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P Vogt

Publications and source records attributed to P Vogt.

At least 37 records · Page 2Linked to original sources
PubMed2001

Silver-coated prosthetic heart valve: a double-bladed weapon.

A St. Jude Medical Silzone was implanted in a 72-year-old female, suffering from mitral valve disease. Four months later, the patient had acute cardiac failure due to partial detachment of the prosthetic valve. The mitral annulus was ulcerated and there were multiple erosions in the myocardial tissue in contact with the prosthetic valve. Histological examination revealed chronic inflammation with hemosiderine deposits and giant cells. No allergy to silver ions was found. The silver-coated sewing cuff had caused a chronic inflammatory reaction due to a toxic reaction to silver. The Silzone valve was withdrawn from the market on January 2000.

Aged↗
PubMed2001

Beating heart coronary artery surgery: is sternotomy a suitable alternative to minimal invasive technique?

OBJECTIVES: To evidence the respective advantages and drawbacks of minimal invasive-thoracotomy (MIDCAB) and off-pump sternotomy (OPCAB) coronary bypass techniques. METHODS: The perioperative and mid-term (3 months) results of the first 31 MIDCABs and 39 OPCABs performed by a single experienced coronary surgeon (F.S.) were compared. Differences were assessed by two-tailed chi-square or unpaired t-test, and significance assumed for P-values < or =0.05. RESULTS: Groups were widely comparable. There were no in-hospital deaths nor permanent neurologic events. OPCAB patients received more anastomoses (mean 1.09/patient vs. 1.89/patient, P<0.001) during a shorter coronary occlusion period (26.1+/-8 vs. 16.6+/-4.5min, P<0.001), whilst immediate extubation prevailed in MIDCABs (22/31 vs. 17/39, P<0.05). Significant complications occurred in seven MIDCABs vs. none in OPCABs (P<0.01). Other in-hospital parameters were similar. Controls at 3 months evidenced more residual discomfort among MIDCAB patients (14/30 vs. 7/39, P<0.05). CONCLUSIONS: Differences in early complication rates may be due to a learning effect. However, OPCAB allows us to implant more grafts and is more comfortable for both patient and surgeon. These advantages may well counterbalance the cosmetic benefits of MIDCAB procedures.

Aged↗
PubMed2001

[Coronary artery bypass by mini-thoracotomy: noticeable benefits with clinical experience of the treatment team].

AIM OF THE STUDY: Minimally invasive coronary artery bypass surgery is fundamentally different as compared to open sternal approach under cardiopulmonary bypass. Modifications of the surgical, anesthesiologic and post-operative techniques are necessary before evaluation of its real benefit. We analyze the potential effect of a learning period on the short term results of this technique. METHODS: From July 1997 to February 1999, 20 patients were operated using this method. We compare the results of the first 10 patients (group 1: 8M/2F, 59.6 +/- 13.8 years) to those of the last 10 patients (group 2: 8M/2F; age = 63.2 +/- 6.1 years). DISCUSSION: Progress between the two groups is striking. Left anterior descending coronary clamping time could be reduced from 28.5 +/- 2.4 min. in group 1 to 22.2 +/- 1.8 min. in group 2 (p < 0.05), and operative time was reduced from 125 +/- 4 min. to 97 +/- 5 min. (p < 0.005). The post-operative atrial fibrillation rate diminished from 4/10 in group 1 to 1/10 in group 2.3/10 patients in group 1 suffered a post-operative pneumonia whereas none in group 2 had pulmonary complication. The stay in the intensive care unit could be reduced from 2.3 +/- 0.3 days to 1.4 +/- 0.2 days (p < 0.05) and the total post-operative stay diminished from 8.5 +/- 0.9 days to 4.7 +/- 0.5 days (p < 0.005). CONCLUSION: There are evidence for a learning period in minimally invasive cardiac surgery. Short term benefits of this technique are then evident as demonstrated by a reduction in the ICU stay and the hospital stay.

Adult↗
PubMed2001

Successful endovascular repair of a leaking abdominal aortic aneurysm under local anesthesia.

UNLABELLED: Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. PATIENT AND METHODS: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24 mm x 12 mm x 153 mm) was implanted under local anesthesia. RESULTS: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. DISCUSSION: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

Aged↗
PubMed2000

Use of an emboli containment and retrieval system during percutaneous coronary angioplasty in native coronary arteries.

BACKGROUND: Prevention of distal embolisation during percutaneous coronary revascularisation may be necessary to reduce postinterventional morbidity and mortality. METHODS AND RESULTS: We employed a newly developed emboli containment and retrieval system in native coronary arteries during percutaneous coronary angioplasty and stenting in 39 selected patients (mean age 58.9 +/- 10.1 years, 11 females) presenting with acute (n = 22; 8 LAD, 3 LCX, 11 RCA), subacute (n = 7; 2 LAD, 2 LCX, 3 RCA) or chronic (n = 6; 2 LAD, 4 RCA) total or subtotal occlusion of an infarct-related vessel, or with severe stenosis and symptoms of unstable angina (n = 4; 2 LAD, 2 RCA). Protection device-assisted angioplasty with stent implantation was uneventful in all patients with good angiographic results and normal postprocedural flow. Intermittent aggravation of anginal pain during inflation of the occlusive balloon (from 2.5 to a maximum of 25 minutes cumulative inflation time) was observed in 19 of the 36 conscious patients (7 with acute, 7 with subacute and 3 with chronic occlusion, and 2 with unstable angina), but caused neither interruption of distal occlusion nor haemodynamic instability. In 31 patients the aspirates contained visible debris. Histological analysis showed particles up to 12 mm in size, consisting of necrotic core, inflammatory cells, cholesterol debris, and old and fresh thrombi. In 8 patients the aspirated particles were too small to allow microscopic diagnosis or debris was absent. CONCLUSIONS: This preliminary report demonstrates the feasibility of using a protection device in native coronary arteries to prevent distal embolisation of particulate matter that is mobilised during percutaneous interventions. To the extent that this material contributes to the mechanisms of distal embolisation, noreflow and infarction, this device may help to reduce such complications. Appropriately designed trials are required to assess the clinical benefit of this system.

Adult↗
PubMed2000

[Special problems after lung transplantation: walking a tightrope between infection and graft rejection].

Between November 1992 and September 1999 84 lungs have been transplanted at University Hospital Zurich. Currently the 1-year survival rate is up to 85%. However, long-term success is limited by the development of chronic rejection in the form of bronchiolitis obliterans. The risk factors are repeated episodes of acute rejection and infections, due to cytomegalovirus in particular. Both can occur in asymptomatic patients and are sometimes detected only by transbronchial lung biopsy. At the Zurich Lung Transplant Centre biopsies are performed as surveillance biopsies in asymptomatic patients in the first 6 months after transplantation, for clinical indications and as follow-up biopsies after a pathological result. Open lung biopsies are performed for special indications only. We evaluated 408 transbronchial biopsies taken between November 1992 and September 1999. Relevant findings were present in 46% of biopsies in symptomatic patients. Relevant acute rejection episodes were diagnosed in 15% of surveillance biopsies. Overall, 72% of acute rejection episodes requiring therapy and 33% of biopsies detecting cytomegalovirus were found in surveillance biopsies. 7 of 11 late (> 45 days postoperative) and 1 of 5 early (< or = 45 days postoperative) open lung biopsies revealed new diagnoses. Transbronchial biopsy after lung transplantation is at present the gold standard for diagnosis of acute rejection and cytomegalovirus pneumonia of the lung.

Adult↗
PubMed2000

Apoptosis induced by ischemia and reperfusion in experimental lung transplantation.

BACKGROUND: Apoptosis is a distinct form of single-cell death in response to injury. Time course of apoptosis in lung parenchymal cells during posttransplant reperfusion and the influence of oxygen content during preservation on apoptosis of parenchymal cells are studied. METHODS: Orthotopic syngenic single left lung transplantation was performed in male Fischer (F344) rats after 18 hours of cold ischemia (n = 5 in all groups). Apoptotic cells were stained by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) technique. Strictly TUNEL-positive pneumocytes were counted on anonymized slides by a pathologist on 100 fields (x400) per specimen (mean +/- SEM). RESULTS: The peak of apoptotic pneumocytes occurred 2 hours after reperfusion (16.8 +/- 2.2 pneumocytes/100 fields [p/100f]; p = 0.000012 vs controls, lungs fixed after 18 hours of ischemia), whereas the lowest level of apoptotic pneumocytes was seen in lungs fixed after harvest (1.4 +/- 0.51 p/100f) and lungs not undergoing reperfusion (2.8 +/- 0.49 p/100f). Four hours after reperfusion, the number of apoptotic pneumocytes was lower than 2 hours after reperfusion (13.6 +/- 3.1 p/100f; p = 0.00032 vs controls), with a further decline at 8 hours (6.4 +/- 1.5 p/100f) and 12 hours after reperfusion (4.0 + 1.2 p/100f). Interestingly, lungs inflated with N2 before storage revealed a significantly lower level of TUNEL-positive pneumocytes 2 hours after reperfusion (8.8 2.0 p/100f) compared with lungs inflated with 100% O2 (p = 0.0052). CONCLUSIONS: Apoptosis of pneumocytes after posttransplant lung reperfusion is a very early event. Prolonged hypothermic preservation without reperfusion, however, does not lead to an elevated rate of apoptotic pneumocytes in lung grafts.

Animals↗
PubMed2000

Surgery for acute type a aortic dissection: comparison of techniques.

OBJECTIVE: In order to determine the optimal surgical strategy for acute ascending aortic dissection, the graft inclusion technique was compared with the open resection technique. METHODS: Between 1985 and 1995 a consecutive series of 193 patients (77% male, mean age 58 years) had emergency surgery during a mean interval of 13.2 h after onset of symptoms. Graft replacement of the ascending aorta was performed in all patients (supracoronary graft 143/193=74%, aortic root replacement 50/193=26%, aortic valve replacement 73/193=38%, arch replacement 44/193=20%) The open resection technique was applied in 93 patients and the inclusion technique in 100 patients with a Cabrol-shunt in 26%. Preoperative risk factors were equally distributed between groups (inclusion technique vs. open technique): left ventricular ejection fraction<45% (13 vs. 2%, not significant (n.s.)), neurological deficit (31 vs. 25%; n.s.), systolic blood pressure<90 mm Hg (20 vs. 15%, n.s.) pericardial tamponade (25 vs. 9%, n.s.), renal failure (6 vs. 4%; n.s.). RESULTS: The overall early mortality was 24%. Following graft inclusion it was 31% compared with 16% in the open technique group (P=0.0154). Postoperative complications (graft inclusion vs. open technique): myocardial infarction (9 vs. 12%, n.s.), low cardiac output (40 vs. 32%, n.s.), reexploration for hemorrhage (23 vs. 25%, n.s.). Survival at 8 years was significantly increased in the open technique group (P=0.0300). Pseudoaneurysm formation occurred in 3% of patients and only after graft inclusion. Freedom from reoperation was 80% at 8 years and did not differ between groups. Graft inclusion was an independent significant predictor of early (P=0.0069; relative risk=2.3673) and late mortality (P=0.0119; relative risk=2.0981). CONCLUSIONS: Surgery of acute ascending aortic dissection still carries a considerable early mortality whereas the late outcome is satisfactory. The open resection technique is the method of choice showing superior early and late results and avoiding pseudoaneurysm formation. The inclusion technique may be indicated in situations with increased risk of bleeding. A consequent decompression of the perigraft-space could reduce the rate of pseudoaneurysms.

Acute Disease↗
PubMed2000

Paravalvular leakage after mitral valve replacement: improved long-term survival with aggressive surgery?

BACKGROUND: Following mitral valve replacement, surgical closure of paravalvular leaks is usually advised in severely symptomatic patients and in those requiring blood transfusions for persisting haemolysis. However, the long-term prognosis of less symptomatic patients or those not needing blood transfusions is unknown. METHODS: Between 1987 and 1997, we observed 96 patients with mitral paravalvular leakage. A paraprosthetic leak was diagnosed after a median time of 119 days (range: 1 day-23 years) after primary mitral valve replacement. During an average follow-up of 5 years (range: 1-23 years), 50/96 patients were referred for surgical closure. RESULTS: Compared with patients who received conservative treatment, those referred for surgery had a significantly lower mean preoperative haematocrit (P = 0.002) with a higher proportion of patients being in the NYHA class III/IV (P = 0.03). Age, gender, left ventricular function and number and size of leaks did not differ between the groups. The 30-day postoperative mortality for valve reoperation was 6% (3/50); during follow-up three further patients died, resulting in an overall mortality rate of 12%. In the group treated conservatively there was a mortality rate of 26% (12/46). Thus, the actuarial survival for patients referred for surgery was 98, 90 and 88% after 1, 5 and 10 years, compared with 90, 75 and 68% for patients treated conservatively (long-rank P = 0.03). In addition, there was a significant increase in mean haematocrit levels (P = 0.0001) and an improvement in NYHA class III/IV symptoms (P = 0.002), vertigo (P = 0.001) and fatigue (P = 0.001) after surgery. CONCLUSIONS: Following mitral valve replacement, a more aggressive surgical treatment is recommended for patients with paraprosthetic leaks. Surgery should be offered to less symptomatic patients, as well as those not requiring blood transfusion.

Adult↗
PubMed2000

FloSeal: a new hemostyptic agent in peripheral vascular surgery.

BACKGROUND: Bleeding is a common and often severe side-effect in vascular surgery. The use of glue is widely accepted to achieve a dry surgical field. The application of sealant is limited when the surface is covered with blood. Aim of this study was to evaluate a new sealant (FloSeal) in patients undergoing vascular surgery. PATIENTS AND METHODS: Between June 1998 and July 1999 a total of 17 patients with peripheral vascular interventions was included in this investigation. Effectiveness was measured by bleeding severity prior and after application, time to hemostasis, amount of fusion matrix necessary for hemostasis, the potential need for additional hemostatic measures, or the need for reoperations to control the bleeding. RESULTS: In 15 out of 17 patients bleeding was controlled with FloSeal alone, two patients required further surgical or hemostatic treatment. There were no local or systemic complications after use of this product. CONCLUSION: FloSeal is an advantageous hemostatic tool.

Administration, Topical↗
PubMed2000

[Surgical repair of aortic coarctation in adults over 30 years of age].

Coarctation of the aorta is nowadays rarely observed among adult population, as it is usually detected and treated during infancy. The natural history of this disease however is known to lead to early death due to the consequences of severe arterial hypertension. We report on 3 patients older than 30 years, recently operated on in our cardiosurgical units. Two of them were foreigners recently arrived in Switzerland, of 46 and 32 years old respectively. The medical examination highlighted severe hypertension and bilateral absence of femoral pulses. The third patient was a Swiss citizen and had a similar examination. Chest X-rays clearly showed rib notching, and the suspected diagnosis was confirmed with angiography. Three different surgical techniques were chosen, according to the peroperative situation. In one case, the stenosis was resected and an end-to-end anastomosis could be performed. In another case, the occlusion was complete and extended over 3 centimeters. The resected segment was replaced by a prosthetic graft. In the third case, we performed a synthetic patch graft aortoplasty. Postoperative care were simple in every cases. Coarctation of the aorta must be evoked among the possible etiologies of severe hypertension, as the surgical treatment is of real benefit and with reduced morbidity.

Adult↗
PubMed1999

[Minimally invasive coronary bypass: optimal performance after a learning period].

Minimally invasive cardiac surgery requires a learning period before the advantages of the method can be demonstrated. We report the progress of our results over 21 consecutive months. 27 patients were considered for minimally invasive coronary bypass via a small thoracotomy. We compare the results of four consecutive groups corresponding to an initial period (July-December 1997; n = 7; 66.8 +/- 8.9 years), an intermediate period (January-June 1998; n = 4; 48.1 +/- 11.2 years), an advanced period (July-December 1998; n = 7; 62.9 +/- 7.0 years) and a current period (January-March 1999; n = 7; 59.3 +/- 10.9 years). 2 patients were converted to sternotomy during the first year of experience. The operating time was reduced from 124 +/- 14 min and 118 +/- 20 min during the initial and intermediate periods to 99 +/- 18 and 98 +/- 18 min during the last two periods. The ICU stay was 2.6 +/- 1.1 days during the initial period and diminished respectively to 1.5 +/- 0.6, 1.7 +/- 0.8 and 1.6 +/- 0.5 days during the intermediate, advanced and current periods. The postoperative hospital stay was reduced from 9.0 +/- 1.4 days to 6.3 +/- 4.6, 5.2 +/- 1.7 and 5.9 +/- 1.5 days respectively. The benefits of minimally invasive coronary bypass were estimated by comparing the results of the last two periods with those of patients operated on through a sternotomy, on a beating heart (n = 12; 62.6 +/- 8.2) or under CPB (n = 81; 63.0 +/- 8.5). In these situations, operative time was 144 +/- 41 min and 180 +/- 35 min respectively. The ICU stay was 1.5 +/- 0.6 and 2.2 +/- 0.9 days, and the postoperative hospital stay was 7.5 +/- 2.8 and 8.6 +/- 3.0 days. We conclude that a learning period is necessary before the real benefits of the minimally invasive approach to coronary disease can be demonstrated. This method will soon replace traditional sternotomy in certain indications.

Aged↗
PubMed1999

Cytokine-mediated Bax deficiency and consequent delayed neutrophil apoptosis: a general mechanism to accumulate effector cells in inflammation.

Neutrophils are important effector cells in immunity to microorganisms, particularly bacteria. Here, we show that the process of neutrophil apoptosis is delayed in several inflammatory diseases, suggesting that this phenomenon may represent a general feature contributing to the development of neutrophilia, and, therefore, in many cases to host defense against infection. The delay of neutrophil apoptosis was associated with markedly reduced levels of Bax, a pro-apoptotic member of the Bcl-2 family. Such Bax-deficient cells were also observed upon stimulation of normal neutrophils with cytokines present at sites of neutrophilic inflammation, such as granulocyte and granulocyte-macrophage colony-stimulating factors, in vitro. Moreover, Bax-deficient neutrophils generated by using Bax antisense oligodeoxynucleotides demonstrated delayed apoptosis, providing direct evidence for a role of Bax as a pro-apoptotic molecule in these cells. Interestingly, the Bax gene was reexpressed in Bax-deficient neutrophils under conditions of cytokine withdrawal. Thus, both granulocyte expansion and the resolution of inflammation appear to be regulated by the expression of the Bax gene in neutrophils.

Apoptosis↗
PubMed1999

Recent experience with the arterial switch operation in transposition of the great arteries.

OBJECTIVE: Review of our experience with the technically demanding arterial switch operation in transposition of the great arteries in children. METHODS: Twenty-seven children who underwent an arterial switch operation in our clinic were retrospectively reviewed. Except for one child (operated on at eight months), the operation was performed during the neonatal period. The underlying pathology was d-transposition of the great arteries in 25 children and a double outlet right ventricle of transposition type in 2. Five children had an associated ventricular septum defect and 1 aortic isthmus coarctation. The pattern of the coronary arteries was favourable in 18 children, difficult in 7 and dangerous in 3. The operation was performed in cardiopulmonary bypass for repair of the transposition and in a period of deep hypothermic circulatory arrest for repair of the intracardiac defects. RESULTS: One child died perioperatively and 1 postoperatively (operative mortality 7%) from myocardial ischaemia following unsuccessful transfer of a dangerous pattern of coronary arteries. Another child, a low-birth weight baby, died 80 days after the operation from respiratory failure. Postoperative morbidity occurred in 10 patients and medium-term morbidity in 6 patients who presented various degrees of stenosis of a pulmonary artery. During a median follow-up of 18 months no patient required reoperation. The children are asymptomatic and thriving satisfactorily. CONCLUSION: Because it restores the heart physiology, the arterial switch operation is considered the procedure of choice for correction of transposition of the great arteries. The operation involves acceptable mortality and morbidity. Transfer of difficult coronary artery patterns and development of stenosis on the pulmonary arteries remain problematic.

Cardiopulmonary Bypass↗
PubMed1999

Five-year outcome in patients with isolated proximal left anterior descending coronary artery stenosis treated by angioplasty or left internal mammary artery grafting. A prospective trial.

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass surgery (CABG) improve the clinical status of patients with isolated proximal left anterior descending coronary artery stenosis. At 2 years, only additional revascularization was more frequently required after PTCA. METHODS AND RESULTS: We monitored 134 patients randomized to PTCA (n=68) or CABG (n=66) for </=5 years. End points were death, myocardial infarction, need for additional revascularization, clinical status, and medical treatment. At 5 years, 6 patients (9%) had died in the PTCA group versus 2 (3%) in the CABG group (P=0.12). One patient in each group died of a cardiac cause. Myocardial infarction was more frequent after PTCA (15% versus 4%; P=0.0001), but Q-wave infarction was not (6% in the PTCA group versus 3% in the CABG group; P=0.8). Additional revascularization was required in 38% of patients in the PTCA group versus 9% in the CABG group (P=0.0001). Functional status was comparable, with 6% of patients after PTCA and 3% after CABG in functional class III or IV. Finally, after PTCA or CABG, 62% and 91% of patients, respectively, were free of events (P=0.0001). CONCLUSIONS: The 5-year prognosis of patients with isolated proximal left anterior descending coronary artery stenosis is good. Both PTCA and CABG improve clinical status, but revascularization was needed more frequently after PTCA. There is an excess incidence of non-Q-wave myocardial infarction in the PTCA group that does not affect the vital or symptomatic outcome.

Angioplasty, Balloon, Coronary↗
PubMed1999

Differentiation-related expression of the Thomsen-Friedenreich glycotope in developing human lung and in lung carcinoma: lack of association with malignancy.

BACKGROUND: It has been proposed that the Thomsen-Friedenreich glycotope represents a general carcinoma-associated antigen and a candidate for the development of a tumor vaccine. However, the expression of the unmasked and masked (sialylated) forms in lung carcinomas, as well as in developing and adult human lung, has not been documented sufficiently. METHODS: Sections from 82 lung carcinomas, including squamous cell carcinomas, adenocarcinomas, and large cell and small cell carcinomas, as well as sections of developing and adult human lung were studied using the lectin amaranthin and a monoclonal antibody. RESULTS: All lung carcinomas but one bronchiolo-alveolar carcinoma were unreactive for the Thomsen-Friedenreich glycotope, whereas its sialylated form was detectable in well-differentiated squamous cell carcinomas and adenocarcinomas, including bronchiolo-alveolar carcinomas. Both unmasked and masked Thomsen-Friedenreich glycotopes were undetectable in large cell and small cell lung carcinomas. In all developmental stages of lung, the Thomsen-Friedenreich glycotope was expressed only in epithelia of the most peripheral parts of the bronchial tree, whereas its sialylated form was expressed in epithelia of all parts of the bronchial tree. In adult lung, the Thomsen-Friedenreich glycotope was expressed in pneumocytes, whereas its sialylated form was expressed ubiquitously in all epithelia. CONCLUSIONS: The Thomsen-Friedenreich glycotope in human lung represents a differentiation antigen, rather than a carcinoma-associated antigen. The sialylated form is expressed constitutively in both developing and adult lung and well-differentiated lung carcinomas. Thus, the Thomsen-Friedenreich glycotope is of limited value in the diagnosis of lung carcinoma, and there is no rationale for a Thomsen-Friedenreich glycotope-based immunotherapy for patients with this disease.

Adenocarcinoma↗
PubMed1999

High-resolution intravascular magnetic resonance imaging: monitoring of plaque formation in heritable hyperlipidemic rabbits.

BACKGROUND: The individual makeup of atherosclerotic plaque has been identified as a dominant prognostic factor. With the use of an intravascular magnetic resonance (MR) catheter coil, we evaluated the effectiveness of high-resolution MR in the study of the development of atherosclerotic lesions in heritable hyperlipidemic rabbits. METHODS AND RESULTS: Sixteen hyperlipidemic rabbits were investigated at the ages of 6, 12, 24, and 36 months. The aorta was studied with digital subtraction angiography and high-resolution MR with the use of a surface coil and an intravascular coil that consisted of a single-loop copper wire integrated in a 5F balloon catheter. Images were correlated with histological sections regarding wall thickness, plaque area, and plaque components. Digital subtraction angiography revealed no abnormalities in the 6- and 12-month-old rabbits and only mild stenoses in the 24- and 36-month-old rabbits. High-resolution imaging with surface coils resulted in an in-plane resolution of 234x468 microm. Delineation of the vessel wall was not possible in younger rabbits and correlated only poorly with microscopic measurements in the 36-month-old rabbits. Intravascular images achieved an in-plane resolution of 117x156 microm. Increasing thickness of the aortic wall and plaque area was observed with increasing age. In the 24- and 36-month-old animals, calcification could be differentiated from fibrous and fatty tissue on the basis of the T2-fast spin echo images, as confirmed by histological correlation. CONCLUSIONS: Atherosclerotic evolution of hyperlipidemic rabbits can be monitored with high-resolution intravascular MR imaging. Image quality is sufficient to determine wall thickness and plaque area and to differentiate plaque components.

Animals↗