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At least 865 records · Page 48Linked to original sources
PubMed2004

Postoperative 3D angiography in intracranial aneurysms.

BACKGROUND AND PURPOSE: Postsurgical evaluation of patients with intracranial aneurysms is important because there is a risk of regrowth and subarachnoid hemorrhage from residual aneurysms. We assessed the role and value of 3D angiography in this evaluation. METHODS: Images from both 3D angiography and digital subtraction angiography (DSA) were preoperatively obtained in 71 consecutive patients with 88 intracranial clipped aneurysms. We analyzed the incidence of postoperative residual aneurysms and compared the 3D angiographic and DSA images in these patients. RESULTS: With 3D angiography, 37 residual aneurysms were found among 88 clipped aneurysms. These comprised 12 large residual necks and 25 small, dog-eared remnants. DSA demonstrated 12 large, residual necks and only six small, dog-eared remnants. 3D angiography also demonstrated the clips, aneurysms, and parent arteries simultaneously, enabling us to appreciate the clip-aneurysm configuration completely. CONCLUSION: 3D angiography allowed us to detect more residual aneurysms after surgical clip placement than did conventional DSA, although none of those detected on only 3D angiography were judged to require additional treatment. 3D angiography may provide baseline data for the long-term follow-up of postsurgical aneurysms.

Adult↗
PubMed1994

Rotational angiography assessment of cerebral aneurysms.

PURPOSE: To compare rotational angiography with conventional digital subtraction angiography in the assessment of cerebral aneurysms. METHODS: Conventional digital subtraction angiography and rotational angiography were compared in 57 patients investigated for the preoperative diagnosis of subarachnoid hemorrhage and in 13 patients after surgery. Images were compared for location, visibility of the aneurysmal neck, vascular branch anatomy, projection, size, presence of spasm, and shape of the aneurysm. RESULTS: Rotational angiography was superior to the digital angiogram in assessing aneurysms and vascular anatomy in the following percentage of cases: 12% for location, 46% for the presence of a neck, 32% in the assessment of branch anatomy, 19% for projection, 12% for size, 3.5% for spasm, and 19% for shape. After surgery, rotational angiography more clearly demonstrated the presence or absence of a neck in 69% of the cases. CONCLUSIONS: Rotational angiography often allows better visualization of vascular anatomy and therefore improves the angiographic assessment of aneurysms when compared with conventional digital subtraction angiography, making it an excellent adjunct in the investigation of subarachnoid hemorrhage. The lack of subtraction artifacts from the surgical clips and multiple angles of view also allow better assessment of the presence or absence of a residual neck in postoperative cases.

Angiography, Digital Subtraction↗
PubMedDate not supplied

Spinal dural arteriovenous fistulas: evaluation with MR angiography.

PURPOSE: To show that postgadolinium three-dimensional time-of-flight MR angiography shows abnormal intradural vessels associated with spinal dural arteriovenous fistula better than routine MR imaging and provides screening information useful for subsequent diagnostic conventional angiography and/or posttreatment evaluation. METHODS: Precontrast and postcontrast MR imaging and MR angiograms, as well as subsequent digital subtraction angiograms, were obtained for eight patients with dural arteriovenous fistulas, diagnosed with digital subtraction angiography and verified with surgery. In four patients, MR studies also were obtained after surgery. RESULTS: All patients had cord hyperintensity of T2-weighted images and postgadolinium enhancement on T1-weighted images. Five had vessellike signal abnormalities in the subarachnoid space on MR. Abnormal intradural vessels were detected in all eight patients with MR angiography. Comparison with digital subtraction angiography revealed these vessels to be primarily enlarged veins of the coronal venous plexus on the cord surface. In six patients, the medullary vein draining the fistula was demonstrated, indicating the level of the fistula, later identified by digital subtraction angiography. After surgical obliteration of the fistula, the draining medullary vein and most or all of the abnormal coronal veins were no longer demonstrated, with decrease or resolution of cord hyperintensity on T2-weighted images. CONCLUSION: Postgadolinium, spinal MR angiography in cases of suspected dural arteriovenous fistula provides information about intradural veins that supplements the diagnostic value of the MR imaging results, facilitates the subsequent digital subtraction angiography study, and, in treated cases, reflects the success of surgery and/or embolization.

Aged↗
PubMed1995

[The current role of cerebral angiography in diagnosis of cerebrovascular disease].

The role of cerebral angiography in diagnosis of cerebrovascular disease has changed considerably because of the increasing availability of neuroimaging (CT, MRI), especially MR angiography (MRA). MRA has almost entirely taken the place of cerebral angiography as a screening procedure in evaluation of the cervical carotid arteries and main trunks of intracranial arteries. However, detection of accurate morphological changes of arterial walls requires cerebral angiography, especially in cases of arteritis, arterial dissection and aneurysm of smaller than 3 mm in diameter. Cerebral angiography is still needed in order to obtain a more precise three dimensional concept of the vascular lesion, esp. in vascular malformations, their detailed blood supply, venous drainage and even for a mere (but definitive) diagnosis in some cases. Angiography is essential in preoperative surgical planning, for evaluation of residual AVM after surgery, etc. Technically, intraarterial stereoscopic DSA and serial cerebral angiography in stereoscopic magnification are most useful for angiographic diagnosis. Intravenous DSA has no advantage over MRA and is therefore no longer a useful diagnostic procedure. Cerebral angiography is also useful for evaluation of cerebral circulation which is most useful in conjunction with SPECT study. Although interventional neuroradiology has made a significant stride in the past, it requires further technical improvements and more skillful performance in the future.

Angiography, Digital Subtraction↗
PubMed1998

[Indocyanine green angiography of basal laminar drusen in the retinal pigment epithelium associated with vitelliform macular degeneration].

PURPOSE: In the mid-late life, basal laminar drusen can be associated with vitelliform macular degeneration and choroidal neovascularization. The differential diagnosis between these two clinical entities is not always easy with fluorescein angiography. The aim of this case report is to describe the indocyanine green angiographic features of basal laminar drusen and pseudo-vitelliform material and to evaluate the role of ICG angiography in differentiating new choroidal vessels from vitelliform macular degeneration. PATIENTS AND METHODS: Six patients (12 eyes) with central visual loss and metamorphopsia underwent a biomicroscopic examination. Diagnosis was basal laminar drusen and bilateral vitelliform macular degeneration. Fluorescein and indocyanine green angiographies were performed and the results were compared. RESULTS: In all eyes, basal laminar drusen were hyperfluorescent with both angiographies. On fluorescein angiography, the macular material was hypofluorescent early, but gradual staining occurred from the borders in the late phase. In 8 out of the 12 eyes, fluorescein angiographic characteristics of the macular lesions could not provide clues to differential diagnostic between new choroidal vessels and vitelliform material. On indocyanine green angiography, in 8 eyes the material remained intensely hypofluorescent during the whole sequence. In 4 eyes, indocyanine green angiography allowed the identification of hyperfluorescent well-defined new choroidal vessels. CONCLUSIONS: Indocyanine green angiography allows the visualization of basal laminar drusen and can easily differentiate choroidal neovascularization from acquired vitelliform degeneration.

Angiography↗
PubMed2002

Carotid and cerebral angiography performed by cardiologists: cerebrovascular complications.

The management of extracranial carotid artery disease is primarily concerned with the prevention of acute stroke. In order to understand the current risks of carotid angiography performed by interventional cardiologists, we undertook a retrospective study to determine the neurologic complications in patients who underwent selective cerebral angiography. All patients undergoing studies that were limited to diagnostic aortic arch angiography and selective four-vessel cerebral angiography in the cardiac catheterization laboratories during the past 6 years were included in this study. Hospital records were reviewed to determine any in-hospital cerebrovascular complications following carotid angiography, ranging from transient ischemic attack to major disabling stroke or death. A total of 189 consecutive patients underwent 191 diagnostic studies limited to aortic arch and four-vessel cerebral angiography in the cardiac catheterization laboratories between 1 January 1995 and 31 December 2000. Only one (0.52%) neurological complication, a minor stroke, occurred in our study population. There were no transient ischemic attacks, major strokes, or death. We have shown that experienced interventional cardiologists can perform diagnostic aortic arch and selective carotid and vertebral angiography in a cardiac catheterization laboratory with a very low complication rate. Because the risks of angiography add to those of revascularization of the carotid artery, the most highly skilled angiographer, regardless of primary specialty, should perform these studies.

Adult↗
PubMed2005

Randomized study of the safety and clinical utility of rotational vs. standard coronary angiography using a flat-panel detector.

The purpose of this study was to test the hypothesis that rotational angiography improves patient safety while maintaining diagnostic accuracy for patients undergoing coronary angiography. Despite advances in angiographic technique, patients remain at risk for complications of coronary angiography, including contrast-induced nephropathy and radiation exposure. Technology has been developed to perform coronary angiography with active rotation of the imaging system that may reduce the quantity of contrast and radiation to which the patient is exposed. Fifty patients undergoing diagnostic cardiac catheterization were randomized to either standard vs. rotational angiography of the coronary arteries using a prespecified protocol with a flat-panel single-plane imaging system. We measured the quantity of radiographic contrast utilized and radiation exposure. Using an intention-to-treat analysis, there was a 40% reduction (24 +/- 5 vs. 40 +/- 10 ml; P < 0.0001) in contrast utilization in the rotational group compared to the standard group. Neither radiation exposure (35 +/- 14 vs. 30 +/- 20 Gycm(2); P = 0.35), fluoroscopic time (44 +/- 33 vs. 44 +/- 40 sec; P = 0.99), nor procedure time (249 +/- 137 vs. 214 +/- 79 sec; P = 0.26) differed, although significant intraoperator variability was noted for both standard and rotational angiography. The radiation exposure using this flat-panel system is significantly lower than prior reports that used an image intensifier system. Rotational coronary angiography has the potential to improve patient safety by markedly reducing radiographic contrast exposure while maintaining comparable diagnostic accuracy, radiation exposure, and procedure time compared to standard coronary angiography.

Adolescent↗
PubMed2006

The effect of coronary angiography on residual renal function in patients on peritoneal dialysis.

BACKGROUND: The risk of intravascular radiocontrast to residual renal function (RRF) in patients on peritoneal dialysis (PD) remains largely unknown. HYPOTHESIS: This study sought to estimate the effect of coronary angiography on RRF in patients on PD. METHODS: All patients at the VA Pittsburgh Healthcare System and University of Pittsburgh who underwent coronary angiography between 1993 and 2005 while on PD and who had RRF measured prior to angiography were identified retrospectively. For patients without a postprocedure RRF recorded, medical records were reviewed to determine whether anuria had developed. The longer-term rate of loss of RRF among cases was compared with a composite rate of decline in RRF among cases before angiography and matched controls. RESULTS: Twenty-nine patients with a mean preprocedure RRF of 4.4+/-3.2 ml/min/1.73m(2) were evaluated. Of these patients, 23 (79%) had postangiography RRF assessments (mean clearance 3.4+/-3.0 ml/min/1.73m(2)). One of the remaining six patients definitely became permanently anuric following angiography, one was lost to follow-up, and there was no postprocedure RRF assessment in four others. The rate of decline in RRF in the cases was similar to the composite rate (0.07 ml/min/1.73m(2)/month vs. 0.09 ml/min/1.73m(2)/month, p=0.53) CONCLUSION: The risk for permanent anuria in patients on PD undergoing coronary angiography appears to be quite small. Patients who do not develop anuria following coronary angiography have the same gradual rate of loss of RRF as other patients on PD. Providers should be vigilant in protecting RRF in patients on PD undergoing coronary angiography.

Anuria↗
PubMed1998

Analysis of cerebrovascular diseases by a new 3-dimensional computerised X-ray angiography system.

We set out to validate the concept of three-dimensional (3D) angiography. We evaluated the sensitivity and the quality of morphological analysis mode possible by an experimental system for imaging cerebrovascular disease versus standard digital subtraction angiography (DSA). The system, the 3D Morphometer, is a computerised X-ray angiography unit capable of acquiring a set of two-dimensional (2D) projections during a rotation and then reconstructing a 3D volume from them. We studied 78 patients with suspected cerebrovascular disease. 3D and 2D images (standard 2D DSA performed during the same procedure), were reviewed blindly to assess detection and display of morphological characteristics of cerebrovascular diseases. We found 53 aneurysms, 22 arteriovenous malformations and two venous angiomas. On 3D angiography we detected two aneurysms we missed on 2D angiography. In 47 aneurysms on which further data were obtained during surgery or embolisation, the 3D angiography allowed more accurate analysis of the neck and surrounding vessels in cases in which the 2D angiographic findings were doubtful. Assessment of arteriovenous malformations was equivalent with both techniques. Under the conditions of our study, the technical constraints being the same for both methods, 3D angiography was superior to 2D angiography. Implementation on C-arm vascular systems is being evaluated.

Algorithms↗
PubMed1998

Angiography of experimental autoimmune uveoretinitis with ultrastructural correlation.

BACKGROUND: Indocyanine green (ICG) angiography has been used to evaluate posterior uveitis in the clinical setting, despite the shortage of data on possible pathological correlates of observed findings. METHODS: We used both ICG angiography and fluorescein angiography to examine rats that developed a mild form of experimental autoimmune uveoretinitis (EAU) induced by immunization with interphotoreceptor retinoid-binding protein (IRBP). Angiography was performed on days 9, 10, 11 and 23 after IRBP immunization, and freshly enucleated eyes obtained on the same days were examined histopathologically by light microscopy and transmission electron microscopy. RESULTS: Diffuse dilatation and tortuosity of the retinal vessels was observed by both ICG and fluorescein angiography, with leakage from these vessels in focal areas in the periphery. In addition, deep hyperfluorescent spots in the central posterior pole, not associated with retinal vessels, were observed by ICG angiography only. These corresponded to Dalen-Fuchs-like nodules on funduscopy. On histopathological examination, eyes showed inflammatory cell infiltration around retinal vessels, disorganization of outer retinal layers, focal subretinal accumulations of cells (resembling Dalen-Fuchs nodules), and diffuse inflammatory cell infiltration in the choroid. Ultrastructural examination of a Dalen-Fuchs-like nodule revealed a mound of monocytes, appearing to contain phagosomes of lipofuscin and phospholipids, sandwiched between transformed retinal pigment epithelium (RPE) cells with disrupted apical processes and loss of basal interdigitation. CONCLUSION: These results suggest that ICG angiography may be useful in delineating certain abnormalities at the level of the RPE, in association with posterior ocular inflammation, that cannot be observed by fluorescein angiography alone.

Animals↗
PubMed2005

Simultaneous multi-section perfusion CT and CT angiography for the assessment of acute ischemic stroke.

BACKGROUND: Introduction of helical computed tomography (CT) scanning has enabled rapid imaging of the vascular status by means of CT angiography and perfusion CT. By virtue of recent multi-detector technology, helical CT has the ability to perform both CT angiography and multi-section perfusion CT simultaneously. This study investigated the clinical feasibility of simultaneous assessment of perfusion CT and CT angiography in patients with acute ischemic stroke. METHOD: Perfusion CT and CT angiography were performed simultaneously in a series of consecutive 31 acute ischemic stroke patients. The time required for the entire processing was about 15 minutes. Contrast agent was used in a total dose of 100 ml (35 ml for perfusion CT and 65 ml for CT angiography). FINDINGS: Simultaneous perfusion CT scans and CT angiographies were of diagnostic quality for 29 patients (94%). In large territorial infarct patients, perfusion CT could predict all perfusion deficits of the final lesions (10 out of 10 lesions) and CT angiography could detect 9 of 10 occlusions of major cerebral arteries (90%). In patients with small lacunar or subcortical infarcts, perfusion CT could predict 9 out of 19 lesions (47.4%), and false-negative were encountered in small lesions (three patients) or in inadequate coverage of data acquisition (seven patients). Acute stage thrombolytic intervention could be carried out based on the findings, and the success of thrombolytic therapy could be demonstrated by follow-up study. CONCLUSIONS: Simultaneous perfusion CT and CT angiography is the very useful tool for the rapid and adequate diagnosis of almost all of the large territorial infarcts and some of non-territorial lacunar infarcts. It is an easy-to-perform and safe imaging technique to assess acute ischemic stroke.

Acute Disease↗
PubMed2005

Multidetector-row CT angiography of upper- and lower-extremity peripheral arteries.

With the introduction of multidetector-row CT (MDCT) technology indications for MDCT angiography have expanded to include assessment of the peripheral arteries of the upper and lower extremities. Combined with patient- and scanner-adjusted CT data acquisition and contrast medium application strategies, an accurate and reliable evaluation of the peripheral arteries of the upper and lower extremities is possible. MDCT angiography is cost-effective and accurate for detection of arterial stenosis and occlusion in patients with peripheral arterial disease (PAD). MDCT angiography allows postoperative assessment of peripheral arterial bypass grafts, including bypass graft stenosis and occlusion, as well as presence of aneurysms or arteriovenous fistulas. In addition, MDCT angiography is helpful in particular for visualization of arterial bypass grafts with a complicated extra-anatomical course. Furthermore, pre-operative peripheral vascular mapping can be performed by using MDCT angiography. Finally, due to the integration of MDCT scanners in many trauma centres, MDCT angiography is increasingly being used for assessment of traumatic arterial injuries. This article gives an overview of technical aspects of peripheral MDCT angiography, including scanning parameters, contrast medium application, image postprocessing and radiation exposure, and summarizes the most frequent acute and non-acute indications of MDCT angiography for assessment of the upper- and lower-extremity peripheral arteries.

Angiography↗
PubMed2004

Effects of iohexol on ventilatory functions in patients undergoing diagnostic coronary angiography.

BACKGROUND AND OBJECTIVES: Adverse respiratory reactions have been reported with intravascular radiographic contrast media. The aim of the present study is to assess the effects of iohexol on pulmonary functions in patients undergoing diagnostic coronary angiography (CA). MATERIALS AND METHODS: 30 patients enrolled in the study. The respiratory functions of the patients were measured at three different stages during angiography (before, immediately after and 2 h later) and arterial blood gas analyses were performed at six stages during CA (before, immediately after the insertion of angiography catheter, 2 min after the injection of contrast agent, at the end of angiography, an hour and 2 h after angiography). A single, experienced angiographer performed the angiography procedures via radial artery route. Totally six multiple angled views of the left and right coronary arteries were recorded in all patients by hand injection. None of the patients were performed ventriculography. RESULTS: Angiography caused significant reduction in forced expiratory volume in 1 sec [FEV1] (from 103 +/- 15 to 95 +/- 17, p < 0.01), forced vital capacity [FVC] (from 99 +/- 13 to 95 +/- 18, p < 0.05) and maximum mid-expiratory flow rate [MMF] (from 95 +/- 33 to 84 +/- 29, p < 0.01) whereas there were no significant changes in the mean FEV1/FVC ratios at different stages of angiography. Statistically significant decrease in PaO2 (from 91 +/- 10 to 85 +/- 13 mmHg, p < 0.01) and arterial O2 saturation (from 97 +/- 1% to 96 +/- 1%, p < 0.01) were also observed. Data in present study showed a clinically insignificant but statistically significant restrictive impairment in pulmonary functions. CONCLUSIONS: Diagnostic CA using iohexol decreases ventilatory functions in a small but significant extent in patients without any overt pulmonary disease.

Carbon Dioxide↗
PubMed2006

Imaging of the coronary venous system: retrograde coronary sinus angiography versus venous phase coronary angiograms.

BACKGROUND: Left ventricular lead implantation for cardiac resynchronization therapy (CRT) usually requires a pre- or intraprocedural occlusion contrast venography of the coronary sinus (CS) in order to identify tributaries to the lateral wall. As many patients undergo a preprocedural coronary angiogram, we investigated the diagnostic accuracy of venous phase imaging of the CS in patients prior to CRT implantation. The aim of this study was to assess the quality of venous phase coronary sinus angiography. METHODS: In 24 CRT patients retrograde occlusion venography and venous phase coronary sinus angiography obtained during coronary angiography were compared with respect to image quality, vessel diameters and the ability to identify a coronary sinus side branch suitable for left ventricular lead placement. RESULTS: Suitable target vessels for left ventricular lead implantation were identified in all patients irrespective of the method (retrograde occlusion venography or venous phase coronary sinus angiography). There was a high concordance in vessel diameters between venous phase and retrograde angiography. Visibility was superior in retrograde venography. CONCLUSIONS: In heart failure patients who are scheduled for coronary angiograms venous phase coronary sinus angiography is a time-saving and easy to perform alternative imaging modality. Radiation exposure and the amount of contrast medium needed is reduced as compared to coronary sinus occlusion angiography. The information obtained thereby may be used to plan subsequent CRT implantation without the need for retrograde coronary sinus angiography.

Aged↗
PubMed2006

Clinical feasibility of free-breathing, gadolinium-enhanced magnetic resonance angiography for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases.

OBJECTIVE: Congenital heart diseases in pediatric patients are associated with a wide variety of extracardiac thoracic vascular abnormalities. This study analyzed the value of gadolinium-enhanced magnetic resonance angiography during quiet free breathing for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases. METHODS: Fifty-three children with congenital heart diseases (age range, 1 day-40 months; mean, 10.9 months) associated with extracardiac thoracic vascular abnormalities who had undergone both free-breathing, gadolinium-enhanced magnetic resonance angiography and cardiac catheterization, surgical intervention, or both within 2 weeks were reviewed. Diagnostic findings on gadolinium-enhanced magnetic resonance angiography among patients grouped according to 3 major conditions of conotruncal abnormalities (n = 33), aortic or venous abnormalities (n = 11), and pulmonary vascular abnormalities (n = 9), as well as associated extracardiac thoracic vascular abnormality findings, were compared with findings made by using cardiac catheterization, surgical intervention, or both. RESULTS: Extracardiac thoracic vascular abnormality findings on gadolinium-enhanced magnetic resonance angiography were similar to those on catheterization, surgical intervention, or both in patients with conotruncal abnormalities (124 vs 127, P = .083), aortic or venous abnormalities (36 vs 33, P = .083), and pulmonary vascular abnormalities (24 vs 25, P = .317). The overall sensitivity of gadolinium-enhanced magnetic resonance angiography for detection of these lesions identified by means of catheterization, surgical intervention, or both was 97.9%. However, gadolinium-enhanced magnetic resonance angiography revealed 11 additional extracardiac thoracic vascular abnormalities that were not found on cardiac catheterization. The kappa coefficient for the correlation of image quality and diagnostic value of gadolinium-enhanced magnetic resonance angiography by using a 4-point-scale (1 = nondiagnostic to 4 = excellent) assessed by 2 independent reviewers was excellent (mean score = 3.66), with superb interobserver agreement (kappa = 0.727-0.874). CONCLUSIONS: Free-breathing, gadolinium-enhanced magnetic resonance angiography is clinically feasible for detailed anatomic delineation and treatment planning of various extracardiac thoracic vascular abnormalities in young children with congenital heart diseases.

Cardiovascular Abnormalities↗
PubMed2006

Intraoperative navigated 3-dimensional ultrasound angiography in tumor surgery.

BACKGROUND: Avoiding damage to blood vessels is often the concern of the neurosurgeon during tumor surgery. Using angiographic image data in neuronavigation may be useful in cases where vascular anatomy is of special interest. Since 2003, we have routinely used 3D ultrasound angiography in tumor surgery, and between January 2003 and May 2005, 62 patients with different tumors have been operated using intraoperative 3D ultrasound angiography in neuronavigation. METHODS: An ultrasound-based neuronavigation system was used. In addition to 3D ultrasound tissue image data, 3D ultrasound angiography (power Doppler) image data were acquired at different stages of the operation. The value and role of navigated 3D ultrasound angiography as judged by the surgeon were recorded. RESULTS: We found that intraoperative ultrasound angiography was easy to acquire and interpret, and that image quality was sufficient for neuronavigation. In 26 of 62 cases, ultrasound angiography was found to be helpful by visualizing hidden vessels adjacent to and inside the tumor, facilitating tailored approaches and safe biopsy sampling. CONCLUSIONS: Intraoperative 3D ultrasound angiography is straightforward to use, image quality is sufficient for image guidance, and it adds valuable information about hidden vessels, increasing safety and facilitating tailored approaches. Furthermore, with updated 3D ultrasound angiography imaging, accuracy of neuronavigation may be maintained in cases of brain shift.

Biopsy↗
PubMed2003

Diagnostic coronary angiography induces a systemic inflammatory response in patients with stable angina.

BACKGROUND: Systemic markers of inflammation increase after percutaneous coronary intervention (PCI). The rise in inflammatory markers after PCI is frequently attributed to the inflammatory stimulus associated with coronary artery injury during balloon inflation and coronary stent implantation. The aim of this study was the determine whether diagnostic coronary angiography performed in patients with stable angina triggers a systemic inflammatory response. METHODS: We prospectively studied patients with chronic stable angina undergoing either coronary angiography (n = 13) or coronary angiography followed by PCI (n = 13). Peripheral blood samples were obtained before and 24 hours, 48 hours, and 4 weeks after the procedure and analyzed for C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). Patients with periprocedural myocardial necrosis were excluded. RESULTS: There was a significant increase in CRP levels at 24 and 48 hours in both the coronary angiography (P <.05) and PCI (P <.01) groups. IL-6 levels peaked at 24 hours in both the coronary angiography (median, 2.5-9.5 pg/mL; P =.01) and PCI (median, 3.0-8.2 pg/mL; P <.005) groups. At 4 weeks, both CRP and IL-6 returned to baseline levels. TNF-alpha levels were unchanged with either coronary angiography or PCI. The magnitude of the rise of CRP and IL-6 levels was not significantly different between the groups. There was a fair correlation between baseline and peak postprocedural levels of CRP (r = 0.67, P =.008) and IL-6 (r = 0.48, P =.016). CONCLUSION: Uncomplicated diagnostic coronary angiography triggers a systemic inflammatory response in patients with stable angina. The contribution of coronary angiography should be considered in interpreting the significance of the systemic inflammatory response observed after PCI.

Angina Pectoris↗
PubMed1997

Indocyanine green angiography of drusen.

PURPOSE: To analyze the indocyanine green angiographic findings of drusen in the early stages of age-related macular degeneration. METHODS: Sixty-nine eyes of 53 consecutive patients with drusen but without exudative complications of age-related macular degeneration were studied. Drusen were classified into four groups: hard drusen, drusen derived from clusters of hard drusen (hard cluster-derived drusen and soft cluster-derived drusen), membranous drusen, and regressing drusen. An additional category was constituted by reticular pseudodrusen that could be associated with drusen of either the inner or outer macula. Results of contact lens biomicroscopy and fluorescein angiography were compared with findings on indocyanine green angiography. RESULTS: Hard drusen, either isolated hard drusen or hard cluster-derived drusen, were hyperfluorescent during indocyanine green angiography; in contrast, all sizes of soft drusen derived from clusters of hard drusen were hypofluorescent throughout the angiogram. Membranous drusen, visible on biomicroscopy and fluorescein angiography, were not visible during indocyanine green angiography. Regressing drusen may have showed hyperfluorescence at the early stages of indocyanine green angiography, but associated calcium and pigmentation were hypofluorescent. Reticular pseudodrusen were visible on red-free photographs; on midphase and late-phase indocyanine green angiography using the scanning laser ophthalmoscope only, reticular pseudodrusen were seen as a pattern of hypofluorescent dots. CONCLUSION: The indocyanine green angiographic findings add to and support the clinicopathologic classification of drusen. Indocyanine green angiography may help to distinguish the different types of drusen and may thus be of use in evaluating the risk of progressive age-related macular degeneration in patients with drusen.

Adult↗