what is the name of dye used in coronary angiography
CT - visible dye
2943024
of the newest innovations in coronary stents is the development of a dissolving stent. Abbott Laboratories has used a dissolvable material, polylactic acid, that will completely absorb within 2 years of being implanted. CT angiography can act as a less invasive alternative to Catheter angiography. Instead of a catheter being inserted into a vein or artery, CT angiography involves only the injection of a CT-visible dye into the arm or hand via an IV line. CT angiography lowers the risk of arterial perforation and catheter site infection. It provides 3D images that can be studied on computer, and also allows
Coronary catheterization
2943024
of the newest innovations in coronary stents is the development of a dissolving stent. Abbott Laboratories has used a dissolvable material, polylactic acid, that will completely absorb within 2 years of being implanted. CT angiography can act as a less invasive alternative to Catheter angiography. Instead of a catheter being inserted into a vein or artery, CT angiography involves only the injection of a CT-visible dye into the arm or hand via an IV line. CT angiography lowers the risk of arterial perforation and catheter site infection. It provides 3D images that can be studied on computer, and also allows
Coronary catheterization
17950131
the cells and cause them to die, weakening the vessels further. The activation of the inflammatory response causes a detectable increase in C reactive protein, interleukin-6, tumor necrosis factor alpha and cell adhesion molecules, which can be used as a diagnostic marker. To discover the extent and severity of coronary artery ectasia there are a variety of diagnostic tools used. The most common method for discovering the disease is through angiography. Angiography is the procedure where a contrast dye is entered into the vessels and an x-ray is taken, which will allow the vessels to be seen on the x-ray.
Coronary artery ectasia
677623
to measure pulse pressure or pulmonary wedge pressures. Angiography, which involves injecting a dye into an artery to visualise an arterial tree, can be used in the heart (coronary angiography) or brain. At the same time as the arteries are visualised, blockages or narrowings may be fixed through the insertion of stents, and active bleeds may be managed by the insertion of coils. An MRI may be used to image arteries, called an MRI angiogram. For evaluation of the blood supply to the lungs a CT pulmonary angiogram may be used. Vascular ultrasonography include for example: There are a number
Circulatory system
15700344
through a catheter inserted into the heart through blood vessels in the leg to determine the functioning of the heart, and, following injections of radiocontrast dye, uses X-ray fluoroscopy, typically at 30 frames per second, to visualize the position and volume of blood within the heart chambers and arteries. Coronary angiography is used to determine the patency and configuration of the coronary artery lumens. "Transthoracic echocardiogram" uses ultrasonic waves for continuous heart chamber and blood movement visualization. In recent times, it has become one of the most commonly used tools in diagnosis of heart problems, as it allows non-invasive visualization
Cardiac imaging
3061579
injectable dye. This new OCT angiography (OCTA) technique is still in development, but has shown promise for assessing retinal microvasculature pathology. OCTA has the potential for evaluating the effects of intensified antithrombotic therapy. Future research and development will extend the use of OCTA beyond the realm of ophthalmology. In the setting of cardiology, OCT is used to image coronary arteries in order to visualize vessel wall lumen morphology and microstructure at a resolution 10 times higher than other existing modalities such as intravascular ultrasounds and x-ray angiography (Intracoronary Optical Coherence Tomography). For this type of application, approximately 1 mm in
Optical coherence tomography
9996126
Computed tomography angiography Computed tomography angiography (also called CT angiography or CTA) is a computed tomography technique used to visualize arterial and venous vessels throughout the body. This ranges from arteries serving the brain to those bringing blood to the lungs, kidneys, arms and legs. CTA can be used to examine blood vessels in many key areas of the body, including the brain, kidneys, pelvis, and the lungs. Coronary CT angiography (CTA) is the use of CT angiography to assess the coronary arteries of the heart. The subject receives an intravenous injection of radiocontrast and then the heart is scanned
Computed tomography angiography
2588774
breath-hold time than MRI. Fluorescein angiography is a medical procedure in which a fluorescent dye is injected into the bloodstream. The dye highlights the blood vessels in the back of the eye so they can be photographed. This test is often used to manage eye disorders. An ocular OCT angiography (OCTA) imaging technique, is currently under development to simulate results of fluorescein angiography without the need to inject intravenous dye into patients. Microangiography is commonly used to visualize tiny blood vessels. Another increasingly common angiographic procedure is neuro-vascular digital subtraction angiography in order to visualise the arterial and venous supply
Angiography
10397891
percutaneous coronary intervention (PCI) is usually based on angiographic results alone. Angiography can be used for the visual evaluation of the inner diameter of a vessel. In ischemic heart disease, deciding which narrowing is the culprit lesion is not always clear-cut. Fractional flow reserve provides a functional evaluation, by measuring the pressure decline caused by a vessel narrowing. FFR has certain advantages over other techniques to evaluate narrowed coronary arteries, such as coronary angiography, intravascular ultrasound or CT coronary angiography. For example, FFR takes into account collateral flow, which can render an anatomical blockage functionally unimportant. Also, standard angiography can
Fractional flow reserve
15651819
of the coronary arteries, regardless of patient heart rate. The latest MSCT scanners acquire images only at 70-80% of the R-R interval (late diastole). This prospective gating can reduce effective dose from 10-15 mSv to as little as 1.2 mSv in follow-up patients acquiring at 75% of the R-R interval. Effective dose using MSCT coronary imaging can average less than the dose in conventional coronary angiography. Coronary CT angiography Coronary CT angiography (CTA) is the use of computed tomography (CT) angiography to assess the coronary arteries of the heart. The subject receives an intravenous injection of radiocontrast and then the
Coronary CT angiography
6650094
dye load is significantly higher than that used in arteriography. However, IV-DSA has been used successfully to study the vessels of the brain and heart and has helped detect carotid artery obstruction and to map patterns of cerebral blood flow. It also helps detect and diagnose lesions in the carotid arteries, a potential cause of strokes. IV-DSA has also been useful in assessing patients prior to surgery and after coronary artery bypass surgery and some transplant operations. DSA is primarily used to image blood vessels. It is useful in the diagnosis and treatment of: DSA is done less and less
Digital subtraction angiography
15651809
Coronary CT angiography Coronary CT angiography (CTA) is the use of computed tomography (CT) angiography to assess the coronary arteries of the heart. The subject receives an intravenous injection of radiocontrast and then the heart is scanned using a high speed CT scanner, allowing physicians to assess the extent of occlusion in the coronary arteries, usually in order to diagnose coronary artery disease. CTA is superior to coronary CT calcium scan in determining the risk of Major Adverse Cardiac Events (MACE). Faster CT machines, due to multidetector capabilities, have made imaging of the heart and circulatory system very practical in
Coronary CT angiography
4172219
Cardiac catheterization Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes. Subsets of this technique are mainly coronary catheterization, involving the catheterization of the coronary arteries, and catheterization of cardiac chambers and valves of the cardiac system. "Cardiac catheterization" is a general term for a group of procedures that are performed using this method, such as coronary angiography and left ventricle angiography. Once the catheter is in place, it can be used to perform a number of procedures including, coronary angioplasty, balloon
Cardiac catheterization
6334393
the coronary arteries, however, MRA has been less successful than CT angiography or invasive catheter angiography. Most often, the underlying disease is atherosclerosis, but medical conditions like aneurysms or abnormal vascular anatomy can also be diagnosed. An advantage of MRA compared to invasive catheter angiography is the non-invasive character of the examination (no catheters have to be introduced in the body). Another advantage, compared to CT angiography and catheter angiography, is that the patient is not exposed to any ionizing radiation. Also, contrast media used for MRI tend to be less toxic than those used for CT angiography and catheter
Magnetic resonance angiography
20998969
at the expense of image quality. For comparison, typical fundus images have a surface area of around 400mm2. Other methods of angiography have existed long before the development of OCTA. The current gold standards of angiography, fluorescein angiography (FA) and indocyanine green angiography (ICGA), both require dye to be injected. OCTA does not need dye, but this method takes a long time to capture an image and is susceptible to motion artefacts. The dyes used in FA and ICGA can cause nausea, vomiting, and general discomfort, and only have an effective lifetime on the order of a few minutes. In
Optical coherence tomography angiography
3782833
Fluorescein angiography Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. Sodium fluorescein is added into the systemic circulation, the retina is illuminated with blue light at a wavelength of 490 nanometers, and an angiogram is obtained by photographing the fluorescent green light that is emitted by the dye. The fluorescein is administered intravenously in intravenous fluorescein angiography (IVFA) and orally in oral fluorescein angiography (OFA). The test is a dye tracing method. The
Fluorescein angiography
13413653
Indocyanine green Indocyanine green (ICG) is a cyanine dye used in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. It has a peak spectral absorption at about 800 nm. These infrared frequencies penetrate retinal layers, allowing ICG angiography to image deeper patterns of circulation than fluorescein angiography. ICG binds tightly to plasma proteins and becomes confined to the vascular system. ICG has a half-life of 150 to 180 seconds and is removed from circulation exclusively by the liver to bile juice. ICG is a fluorescent dye which is
Indocyanine green
15651812
every 100 patients who have a negative CT angio test result (i.e. the test says they do not have coronary artery disease), 7 will actually have the disease as defined by the reference standard of invasive coronary angiography via cardiac catheterization. Both coronary CT angiography and invasive angiography via cardiac catheterization yield similar diagnostic accuracy when both are being compared to a third reference standard such as intravascular ultrasound or fractional flow reserve. In addition to the diagnostic abilities, cardiac CTA beholds important prognostic information. Stenosis severity and extent of coronary artery disease are important prognostic indicators. However, one of
Coronary CT angiography
12513518
format to a central server at the Uppsala Clinical Research Center. All consecutive patients undergoing coronary angiography or PCI in Sweden are registered in this database which provides a unique opportunity for prospective observational studies within the field of interventional cardiology. Scaar SCAAR (Swedish Coronary Angiography and Angioplasty Register) The SCAAR is a Swedish national registry that contains relevant medical data on consecutive patients from 29 hospitals in Sweden at which coronary angiography and PCI (percutaneous coronary interventions) are performed. The registry was established in 1989. It is sponsored by the National Board of Health and Welfare and is independent
Scaar
10397894
with multivessel coronary artery disease. In 20 centers in Europe and the United States, 1005 patients undergoing percutaneous coronary intervention with drug eluting stent implantation were randomized to intervention based on angiography or based on fractional flow reserve in addition to angiography. In the angiography arm of the study, all suspicious-looking lesions were stented. In the FFR arm, only angiographically suspicious lesions with an FFR of 0.80 or less were stented. In the patients whose care was guided by FFR, fewer stents were used (2.7±1.2 and 1.9±1.3, respectively). After one year, the primary endpoint of death, nonfatal myocardial infarction, and
Fractional flow reserve
15651811
This is because the test is highly sensitive (over 90% detection rate), so a negative test result largely rules out coronary artery disease (i.e. the test has a high negative predictive value). The test is somewhat less specific, however, so a positive result is less conclusive and may need to be confirmed by subsequent invasive angiography. The positive predictive value of cardiac CTA is approximately 82% and the negative predictive value is around 93%. This means for every 100 patients who appear to have coronary artery disease after CT angiography, 18 of them actually won't have it, and that for
Coronary CT angiography
18103312
who are low risk generally do not. Coronary artery calcium scoring is a diagnosic test in the field of cardiovascular x-ray computed tomography. It is used to screen for coronary artery disease. Asymptomatic people who have low risk, including a lack of family history of premature coronary artery disease, should not be screened with this test. Coronary computed tomography angiography should not be used to screen people who are asymptomatic. Additionally, this test rarely provides insight which cannot be gained from coronary artery calcium scoring. Overscreening has been called "unethical". Overscreening Overscreening, also called unnecessary screening, is the performance of
Overscreening
6393309
carried out by other personnel, such as trained nurses or technologists. Cardiac catheterization is a general term for a group of procedures that are performed in the cath lab, such as coronary angiography. Once a catheter is in place, it can be used to perform a number of procedures including angioplasty, PCI (percutaneous coronary intervention) angiography, transcatheter aortic valve replacement, balloon septostomy, and an electrophysiology study or catheter ablation. Devices such as pacemakers may be fitted, or rotablation to remove plaque can be performed. Cath lab A catheterization laboratory or cath lab is an examination room in a hospital or
Cath lab
72580
admission and close observation on a coronary care unit for possible complications (such as cardiac arrhythmias – irregularities in the heart rate). Depending on the risk assessment, stress testing or angiography may be used to identify and treat coronary artery disease in patients who have had an NSTEMI or unstable angina. There are various risk assessment systems for determining the risk of coronary artery disease, with various emphasis on different variables above. A notable example is Framingham Score, used in the Framingham Heart Study. It is mainly based on age, gender, diabetes, total cholesterol, HDL cholesterol, tobacco smoking and systolic
Coronary artery disease
3782836
Additionally, the transit time (the period between injection of the dye and when it appears in the examined blood vessels) can provide an objective measurement of the rate of blood flow through the imaged blood vessels. Fluorescein angiography Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. Sodium fluorescein is added into the systemic circulation, the retina is illuminated with blue light at a wavelength of 490 nanometers, and an angiogram is obtained by
Fluorescein angiography
1600162
is "CABG" (pronounced 'cabbage'), pluralized as "CABGs" (pronounced 'cabbages'). Initially the term "aortocoronary" "bypass" (ACB) was more popularly used to describe this procedure. "CAGS" (coronary artery graft surgery, pronounced phonetically) should not be confused with coronary angiography (CAG). The terms "single bypass", "double bypass", "triple bypass", "quadruple bypass" and "quintuple bypass" refer to the number of coronary arteries bypassed in the procedure. In other words, a double bypass means two coronary arteries are bypassed (e.g., the left anterior descending (LAD) coronary artery and right coronary artery (RCA)); a triple bypass means three vessels are bypassed (e.g., LAD, RCA and left
Coronary artery bypass surgery
17573487
Instantaneous wave-free ratio The instantaneous wave-free ratio (iFR, sometimes referred to as the instant wave-free ratio or instant flow reserve) is a diagnostic tool used to assess whether a stenosis is causing a limitation of blood flow in coronary arteries with subsequent ischemia. iFR is performed during cardiac catheterisation (angiography) using invasive coronary pressure wires which are placed in the coronary arteries that are to be assessed. Pressure wires are commonly used by interventional cardiologists to guide decisions to perform revascularization, either by stenting or bypass surgery. Coronary artery blockages or stenoses that limit blood flow to the heart muscle
Instantaneous wave-free ratio
10066622
in a limited number of fixed tip shapes. Catheters in these shapes carry his name and are still used to this day for selective coronary angiography. The use of tapered Teflon dilating catheters for the treatment of atherosclerotic vascular disease was first described in 1964 by two interventional radiologists, Charles Dotter and Melvin Judkins, when they used it to treat a case of atherosclerotic disease in the superficial femoral artery of the left leg. Building on their work and his own research involving balloon-tipped catheters, Andreas Gruentzig performed the first success percutaneous transluminal coronary angioplasty (known as PTCA or percutaneous
History of invasive and interventional cardiology
11072824
a stent follows the same steps as other angioplasty procedures with a few important differences. The interventional cardiologist uses angiography to assess the location and estimate the size of the blockage ("lesion") by injecting a contrast medium through the guide catheter and viewing the flow of blood through the downstream coronary arteries. Intravascular ultrasound (IVUS) may be used to assess the lesion's thickness and hardness ("calcification"). The cardiologist uses this information to decide whether to treat the lesion with a stent and if so, what kind and size. Drug-eluting stents are most often sold as a unit, with the stent
Coronary stent
14974872
which is why blood tests for them are taken over a 24-hour period. Because these enzyme levels are not elevated immediately following a heart attack, patients presenting with chest pain are generally treated with the assumption that a myocardial infarction has occurred and then evaluated for a more precise diagnosis. In difficult cases or in situations where intervention to restore blood flow is appropriate, coronary angiography can be performed. A catheter is inserted into an artery (usually the femoral artery) and pushed to the vessels supplying the heart. A radio-opaque dye is administered through the catheter and a sequence of
Myocardial infarction diagnosis
15651813
the unique features of cardiac CTA is the fact that it enables the visualization of the vessel wall, in a non-invasive manner. Therefore, the technique is able to identify characteristics of coronary artery disease that are associated to the development of acute coronary syndrome. Because the heart is effectively imaged more than once (described above), cardiac CT angiography can result in a relatively high radiation exposure (around 12 millisievert), although newer acquisition protocols, have recently been developed which drastically reduce this exposure to around 1 mSv (cfr. Pavone, Fioranelli, Dowe: Computed Tomography or Coronary Arteries, Springer 2009). By comparison, a
Coronary CT angiography
12513517
Scaar SCAAR (Swedish Coronary Angiography and Angioplasty Register) The SCAAR is a Swedish national registry that contains relevant medical data on consecutive patients from 29 hospitals in Sweden at which coronary angiography and PCI (percutaneous coronary interventions) are performed. The registry was established in 1989. It is sponsored by the National Board of Health and Welfare and is independent of funding from industry. The data technology was developed by, and is administered by the Uppsala Clinical Research Center (). Since 2001, SCAAR has been Internet-based, with recording of data online through a Web interface. Data are transferred in an encrypted
Scaar
9996127
using a high speed CT scanner, allowing radiologists to assess the extent of occlusion in the coronary arteries, usually in order to diagnose coronary artery disease. CTA has not replaced invasive catheter coronary angiography. The procedure is able to detect narrowing of blood vessels in time for corrective therapy to be done. This method displays the anatomical detail of blood vessels more precisely than magnetic resonance imaging (MRI) or ultrasound. Today, many patients can undergo CTA in place of a conventional catheter angiogram. CTA is a useful way of screening for arterial disease because it is safer and much less
Computed tomography angiography
20998959
the resolution needed to detect the tiny capillaries found in the retina. Recent advancements in OCT acquisition speed have made it possible the required sampling density to obtain a high enough resolution for OCTA. This has allowed OCTA to become widely used clinically to diagnose a variety of ophthalmological diseases, such as, age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma. Prior to the emergence of OCTA, the most common angiographic techniques were fluorescein (FA) or indocyanine green angiography (ICGA), which both involve the use of an injectable dye. Intravenous dye injection is time consuming and
Optical coherence tomography angiography
2588773
be clearly determined. Coronary angiography can visualize coronary artery stenosis, or narrowing of the blood vessel. The degree of stenosis can be determined by comparing the width of the lumen of narrowed segments of blood vessel with wider segments of adjacent vessel. To detect coronary artery disease, a CT scan is more satisfactory than an MRI scan. The sensitivity and specificity between CT and MRI were (97.2 percent and 87.4 percent) and (87.1 percent and 70.3 percent), respectively. Therefore, CT (mainly multislice CT) is more accepted, more widely available, more favored by patients, and more economic. Moreover, CT requires shorter
Angiography
15651816
arrhythmias, coronary artery stents and tachycardia may result in a reduced image quality. With the advent of subsecond rotation combined with multi-slice CT (up to 320 slices), high resolution and high speed can be obtained at the same time, allowing excellent imaging of the coronary arteries (cardiac CT angiography). Images with even higher temporal resolution can be obtained using multi-cycle (also called multi-segmental) image reconstruction. In this technique, a portion of the heart is imaged during one heart cycle while an ECG trace is recorded. During the next heart cycle, the next portion of the heart is scanned for up
Coronary CT angiography
72577
an electrocardiogram (ECG/EKG), both for "stable" angina and acute coronary syndrome. An X-ray of the chest and blood tests may be performed. In "stable" angina, chest pain with typical features occurring at predictable levels of exertion, various forms of cardiac stress tests may be used to induce both symptoms and detect changes by way of electrocardiography (using an ECG), echocardiography (using ultrasound of the heart) or scintigraphy (using uptake of radionuclide by the heart muscle). If part of the heart seems to receive an insufficient blood supply, coronary angiography may be used to identify stenosis of the coronary arteries and
Coronary artery disease
8931966
and better recovery rates. Post centrifugation the supernatant above and the cushion below is removed, leaving a concentrated sperm pellet in the conical tube. Iodixanol Iodixanol is an iodine-containing non-ionic radiocontrast agent. It is sold under the trade name Visipaque; it is also sold as a density gradient medium under the name OptiPrep. Visipaque is commonly used as a contrast agent during coronary angiography. It is the only iso-osmolar contrast agent, with an osmolality of 290 mOsm/kg HO, the same as blood. It is sold in 2 main concentrations 270 mgI/ml and 320 mgI/ml - hence the name Visipaque 270
Iodixanol
8931964
Iodixanol Iodixanol is an iodine-containing non-ionic radiocontrast agent. It is sold under the trade name Visipaque; it is also sold as a density gradient medium under the name OptiPrep. Visipaque is commonly used as a contrast agent during coronary angiography. It is the only iso-osmolar contrast agent, with an osmolality of 290 mOsm/kg HO, the same as blood. It is sold in 2 main concentrations 270 mgI/ml and 320 mgI/ml - hence the name Visipaque 270 or 320. It is sold in single dose units and a large 500ml plastic bottle for multi-dose dispensing. It was originally made by Nycomed,
Iodixanol
14988909
segment elevation are presumed to be experiencing either unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). They receive many of the same initial therapies and are often stabilized with antiplatelet drugs and anticoagulated. If their condition remains (hemodynamically) stable, they can be offered either late coronary angiography with subsequent restoration of blood flow (revascularization), or non-invasive stress testing to determine if there is significant ischemia that would benefit from revascularization. If hemodynamic instability develops in individuals with NSTEMIs, they may undergo urgent coronary angiography and subsequent revascularization. The use of thrombolytic agents is contraindicated in this patient subset,
Management of acute coronary syndrome
2588772
the most common angiograms performed is to visualize the blood in the coronary arteries. A long, thin, flexible tube called a catheter is used to administer the X-ray contrast agent at the desired area to be visualized. The catheter is threaded into an artery in the forearm, and the tip is advanced through the arterial system into the major coronary artery. X-ray images of the transient radiocontrast distribution within the blood flowing inside the coronary arteries allows visualization of the size of the artery openings. The presence or absence of atherosclerosis or atheroma within the walls of the arteries cannot
Angiography
9630552
can influence the intensity of dyes. Each sampling area is analyzed by a quantitative instrument to test the background fluorescence. Each dye has significant performance factors that distinguish it in different settings. These factors influence how each dye interacts and is affected by each environment. Therefore, one dye can be particularly useful in one environment, whereas it could be inadequate another. These performance factors include: Typical application of water flow tracing include: Dye tracing may be used for the analysis of blood circulation within various parts of the human or animal body. For example, fluorescent angiography, a technique of analysis
Dye tracing
3483554
in cases where routine coronary angiography gives equivocal results. Many studies in the past have shown that significant left main disease can increase mortality, and that intervention (either coronary artery bypass graft surgery or percutaneous coronary intervention) to reduce mortality is necessary when the left main stenosis is significant. When using IVUS to determine whether an individual's left main disease is clinically significant, in terms of the desirability of physical intervention, the two most widely used parameters are the degree of stenosis and the minimal lumen area. A cross sectional area of ≤7 mm² in a symptomatic individual or ≤6
Intravascular ultrasound
72579
indicative of an acute myocardial infarction (MI); this is termed a STEMI (ST-elevation MI) and is treated as an emergency with either urgent coronary angiography and percutaneous coronary intervention (angioplasty with or without stent insertion) or with thrombolysis ("clot buster" medication), whichever is available. In the absence of ST-segment elevation, heart damage is detected by cardiac markers (blood tests that identify heart muscle damage). If there is evidence of damage (infarction), the chest pain is attributed to a "non-ST elevation MI" (NSTEMI). If there is no evidence of damage, the term "unstable angina" is used. This process usually necessitates hospital
Coronary artery disease
20998973
by neovascularization. For example, OCTA may theoretically be used to estimate the depth of melanoma on the surface of the skin by probing how deep abnormal blood vessels are found below the skin. This process is already being applied to melanomas on and within the eye. Optical coherence tomography angiography Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that is capable of visualizing retinal vasculature down to the capillary level without the use of injected dye. OCTA uses low-coherence interferometry to measure changes in backscattered signal intensity or amplitude in order to differentiate areas of blood flow from
Optical coherence tomography angiography
5426264
suspected), and telemetry (monitoring of the heart rhythm). Combination of troponin levels (less than 5 ng/l) with low TIMI scores can help to predict those with low possibility of myocardial infarction and discharge them safely from the emergency department. Coronary CT angiography combined with Troponin levels is also helpful to triage those who are susceptible to ACS. F-fluoride positron emission tomography is also helpful in identifying those with high risk, lipid-rich coronary plaques. The ACI-TIPI score can be used to aid diagnosis; using seven variables from the admission record, this score predicts crudely which patients are likely to have myocardial
Acute coronary syndrome
4172220
septostomy, electrophysiology study or catheter ablation. Procedures can be diagnostic or therapeutic. For example, coronary angiography is a diagnostic procedure that allows the interventional cardiologist to visualize the coronary vessels. Percutaneous coronary intervention, however, involves the use of mechanical stents to increase blood flow to previously blocked (or occluded) vessels. Other common diagnostic procedures include measuring pressures throughout the four chambers of the heart and evaluating pressure differences across the major heart valves. Interventional cardiologists can also use cardiac catheterization to estimate the cardiac output, the amount of blood pumped by the heart per minute. Cardiac catheterization can be used
Cardiac catheterization
3782834
fluorescein dye also reappears in the patient urine, causing the urine to appear darker, and sometimes orange. It can also cause discolouration of the saliva. Fluorescein angiography is one of several health care applications of this dye, all of which have a risk of severe adverse effects. See fluorescein safety in health care applications. Fluorescein angiography does not involve the use of ionizing radiation. "times are approximate" Fluorescein enters the ocular circulation from the internal carotid artery via the ophthalmic artery. The ophthalmic artery supplies the choroid via the short posterior ciliary arteries and the retina via the central retinal
Fluorescein angiography
3623736
to an appropriate stimulus, such as exogenous nitroglycerine, that stimulates release of vasodilators from the endothelium like NO. Endothelial dysfunction is commonly associated with decreased NO bioavailability, which is due to impaired NO production by the endothelium or inactivation of NO by reactive oxygen species. In the coronary circulation, angiography of coronary artery responses to vasoactive agents may be used to test for endothelial function, and venous occlusion plethysmography and ultrasonography are used to assess endothelial function of peripheral vessels in humans. A non-invasive method to measure endothelial dysfunction is % Flow-Mediated Dilation (FMD) as measured by Brachial Artery Ultrasound
Endothelial dysfunction
2198473
of the surgical team, working with Donald B. Effler, head of cardiovascular surgery, F. Mason Sones, Jr., who was in charge of the Angiography Laboratory and William L. Proudfit, head of the Department of Cardiology. In the beginning, the major part of his work revolved around valvular and congenital diseases; later on he became interested in other areas. Every day, having hardly finished working in the operating room, Favaloro would spend hours and hours reviewing coronary angiograms and studying coronary arteries and their relation with the cardiac muscle. The laboratory of Sones, father of the coronary angiography, had the largest
René Favaloro
15651815
low radiation doses used in diagnostic imaging is unknown, although the possibility of increasing cancer incidence across a population is of significant concern. This potential risk must be weighed against the competing risk of not diagnosing a significant health problem in a particular individual, such as coronary artery. Pregnancy is considered a relative contraindication, similarly to many forms of medical imaging in pregnancy. The potential harms to a fetus include the application of X-rays in addition to radiocontrast. Since an iodine-containing contrast agent is used, severe contrast agent allergy, uncontrolled hyperthyroidism or renal function impairment are also relative contraindications. Cardiac
Coronary CT angiography
2774704
sodium. Intravenous or oral fluorescein is used in fluorescein angiography in research and to diagnose and categorize vascular disorders including retinal disease macular degeneration, diabetic retinopathy, inflammatory intraocular conditions, and intraocular tumors. It is also being used increasingly during surgery for brain tumors. Diluted fluorescein dye has been used to localise multiple muscular ventricular septal defects during open heart surgery and confirm the presence of any residual defects. During World War II, German aircrew carried small containers of fluorescein. In the event of parachuting into the sea after being shot down, the dye would be released into the water. This
Fluorescein
14988891
which includes coronary angiography and, if necessary, revascularization with percutaneous coronary intervention or coronary artery bypass surgery. Medical therapy for acute coronary syndromes is based on drugs that act against ischemia and resultant angina and limit the infarct size (i.e., the area of myocardium that is affected), as well as drugs that inhibit clot formation. The latter include antiplatelet agents, which block the activation and aggregation of platelets (cellular blood components that contribute to clot formation), and anticoagulant agents (which attenuate the coagulation cascade). Long-term therapy in acute coronary syndrome survivors is targeted against recurrence and long term complications (secondary
Management of acute coronary syndrome
12759158
mechanism of an MI. MIs are less commonly caused by coronary artery spasms, which may be due to cocaine, significant emotional stress, and extreme cold, among others. A number of tests are useful to help with diagnosis, including electrocardiograms (ECGs), blood tests, and coronary angiography. An ECG, which is a recording of the heart's electrical activity, may confirm an ST elevation MI (STEMI) if ST elevation is present. Commonly used blood tests include troponin and less often creatine kinase MB. Treatment of an MI is time-critical. Aspirin is an appropriate immediate treatment for a suspected MI. Nitroglycerin or opioids may
Myocardial infarction
14988886
Management of acute coronary syndrome Management of acute coronary syndrome is targeted against the effects of reduced blood flow to the afflicted area of the heart muscle, usually because of a blood clot in one of the coronary arteries, the vessels that supply oxygenated blood to the myocardium. This is achieved with urgent hospitalization and medical therapy, including drugs that relieve chest pain and reduce the size of the infarct, and drugs that inhibit clot formation; for a subset of patients invasive measures are also employed (coronary angiography and percutaneous coronary intervention). Basic principles of management are the same for
Management of acute coronary syndrome
17010059
other forms of the so-called white dot syndromes. The diagnosis is made by eliminating all the other possibilities by careful examination by an experienced ophthalmologist, aided with visual field testing and Fluorescein angiography (an intravenous dye used to show the blood vessels at the back of the eye). It is important that the correct diagnosis is made because treatment may be quite different for apparently similar conditions. What happens with PIC depends a lot on the presence or absence of an important complication, Choroidal neovascularization (known as CNV). Often, the inflammation in PIC is self-limiting, not always requiring treatment. However
Punctate inner choroiditis
2943025
measurement of heart ventricle size. Infarct area and arterial calcium can also be observed (however those require a somewhat higher radiation exposure). That said, one advantage retained by Catheter angiography is the ability of the physician to perform procedure such as balloon angioplasty or insertion of a stent to improve blood flow to the artery. Coronary catheterization A coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes. Coronary catheterization is one of the several cardiology diagnostic tests
Coronary catheterization
2132693
and turkeys Diagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid hemorrhage on a computed tomography (CT) scan. If the CT scan is negative but a ruptured aneurysm is still suspected based on clinical findings, a lumbar puncture can be performed to detect blood in the cerebrospinal fluid. Computed tomography angiography (CTA) is an alternative to traditional angiography and can be performed without the need for arterial catheterization. This test combines a regular CT scan with a contrast dye injected into a vein. Once the dye is injected into a vein, it travels to the
Aneurysm
15292124
Cardiac magnetic resonance imaging perfusion Cardiac magnetic resonance imaging perfusion (cardiac MRI perfusion, CMRI perfusion), also known as stress CMR perfusion, is a clinical magnetic resonance imaging test performed on patients with known or suspected coronary artery disease to determine if there are perfusion defects in the myocardium of the left ventricle that are caused by narrowing of one or more of the coronary arteries. CMR perfusion is increasingly used in cardiac imaging to test for inducible myocardial ischaemia and has been well validated against other imaging modalities such as invasive angiography or FFR. Several recent large-scale studies have shown
Cardiac magnetic resonance imaging perfusion
12754334
has a blockage in the arteries. Women and those who are young may show abnormalities on their test even though no signs of coronary ischemia or CAD are present. A coronary angiography is performed only after a stress test or ECG shows a sign of coronary ischemia or CAD. This test is very important in finding where the blockages are in the arteries. This test helps determine if an angioplasty or bypass surgery is needed. During this test the doctor makes a small incision in the patient's groin (femoral) or wrist (radial) and inserts a catheter. The catheter has a
Coronary ischemia
17573489
or SPECT. Alternatively, invasive tests can be performed at the time of angiography, and these include those that measure coronary flow velocity in the vessel, CFR or index flow against pressure gradients such as hyperaemic or basal stenosis resistance (HSR or BSR). More commonly coronary pressure measurements are used as a surrogate for flow measurement and techniques include iFR and fractional flow reserve (FFR). Cardiologists use a combination of these investigations together with the patient's history, symptoms and clinical risk factors to decide if a stenosis requires further treatment. An example of use in clinical practice is seen here. Instantaneous
Instantaneous wave-free ratio
15651810
a number of clinical settings. The faster capability has allowed the imaging of the heart with minimal involuntary motion, which creates motion blur on the image, and has a number of practical applications. It may be useful in the diagnosis of suspected coronary heart disease, for follow-up of a coronary artery bypass, for the evaluation of valvular heart disease and for the evaluation of cardiac masses. It is uncertain whether this modality will replace invasive coronary catheterization. At present, it appears that the greatest utility of cardiac CT lies in ruling out coronary artery disease rather than ruling it in.
Coronary CT angiography
15984354
a particular anatomic lesion. Thus hybrid coronary revascularization and MIDCAB (minimally invasive direct coronary artery bypass surgery) have been developed. Revascularization of the left anterior descending artery with the left internal mammary artery is by far the best treatment option in terms of long-term results. Integrating this therapy with percutaneous coronary angioplasty (hybrid procedure) offers multi-vessel revascularization through a mini-thoracotomy. Particularly in high risk patients, morbidity and mortality decreases in comparison to conventional surgery. For people who undergo coronary artery bypass grafting, coronary imaging (completion angiography) for the routine evaluation of the bypass grafts may be reasonable. For congenital cardiac
Hybrid cardiac surgery
15757643
"Aspergillus niger". It is very rarely caused by "Aspergillus flavus", "Aspergillus oryzae", "Aspergillus terreus" or "Aspergillus nidulans". Patients with single aspergillomas generally do well with surgery to remove the aspergilloma, and are best given pre-and post-operative antifungal drugs. Often, no treatment is necessary. However, if a patient coughs up blood (haemoptysis), treatment may be required (usually angiography and embolisation, surgery or taking tranexamic acid). Angiography (injection of dye into the blood vessels) may be used to find the site of bleeding which may be stopped by shooting tiny pellets into the bleeding vessel. For chronic cavitary pulmonary aspergillosis and chronic
Chronic pulmonary aspergillosis
10796090
diagnosis. Therefore, the use of the CAC score alone is limited in symptomatic patients. In patients with diabetes, the CAC score helps identify the individuals most at risk, who could benefit from screening for silent ischemia and from more aggressive clinical treatment. However, coronary CT angiography (CTA) is superior to coronary CT calcium scanning in determining the risk of Major Adverse Cardiac Events (MACE). There is potential to measure CAC on chest radiographs taken for other indications, possibly allowing some primary screening for coronary artery disease without adding to radiation exposure and with minimal marginal cost. The "Agatston score", named
Coronary CT calcium scan
19087573
maximal decrease in cardiac power output from baseline of −0.04±0.24 W in comparison with −0.14±0.27 W for IABP ("P"=0.001)." Hospitals such as Detroit Medical Center, and organizations such as the Society of Cardiovascular Angiography and Interventions, have featured lectures including "The New Era of Protected PCI: Treating Elective and High-Risk PCI Patients with Impella 2.5", and "Expanding your Patient Practice with Protected PCI: Treating the Most Complex Patients" in order to educate physicians on using protected percutaneous coronary intervention, respectively. Protected percutaneous coronary intervention Protected percutaneous coronary intervention, abbreviated as Protected PCI, is a heart procedure that involves a ventricular
Protected percutaneous coronary intervention
6917691
The ideal length of time a patient needs to be on dual antiplatelet therapy is not fully determined, but guidelines recommend continuing for 12 months beyond placement unless a patient is at a high risk for bleeding. In primary PCI, angiography may demonstrate thrombus (blood clots) inside the coronary arteries. Various studies have been performed to determine whether aspirating these clots (thrombus aspiration or manual thrombectomy) is beneficial. At the moment there is no evidence that routine clot aspiration improves outcomes. Percutaneous coronary angioplasty is one of the most common procedures performed during U.S. hospital stays; it accounted for 3.6%
Percutaneous coronary intervention
19797454
balloon valvuloplasty and novel therapies, coronary atherectomy and thrombectomy, intra-coronary stents, distal embolic protection devices, and evaluation of new devices for coronary intervention. 3. Congestive heart failure: utility of endomyocardial biopsy and new inotropic agents. Mainstays of coronary intervention include balloon angioplasty and coronary stenting. Additional techniques include atherectomy (removal of plaque from lesions), thrombectomy (removal of clots from vessels) and embolic protection (capture and removal of embolic debris). Baim wrote several chapters for and served as lead editor of the main textbook in the field of interventional cardiology, "Grossman's Cardiac Catheterization, Angiography and Intervention, 7th Edition", published in 2006,
Donald S. Baim
751123
precipitate and further decrease the area of the coronary vessel's lumen. This explains why, in many cases, unstable angina develops independently of activity. Cardiac syndrome X, sometimes known as microvascular angina is characterized by angina-like chest pain, in the context of normal epicardial coronary arteries (the largest vessels on the surface of the heart, prior to significant branching) on angiography. The original definition of cardiac syndrome X also mandated that ischemic changes on exercise (despite normal coronary arteries) were displayed, as shown on cardiac stress tests. The primary cause of cardiac syndrome X is unknown, but factors apparently involved are
Angina
5426271
angina and acute coronary syndrome is therefore empirical treatment with aspirin, a second platelet inhibitor such as clopidogrel, prasugrel or ticagrelor, and heparin (usually a low-molecular weight heparin), with intravenous nitroglycerin and opioids if the pain persists. The heparin-like drug known as fondaparinux appears to be better than enoxaparin. A blood test is generally performed for cardiac troponins twelve hours after onset of the pain. If this is positive, coronary angiography is typically performed on an urgent basis, as this is highly predictive of a heart attack in the near-future. If the troponin is negative, a treadmill exercise test or
Acute coronary syndrome
20998958
Optical coherence tomography angiography Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that is capable of visualizing retinal vasculature down to the capillary level without the use of injected dye. OCTA uses low-coherence interferometry to measure changes in backscattered signal intensity or amplitude in order to differentiate areas of blood flow from areas of static tissue. To correct for patient movement during scanning, bulk tissue changes in the axial direction are eliminated, ensuring that all detected changes are due to red blood cell movement. This form of OCT requires a very high sampling density in order to achieve
Optical coherence tomography angiography
3483543
of the lumen. Additionally, IVUS examinations, as they were done more frequently, served to reveal and confirm the autopsy research findings of the late 1980s, showing that atheromatous plaque tends to cause expansion of the internal elastic lamina, causing the degree of plaque burden to be greatly underestimated by angiography. Angiography only reveals the edge of the atheroma that protrudes into the lumen. Perhaps the greatest contribution to understanding, so far, was achieved by clinical research trials completed in the United States in the late 1990s, using combined angiography and IVUS examination, to study which coronary lesions most commonly result
Intravascular ultrasound
7854912
if ever observed during angiography in the absence of severe ischemia (vessels less than 200 micrometers are not visible, generally), and only coronary stenosis, anemia, and exercise have experimentally been shown to cause transformation. Most observers agree that a 90% occlusion is necessary to bring about transformation in the absence of other factors, though a recent article suggests that they may appear as a result of coronary spasm in the absence of total occlusion (see below). Within ninety seconds of occlusion, the pressure gradient between the segment of the coronary vessel distal to the occlusion and the incipient collateral vessel
Collateralization
12754331
diabetes,obesity, inactive lifestyle and high cholesterol. If there is a suspicion that one may have coronary ischemia, a doctor will administer a series of tests to confirm the diagnosis.. The most common tests today are an electrocardiogram, an exercise stress test, and a coronary angiography. The doctor will also ask a series of questions to determine the medical history of the patient, including past incidences of chest pain or shortness of breath. He may also inquire about the duration of symptoms, how often they occur and any measures taken in attempts to relieve them. When a doctor performs an electrocardiogram
Coronary ischemia
20277303
pulmonary angiography (PA). Both V/Q scanning and modern multidetector CT angiography (CTPA) may be accurate methods for the detection of CTEPH, with excellent diagnostic efficacy in expert hands (sensitivity, specificity, and accuracy of 100%, 93.7%, and 96.5% for V/Q and 96.1%, 95.2%, and 95.6% for CTPA). However, CTPA alone cannot exclude the disease, but may help identify pulmonary artery distension resulting in left main coronary artery compression, pulmonary parenchymal lesions (e.g. as complications from previous pulmonary infarctions), and bleeding from bronchial collateral arteries. Today, the gold standard imaging remains invasive pulmonary angiography (PAG) using native angiograms or a digital subtraction
Chronic thromboembolic pulmonary hypertension
17950132
Using angiography clinicians are able to display the size, location and number of vessels affected by the disease. Is can also be analyzed through other methods such as intravascular ultrasound, and magnetic resonance imaging. Using these diagnostic methods, it has been discovered that the disease normally occurs most often in the right coronary artery, followed by the left anterior descending artery, and finally the left anterior circumflex artery. Using these methods Coronary artery ectasia can be divided into four different types: Type 1¬→diffuse ectasia in 2-3 different vessels, Type 2¬→ diffuse disease in 1 vessel and local disease in another,
Coronary artery ectasia
7854919
shortening. By comparison, 72% of areas with abnormal rest perfusion showed decreased segment shortening. Infarctions also occurred less often in the normals than in the abnormals (12% vs. 62%). Examining four variables—rest perfusion, stress perfusion, wall motion abnormalities, and EKG evidence of MI, Kolibash found that 86% of the variables were normal in the normal perfusion group and 81% of the variables were abnormal in the abnormal perfusion group. Neither the extent of coronary disease nor the appearance of the collateral vessels during angiography differed between the two groups, leading Kolibash to conclude that angiography is inadequate in and of
Collateralization
72566
complications include heart failure or an abnormal heartbeat. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, and excessive alcohol. The underlying mechanism involves reduction of blood flow and oxygen to the heart muscle due to atherosclerosis of the arteries of the heart. A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, and coronary angiogram, among others. Ways to reduce CAD risk include eating a healthy diet, regularly exercising, maintaining a healthy weight, and not smoking. Medications for diabetes, high cholesterol, or high
Coronary artery disease
11072827
challenges and requires additional techniques. Though the chances of having complications from a PCI are small, some serious complications include the development of arrythmias, adverse reactions/effects of the dye used in the procedure, infection, restenosis, clotting, blood vessel damage, and bleeding at catheter insertion site. Coronary artery stents, typically a metal framework, can be placed inside the artery to help keep it open. However, as the stent is a foreign object (not native to the body), it incites an immune response. This may cause scar tissue (cell proliferation) to rapidly grow over the stent. In addition, there is a strong
Coronary stent
2461269
the patient. The dye travels from the blood stream and into the kidneys which in time, passes into the kidneys and bladder. This test is not necessary if a CT or MRI scan has been conducted. Renal angiography uses the same principle as IVP, as this type of X-ray also uses a contrasting dye. This radiologic test is important in diagnosing renal cell carcinoma as an aid for examining blood vessels in the kidneys. This diagnostic test relies on the contrasting agent which is injected in the renal artery to be absorbed by the cancerous cells. The contrasting dye provides
Renal cell carcinoma
7930333
Azerbaijan Province. Imam Reza hospital has taken over the main clinical departments of the university including: Internal Medicine (other than Cardiology and Hematology/Oncology), Neurology, Infectious Diseases, Surgery, Urology, Neurosurgery, Otolaryngology, Radiology and Emergency Medicine. Shahid Madani Hospital serves as the heart center of TUMS (Madani Heart Center) and consists of cardiology and cardiac surgery wards, heart emergency care section and Coronary Care Unit (CCU). Madanai Heart Center was a part of Imam Khomeini Hospital before 1994 until it became an independent institution for cardiac surgery. Madani Heart Center serves as the main hospital for Angiography, Percutaneous Coronary Intervention (PCI), Coronary
Tabriz University of Medical Sciences
18662927
temporoparietal infarct, which is an area of dead tissue due to lack of adequate blood supply. The infarct was believed to have been caused by a problem during a coronary angiography, which is a test to show the insides of an individual's coronary arteries. H.J. suffered difficulties with creating a steady beat, an inability to distinguish between different sets of rhythms, and also experienced difficulties when playing his instruments. Research was conducted on birds such as the Zebra Finch because this species has parallels to humans' vocal learning patterns and neurological structures. Adult zebra finches were placed in similar conditions,
Auditory arrhythmia
18945546
field with velocity vectors along the ultrasound beam over the whole sector. It measures the velocity gradient between two points along the ultrasound beam with a set distance. It gives the same result as the velocity gradient. This method has been validated experimentally in a mechanical model, in an animal model, and in patients against echocardiography, coronary angiography and MR The method is limited to one direction; along the ultrasound beam, can thus mainly be used from the apical window, and for longitudinal strain and strain rate measurements only. It is sensitive to angle deviation between the velocity vector (direction
Strain rate imaging
12683814
dose area product. However, strictly speaking formula_1 where "g" is the fraction of energy of liberated charged particles that is lost in radiative processes in the material, and the dose is expressed in absorbed dose to air. The value of "g" for diagnostic X-rays is only a fraction of a percent. Adult coronary angiography and PCI procedures expose patients to an average DAP in the range of 20 to 106 Gy·cm and 44 to 143 Gy·cm respectively. Dose area product Dose area product (DAP) is a quantity used in assessing the radiation risk from diagnostic X-ray examinations and interventional procedures.
Dose area product
67249
and get better with rest. Shortness of breath may also occur and sometimes no symptoms are present. The first sign is occasionally a heart attack. Other complications include heart failure or an irregular heartbeat. Risk factors include: high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol, among others. Other risks include depression. The underlying mechanism involves atherosclerosis of the arteries of the heart. A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, and coronary angiogram, among others. Prevention is by eating a healthy diet,
Cardiology
15292131
patients who have had a previous myocardial infarction or previous coronary artery bypass surgery, the images may be very difficult to interpret and in such cases, the analysis of the scans is performed with the complement of an other imaging modality (such as coronary angiography). It is a non-invasive test as is generally regarded as safe however, there are some patients for whom this is contraindicated and there are a number of potential complications: Any patient who has a contraindication to MRI scanning, especially those with pacemakers Patients with severe asthma, as Adenosine may provoke an attack Patients with severe
Cardiac magnetic resonance imaging perfusion
16839169
coronary CT angiography (cCTA) studies. The system exhibits "per study" specificity of 60–70%, while keeping the sensitivity above 90%. It can be used for chest pain patient triage in emergency room. A deep learning system is available for automatic detection of Intracranial Hemorrhages in acute care settings . Computer-aided simple triage Computer-aided simple triage (CAST) are computerized methods or systems that assist physicians in initial interpretation and classification of medical images. CAST is a sub-class of computer-aided diagnosis (CAD). CAST software systems perform a fully automatic initial triage (classification) of diagnostic medical imaging studies. CAST is primarily intended for emergency
Computer-aided simple triage
4127170
For normal subjects, peak filling rates should be between 2.4 and 3.6 end diastolic volume (EDV) per second, and the time to peak filling rate should be 135-212 ms. (source?) An uneven distribution of technetium in the heart indicates that the patient has coronary artery disease, a cardiomyopathy, or blood shunting within the heart. Abnormalities in a resting MUGA usually indicate a heart attack, while those that occur during exercise usually indicate ischemia. In a stress MUGA, patients with coronary artery disease may exhibit a decrease in ejection fraction. For a patient that has had a heart attack, or is
Radionuclide angiography
18210715
2016 Apr 29;5(5). 5. HDL cholesterol subclasses, myocardial infarction, and mortality in secondary prevention: the Lipoprotein Investigators Collaborative. Eur Heart J. 2015 Jan 1;36(1):22-30. 6. A new ratio for better predicting future death/myocardial infarction than standard lipid measurements in women >50 years undergoing coronary angiography: the apolipoprotein A1 remnant ratio (Apo A1/ [VLDL₃+IDL]). Lipids Health Dis. 2013 Apr 26;12:55. Vertical auto profile The vertical auto profile (VAP) test is a cholesterol, lipid and lipoprotein test. The name "VAP test" uses a technology, the vertical auto profile, to measure and report risk factors for patients who are at increased risk for
Vertical auto profile
9574511
the colon. CAD detects the polyps by identifying their characteristic "bump-like" shape. To avoid excessive false positives, CAD ignores the normal colon wall, including the haustral folds. CAD is able to detect polyps “missed” by radiologists. In early clinical trials, CAD helped radiologists find more polyps in the colon than they found prior to using CAD. CAD is available for the automatic detection of significant (causing more than 50% stenosis) coronary artery disease in coronary CT angiography (CCTA) studies. A low false positives rate (60-70% specificity per patient) allows using it as a computer-aided simple triage (CAST) tool distinguishing between
Computer-aided diagnosis
3811180
coronary angioplasty services to the entire south eastern area of the state. MonashHeart is the largest non-invasive imaging service in Victoria, performing nearly 14,000 echocardiograms each year for newborns through to adults. Acute cardiac inpatient services are provided across the network. There is a 21 bed cardiac care unit at Monash Medical Centre, Clayton, which manages a high case load of ST-elevation acute myocardial infarctions, with a daily case load of 3–4 cases not being unusual; A 12 bed cardiac care unit at Dandenong Hospital, which shares the coronary angiography and angioplasty services with Monash Medical Centre, Clayton; A 24
Monash Medical Centre
6650093
(IV-DSA) is a form of angiography which was first developed in the late 1970s. IV-DSA is a computer technique which compares an X-ray image of a region of the body before and after radiopaque iodine based dye has been injected intravenously into the body. Tissues and blood vessels on the first image are digitally subtracted from the second image, leaving a clear picture of the artery which can then be studied independently and in isolation from the rest of the body. Some limited studies have indicated that IV-DSA is not suitable for patients with diabetes or renal insufficiency because the
Digital subtraction angiography
4779879
Nevertheless, it is still used in cases where CT angiography is nondiagnostic. Conventional pulmonary angiography was first performed in 1931 by Portuguese angiography pioneers Lopo de Carvalho, Egas Moniz and colleagues. Robb and Steinberg described pulmonary angiography by infusion of peripheral radiocontrast. Pulmonary angiography Pulmonary angiography (or pulmonary arteriography) is medical fluoroscopic procedure used to visualize the pulmonary arteries and much less frequently, the pulmonary veins. Conventional pulmonary angiography is a minimally invasive procedure performed most frequently by an interventional radiologist or interventional cardiologist. This form of angiography has the added benefit of the ability to treat certain conditions. CT
Pulmonary angiography
17942545
valve allows for the best view of the aortic valve, and gives a clear indication of the adduction pattern of the aortic valves. If an “X” shape is seen, then the patient can be diagnosed with having a quadricuspid aortic valve. A transthoracic echocardiogram (TTE) indicates if there is an aortic regurgitation, but a 3-D transesophageal echocardiogram can give a better view of the aortic valve. Multidetector coronary CT angiography has been indicated as a single competent diagnostic imaging tool capable of delineating valvular anatomy, severity of regurgitation, and high risk coronary problems. There have been seven described variations of
Quadricuspid aortic valve
2943006
only significant luminal changes which have occurred as a result of end stage complications of the atherosclerotic process. See IVUS and atheroma for a better understanding of this issue. The technique of angiography itself was first developed in 1927 by the Portuguese physician Egas Moniz at the University of Lisbon for cerebral angiography, the viewing of brain vasculature by X-ray radiation with the aid of a contrast medium introduced by catheter. Heart catheterization was first performed in 1929 when the German physician Werner Forssmann inserted a plastic tube in his cubital vein and guided it to the right chamber of
Coronary catheterization
3598281
performed clinically with the goal of predicting susceptibility to future heart attack. In contrast to conventional angiography, cardiac CT angiography does enable visualization of the vessel wall as well as plaque composition. Some of the CT derived plaque characteristics can help predict for acute coronary syndrome. In addition, because these lesions do not produce significant stenoses, they are typically not considered "critical" and/or interventionable by interventional cardiologists, even though research indicates that they are the more important lesions for producing heart attacks. The tests most commonly performed clinically with the goal of testing susceptibility to future heart attack include several
Vulnerable plaque
12754335
very small video camera on the end of it so that the doctor can find the arteries. Once he has found the arteries, he injects a dye in them so that he/she can detect any blockages in the arteries. The dye is able to be seen on a special x-ray machine. The test takes one to two hours. Coronary ischemia can be treated but not cured. By changing lifestyle, further blockages can be prevented. A change in lifestyle, mixed with prescribed medication, can improve health. A study showed that those who quit smoking reduced their risk of being hospitalized over
Coronary ischemia
7629188
including the Netherlands, would have rescued him. According to Bokeria, the necessary medical procedures (coronary angiography and stenting) were "elementary". Bokeria said he saw "nothing showing signs of suicide", but there remained questions over whether Milošević received adequate care while standing trial at the U.N. tribunal. Bokeria also claimed that the center had sent Pocar a letter informing him that Milošević needed hospital treatment and naming several countries beside Russia where that could be done. "The Times"' medical columnist Thomas Stuttaford commented that, taking into account what had been known about Milošević's health condition for years, he was "surprised that
Death of Slobodan Milošević
5426268
2006, there was a 17% reduction in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers. People with presumed ACS are typically treated with aspirin, clopidogrel or ticagrelor, nitroglycerin, and if the chest discomfort persists morphine. Other analgesics such as nitrous oxide are of unknown benefit. Angiography is recommended in those who have either new ST elevation or a new left bundle branch block on their ECG. Unless the person has low oxygen levels additional oxygen does not appear to be useful. If the ECG confirms changes suggestive of myocardial infarction (ST elevations in specific leads,
Acute coronary syndrome
3453105
Traditionally, clinical carotid ultrasounds have only estimated the degree of blood lumen restriction, stenosis, a result of very advanced disease. The National Institute of Health did a five-year $5 million study, headed by medical researcher Kenneth Ouriel, to study intravascular ultrasound techniques regarding atherosclerotic plaque. More progressive clinicians have begun using IMT measurement as a way to quantify and track disease progression or stability within individual patients. Angiography, since the 1960s, has been the traditional way of evaluating for atheroma. However, angiography is only motion or still images of dye mixed with the blood with the arterial lumen and never
Atheroma
4322665
to iodine-containing topical antiseptics (e.g., povidone-iodine) are of any specific relevance to administration of I.V. contrast material. IL-2 medication poses no risk for the acquisition of adverse events by radiocontrast agents. Contrast-induced nephropathy is defined as either a greater than 25% increase of serum creatinine or an absolute increase in serum creatinine of 0.5 mg/dL. Iodinated contrast may be toxic to the kidneys, especially when given via the arteries prior to studies such as catheter coronary angiography. Non-ionic contrast agents, which are almost exclusively used in computed tomography studies, have not been shown to cause CIN when given intravenously at
Iodinated contrast