Evaluation of major coronary artery Bifurcation angles with digital angiography: A detailed study of prevalence in the Upper Euphrates Basin

Objectives: To investigate the diversity and average values of bifurcation angles in a large population to help develop new methods. Methods: One thousand five individuals (504 females, 501 male) who visited the Cardiology Polyclinic of Fırat University Hospital with the complaint of chest pain between 2010 and 2015 were evaluated retrospectively. Bifurcation angle measurements between LMCA-CX, CX-LAD, LMCA-LAD, CX-OM1, CX-OM2, LAD-D1, LAD-D2, RCA-RMD, RCA-RVD and PDA-PL were evaluated in all cases. Results: Bifurcation angles between LMCA-LAD, LMCA-Cx and LAD-Cx branches with “> 90 wide angle bifurcations”, and Cx-OM1, Cx-OM2, LAD-D1, LAD-D2, RCA-RMD and PDA-PL with “<70 Y type bifurcation angle” were found to be high in male and female individuals. The RCA-RVD in female individuals was “<70 Y-type bifurcation” in 14 (2.8%) people, “> 70-90 T-type bifurcation” in 209 (41.5%) people, and “> 90 wide angle bifurcation” in 281 (55.8%) people. Results for male subjects were compatible with this. The correlations of all angles were examined. Robust positive correlations (p≤0.001) were found for the angular measurements between the main branches and the side branches (Cx-OM1, Cx-OM2, LAD-D1, LAD-D2 and RCA-RMD, PDA-PL). Conclusion: With the help of developing technology, we believe that all this coronary angiography data will guide bifurcation stent techniques, which are essential alternatives to bypass. doi: https://doi.org/10.12669/pjms.38.3.4782 How to cite this:Deniz G, Kavakli A, Kucukukur M, Kose E, Karaca I. Evaluation of major coronary artery Bifurcation angles with digital angiography: A detailed study of prevalence in the Upper Euphrates Basin. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4782 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Presentation of cerebral and cervical arterial dissections in Botucatu, Brazil: case series

Spontaneous dissection of the cervical and cerebral arteries is an important cause of stroke and disability in young patients. In this report, the authors present a case series of patients with spontaneous carotid, vertebral, or cerebral artery dissection who underwent digital angiography. A review of the published literature on this subject is also presented.

Clinical applications of digital angiography with the harmonization function in body interventional radiology

Digital subtraction angiography (DSA) is frequently applied in interventional radiology (IR). When DSA is not useful due to misregistration, digital angiography (DA) as an alternative option is used. In DA, the harmonization function (HF) works in real time by harmonizing the distribution of gray steps or reducing the dynamic range; thus, it can compress image gradations, decrease image contrast, and suppress halation artifacts. DA with HF as a good alternative to DSA is clinically advantageous in body IR for generating DSA-like images and simultaneously reducing various motion artifacts and misregistrations caused by patient body motion, poor breath-holding, bowel and ureter peristalsis, and cardiac pulsation as well as halation artifacts often stemming from the lung field. Free-breath DA with HF can improve body IR workflow and decrease the procedure time by reducing the risk of catheter dislocation and using background structures as anatomical landmarks, demonstrating reduced radiation exposure relative to DSA. Thus, HF should be more widely and effectively utilized for appropriate purposes in body IR. This article illustrates the basic facts and principles of HF in DA, and demonstrates clinical advantages and limitations of this function in body IR.

STMO-02 PREOPERATIVE FENCE-POST METHOD PLANNING WITH 3D-FUSION IMAGING

The fence-post method has been used for removal of intra-axial tumors. Preoperative detailed planning with only navigation work system is sometimes difficult to identify actual brain surface, small feeding artery and passing artery. Recently, 3-dementional imaging is well developed to integrate various anatomical findings. The purpose of this study is pursuit of perfect preoperative planning for removal intra-axial tumors with 3D-fusion imaging. From May 2017 to June 2019, 21 patients with intra-axial tumor were included. The software “AZE” was used to create 3D-fusion imaging. The brain tumor, brain surface and tractography were built from MRI, artery from digital angiography and vein from subtraction enhanced computed tomography. Then detailed preoperative planning was planned including how many fence-posts, procedure of cutting feeder, making sulcotomy or corticotomy, and finally cutting drainer. The average bleeding volume was 101±129cc, and there were no patients who had transfusion. All patients did not show additional neurological impairment after surgery. Detailed and perfect preoperative planning with 3D-sufion imaging should be effective for secure neurosurgery.