: 37502638 PMCID: PMC10370631 DOI: 10.5797/jnet.oa.2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/22/2022] [Indexed: 07/29/2023]
Abstract
Objective This study aimed to use optical frequency domain imaging (OFDI) to evaluate the efficacy of post-dilatation (PD) after stent placement for unstable plaques during carotid artery stenting (CAS) using a double-layer stent. Methods Twelve unstable carotid plaque lesions diagnosed by MRI were evaluated using OFDI during CAS. The pre-procedural minimum lumen diameter was 1.6 ± 0.7 mm. Each lesion was pre-dilated with balloon catheters (diameter, 5.3 ± 0.5 mm), and a double-layer stent was deployed. PD was performed with balloon catheters of the same size as those used for pre-dilatation. Cross-sectional OFDI images within the stented segment were evaluated at 1-mm intervals for a 20-mm segment, including the most stenotic lesion. Slice rates for the presence of in-stent plaque protrusion (PP) and plaque between the double-layer lumen were calculated. Results No procedural complications occurred with the use of an embolic protection device. Compared to after stent placement, slice rates for any PP (44 ± 19% to 62 ± 22%, P <0.05) and plaque between the double-layer lumen (79 ± 16% to 91 ± 34%, P <0.05) were significantly increased after PD; slice rates for >500 μm PP (7.5 ± 14% to 0%, P <0.05) were significantly decreased. Visible debris were captured in 50% of lesions. Conclusion PD after double-layer carotid stent placement decreases in-stent large PP. Double-layer construction contributed to the prevention of large PP, as the PP may have been crushed into debris by PD.
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Affiliation(s)
- Ryuichiro Kiyosawa
- Department of Neurosurgery, Fukuoka Wajiro Hospital, Fukuoka, Fukuoka, Japan
| | - Takaya Saito
- Department of Neurosurgery, Fukuoka Wajiro Hospital, Fukuoka, Fukuoka, Japan
| | - Shingo Yamada
- Department of Neurosurgery, Fukuoka Wajiro Hospital, Fukuoka, Fukuoka, Japan
| | - Kei Harada
- Department of Neurosurgery, Fukuoka Wajiro Hospital, Fukuoka, Fukuoka, Japan
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Oura K, Yamaguchi Oura M, Itabashi R, Maeda T. Vascular Imaging Techniques to Diagnose and Monitor Patients with Takayasu Arteritis: A Review of the Literature. Diagnostics (Basel) 2021; 11:diagnostics11111993. [PMID: 34829340 PMCID: PMC8620366 DOI: 10.3390/diagnostics11111993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/16/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022] Open
Abstract
Takayasu arteritis (TA) is a large vessel vasculitis that causes stenosis, occlusion, and sometimes the aneurysm of the aorta and its major branches. TA often occurs in young women, and because the symptoms are not obvious in the early stages of the disease, diagnosis is difficult and often delayed. In approximately 10% to 20% of patients, TA is reportedly complicated by ischemic stroke or transient ischemic attack. It is important to diagnose TA early and provide appropriate treatment to prevent complications from stroke. Diagnostic imaging techniques to visualize arterial stenosis are widely used in clinical practice. Even if no signs of cerebrovascular events are present at the time of the most recent evaluation of patients with TA, follow-up vascular imaging is important to monitor disease progression and changes in the cerebrovascular risk. However, the optimal imaging technique for monitoring of TA has not been established. Therefore, the purpose of this review is to describe newly available evidence on the usefulness of conventional imaging modalities (digital subtraction angiography, computed tomography angiography, magnetic resonance imaging/angiography, duplex ultrasound, and positron emission tomography) and novel imaging modalities (optical coherence tomography, infrared thermography, contrast-enhanced ultrasonography, and superb microvascular imaging) in the diagnosis and monitoring of TA.
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Pasqui E, de Donato G, Panzano C, Alba G, Grottola G, Cappelli A, Palasciano G. Multiple cavernous malformation syndrome: a casual diagnosis during carotid revascularization procedure. Neurol Sci 2021; 42:4737-4739. [PMID: 34218326 DOI: 10.1007/s10072-021-05414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Abstract
INTODUCTION Familial cerebral cavernous malformations (FCCM) are a rare condition characterized by the multiple presences of cavernous malformations located in the central nervous system. CASE DESCRIPTION We present a case of FCCM incidental diagnosis in a 71-year-old male patient who underwent carotid artery stenting for high-grade carotid artery disease and subsequent reintervention for severe stent restenosis, determining neurological deficit. FCCM diagnosis was made due to the presence of hundreds of cavernous malformations located both in supra- and sub-tentorial regions highlighted by magnetic resonance and confirmed by genetic test for the mutation of the gene KRIT1, inherited also by his son.
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Affiliation(s)
- Edoardo Pasqui
- Department of Vascular Surgery, University of Siena, Siena, Italy. .,Department of Medicine, Surgery and Neuroscience Vascular Surgery Unit, University of Siena, Viale Bracci, 53100, Siena, Italy.
| | | | - Claudia Panzano
- Department of Vascular Surgery, University of Siena, Siena, Italy
| | - Giuseppe Alba
- Department of Vascular Surgery, University of Siena, Siena, Italy
| | - Gaia Grottola
- Department of Vascular Surgery, University of Siena, Siena, Italy
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Yang B, Feng Y, Ma Y, Wang Y, Chen J, Li L, Dong J, Zhang B, Gao P, Chen Y, Dmytriw AA, Jiao L. Frequency-Domain Optical Coherence Tomography for Intracranial Atherosclerotic Stenosis: Feasibility, Safety, and Preliminary Experience. Front Neurol 2021; 12:678443. [PMID: 34220686 PMCID: PMC8247572 DOI: 10.3389/fneur.2021.678443] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite advances in non-invasive imaging, the characterization of atherosclerotic plaque remains superior with frequency-domain optical coherence tomography (FD-OCT) in the clinical coronary and experimental cerebrovascular literature. An assessment of the feasibility and safety of FD-OCT for intracranial atherosclerotic stenosis (ICAS) is desirable. Methods: We analyzed a cohort of all consecutive FD-OCT evaluations for ICAS performed at our institution from April 2017 to August 2018 (16 months) in patients who suffered from transient ischemic attack (TIA) or non-disabling stroke despite optimal medical management within 90 days of admission attributable to angiographically verified 70-99% stenosis of an intracranial artery. Results: Thirty-three patients harboring 36 lesions with an average age of (57.6 ± 7.1) years (male sex 27 cases) comprising nine cases of lesions located within the anterior circulation and 24 cases within the posterior circulation were identified. Of the 33 patients with 36 lesions, the FD-OCT imaging catheter detected 35/36 (97%) lesions except in one case in which the FD-OCT catheter failed to navigate excessively tortuous vessels, and FD-OCT images in 27 patients (81.8%) were finally obtained successful, where the target lesion was fully visible, and image quality under at least one pullback was graded 2 or 3. There were no symptomatic complications. Blood flow was the most common artifact encountered (51.9%). Conclusion: FD-OCT is safe and feasible for the assessment of ICAS in the anterior and posterior circulation. The use of diagnostic interferometry will have to be weighed against its cost, and these preliminary findings should be verified by prospective large-scale studies.
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Affiliation(s)
- Bin Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yiding Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yabing Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Long Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jia Dong
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bairu Zhang
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yanfei Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Adam A Dmytriw
- Neuroradiology & Neurointervention Service, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Pasqui E, de Donato G, Alba G, Brancaccio B, Panzano C, Cappelli A, Setacci C, Palasciano G. Early and Long-Term Outcomes of Carotid Stenting and Carotid Endarterectomy in Women. Front Surg 2021; 8:646204. [PMID: 33763447 PMCID: PMC7982589 DOI: 10.3389/fsurg.2021.646204] [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: 12/25/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The role of carotid revascularization in women remains intensely debated because of the lower benefit and higher perioperative risks concerning the male counterpart. Carotid artery endarterectomy (CEA) and stenting (CAS) represent the two most valuable stroke prevention techniques due to large vessel disease. This study investigates the early and late outcomes in female sex in a real-world everyday clinical practice. Methods: Data were retrospectively analyzed from a single-center database prospectively compiled. A total of 234 procedures, both symptomatic and asymptomatic, were identified (98 CEAs and 136 CASs). Perioperative risks of death, cerebral ischemic events, and local complications were analyzed and compared between the two groups. Long-term outcomes were evaluated in overall survival, freedom from ipsilateral stroke/transient ischemic attack, and freedom from restenosis (>50%) and reintervention. Results: Women who underwent CAS and CEA did not differ in perioperative ischemic cerebral events (2.2 vs. 0%, p = 0.26) and death (0.8 vs. 0%, p = 1). Other perioperative and 30-day outcomes were similarly distributed within the two groups. Kaplan–Meier curves between CAS and CEA groups highlighted no statistical differences at 6 years in overall survival (77.4 vs. 77.1%, p = 0.47) of ipsilateral stroke/transient ischemic attack (94.1 vs. 92.9%, p = 0.9). Conversely, significant differences were showed in 6 years freedom from restenosis (93.1 vs. 83.3%, p = 0.03) and reinterventions (97.7 vs. 87.8%, p = 0.015). Conclusion: Our results revealed that both CEA and CAS have acceptable perioperative risk in women. Long-term outcomes highlighted favorable indications for both procedures, especially for CAS, which seemed to be an excellent alternative to CEA in female patients when performed by well-trained operators.
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Affiliation(s)
- Edoardo Pasqui
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Gianmarco de Donato
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Giuseppe Alba
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Brenda Brancaccio
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Claudia Panzano
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Alessandro Cappelli
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Carlo Setacci
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Giancarlo Palasciano
- Vascular Surgery Unit, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
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