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• Acist Medical Systems (1)
  • Acist Product Names
  • Acist Contrast Delivery System (1)
  • Angiographic Injector
• Applied Medical Resources
  • Applied Medical Resources Product Names
  • Angiographic Injector
• Argon Medical Devices (1)
  • Argon Medical Devices Product Names
  • Angiographic Injector
• Atrion Medical Products
  • Atrion Medical Product Names
  • Angiographic Injector
• Bard Peripheral
  • Bard Peripheral Product Names
  • Angiographic Injector
• Mallinckrodt
  • Mallinckrodt Product Names
  • Angiographic Injector (1)
• Marconi Medical Systems
  • Marconi Medical Systems Product Names
  • Angiographic Injector
• Medrad (3)
  • Medrad Product Names (1)
  • Angiographic Injector
• Medtronic
  • Medtronic Product Names
  • Angiographic Injector
• Nemoto Medical
  • Nemoto Product Names
  • Angiographic Injector
• Angiography
  • Catheters (1)
  • Injector (1)
  • Iliac (3)
  • Femoral (2)
  • Popliteal (2)
  • Tibial
  • Carotid
  • Renal (1)
  • Vascular Plaque (1)
  • Lower Limb

(A small sampling of results from a September 1, 2006 to January 22, 2007 MIB Abstract Alert search)

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Software Improves Company Compliance, and More

Medical Design News. Cleveland: Dec 2006. Vol. 6, Iss. 10; pg. 10, 1 pgs

After recognizing that its home-grown data systems were inefficient, insecure, and non-compliant with 21 CFR Part 11, imaging-equipment manufacturer ACIST Medical Systems decided to upgrade to TrackWise from Sparta Systems, Holmdel, N.J., (spartasystems.com). The datamanagement system lets the manufacturer improve its efficiencies and compliance. For instance, automatic notification, distribution, and record assignment has reduced the time-to-closure for complaints, and let ACIST complete investigations ahead of its 30-day goal. Reports from the software provide accurate and up-to-date information to authorized users on demand.

TrackWise was deployed for managing failure investigations, material-review-board issues, and corrective and preventive actions (CAPA). The system provides a mechanism to manage rootcause analysis and to let staff know which CAPAs are assigned to their areas.

ACIST's home-grown quality systems used Microsoft Access databases, Excel spreadsheets, and paper forms. A lack of centralization in its disparate systems led to growing difficulties obtaining accurate and reliable information on a timely basis, particularly for complaint management.

While designing the initial workflow, ACIST personnel identified bottlenecks in its business process and designed TrackWise to streamline the workflow. Implementation with validation and training completed in just four months. What's more, eliminating manual data gathering, code changes, monthly report consolidation and other laborintensive processes has cut four to six hours per person per week for key system users. Data is now secure, validated and 21 CFR Part 11 compliant. And customer service improved to the point where servicecontract- renewal rates for the company's imaging equipment have increased to 90% since implementing the process.

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Newly released! Clinical Article Highlights a Reduction of Contrast Induced Nephropathy (CIN) Incidence

Business Wire. New York: Jan 4, 2007. pg. n/a

Call, Jason

ACIST Medical Systems

952-995-9300

marcomm@acistmedical.com

Logo: http://www.acist.com

ACIST Medical Systems, leading the market in variable-rate, automated contrast delivery systems used in cardiac and vascular angiography, announced the recent publication of a clinical study which showed that use of lower volumes of contrast media while using the ACIST Contrast Delivery System was associated with a reduced relative risk of Contrast Induced Nephropathy (CIN). The study, Automated Contrast Injection in Contemporary Practice during Cardiac Catheterization and PCI: Effects on Contrast-Induced Nephropathy, by Jason Call, et al, was published in the October 2006 issue of the Journal of Invasive Cardiology (Volume 18, Number 10, pages 469-474.) This study is believed to be "the first study to demonstrate that methods to reduce contrast use and strategies to minimize CIN are associated with a lower incidence of CIN and Acute Renal Failure (ARF) after diagnostic catheterization and PCI procedures," according to the study authors.

This retrospective, observational study involved 2,175 patients from April 2002 through November 2004 who underwent coronary catheterizations and PCI procedures at Wake Forest University Baptist Medical Center in North Carolina. Data were compared between patients undergoing traditional hand injection methods (n=1798) and those who were treated using the ACIST variable-rate, automated contrast injection method (n=377), to reduce contrast volumes, in conjunction with contemporary strategies of hydration and N-acetylcysteine use. It was found that the use of the ACIST to reduce contrast volume in conjunction with strategies to minimize CIN was associated with a significant reduction in the incidence of CIN. The study demonstrated a 28% reduction in contrast volume, a 31% lower incidence of CIN, and a 49% lower incidence of acute renal failure, when compared to traditional hand injection methods.

CIN is associated with significant economic and clinical consequences, including prolonged hospitalization, the requirement for dialysis, and an increased risk of death.1 In susceptible patients, CIN is first noticed 24 to 72 hours after contrast exposure, and typically becomes most severe five to seven days later. CIN is particularly more likely to occur in those with preexisting renal disease or diabetes. While renal function often returns to normal over the next 2 weeks, clinical studies have shown that CIN is associated with significant increases in morbidity, and mortality after coronary angiography2-5. In the study by Call et al, the risk of CIN was correlated with the dose of contrast injected into the patient. Use of the ACIST Contrast Delivery System was associated with a significant reduction in contrast dose compared to the traditional, older method of hand injection of contrast using a standard syringe.

"We are pleased with the results of this important study." states Fulvio Renoldi Bracco, Chairman of ACIST. "We believe this recent publication, in addition to the previously published clinical literature5-15, helps convey the important role that ACIST Contrast Delivery Systems play in today's modern world of cardiac and vascular angiography."

About ACIST

ACIST is a world leader in contrast delivery solutions for the imaging field, dedicated to advancing the art of angiography through research and development of new products and technologies - supporting today's needs and anticipating those of tomorrow. More than four million people around the world have had cardiovascular angiographic procedures using an ACIST system, now at over 1 million annually - and growing. ACIST systems are widely proven in the global health care arena, with clinical usage in over 30 countries and in many world-renowned centers, as well as in community hospitals and university settings.

About Bracco

The Bracco Group is a world leading provider in diagnostic imaging, with net sales of about 800 million Euros per year. Bracco has operations in 115 countries and about 2,100 employees, around 300 of whom work in R & D. Bracco invests approximately 15% of its annual turnover in R & D and has a portfolio of 1,500 patents worldwide.

The Bracco Group is a leader in the diagnostic imaging market with an integrated product offering from a diverse roster of subsidiary companies. While Bracco is recognized internationally as a definitive market leader in its core business of contrast media, Bracco also markets key diagnostic imaging resources through the following companies: ACIST Medical Systems, a manufacturer of advanced contrast media injection systems and Singapore-based Volume Interactions, which also produces advanced 3-D medical software.

Bracco also operates a high-level international research network, with three centers (Ivrea, Geneva, and Princeton). These centers develop products of the latest-generation diagnostic techniques, from X-ray and computed tomography (CT), magnetic resonance imaging (MRI), echocontrast and nuclear medicine.

AngioTouch is a registered trademark of ACIST Medical Systems.

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Finance; RoundTable Healthcare Partners completes portfolio company recapitalization

Medical Devices & Surgical Technology Week. Atlanta: Jan 21, 2007. pg. 108

2007 JAN 21 - (NewsRx.com) -- RoundTable Healthcare Partners, an operating-oriented private equity firm focused exclusively on the healthcare industry, announced completion of the recapitalization of its portfolio company ACI Medical Devices, Inc.

ACI Medical is a specialty medical device manufacturer and contains two business units, Argon Medical Devices, Inc. and Clinical Innovations, Inc. Argon is a manufacturer and supplier of specialty single-use vascular access and pressure monitoring devices utilized in the cardiology, radiology and critical care market segments. Clinical is a designer and manufacturer of single-use medical devices used primarily in the women's health, urology, and gastroenterology markets.

RoundTable initially acquired Argon in November 2003 when it was operating as part of a business unit of Maxxim Medical, Inc. Argon subsequently acquired Clinical Innovations from its owner/founders in May 2005, resulting in the creation of ACI Medical Devices. The recently completed recapitalization was financed entirely with new senior debt and enabled ACI Medical to prepay its higher cost subordinated debt. The recapitalization also funded a substantial dividend to shareholders.

As part of the recapitalization, ACI Medical amended and expanded its current senior credit facilities led by GE Healthcare Financial Services. Other senior lenders participating in the transaction included LaSalle Bank and National City Bank.

RoundTable Healthcare Partners, Lake Forest, Illinois, currently manages $1.1 billion in capital, including two equity funds totaling $900 million and a subordinated debt fund of $200 million.

Argon Medical Devices, Athens, Texas, products include the Jawz biopsy forcep, Argo-Bag fluid control system, One Step introducer and ArgoGuide hydrophilic guidewire.

Clinical Innovations, Murray, Utah, products include the Kiwi vacuum assisted fetal delivery device and the Koala sensor-tip intrauterine pressure monitoring catheter.

This article was prepared by Medical Devices & Surgical Technology Week editors from staff and other reports. Copyright 2007, Medical Devices & Surgical Technology Week via NewsRx.com.

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Hospitals, Healthcare Providers to Save with Premier Contrast Media, Injectors, Radiopharmaceutical Products and Distribution Agreements

Business Wire. New York: Jan 3, 2007. pg. n/a

Premier Inc.

Hunter Kome, 704-733-5698;

hunter_kome@premierinc.com

Logo: http://www.premierinc.com

Premier Purchasing Partners, LP, today announced new agreements for contrast media, contrast media injectors and disposables, and radiopharmaceutical products and distribution.

New contracts have been awarded to:

-- Mallinckrodt Inc., a Tyco Healthcare Company, of St. Louis, for ionic/non-ionic and barium contrast media;

-- Berlex, Inc., of Wayne, N.J., and Mallinckrodt for magnetic resonance (MR) contrast media;

-- Mallinckrodt and Medrad, Inc., of Indianola, Pa., for contrast media injectors and disposables; and

-- Mallinckrodt for radiopharmaceutical products and distribution.

"The new portfolio features contracts and products with market-share leading suppliers that offer considerable savings opportunities to Premier members in this fast growing market," said Mike Georgulis, Purchasing Partners vice president, sourcing.

Georgulis noted that the agreement for radiopharmaceutical distribution offers "enhanced product coverage and service capabilities" as a result of Mallinckrodt's extensive distribution network, which in addition to Mallinckrodt's own radiopharmacies, includes pharmacies owned by Cardinal Health and selected GE Healthcare pharmacies.

A Premier contrast media task force studied various alternatives in the portfolio for nearly a year.

These 36-month contracts, effective January 1, 2007, are available to the acute care and continuum of care markets.

About Premier, 2006 Malcolm Baldrige National Quality Award recipient

Serving 1,700 hospitals and more than 43,000 other healthcare sites, Premier Inc. is the largest healthcare alliance in the United States dedicated to improving patient outcomes while safely reducing the cost of care. Owned by not-for-profit hospitals, Premier operates the nation's largest healthcare purchasing network, the most comprehensive repository of hospital clinical and financial information and one of the largest policy-holder owned, hospital professional liability risk-retention groups in healthcare. Headquartered in San Diego, Premier has offices in Charlotte, N.C. and Washington. For more information, visit www.premierinc.com.

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General Dynamics ATP, MEDRAD & CMA to Receive 2006 American Business Ethics Awards

PR Newswire. New York: Sep 22, 2006.  pg. n/a

NEWTOWN SQUARE, Pa., Sept. 22 /PRNewswire/ -- The Society of FinancialService Professionals (FSP) today announced the recipients of the 2006American Business Ethics Awards (ABEA). They are: General Dynamics Armamentand Technical Products, Charlotte, NC; MEDRAD, Inc., Indianola, PA; and RTI/Community Management Associates, Inc. (CMA), Plano, TX. FSP will honor the recipients at a luncheon on September 25 at the Union League in Philadelphia.

Established in 1994, the American Business Ethics Award recognizes companies that exemplify high standards of ethical behavior in their everyday business conduct and in response to specific crises or challenges. Nominees are rated in four broad areas: executive commitment to ethics, ongoing ethics programming, demonstrated ethical business practices, and commitment to stakeholders, including employees, customers, and the community. Past recipients include Whirlpool Corporation, Starbucks Coffee, Weyerhauser and Lockheed Martin.

Founded in 1928, the Society of Financial Service Professionals is the standard bearer for excellence in professionalism, advanced continuing education, and ethical guidance for the nation's top financial advisers. The Society has approximately 19,000 members, each of whom holds one or more of the following recognized financial service credentials: CLU(R), ChFC(R), CFP(R), CPA, JD (licensed), RHU(R), REBC(R), CEBS(R), CLF(R), CFA(C), CTFA(R), and graduate degrees in financial services. Active in nearly 200 Chapters nationwide, Society members assist the public in their efforts to achieve personal and business-related financial goals. Consumers can obtain free financial information or find a Society member in their community by calling the Society's toll-free National Consumer Referral Service at 1-888-243-2258 or visiting http://www.financialpro.org.

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MEDRAD Employees Care in a Big Way: Facilities Suspend Operations Today so That 800 Can Volunteer in Community

PR Newswire. New York: Sep 14, 2006.  pg. n/a

INDIANOLA, Pa., Sept. 14 /PRNewswire/ -- Local MEDRAD facilities willsuspend operations today so that over 800 employees in Pittsburgh and aroundthe world can spend the day volunteering in the community as part of the MEDRAD Day of Caring. Believed to be the largest event of its kind in the country, the event is equivalent to 5,200 total employee hours and an estimated $150,000 in payroll costs.

(Logo: http://www.newscom.com/cgi-bin/prnh/20040309/MEDRADLOGO)

Pittsburgh-area employees will spend the day at 35 local social service agencies*, while employees in MEDRAD's global offices will volunteer in The Netherlands at a nursing home, animal shelter, children's hospital and school, and participate in a walkathon in Japan to support women in the workplace.

Offering employees an opportunity to volunteer en masse remains a tangible example of MEDRAD's commitment to giving back to the community and providing a rewarding workplace. "This day is meant to share our success with those in the community who need it, and get employees to think about volunteering long after the day is over," says John P. Friel, president and CEO. "What we lose in work hours, we recoup with a renewed perspective about the impact each of us can make."

Vice President of New Product Development Bill Bullis and Quality Technician Jim McKee first interacted with the residents of Saint Barnabas nursing home in Gibsonia three years ago. Since then, they have taken residents to church, honored veteran residents, and connected MEDRAD to Presents for Patients, an annual program at St. Barnabas that brings Christmas gifts to the residents. Similarly, Associate Product Planner Julie Gulick was first introduced to the Wagner House daycare center for teen and single parents during the 2001 Day of Caring, and now serves on its board of directors.

The Day of Caring is organized annually by MEDRAD's Points of Light Committee, a group of employee volunteers that undertakes the massive job of coordinating hundreds of people at various worksites. The same team keeps the spirit of giving alive and well throughout the year, organizing dozens of other opportunities for MEDRAD employees to give their time and money to worthy causes.

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Awards; Frost & Sullivan lauds MEDRAD's excellent product innovation abilities in the MRI coils market

Women's Health Weekly. Atlanta: Sep 14, 2006.  pg. 20

2006 SEP 14 - (NewsRx.com) -- Frost & Sullivan selected MEDRAD, Inc. for its 2006 Product Differentiation Innovation Award in recognition of its full line of eCoil products.

These products offer unprecedented MR imaging of pelvic regions such as the prostate, colon, bladder, and cervix, to assist physicians in cancer diagnosis, staging, and radiation therapy planning.

The eCoil product line has expanded to include the first prostate endorectal coils for the fast-growing 3.0T scanner market. The 3.0T Prostate eCoil joins disposable prostate, colorectal, and cervix endorectal coils that are currently the main internal coils for pelvic imaging for both 1.0T and 1.5T MR systems.

These coils offer significantly higher signal-to-noise ratios than traditional pelvic coils as well as assist physicians in diagnosing tumor stages of various cancers. Nearly all major MR scanner manufacturers include MEDRAD's eCoils in their coil inventory.

"The predominant coil offerings from third-party manufacturers are mainly head, neck, spine, breast, and extremity coils for knees, wrists, and shoulders," said Frost & Sullivan Research Analyst Subha B. Basu. "MEDRAD introduced endorectal coils in order to effectively visualize the pelvis and lower abdomen structures without the need for invasive surgical procedures such as laparoscopy or endoscopies."

MR-based diagnoses of pelvic and endorectal examinations are especially important due to the projected increase in prostate cancer incidence rates in males and colorectal cancers in both males and females.

According to data from the American Cancer Institute, in 2005, the incidence of prostate cancer in males is expected to be 33%, while colorectal cancer is likely to occur in almost 11% of both males and females. The number of deaths from prostate, colorectal, and urinary bladder cancers is expected to top 70,000 among males in 2005.

However, the five-year survival rate for patients with malignant tumors that have been detected early and localized to the organ of origin is over 90% for colorectal, bladder, cervical, and prostate cancers. The eCoils line of MR internal coils from MEDRAD is helping lower fatalities attributed to endorectal cancers. It also identifies physiological abnormalities of the prostate and pelvic organs. This can help remedy incontinence, erectile dysfunction, and neuromuscular dysfunction of the lower abdomen and pelvis.

"MEDRAD's position as a leading provider of both surface and internal coils have consistently helped increase company revenues, which exceeded $400 million in 2005," noted Basu. "In addition to eCoils, the company also has an array of surface coils for multi- channel, phased array coils for neurovascular, extremity, and torso imaging."

Each year Frost & Sullivan presents this award to a company that has demonstrated the ability to develop and/or advance products with more innovative capabilities than competing vendors and products. The award recognizes the company's successful adoption of new or existing technology that has become a part of its well-designed product family. Such innovation is expected to significantly contribute to the industry in terms of product performance and degree/rate of technical change.

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MEDRAD Introduces the Certo(TM) MR Wireless Network

PR Newswire. New York: Oct 13, 2006.  pg. n/a

INDIANOLA, Pa., Oct. 13 /PRNewswire/ -- MEDRAD today introduced theCerto(TM) MR Wireless Network, a revolutionary wireless network for magneticresonance (MR) imaging. The new system provides greater flexibility byallowing MEDRAD wireless-enabled equipment to move freely both in the MRIsuite and in the control room.

(Logo: http://www.newscom.com/cgi-bin/prnh/20040309/MEDRADLOGO)

The first wireless-enabled MEDRAD product to operate on the Certo Network is the Veris(R) MR Patient Monitor with the Veris remote display. Certo allows Veris to freely travel with the patient from the prep room to the scanner room and then to the recovery area, while maintaining full communication with the remote display on the network. Clinicians can focus less on equipment and more on patient care while efficiently managing patients through the scanner suite.

"MEDRAD's focus is to identify market needs and then create innovative products that deliver high customer value," said Gary Bucciarelli, senior vice president, magnetic resonance business unit. "The MR marketplace is ready for a robust, reliable wireless network like Certo for the flexibility, ease-of- care, and increased throughput demanded of MR healthcare providers."

For over a decade, MEDRAD has delivered advanced technology to the MR suite and supported it with a robust global support organization. Other MEDRAD MR products include the Spectris Solaris(R) EP Injection System, a wide array of Leading Image(TM) Coils, Continuum MR Infusion System, as well as the Veris MR Patient Monitor, winner of the Frost & Sullivan Customer Value Enhancement Award in 2005.

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Efficacy of a direct puncture approach for anterior circulation aneurysms using a newly developed guiding catheter-especially for geriatric patients.

Surg Neurol. 2007 Jan;67(1):30-4. Epub 2006 Oct 6.

Yuzawa I, Kurata A, Suzuki S, Ozawa H, Hagiwara H, Niki J, Yamada M, Fujii K, Kan S, Kitahara T.

Department of Neurosurgery, Kitasato University School of Medicine, 228-8555 Sagamihara, Japan.

BACKGROUND: Endovascular surgery is being increasingly used as an alternative to craniotomy clipping surgery, especially for aged patients and complicated cases. However, tortuous atherosclerotic arteries sometimes interfere with advancement of catheters so that direct puncture may be necessary. Short guiding catheters for use with this approach have been newly developed, as discussed in this article. METHODS: One hundred twenty three anterior circulation aneurysms in 121 patients were consecutively treated by endovascular coil embolization, of which 42 (34%) were older than 70 years. RESULTS: With 21 aneurysms, coil embolization via the transfemoral approach failed, but all could be successfully treated with the direct puncture approach with minor complications such as 1 transient ischemic attack and 1 nonsymptomatic minor leakage. In the aged patients, the direct puncture approach with short guiding catheter resulted in complete obliteration of aneurysms in 20 (71%) of 28 with follow-up angiography. CONCLUSION: Direct puncture using newly developed short guiding catheters is an alternative to femoral approaches for patients with anterior circulation aneurysm with tortuous arteries and obvious atherosclerotic change at bifurcations of the common carotid artery.

PreMedline Identifier: 17210291

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Comparison of enhancement, image quality, cost, and adverse reactions using 2 different contrast medium concentrations for routine chest CT on 16-slice MDCT.

J Comput Assist Tomogr. 2006 Sep-Oct;30(5):818-22.

Setty BN, Sahani DV, Ouellette-Piazzo K, Hahn PF, Shepard JA.

Division of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.

OBJECTIVE: To evaluate the degree of enhancement and image quality of chest computed tomographic (CT) examinations on 16-slice multidetector CT using low-concentration [300 milligrams of iodine per milliliter (mg I/mL)] and high-concentration (370 mg I/mL) contrast media; to assess the impact on cost and adverse reactions of the use of high-iodine concentration contrast medium. MATERIALS AND METHODS: A total of 100 patients scheduled for routine chest CT examinations were administered nonionic contrast medium of 2 strengths: low-iodine concentration contrast medium (300 mg I/mL) [group A: n = 50; male-female ratio, 28:22; mean age, 58.4 years] and high-iodine concentration contrast medium (370 mg I/mL) (group B: n = 50; male-female ratio, 18:32; mean age, 57.6 years) with a constant amount of iodine (400 mg) injected per kilogram of body weight. Contrast media were injected using a dual injector at 2.5 mL/s followed by a 30-mL saline at 2.5 mL/s. The degree of enhancement was quantified by measuring Hounsfield unit values in different arteries and veins and was also rated on a 5-point scale for qualitative assessment. We also evaluated perivenous contrast-related artifacts. The data were compared using Mann-Whitney U test for both qualitative and quantitative enhancement ratings. A value of less than 0.05 was considered statistically significant. The value was adjusted using Bonferroni correction for statistical significance when multiple comparisons were performed. The difference in cost and the incidence of adverse reactions in both groups were calculated. RESULTS: The mean enhancement values in group B were significantly greater (P < 0.05) than those in group A. The mean Hounsfield units and standard deviation in groups A and B were aorta = 153 +/- 4, 216 +/- 20; pulmonary artery = 147 +/- 10, 208 +/- 20; superior vena cava = 155 +/- 27, 299 +/- 72; and pulmonary vein = 134 +/- 10, 215 +/- 30, respectively. The mean enhancement on a 5-point scale was greater in group B (4.2) than in group A (3.3) (P < 0.01). No significant difference between groups in perivenous artifacts was seen. Up to 5.5% savings in cost resulted from the use of a higher concentration of iodine, with no increase in adverse reactions. CONCLUSIONS: Use of higher-concentration contrast media provides a higher degree of contrast enhancement and image quality for a routine chest CT on a 16-slice multidetector CT. It also contributes to considerable cost savings with no increased risk of adverse reactions compared with low-concentration contrast media.

PreMedline Identifier: 16954936

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Optimization of spatial resolution for peripheral magnetic resonance angiography.

Acad Radiol. 2007 Jan;14(1):54-61.

Tang A, Cloutier G, Therasse E, Beaudoin G, Qanadli SD, Giroux MF, Boussion N, de Guise JA, Oliva VL, Soulez G.

Department of Radiology, Centre Hospitalier de l'Universite de Montreal (CHUM)-Hopital Notre-Dame, Montreal, Quebec, Canada.

RATIONALE AND OBJECTIVES: To determine optimum spatial resolution when imaging peripheral arteries with magnetic resonance angiography (MRA). MATERIALS AND METHODS: Eight vessel diameters ranging from 1.0 to 8.0 mm were simulated in a vascular phantom. A total of 40 three-dimensional flash MRA sequences were acquired with incremental variations of fields of view, matrix size, and slice thickness. The accurately known eight diameters were combined pairwise to generate 22 "exact" degrees of stenosis ranging from 42% to 87%. Then, the diameters were measured in the MRA images by three independent observers and with quantitative angiography (QA) software and used to compute the degrees of stenosis corresponding to the 22 "exact" ones. The accuracy and reproducibility of vessel diameter measurements and stenosis calculations were assessed for vessel size ranging from 6 to 8 mm (iliac artery), 4 to 5 mm (femoro-popliteal arteries), and 1 to 3 mm (infrapopliteal arteries). Maximum pixel dimension and slice thickness to obtain a mean error in stenosis evaluation of less than 10% were determined by linear regression analysis. RESULTS: Mean errors on stenosis quantification were 8.8% +/- 6.3% for 6- to 8-mm vessels, 15.5% +/- 8.2% for 4- to 5-mm vessels, and 18.9% +/- 7.5% for 1- to 3-mm vessels. Mean errors on stenosis calculation were 12.3% +/- 8.2% for observers and 11.4% +/- 15.1% for QA software (P = .0342). To evaluate stenosis with a mean error of less than 10%, maximum pixel surface, the pixel size in the phase direction, and the slice thickness should be less than 1.56 mm2, 1.34 mm, 1.70 mm, respectively (voxel size 2.65 mm3) for 6- to 8-mm vessels; 1.31 mm2, 1.10 mm, 1.34 mm (voxel size 1.76 mm3), for 4- to 5-mm vessels; and 1.17 mm2, 0.90 mm, 0.9 mm (voxel size 1.05 mm3) for 1- to 3-mm vessels. CONCLUSION: Higher spatial resolution than currently used should be selected for imaging peripheral vessels.

PreMedline Identifier: 17178366

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Flow direction of ascending lumbar veins on magnetic resonance angiography and venography: would "descending lumbar veins" be a more precise name physiologically?

Abdom Imaging. 2006 Dec 7; [Epub ahead of print]

Morita S, Kimura T, Masukawa A, Saito N, Suzuki K, Mitsuhashi N.

Department of Radiology, Saiseikai Kurihashi Hospital, 714-6, Gotanda, Kouemon, Kurihashi-Machi, Kitakatsushika-Gun, Saitama, 349-1105, Japan, i@imodey.com.

BACKGROUND: Physiological flow direction of ascending lumbar vein (ALV) is not well recognized. METHODS: Two-dimensional time-of-flight magnetic resonance angiography (MRA) examinations of the lower extremities in 44 patients and venography (MRV) in 59 patients were retrospectively reviewed. chi(2) analysis was used to compare the frequency of ALV detection between the MRA and MRV groups and between cases with filling defects above the ALV confluence and other cases in the MRV group. RESULTS: Frequency of ALV detection was significantly higher in the MRA group (60 of 88 veins, 68.2%) than in the MRV group (9 of 118 veins, 7.6%, P < 0.0001) and in cases with filling defects above the ALV confluence (8 of 23 veins, 34.8%; 6 were compression of the left common iliac vein by the right common iliac artery, 2 were thrombus of the proximal bilateral common iliac veins) than in other cases (1 of 95 veins, 1.1%) in the MRV group (P < 0.0001). CONCLUSIONS: Without compression or occlusion above the ALV confluence, the general flow direction of the ALVs is not ascending but descending, suggesting that "descending lumbar veins" is a more physiologically precise name for these veins than ALVs.

PreMedline Identifier: 17151894

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Successful endovascular management of an acute iliac venous injury during lumbar discectomy and anterior spinal fusion.

J Vasc Surg. 2006 Dec;44(6):1353-6.

Schneider JR, Alonzo MJ, Hahn D.

Endovascular Center, Evanston Northwestern Healthcare, Evanston, IL 60201, USA. joe-schneider@northwestern.edu

A 61-year-old woman experienced laceration of the left common iliac vein with significant hemorrhage during lumbar discectomy. An endovascular approach using stent grafts provided a minimally invasive and successful solution to the problem.

PreMedline Identifier: 17145442

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Early endothelial and haematological response to cryoplasty compared to balloon angioplasty of the superficial femoral artery - a pilot study.

Br J Radiol. 2007 Jan 3; [Epub ahead of print]

Wildgruber M, Weiss W, Berger H, Eckstein HH, Wolf O, Heider P.

Department of Vascular Surgery, Rechts der Isar Medical Center, Technical University of Munich, Germany.

The purpose of the present study was to asses the course of the adhesion molecules (ICAM, VCAM, e-selectin, p-selectin, MCP-1), growth factors (TGFb, bFGF) and the cytokine TNFa both after angioplasty and cryoplasty. Recently cryoplasty has been suggested as a new method to oppose neointimal hyperplasia resulting in restenosis formation. While in vitro models have shown that the application of cryothermal energy to the endothelium during angioplasty leads to apoptosis induction and reduced proliferation rates, no human in vivo proof for an inhibition of neointimal hyperplasia exists. For restenosis initiation adhesion molecules, growth factors and cytokines play an important role. One possibility to investigate endothelial response to angioplasty is the measurement of the soluble forms of adhesion molecules, growth factors and cytokines that are released into the circulation after denuding the vessel wall In the present study we assessed the distribution pattern of the soluble forms of e-selectin, p-selectin, ICAM, VCAM, MCP-1, TGFb, bFGF and TNFa after angiography, angioplasty and cryoplasty of the femoropopliteal artery in the early course of 4 weeks in 29 patients with peripheral arterial occlusive disease During the 4 weeks after intervention levels of e-selectin, ICAM, VCAM, and MCP-1 increased both after angioplasty and cryoplasty. The course of the screened biomarkers was similar between angioplasty and cryoplatsy. P-selectin and TGFb both decreased after cryoplasty, but not significantly The present results show that the release of adhesion molecules, growth factors and cytokines is similar between balloon angioplasty and cryoplasty.

PreMedline Identifier: 17202198

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Common femoral artery injury secondary to tennis ball strike.

J Vasc Surg. 2006 Dec;44(6):1350-2.

Vasdekis SN, Kakisis JD, Lazaris AM, Panayiotides JG, Angeli AA, Karkaletsis KG.

Vascular Unit, 3rd Department of Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece. vas25@otenet.gr

Tennis is a popular, safe sport that exposes amateur or professional players to minimal risk of injury. Most of this risk is related to musculoskeletal injuries, and vascular trauma is extremely rare. We present a case of a 68-year-old man in whom intermittent claudication developed after his right groin was struck by a tennis ball. The patient sought medical evaluation 2 months after the accident, and a subtotal occlusion of his right common femoral artery was disclosed by angiography and treated by endarterectomy.

PreMedline Identifier: 17145441

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Popliteal venous aneurysm.

J Vasc Surg. 2006 Dec;44(6):1360.

Velu RB, Quigley F, Barber G.

Department of Vascular Surgery, Townsville General Hospital, Queensland, Australia.

PreMedline Identifier: 17145444

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Duplex-guided endovascular treatment for occlusive and stenotic lesions of the femoral-popliteal arterial segment: a comparative study in the first 253 cases.

J Vasc Surg. 2006 Dec;44(6):1230-7; discussion 1237-8. Epub 2006 Oct 20.

Ascher E, Marks NA, Hingorani AP, Schutzer RW, Mutyala M.

Maimonides Medical Center, Brooklyn, NY 11219, USA. aober@maimonidesmed.org

OBJECTIVE: The standard technique of balloon angioplasty with or without subintimal dissection of infrainguinal arteries requires contrast arteriography and fluoroscopy. We attempted to perform this procedure with duplex guidance to avoid the use of nephrotoxic contrast material and eliminate or minimize radiation exposure. METHODS: From September 2003 to June 2005, 196 patients (57% male) with a mean age of 73 +/- 10 years (range, 42-97 years) had a total of 253 attempted balloon angioplasties of the superficial femoral and/or popliteal artery under duplex guidance in 218 limbs. Critical ischemia was the indication in 38% of cases, and disabling claudication was the indication in 62%. Hypertension, diabetes, chronic renal insufficiency, smoking, and coronary artery disease were present in 78%, 51%, 41%, 39%, and 37% of patients, respectively. The TransAtlantic Inter-Society Consensus (TASC) classification was used for morphologic description of femoral-popliteal lesions. The common femoral artery was cannulated under direct duplex visualization. Still under duplex guidance, a guidewire was directed into the proximal superficial femoral artery, across the diseased segment(s), and parked at the tibioperoneal trunk. The diseased segment(s) were then balloon-dilated. Balloon diameter and length were chosen according to arterial measurements obtained by duplex scan. Hemodynamically significant defects causing diameter reductions greater than 30% and peak systolic velocity ratios greater than 2 were stented with a variety of self-expandable stents under duplex guidance. Completion duplex examinations and ankle-brachial indices were obtained routinely before hospital discharge. RESULTS: There were 11 (4%) TASC class A lesions, 31 (12%) TASC class B lesions, 177 (70%) TASC class C lesions, and 34 (14%) TASC class D lesions in this series. The overall technical success was 93% (236/253 cases). Eight of the 17 failed subintimal dissections belonged to TASC class C and the remaining 9 to TASC class D. End-stage renal disease was the only significant predictor of subintimal dissection failure in patients with femoral-popliteal occlusions (5/17 cases; P < .04). Intraluminal stents were placed in 153 (65%) of 236 successful cases. Overall pre-procedure and post-procedure ankle-brachial indices changed from a mean of 0.69 +/- 0.16 (range, 0.2-1.1) to 0.95 +/- 0.14 (range, 0.55-1.3), respectively (P < .0001). The mean duration of follow-up was 10 +/- 7 months (range, 1-29 months). The overall 30-day survival rate was 100%. Overall limb salvage rates were 94% and 90% at 6 and 12 months, respectively. Six-month patency rates for TASC class A, B, C, and D lesions were 89%, 73%, 72%, and 63%, respectively. Twelve-month patency rates for TASC class A, B, C, and D lesions were 89%, 58%, 51%, and 45%, respectively. CONCLUSIONS: Duplex-guided balloon angioplasty and stent placement seems to be a safe and effective technique for the treatment of infrainguinal arterial occlusive disease. Technical advantages include direct visualization of the puncture site, accurate selection of the proper size balloon and stent, and confirmation of the adequacy of the technique by hemodynamic and imaging parameters. Additional benefits are avoidance of radiation exposure and contrast material.

PreMedline Identifier: 17055689

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[Percutaneous ablation of the segmental renal artery for the treatment of the arterio-pelvic fistula complicating percutaneous nephrolithotomy - a case report.]

Kardiol Pol. 2006 Dec;64(12):1419-21.

[Article in Polish]

Buszman P, Debinski M, Noga A, Kuligowski A, Bochenek T, Milewski K.

III Klinika Kardiologii, Gornoslaskie Centrum Medyczne, ul. Ziolowa 47, 40-635 Katowice, tel.: +48 32 252 72 12, e-mail: pbuszman@ka.onet.pl.

We present a case of an 18-year-old female who underwent two percutaneous nephrolithotomy procedures complicated with haematuria. Angiography revealed the presence of an aneurysm of the right superior renal artery branch and arterio-pelvic fistula. The aneurysm was successfully obliterated using alcohol injection via coronary balloon catheter.

PreMedline Identifier: 17206541

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C-reactive protein and angiographic characteristics of stable and unstable coronary artery disease: Data from the prospective PREVEND cohort.

Atherosclerosis. 2006 Dec 6; [Epub ahead of print]

Geluk CA, Post WJ, Hillege HL, Tio RA, Tijssen JG, van Dijk RB, Arnold Dijk W, Bakker SJ, de Jong PE, van Gilst WH, Zijlstra F.

Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, The Netherlands.

AIMS: High sensitive-C-reactive protein (hs-CRP) is associated with coronary risk, which may be explained by an association with (unstable) coronary artery disease (CAD). Until now, histopathological and angiographic studies have failed to consistently demonstrate a strong relationship. However, most of these studies were limited by a cross-sectional design. Our aim was to prospectively evaluate the association between hs-CRP and plaque instability. Therefore, firstly, we investigated the relation between hs-CRP measured long before coronary angiography (CAG) and angiographic characteristics of stable and unstable CAD. In addition, we investigated the association with coronary events during follow up in the total PREVEND population. METHODS AND RESULTS: Of the population based Prevention of Renal and Vascular Endstage Disease (PREVEND) study, 8139 subjects without previous documented CAD were followed for the incidence of CAG and coronary events from 1997 to 2003. For the qualitative angiographic analysis, 216 CAGs were available. Mean time to CAG was 37+/-19 months. The 864 coronary vessels were graded as follows: 436 coronary vessels as normal, 175 as non-obstructive CAD, 179 as stable obstructive CAD and 74 as unstable obstructive CAD. Multilevel ordinal regression analysis was performed to study associations between baseline clinical variables and angiographic findings. Hs-CRP contributed significantly to the multivariate model after adjustment for age, gender, smoking, lipids and blood pressure. In 8139 subjects, 201 (2.5%) first coronary events occurred during follow up. Cox survival analysis showed age- and sex-adjusted hazard ratios for hs-CRP 1-3 and >3mg/L of, respectively, 1.26 (95% CI 0.67-2.40) and 3.16 (95% CI 1.26-3.16), relative to hs-CRP <1mg/L. CONCLUSION: In the prospective PREVEND study of subjects without previous documented CAD, hs-CRP levels at baseline were associated with angiographic characteristics and clinical consequences of plaque instability during follow up. This observation supports the concept that hs-CRP significantly contributes to coronary atherogenesis.

PreMedline Identifier: 17157301

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