- Email: [email protected]
Abstract No. 337: MRI molecular imaging of VCAM-1
rotic calcificatoin at lesion site, complete occlusions, filling defect at lesion site, irregular/ulcerated lesions. Aim was to assess for signs of distal embolization as evidenced by vessel cut off/loss of run-off (compared to pre-intervention angiogram) and sluggish flow, with or without capturing macroscopically visualized debris.
tion of targeted FPM targeted against VCAM-1 caused a visually detectable loss of signal in the luminal surface of atherosclerotic plaque in 4 out of 5 rabbits. The remaining 11 rabbit aortae showed no demonstrable loss of signal at the site of plaque formation. Subsequent histological examination confirms the presence of FPMs on the plaque.
Results: 55 patients (48 men; mean age 68.2 ⫾ 12 years) with 67 lesions in the SFA and/or popliteal artery underwent treatment with angioplasty (group I), stenting (group II) or SilverHawk atherectomy with PTA/stent (group III). One filter was used per patient (35 EmboShield and Spider and 20). Clinically significant macrodebris was found in the filters in 25 patients: 5 in group I, 6 in group II and 14 in group III. Distal macroembolization into the native run off vessels did not occur in any patient with filter protection device in situ. All filters were retrieved successfully with no complications.
Conclusion: This study demonstrates the feasibility of imaging VCAM-1 expression using targeted FPM.
Conclusion: Macroembolization is very frequent in patients undergoing lower extremity interventions, particularly with SilverHawk atherectomy. DEP appears to be very effective in capturing macrodebris, and its use is associated with good acute angiographic outcome. The clinical significance of these findings needs to be determined in future studies. Abstract No. 337 MRI molecular imaging of VCAM-1 K.T. Tan1,2, J.Q. Zhan2, S. Chiu2, S.G. Pasian2, K. Goyal2, G. Leung2, A. Moody2; 1University of Alberta, Edmonton, AB, Canada; 2Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Purpose: To image VCAM-1 expression in vitro and ex vivo using MRI
Results: All data expressed as mean⫹(-)SD. Flow cytometric examination of the HUVECs demonstrate no significant difference in autofluorescence, as measured by mean fluorescence intensity, between virgin and TNF treated HUVECs (17.587⫹(-)0.110 vs 16.550⫹(-)0.824, P⫽0.163). There is a marked increase in green fluorescence in both groups of cells when VCAM-1 targeted FPM was added (26.68⫹(-)1.61 P⫽0.01 for TNF treated cells, 21.313⫹(-) 0.786 P⫽0.015 for virgin cells), with greater fluorescence in the TNF treated cells (P⫽0.035). Coadministration of a VCAM-1 blocking antibody abolished the increased fluorescence induced by administration of the targeted FPM (26.68⫹(-)1.61 vs 19.83⫹(-)1.10 P⫽0.009). Administra-
Effects on IVC diameters in normal subjects with respiration M. Tan1, H. Teh2; 1Tan Tock Seng Hospital, Singapore, Singapore; 2Alexandra Hospital, Singapore, Singapore. Purpose: To evaluate the degree of change on the sonographric AP diameter of the IVC in normal patients with respiration. Materials and Methods: The descriptive study was conducted from 1/5/2008 to 1/8/2008. Patients who came to our institution for ultrasound of the hepato-biliary system were evaluated. The AP diameters of the intra-hepatic segment of the IVC were taken in a subxiphoid position, with patients in supine position. Diameters were taken with patients in full inspiration as well as rest. Results: There were a total of 125 patients evaluated. There were 80 males and 45 females. They had an average age of 49, with a range of 18 to 88 years. The average age of the males was 46.8, with a range of 18 to 81. The average age of the females was similar, at 55.0 with a range of 25 to 88. The average diameter of the IVC at rest for all the patients was 2.36 cm with a range of 1.25 to 4.62 cm. The IVC on inspiration for all the patients was 1.91 cm with a range of 0.83 to 3.39 cm. The average difference in diameter is 0.46 cm. The average diameter of the IVC for males as rest was 2.48 cm, with a range from 1.25 to 4.62 cm. The average diameter of the IVC at inspiration is 2.00, with a range 0.83 to 2.00 cm. The average difference in diameter is 0.48 cm. The average diameter of the IVC for females at rest was 2.16 cm, with a range 1.32 to 3.37. The average diameter on inspiration was 1.74 cm with a range of 1.05 to 2.57. The average difference in diameter is 0.41 cm. Conclusion: IVC diameters can vary about 0.4 to 0.5 cm in healthy subjects from rest to deep inspiration. Results are similar in males and females. IVC diameters have been evaluated in sick patients in other studies, but they can also vary in healthy patients. This variation in diameter has implications in therapeutic decisions or when interventional procedures like retrievable IVC filters are performed, even in normal patients.
POSTER SESSIONS
Materials and Methods: VCAM-1 is an adhesion molecule that is involved in atherogenesis, restenosis and microvascular obstruction. A fluorescent paramagnetic microparticle (FPM) was conjugated to a monoclonal antibody targeted towards VCAM-1 using the streptavidin-biotin interaction. Human umbilical vein endothelial cells (HUVECS) were grown to confluence. TNF-exposed as well as virgin HUVECS were then exposed to one of the following; nontargeted FPM alone; FPM targeted against VCAM-1; FPM targeted against VCAM-1 along with an antibody that blocks the binding site of VCAM-1. These were allowed to incubate at 37C for 30 minutes before flow cytometry. Aortae from 16 cholesterol-fed rabbits were incised and perfused with; VCAM-1 targeted FPM; non-targeted FPM; or VCAM-1 targeted FPM in the presence of a blocking antibody. After a 20 minute incubation time, the aortae were excised an imaged using a T2* weighted sequence. 10 of the imaged rabbit aortae were sectioned and viewed under a fluorescent microscope.
Abstract No. 338
Abstract No. 339 Transcranial Doppler for carotid stenting: Comparison of filter and flow reversal for cerebral protection R. Uflacker, C. Schonholz, C. Welzig; Medical University of South Carolina, Charleston, SC. Purpose: Embolic events are common during carotid artery stenting (CAS). Embolic protection devices are used to prevent emboli from reaching the brain and cause infarction. Transcranial Doppler (TCD) is the only non-invasive technique available to detect and quantify the occurrence of microembolism in the cerebral arteries during the procedure. S127
tion of targeted FPM targeted against VCAM-1 caused a visually detectable loss of signal in the luminal surface of atherosclerotic plaque in 4 out of 5 rabbits. The remaining 11 rabbit aortae showed no demonstrable loss of signal at the site of plaque formation. Subsequent histological examination confirms the presence of FPMs on the plaque.
Results: 55 patients (48 men; mean age 68.2 ⫾ 12 years) with 67 lesions in the SFA and/or popliteal artery underwent treatment with angioplasty (group I), stenting (group II) or SilverHawk atherectomy with PTA/stent (group III). One filter was used per patient (35 EmboShield and Spider and 20). Clinically significant macrodebris was found in the filters in 25 patients: 5 in group I, 6 in group II and 14 in group III. Distal macroembolization into the native run off vessels did not occur in any patient with filter protection device in situ. All filters were retrieved successfully with no complications.
Conclusion: This study demonstrates the feasibility of imaging VCAM-1 expression using targeted FPM.
Conclusion: Macroembolization is very frequent in patients undergoing lower extremity interventions, particularly with SilverHawk atherectomy. DEP appears to be very effective in capturing macrodebris, and its use is associated with good acute angiographic outcome. The clinical significance of these findings needs to be determined in future studies. Abstract No. 337 MRI molecular imaging of VCAM-1 K.T. Tan1,2, J.Q. Zhan2, S. Chiu2, S.G. Pasian2, K. Goyal2, G. Leung2, A. Moody2; 1University of Alberta, Edmonton, AB, Canada; 2Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Purpose: To image VCAM-1 expression in vitro and ex vivo using MRI
Results: All data expressed as mean⫹(-)SD. Flow cytometric examination of the HUVECs demonstrate no significant difference in autofluorescence, as measured by mean fluorescence intensity, between virgin and TNF treated HUVECs (17.587⫹(-)0.110 vs 16.550⫹(-)0.824, P⫽0.163). There is a marked increase in green fluorescence in both groups of cells when VCAM-1 targeted FPM was added (26.68⫹(-)1.61 P⫽0.01 for TNF treated cells, 21.313⫹(-) 0.786 P⫽0.015 for virgin cells), with greater fluorescence in the TNF treated cells (P⫽0.035). Coadministration of a VCAM-1 blocking antibody abolished the increased fluorescence induced by administration of the targeted FPM (26.68⫹(-)1.61 vs 19.83⫹(-)1.10 P⫽0.009). Administra-
Effects on IVC diameters in normal subjects with respiration M. Tan1, H. Teh2; 1Tan Tock Seng Hospital, Singapore, Singapore; 2Alexandra Hospital, Singapore, Singapore. Purpose: To evaluate the degree of change on the sonographric AP diameter of the IVC in normal patients with respiration. Materials and Methods: The descriptive study was conducted from 1/5/2008 to 1/8/2008. Patients who came to our institution for ultrasound of the hepato-biliary system were evaluated. The AP diameters of the intra-hepatic segment of the IVC were taken in a subxiphoid position, with patients in supine position. Diameters were taken with patients in full inspiration as well as rest. Results: There were a total of 125 patients evaluated. There were 80 males and 45 females. They had an average age of 49, with a range of 18 to 88 years. The average age of the males was 46.8, with a range of 18 to 81. The average age of the females was similar, at 55.0 with a range of 25 to 88. The average diameter of the IVC at rest for all the patients was 2.36 cm with a range of 1.25 to 4.62 cm. The IVC on inspiration for all the patients was 1.91 cm with a range of 0.83 to 3.39 cm. The average difference in diameter is 0.46 cm. The average diameter of the IVC for males as rest was 2.48 cm, with a range from 1.25 to 4.62 cm. The average diameter of the IVC at inspiration is 2.00, with a range 0.83 to 2.00 cm. The average difference in diameter is 0.48 cm. The average diameter of the IVC for females at rest was 2.16 cm, with a range 1.32 to 3.37. The average diameter on inspiration was 1.74 cm with a range of 1.05 to 2.57. The average difference in diameter is 0.41 cm. Conclusion: IVC diameters can vary about 0.4 to 0.5 cm in healthy subjects from rest to deep inspiration. Results are similar in males and females. IVC diameters have been evaluated in sick patients in other studies, but they can also vary in healthy patients. This variation in diameter has implications in therapeutic decisions or when interventional procedures like retrievable IVC filters are performed, even in normal patients.
POSTER SESSIONS
Materials and Methods: VCAM-1 is an adhesion molecule that is involved in atherogenesis, restenosis and microvascular obstruction. A fluorescent paramagnetic microparticle (FPM) was conjugated to a monoclonal antibody targeted towards VCAM-1 using the streptavidin-biotin interaction. Human umbilical vein endothelial cells (HUVECS) were grown to confluence. TNF-exposed as well as virgin HUVECS were then exposed to one of the following; nontargeted FPM alone; FPM targeted against VCAM-1; FPM targeted against VCAM-1 along with an antibody that blocks the binding site of VCAM-1. These were allowed to incubate at 37C for 30 minutes before flow cytometry. Aortae from 16 cholesterol-fed rabbits were incised and perfused with; VCAM-1 targeted FPM; non-targeted FPM; or VCAM-1 targeted FPM in the presence of a blocking antibody. After a 20 minute incubation time, the aortae were excised an imaged using a T2* weighted sequence. 10 of the imaged rabbit aortae were sectioned and viewed under a fluorescent microscope.
Abstract No. 338
Abstract No. 339 Transcranial Doppler for carotid stenting: Comparison of filter and flow reversal for cerebral protection R. Uflacker, C. Schonholz, C. Welzig; Medical University of South Carolina, Charleston, SC. Purpose: Embolic events are common during carotid artery stenting (CAS). Embolic protection devices are used to prevent emboli from reaching the brain and cause infarction. Transcranial Doppler (TCD) is the only non-invasive technique available to detect and quantify the occurrence of microembolism in the cerebral arteries during the procedure. S127