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Tomographic Angiography (tomographic + angiography)

Distribution by Scientific Domains

Medical Sciences	90%

Kinds of Tomographic Angiography

computed tomographic angiography

Selected Abstracts

What Are the Unintended Consequences of Changing the Diagnostic Paradigm for Subarachnoid Hemorrhage After Brain Computed Tomography to Computed Tomographic Angiography in Place of Lumbar Puncture?

ACADEMIC EMERGENCY MEDICINE, Issue 9 2010
Jonathan A. Edlow MD
First page of article [source]

One-year Outcomes Following Coronary Computerized Tomographic Angiography for Evaluation of Emergency Department Patients with Potential Acute Coronary Syndrome

ACADEMIC EMERGENCY MEDICINE, Issue 8 2009
Judd E. Hollander MD
Abstract Objectives:, Coronary computerized tomographic angiography (CTA) has high correlation with cardiac catheterization and has been shown to be safe and cost-effective when used for rapid evaluation of low-risk chest pain patients from the emergency department (ED). The long-term outcome of patients discharged from the ED with negative coronary CTA has not been well studied. Methods:, The authors prospectively evaluated consecutive low- to intermediate-risk patients who received coronary CTA in the ED for evaluation of a potential acute coronary syndrome (ACS). Patients with cocaine use, known cancer, and significant comorbidity reducing life expectancy and those found to have significant disease (stenosis , 50% or ejection fraction < 30%) were excluded. Demographics, medical and cardiac history, labs, and electrocardiogram (ECG) results were collected. Patients were followed by telephone contact and record review for 1 year. The main outcome was 1-year cardiovascular death or nonfatal acute myocardial infarction (AMI). Results:, Of 588 patients who received coronary CTA in the ED, 481 met study criteria. They had a mean (±SD) age of 46.1 (±8.8) years, 63% were black or African American, and 60% were female. There were 53 patients (11%) rehospitalized and 51 patients (11%) who received further diagnostic testing (stress or catheterization) over the subsequent year. There was one death (0.2%; 95% confidence interval [CI] = 0.01% to 1.15%) with unclear etiology, no AMI (0%; 95% CI = 0 to 0.76%), and no revascularization procedures (0%; 95% CI = 0 to 0.76%) during this time period. Conclusions:, Low- to intermediate-risk patients with a Thrombosis In Myocardial Infarction (TIMI) score of 0 to 2 who present to the ED with potential ACS and have a negative coronary CTA have a very low likelihood of cardiovascular events over the ensuing year. [source]

Various Origins of the Duplicated Middle Cerebral Artery

JOURNAL OF NEUROIMAGING, Issue 4 2008
Nihal Uslu Tutar MD
ABSTRACT We describe the features of a duplicated middle cerebral artery identified by computed tomographic angiography that originates from a previously undefined origin, ie, from the petrous portion of the internal carotid artery. Recognition of this anomaly is important in patients with a possible aneurysm, which was not present in our patient. [source]

Contribution of indirect computed tomographic venography to the diagnosis of postpartum venous thromboembolism

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 9 2008
M. P. REVEL
Summary.,Background:,The diagnostic value of indirect computed tomographic venography (CTV), following thoracic computed tomographic angiography (CTA), has not been specifically evaluated in postpartum patients with suspected pulmonary embolism. Objectives: To assess the diagnostic value of CTV in postpartum venous thromboembolism. Methods: We reviewed all CTA and CTV procedures performed during the last 7 years in our institution for suspected pulmonary embolism during the postpartum period. We focused on the quality of CTA, the rates of positive CTA and isolated positive CTV findings, and alternative diagnoses provided by CTV. Results: Fifty-five CTA and 33 CTV procedures were performed for suspected pulmonary embolism in 47 patients referred between 24 h and 2 months after Cesarean (34 patients) or vaginal (13 patients) delivery. Of the 33 patients who had both CTA and CTV, seven had positive CTA findings and four had isolated positive CTV findings. Thus, the absolute increase in the venous thromboembolism detection rate following CTV was 12.1% [95% confidence interval (CI) 4.0,29.1]. Subcapsular hematoma of the liver or spleen was found on CTV in another two patients without venous thromboembolism. Consequently, CTV had a direct impact on clinical management in six of 33 patients (18%). Conclusion: Our results suggest that postpartum patients with suspected pulmonary embolism have a significant rate of pelvic vein thrombosis and that the use of CTV leads to a 31% relative increase in the detection rate of venous thromboembolism as compared to CTA alone in these patients. [source]

A subfascial variant of the deep inferior epigastric artery demonstrated by preoperative multidetector computed tomographic angiography: A case report

MICROSURGERY, Issue 2 2010
Cristina Garusi M.D.
Precise preoperative imaging by multidetector computed tomographic (MDCT) angiography for planning of deep inferior epigastric artery perforator (DIEP) flap dissection has been reported for enormous advantages in terms of reduced operative time and minimized flap-related complications. This case report shows a particularly rare anatomical subfascia variant of deep inferior epigastric artery (DIEA) which can be preoperatively demonstrated by MDCT angiogram. Therefore, the intraoperative finding also confirms the radiologic data and results in meticulous flap harvesting during incision on anterior rectus sheath. Additionally, the authors emphasize on performing preoperative high quality imaging for DIEP intervention precisely for specific vulnerable course of subfascial plane DIEP, which is rare but tends to be at risk without foreknowing its exact course. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source]

One-year Outcomes Following Coronary Computerized Tomographic Angiography for Evaluation of Emergency Department Patients with Potential Acute Coronary Syndrome

Modifying techniques in deep inferior epigastric artery perforator flap harvest with the use of preoperative imaging

ANZ JOURNAL OF SURGERY, Issue 9 2009
Warren M. Rozen
Abstract New techniques in the harvest of deep inferior epigastric artery perforator (DIEP) flaps have become introduced as a result of modern imaging technologies that can allow virtual surgery to be achieved preoperatively. With computed tomographic angiography, individual anatomy can be appreciated in detail to a level not previously appreciated. These imaging techniques can be successfully used to guide DIEP flap surgery. ,Optimal' perforators can be selected based on size, location, intramuscular and subcutaneous course, and their association with motor nerves. Flap design can be safely achieved based on the cutaneous distribution of perforators. Abdominal wall closure can be improved based on the abdominal contour seen with imaging. Preoperative planning can aid patient selection, plan all aspects of the operative technique, reduce operating time and improve operative outcomes. [source]

Prospective Study of the Clinical Features and Outcomes of Emergency Department Patients with Delayed Diagnosis of Pulmonary Embolism

ACADEMIC EMERGENCY MEDICINE, Issue 7 2007
Jeffrey A. Kline MD
Objectives:The authors hypothesized that emergency department (ED) patients with a delayed diagnosis of pulmonary embolism (PE) will have a higher frequency of altered mental status, older age, comorbidity, and worsened outcomes compared with patients who have PE diagnosed by tests ordered in the ED. Methods:For 144 weeks, all patients with PE diagnosed by computed tomographic angiography were prospectively screened to identify ED diagnosis (testing ordered from the ED) versus delayed diagnosis (less than 48 hours postadmission). Serum troponin I level, right ventricular hypokinesis on echocardiography, and percentage pulmonary vascular occlusion were measured at diagnosis; patients were prospectively followed up for adverse events (death, intubation, or circulatory shock). Results:Among 161 patients with PE, 141 (88%) were ED diagnosed and 20 (12%) had a delayed diagnosis. Patients with a delayed diagnosis were older than ED-diagnosed patients (61 [±15] vs. 51 [±17] years; p < 0.001), had a longer median time to heparin administration (33 vs. 8 hours; p < 0.001), and had a higher frequency of altered mental status (30% vs. 8%; p = 0.01) but did not have a higher frequency of prior cardiopulmonary disease (25% vs. 23%). Patients with a delayed diagnosis had equal or worse measures of PE severity (right ventricular hypokinesis on echocardiography, 60% vs. 58%; abnormal troponin I level, 55% vs. 24%); on computed tomographic angiography, ten of 20 patients with a delayed diagnosis had PE in lobar or larger arteries and >50% vascular obstruction. Patients with a delayed diagnosis had a higher rate of in-hospital adverse events (9% vs. 30%; p = 0.01). Conclusions:In this single-center study, the diagnosis of PE was frequently delayed and outcomes of patients with delayed diagnosis were worse than those of patients with PE diagnosed in the ED. [source]

The branching pattern of the deep inferior epigastric artery revisited in-vivo: A new classification based on CT angiography

CLINICAL ANATOMY, Issue 1 2010
Warren M. Rozen
Abstract The deep inferior epigastric artery (DIEA) is a reliable pedicle in the design of DIEA perforator flaps, with variations in its anatomy infrequent. Previous studies describing its branching pattern have all been based on cadaveric anatomy and described the following three branching patterns: Type 1 (single trunk), Type 2 (bifurcating trunk), and Type 3 (trifurcating trunk). The increased use of preoperative imaging, particularly with computed tomographic angiography (CTA), has enabled visualization of the DIEA and its branches in vivo, providing a functional view of this anatomy. We undertook a study of 250 patients (500 hemiabdominal walls) undergoing preoperative CTA before DIEA perforator flaps for breast reconstruction. The branching pattern of the DIEA and correlation to the contralateral hemiabdominal wall were assessed. The branching patterns of the DIEA were found to be different in vivo compared with cadaveric studies, with a higher than previously reported incidence of Type 1 patterns and lower than reported incidence of Type 3 patterns, and that some patterns exist which were not included within the previous nomenclature (namely, Type 0 or absent DIEA and Type 4 or four-trunk DIEA). There was also shown to be no overall concordance in the branching patterns of the DIEA between contralateral sides of the same abdominal wall; however, there was shown to be a statistically significant concordance in cases of a Type 1 DIEA (51% concordance, P = 0.04). As such, a new modification to the classification system for the branching pattern of the DIEA is presented based on imaging findings. Clin. Anat. 23:87,92, 2010. © 2009 Wiley-Liss, Inc. [source]

Cardiac computed tomography: Diagnostic utility and integration in clinical practice

CLINICAL CARDIOLOGY, Issue S1 2006
Matthew J. Budoff M.D.
Abstract Cardiac applications of computed tomography (CT) is a rapidly growing diagnostic area because of the ability to visualize plaque burden (coronary artery calcification [CAC]) and luminal obstruction (computed tomographic angiography [CTA]) noninvasively. Coronary artery calcification has been validated in over 1,000 studies over the last 20 years, primarily with electron beam tomography. Studies demonstrate several indications that could aid physicians in the management of symptomatic and asymptomatic patients. Determining that a symptomatic patient has no CAC is associated with both a lower risk of an abnormal nuclear study and angiographic obstruction. The ability to detect subclinical atherosclerosis (CAC) with minimal radiation and no contrast makes this an attractive method for risk stratification. New studies demonstrate a 10-fold risk of cardiovascular events with increasing amounts of coronary calcification. The invasive nature, expense, and risk resulting from invasive angiography have been instrumental in encouraging the development of new diagnostic methods that allow the coronary arteries to be visualized noninvasively. Multislice CT, with its advanced spatial and temporal resolution, has opened up new possibilities in the imaging of the heart and major vessels of the chest, including the coronary arteries. The last decade has seen great strides in the field of cardiac imaging, particularly in the ability to visualize the coronary lumen with sufficient diagnostic accuracy. Possessing that qualification, CTA is now being used increasingly in clinical practice. As a result of having high spatial and improved temporal resolutions, this imaging modality not only allows branches of the coronary artery to be evaluated, but also allows simultaneous analysis of other cardiac structures, making it extremely useful for other cardiac applications. This paper reviews the diagnostic utility and limitations of cardiac CT and how it could be integrated into clinical practice. [source]