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TCT-784 An Innovative MRA Technique for Simultaneous Imaging of Artery and Vein for Diagnosis of Venous Compression Syndrome
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 18, SUPPL B, 2016
Medical Center, Seoul, Korea, Republic of; 14Asan Medical Center, Seoul, Korea, Republic of; 15Asan Medical Center, Seoul, Korea, Republic of; 16Asan Medical Center, Seoul, Korea, Republic of; 17Asan Medical Center, Seoul, Korea, Republic of; 18Asan Medical Center, Seoul, Korea, Republic of; 19Asan Medical Center, Seoul, Korea, Republic of BACKGROUND BTK artery disease was quite common with multivessel disease. Recently, angiosome-targeted percutaneous transluminal angioplasty (PTA) was widely used among BTK artery disease. METHODS From January 2008 to May 2015, a total of 226 consecutive patients with 250 wounds underwent complete angiosome-targeted PTA for only ischemic foot wound and multi-vessel BTK artery disease. We evaluated the clinical outcome of angiosome-targeted single-vessel versus multi-vessel PTA. The primary endpoint was defined as the complete wound healing within 12 months without death before wound healing, unexpected amputation or flap or target vessel revascularization, or death. The secondary endpoint of the study was the major adverse limb event (MALE) at 1 year. RESULTS Among study patients, 115 wounds (110 patents) were treated with single-vessel angioplasty and 135 wounds (126 patients) were treated multi-vessel angioplasty. 1-year event rates of wound healing did not differ single versus multi-vessel PTA (61.9% vs 70.0%, P ¼ 0.32). The adjusted-risk of wound healing (hazard ratio [HR], 0.84; 95% confidence interval [CI] 0.59-1.21, P ¼ 0.35) did not differ between patient who received single- and multi-vessel PTA. The multivariable adjusted risk of major adverse limb event (HR, 0.84; 95% CI, 0.59-1.21, P ¼ 0.36), MALE (HR, 0.83; 95% CI, 0.50-1.38, P ¼ 0.46), and repeat revascularization (HR, 1.27; 95% CI, 0.73-2.20, P ¼ 0.40) were also similar between two groups.
B317
BACKGROUND May-Thurner sx is compression of the L common iliac vein by the R common iliac artery. Venous compression sx (VCS) can occur in the external iliac, common femoral vein and R sided veins also. Prevalence among L iliofemoral DVT pts is 50% and is associated with recurrent DVT, venous reflux disease (VRD), PE and ulcers. VCS prevalence in non-thrombotic pts with venous insufficiency is unkonwn. Simultaneous magnetic resonance arterio-venography imaging (SMRAVI) is a powerful dynamic noninvasive tool for diagnosing VCS with the use of ABLAVAR (albumin-bound gadolinium, longer intravascular t1/2) that allows improved simultaneous arterial and venous imaging compared to standard gadolinium. METHODS 76 pts w/ advanced VRD and 6 pts w/ recurrent / extensive DVT were evaluated for VCS. SMRAVI was performed in the calves following a 5cc injection of gad using a 3D fast gradient echo dynamic sequence. Iliac, femoral, and popliteal veins and arteries were then evaluated following a 10cc injection of ABLAVAR using a spoiled gradient echo sequence. Vein stenosis > 50% is positive for VCS. Those patients proceeded to IVUS (Volcano, 10MHz transducer) and venography. RESULTS Among 82 pts (6716yo, 35% men), 67 (82%) had pathological compression (> 50%), and 32 (47%) had severe compression (>70%). 30 (45%) of those with pathological compression underwent IVUS (97% correlation) and venography. 1 pt (3%) had <50% stenosis by IVUS. 25 pts (83%) did not show significant stenosis on conventional venography.
CONCLUSION MRA with ABLAVAR is a novel and sensitive tool to dx VCS due to superior simultaneous opacification of the artery and vein. It has excellent correlation to IVUS and is superior to conventional venography. CATEGORIES ENDOVASCULAR: Peripheral Vascular Disease and Intervention
CONCLUSION The clinical performance of single- versus multi-vessel angioplasty was not significantly different for patients with multivessel BTK artery disease. CATEGORIES ENDOVASCULAR: Peripheral Vascular Disease and Intervention TCT-784 An Innovative MRA Technique for Simultaneous Imaging of Artery and Vein for Diagnosis of Venous Compression Syndrome Yu Xie,1 Abhimanyu Uberoi,1 Jill Tannerc,3 Samir Mehrotra,3 Norman Leporv,2 Hooman Madyoon2 1 Cedars-Sinai Medical Center, Los Angeles, California, United States; 2 Cedars-Sinai Medical Center/Westside Medical Associates of Los Angeles, Beverly Hills, CA, California, United States; 3Arrowhead Regional Medical Center, Colton, California, United States
TCT-785 Association between the Platelet Reactivity under Clopidogrel Treatment and the Severity of Angioscopic Intra-stent Thrombus Following Drug-eluting Stent Implantation in the Femoropopliteal Artery Takayuki Ishihara,1 Osamu Iida,2 Amane Kozuki,3 Toshiro Shinke,4 masashi fukunaga,5 Tetsuo Horimatsu,6 Kenichi Fujii,7 Junya Shite,8 Daisuke Terashita,9 yoshiro tsukiyama,10 Kan Zen,11 Mitsuyoshi Takahara,12 Masaaki Uematsu,13 Shinsuke Nanto14 1 Kansai Rosai Hospital, Amagasaki, Japan; 2Kansai Rosai Hospital, Cardiovascular Center, Amagasaki city, Japan; 3Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; 4Kobe University Hospital, Kobe, Japan; 5 Hyogo college of medicine, nishinomiya, Japan; 6kawasaki hospital, Kobe, Japan; 7Hyogo College of Medicine, Nishinomiya, Japan; 8Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; 9Kobe University Hospital; 10 Osaka Saiseikai Nakatsu Hospital, Kobe, Japan; 11Omihachiman Community Medical Center, Omihachiman, Japan; 12Shanghai Chest Hospital; 13Hofstra Northwell School of Medicine; 14Nishinomiya Municipal Hospital, Nishinomiya, Japan BACKGROUND Drug-eluting stents (DESs) are widely used for the treatment of the femoropopliteal (FP) artery disease. Although
Medical Center, Seoul, Korea, Republic of; 14Asan Medical Center, Seoul, Korea, Republic of; 15Asan Medical Center, Seoul, Korea, Republic of; 16Asan Medical Center, Seoul, Korea, Republic of; 17Asan Medical Center, Seoul, Korea, Republic of; 18Asan Medical Center, Seoul, Korea, Republic of; 19Asan Medical Center, Seoul, Korea, Republic of BACKGROUND BTK artery disease was quite common with multivessel disease. Recently, angiosome-targeted percutaneous transluminal angioplasty (PTA) was widely used among BTK artery disease. METHODS From January 2008 to May 2015, a total of 226 consecutive patients with 250 wounds underwent complete angiosome-targeted PTA for only ischemic foot wound and multi-vessel BTK artery disease. We evaluated the clinical outcome of angiosome-targeted single-vessel versus multi-vessel PTA. The primary endpoint was defined as the complete wound healing within 12 months without death before wound healing, unexpected amputation or flap or target vessel revascularization, or death. The secondary endpoint of the study was the major adverse limb event (MALE) at 1 year. RESULTS Among study patients, 115 wounds (110 patents) were treated with single-vessel angioplasty and 135 wounds (126 patients) were treated multi-vessel angioplasty. 1-year event rates of wound healing did not differ single versus multi-vessel PTA (61.9% vs 70.0%, P ¼ 0.32). The adjusted-risk of wound healing (hazard ratio [HR], 0.84; 95% confidence interval [CI] 0.59-1.21, P ¼ 0.35) did not differ between patient who received single- and multi-vessel PTA. The multivariable adjusted risk of major adverse limb event (HR, 0.84; 95% CI, 0.59-1.21, P ¼ 0.36), MALE (HR, 0.83; 95% CI, 0.50-1.38, P ¼ 0.46), and repeat revascularization (HR, 1.27; 95% CI, 0.73-2.20, P ¼ 0.40) were also similar between two groups.
B317
BACKGROUND May-Thurner sx is compression of the L common iliac vein by the R common iliac artery. Venous compression sx (VCS) can occur in the external iliac, common femoral vein and R sided veins also. Prevalence among L iliofemoral DVT pts is 50% and is associated with recurrent DVT, venous reflux disease (VRD), PE and ulcers. VCS prevalence in non-thrombotic pts with venous insufficiency is unkonwn. Simultaneous magnetic resonance arterio-venography imaging (SMRAVI) is a powerful dynamic noninvasive tool for diagnosing VCS with the use of ABLAVAR (albumin-bound gadolinium, longer intravascular t1/2) that allows improved simultaneous arterial and venous imaging compared to standard gadolinium. METHODS 76 pts w/ advanced VRD and 6 pts w/ recurrent / extensive DVT were evaluated for VCS. SMRAVI was performed in the calves following a 5cc injection of gad using a 3D fast gradient echo dynamic sequence. Iliac, femoral, and popliteal veins and arteries were then evaluated following a 10cc injection of ABLAVAR using a spoiled gradient echo sequence. Vein stenosis > 50% is positive for VCS. Those patients proceeded to IVUS (Volcano, 10MHz transducer) and venography. RESULTS Among 82 pts (6716yo, 35% men), 67 (82%) had pathological compression (> 50%), and 32 (47%) had severe compression (>70%). 30 (45%) of those with pathological compression underwent IVUS (97% correlation) and venography. 1 pt (3%) had <50% stenosis by IVUS. 25 pts (83%) did not show significant stenosis on conventional venography.
CONCLUSION MRA with ABLAVAR is a novel and sensitive tool to dx VCS due to superior simultaneous opacification of the artery and vein. It has excellent correlation to IVUS and is superior to conventional venography. CATEGORIES ENDOVASCULAR: Peripheral Vascular Disease and Intervention
CONCLUSION The clinical performance of single- versus multi-vessel angioplasty was not significantly different for patients with multivessel BTK artery disease. CATEGORIES ENDOVASCULAR: Peripheral Vascular Disease and Intervention TCT-784 An Innovative MRA Technique for Simultaneous Imaging of Artery and Vein for Diagnosis of Venous Compression Syndrome Yu Xie,1 Abhimanyu Uberoi,1 Jill Tannerc,3 Samir Mehrotra,3 Norman Leporv,2 Hooman Madyoon2 1 Cedars-Sinai Medical Center, Los Angeles, California, United States; 2 Cedars-Sinai Medical Center/Westside Medical Associates of Los Angeles, Beverly Hills, CA, California, United States; 3Arrowhead Regional Medical Center, Colton, California, United States
TCT-785 Association between the Platelet Reactivity under Clopidogrel Treatment and the Severity of Angioscopic Intra-stent Thrombus Following Drug-eluting Stent Implantation in the Femoropopliteal Artery Takayuki Ishihara,1 Osamu Iida,2 Amane Kozuki,3 Toshiro Shinke,4 masashi fukunaga,5 Tetsuo Horimatsu,6 Kenichi Fujii,7 Junya Shite,8 Daisuke Terashita,9 yoshiro tsukiyama,10 Kan Zen,11 Mitsuyoshi Takahara,12 Masaaki Uematsu,13 Shinsuke Nanto14 1 Kansai Rosai Hospital, Amagasaki, Japan; 2Kansai Rosai Hospital, Cardiovascular Center, Amagasaki city, Japan; 3Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; 4Kobe University Hospital, Kobe, Japan; 5 Hyogo college of medicine, nishinomiya, Japan; 6kawasaki hospital, Kobe, Japan; 7Hyogo College of Medicine, Nishinomiya, Japan; 8Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; 9Kobe University Hospital; 10 Osaka Saiseikai Nakatsu Hospital, Kobe, Japan; 11Omihachiman Community Medical Center, Omihachiman, Japan; 12Shanghai Chest Hospital; 13Hofstra Northwell School of Medicine; 14Nishinomiya Municipal Hospital, Nishinomiya, Japan BACKGROUND Drug-eluting stents (DESs) are widely used for the treatment of the femoropopliteal (FP) artery disease. Although