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New Perspectives in Surgical Marking Since the Advent of Infrared Laser Angiography
摘要： This study investigates the utility of common surgical dyes under direct visualization and infrared laser angiography. Pigments affecting light within the visual (λ = 400–700 nm) and infrared (λ = 700–1000 nm) spectra were placed on subjects spanning the Fitzpatrick scale. Photometric properties of these pigments were assessed under direct visualization and infrared laser angiography. Among patients of various Fitzpatrick classifications, black ink pigment and pigment within the violet spectrum (λ = 380–450 nm) were most distinguishable under direct visualization. Colored inks, gentian violet and methylene blue dyes, were not visualized under infrared laser angiography. Black permanent ink appeared under both direct visualization and infrared laser angiography. Indocyanine green suspended in ethyl alcohol and applied to skin as a marking pen appeared clear under direct visualization and was detectable under infrared laser angiography. Black permanent marking ink allows visualization of surgical markings under infrared laser angiography, whereas gentian violet and methylene blue did not interfere with infrared visualization. Indocyanine green suspended in ethyl alcohol is a contemporary marking pen that may be used to outline anatomical surface landmarks under infrared laser angiography.
关键词： dye,methylene blue,skin marking,surgical marking,infrared laser angiography,marking pen,indocyanine green,gentian violet,surgical planning,ink
更新于2025-09-12 10:27:22
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Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment
摘要： Background and Purpose—Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite. Methods—The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA). Results—Endovascular treatment was successful in 26 patients (Thrombolysis in Cerebral Infarction, 2b-3). Overall, the median preinterventional PBV-deficit was 9×larger than median final infarct volume on multislice-CT (86.4 mL [10.3; 111.6] versus 9.6 mL [3.6; 36.8]). This was especially evident in the subgroup of successful recanalization (PBV-deficit: 87.5 mL [10.6; 115.1], final infarct: 8.7 mL [3.6; 29]). In futile recanalization, the final infarct tended to be underestimated (PBV-deficit: 86.4 mL [5.9; –] and final infarct: 116.4 mL [3.5; –]). Conclusions—Flat panel detector CT-PBV is not reliable in predicting the final infarct volume and should not be used in clinical decision making for endovascular treatment of acute cerebral artery occlusions.
关键词： middle cerebral artery,angiography,prognosis,cerebral infarction,blood volume
更新于2025-09-11 14:15:04
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Retinal and Choroidal Perfusion Status in the Area of Laser Scars Assessed With Swept-Source Optical Coherence Tomography Angiography
摘要： To evaluate the perfusion status of the retina and choriocapillaris in the area of laser scars on swept-source optical coherence tomography angiography (OCTA) images of eyes previously treated with panretinal photocoagulation (PRP).
关键词： diabetic retinopathy,OCT angiography,laser photocoagulation,choriocapillaris
更新于2025-09-11 14:15:04
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Analysis of Choroidal Thickness and Vascular Density Using Optical Coherence Tomography Angiography after Laser Photocoagulation
摘要： Purpose: To evaluate the changes in choroidal thickness and superficial vascular density of the macula and optic disc using optical coherence tomography angiography after laser photocoagulation. Methods: We conducted a retrospective chart review of 25 eyes of diabetic retinopathy patients who underwent panretinal photocoagulation. The macula and optic disc were divided into nine areas, and the vascular density of each area was quantitatively measured using optical coherence tomography angiography. The changes in vascular density and choroidal thickness were analyzed before laser photocoagulation and at 1 week after, 1 month after, and 3 months after treatment. Results: In the panretinal photocoagulation group, the average vascular densities of the macula were 13.5 ± 3.6 mm-1 before treatment, and 14.7 ± 3.1 mm-1 after 1 week, 13.7 ± 2.6 mm-1 after 1 month, and 12.8 ± 3.8 mm-1 after 3 months of treatment. The average vascular densities of the optic disc were 14.7 ± 5.2 mm-1 before treatment, and 14.1 ± 4.7 mm-1 after 1 week, 14.8 ± 5.3 mm-1 after 1 month, and 15.0 ± 4.7 mm-1 after 3 months of treatment. The average subfoveal choroidal thicknesses were 327.5 ± 57.9 μm before treatment, and 334.4 ± 52.5 μm after 1 week, 291.2 ± 52.9 μm after 1 month, and 286.3 ± 44.4 μm after 3 months of treatment. Conclusions: The vascular density of the macula increased temporarily after 1 week of treatment but decreased afterwards. The vascular density of the optic disc decreased after 1 week of laser treatment but increased over time. The subfoveal choroidal thickness increased after 1 week of laser treatment but decreased afterwards.
关键词： Vascular density,Panretinal photocoagulation,Optical coherence tomography angiography
更新于2025-09-11 14:15:04
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Evaluation of the Intraoperative Blood Flow of Pedicled Perforator Flaps Using Indocyanine Green-fluorescence Angiography
摘要： Background: Although indocyanine-green fluorescence angiography (ICG-FA) has been established as a useful tool to assess perfusion in free tissue transfer, only few studies have applied this modality to pedicled perforator flaps. As both volume and reach of pedicled perforator flaps are limited and tip necrosis often equals complete flap failure, ICG-FA may help to detect hypoperfusion in pedicled flaps. Methods: In 5 patients, soft tissue reconstruction was achieved with pedicled perforator flaps. ICG-FA was utilized intraoperatively to visualize flap perfusion. Results: Three pedicled anterolateral thigh flap flaps and 2 propeller flaps were transferred. ICG-FA detected hypoperfusion in 2 flaps. No flap loss occurred; in 2 cases, prolonged wound healing was encountered. Conclusions: ICG-FA confirmed clinical findings and reliably detected tissue areas with hypoperfusion. A clear cut-off point between nonvital tissue and such that stabilized in the following clinical course could not be found. ICG-FA is a promising technology which could also be used in pedicled perforator flaps.
关键词： flap perfusion,soft tissue reconstruction,pedicled perforator flaps,indocyanine-green fluorescence angiography
更新于2025-09-11 14:15:04
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Assessing the Use of Incorrectly Scaled Optical Coherence Tomography Angiography Images in Peer-Reviewed Studies
摘要： IMPORTANCE Individual differences in axial length affect the lateral magnification of in vivo retinal images and as a result can affect the accuracy of quantitative measurements made from these images. As measurements from optical coherence tomography angiography (OCTA) images are becoming increasingly used in the diagnosis and monitoring of a wide range of diseases, evaluating which studies use correctly scaled images is crucial to their interpretation. OBJECTIVE To perform a systematic literature review to assess the percentage of articles that report correcting the scale of their OCTA images for individual differences in retinal magnification. EVIDENCE REVIEW A PubMed (MEDLINE) search was conducted for articles on OCTA retinal imaging published between June 1, 2015, and June 1, 2018. Initial results included 7552 articles. Initial exclusion criteria removed studies of animal models, as well as reviews, letters, replies, comments, and image-based or photographic essays. Articles not written in English and those that required purchase from non–English language websites were excluded. Articles that did not use OCTA for imaging the retina were also excluded. Remaining articles were reviewed in detail to assess whether the OCTA measurements required correct lateral scaling, and if so, whether axial length was reported or used to scale the images. We also determined the number of articles that mentioned the lack of correct lateral scaling as a limitation of the study. FINDINGS A total of 989 articles were included in the detailed review. Of these, 509 were determined to require correct image scaling for their analyses, but only 41 (8.0%) report measuring and using axial length to correct the lateral scale of their OCTA images. Furthermore, of the 468 articles that did not correctly scale their images, only 18 (3.8%) mentioned this as a limitation to their study. CONCLUSIONS AND RELEVANCE These findings suggest that most peer-reviewed articles in PubMed that use quantitative OCTA measurements use incorrectly scaled images. This could call into question the conclusions of such studies and warrants consideration by OCTA manufacturers, physicians, authors, journal reviewers, and journal editors.
关键词： retinal imaging,axial length,optical coherence tomography angiography,lateral scaling,OCTA
更新于2025-09-11 14:15:04
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Coronary computed tomography: current role and future perspectives for cardiovascular risk stratification
摘要： Coronary computed tomography: current role and future perspectives for cardiovascular risk stratification. F. Musella, R. Formisano, G. Mattiello, E. Iardino, L. Petraglia, A. Vitagliano, I. Fabiani, A.P. Cirillo, M. Petito, P. Perrone-Filardi. Atherosclerotic coronary artery disease (CAD) is a major cause of morbidity and mortality. The majority of cardiovascular events, more than 50% of CAD deaths, occur in previously asymptomatic individuals at intermediate cardiovascular risk, highlighting the relevance of accurate individual risk assessment to decrease cardiovascular events through more appropriate targeting of preventive measures. In the last decades, the development of non-invasive imaging techniques have prompted interest in imaging of atherosclerosis. Coronary computed tomography provides the opportunity to assess the deposition of calcium in the coronary tree and to non-invasively image coronary vessels. Both information are useful for risk stratification of asymptomatic subjects or of subjects with suspected CAD.
关键词： cardiovascular imaging,coronary artery disease,coronary calcium score,atherosclerosis,coronary CT angiography.
更新于2025-09-10 09:29:36
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Transanal total mesorectal excision for rectal cancer with indocyanine green fluorescence angiography
摘要： Background The aim of this study was to evaluate the impact of fluorescence angiography (FA) on any change in proximal resection margin and/or anastomotic leak (AL) following transanal total mesorectal excision (TaTME) for rectal cancer (RC). Methods This retrospective cohort study was conducted at two centers by three senior surgeons. Both institutions’ prospectively maintained Institutional Review Board-approved databases were retrospectively queried for all consecutive patients between July 2015 and May 2017 who had laparoscopic hybrid trans-abdominal total mesorectal excision (TME) and TaTME for RC with colorectal or coloanal anastomosis < 10?cm from the anal verge. All patients had intraoperative FA to assess colonic perfusion of the planned proximal resection margin before bowel transection and after construction of the anastomosis. Primary outcomes measured any changes in proximal resection margins and AL rates. Results Fifty-four patients (31 males; mean age 63 ± 12?years) were included; 30 (55%) of whom received neoadjuvant chemoradiation. The average anastomotic height was 3.6?cm from the anal verge and 8 (14.5%) patients required intersphincteric dissection. Forty-six patients (85%) had loop ileostomy. FA led to a change in the proximal resection margin in 10 patients (18.5%), one of whom had AL on postoperative day 3 requiring diagnostic laparoscopy and loop ileostomy. A second patient, without a change in the proximal resection margin, also had an AL. The overall AL rate was 3.7%. Conclusions FA changed the planned proximal resection margin in 18.5% of patients, possibly accounting for the relatively low AL rate. FA is imperfect, and subjective but does have the potential to improve outcomes.
关键词： Transanal total mesorectal excision,Fluorescence angiography,Indocyanine green,Anastomotic leak,Rectal cancer,Resection margin
更新于2025-09-10 09:29:36
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Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis
摘要： Purpose To evaluate pre-operative and post-operative morphologic characteristics in idiopathic macular epiretinal membrane (ERM) by optical coherence tomography angiography (OCTA). Methods Thirty-three subjects with unilateral idiopathic ERM were enrolled and the contralateral eyes served as controls. Vascular parameters including super?cial capillary plexus (SCP), deep capillary plexus (DCP), outer capillary plexus (OCP), and choroidal capillary plexus (CCP) were evaluated by OCTA. Results The super?cial foveal avascular zone (FAZ) was signi?cantly smaller in eyes with ERM (P < 0.0001). The vessel densities (VDs) were signi?cantly increased in the fovea but dramatically decreased in the parafovea in SCP and DCP of ERM eyes (all P < 0.0001), in contrast to those in OCP and CCP. The blood ?ow was augmented in OCP but declined in choroid compared with the controls. In CCP, the mean foveal VD in ERM was signi?cantly smaller (P = 0.023), whereas parafoveal VD did not signi?cantly change (P = 0.66). At 6 months after surgery, ?ow area was decreased in OCP (P = 0.0007), and foveal and parafoveal VDs were signi?cantly altered in all layers except the foveal VD in OCP and the choroid (all P < 0.05). The total and inner retinal thickness of the fovea and parafovea were correlated with pre-operative and post-operative visual outcomes, respectively. Smaller FAZ and greater interocular differences between post-operative and fellow eyes in FAZ were associated with worse post-operative visual outcomes. Conclusions OCTA provides a better display of the vascular network of the retina and choroid to evaluate the severity and surgical prognosis of ERM patients.
关键词： Microvasculature,Vitrectomy,Epiretinal membrane,Optical coherence tomography angiography
更新于2025-09-10 09:29:36
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Changes in retinal flow density measured by optical coherence tomography angiography in patients with carotid artery stenosis after carotid endarterectomy
摘要： The aim of the study presented here was to evaluate retinal and optic nerve head (ONH) perfusion in patients with severe asymptomatic carotid artery stenosis (CAS) compared with healthy controls and to analyze the impact of carotid endarterectomy using optical coherence tomography angiography (OCT-A). 25 eyes of 25 patients with CAS (study group) and 25 eyes of 25 healthy controls (control group) were prospectively included in this study. OCT-A was performed using RTVue XR Avanti (Optovue, Inc, Fremont, California, USA). The flow density data in the superficial and deep retinal OCT-angiogram of the macula and in the radial peripapillary capillary network (RPC) of the ONH were extracted and analyzed. The flow density in the superficial retinal OCT angiogram of the macula and in the ONH were significantly lower in the study group compared with the control group (macula: p = 0.003) (ONH: p = 0.013). The flow density in the ONH improved significantly after carotid endarterectomy (p = 0.004). A reduced flow density was observed in patients with CAS when compared with healthy controls. The flow density also improved after carotid endarterectomy. Quantitative changes in the microvascular density, as measured using OCT-A, could well be useful in the diagnosis of CAS and the evaluation of therapy success.
关键词： carotid endarterectomy,optical coherence tomography angiography,carotid artery stenosis,retinal flow density
更新于2025-09-10 09:29:36