Fluorescence Video Angiography for Evaluation of Dynamic Perfusion Status in an Aneurysm Preclinical Experimental Setting

BACKGROUND Experimental studies to assess aneurysm occlusion or perfusion typically rely on macroscopic examination or histological analysis but cannot assess dynamic perfusion. OBJECTIVE To describe an easy-to-implement and inexpensive fluorescence angiographic technique for the in vivo assessment and imaging of the dynamic perfusion status of aneurysms and their underlying blood vessels in a rat model. METHODS In a rat sidewall aneurysm model, the angiographic setup included 2 bandpass filters, a video camera, and a bicycle spotlight. After 48 rats underwent fluorescein angiography, dissections were performed to confirm the perfusion status by macroscopic and histologic examination of the aneurysm. RESULTS Direct injection of 0.2 mL fluorescein 10% Faure achieved strong, clear visibility in all 48 aneurysms. Macro-/microscopic examination identified residual perfusion in 25 and complete healing in 23 aneurysms. Fluorescein imaging identified 21 of these 25 aneurysms (84%) with residual perfusion and 22 of 23 aneurysms (96%) with no residual perfusion. CONCLUSION Our fluorescein imaging technique proved efficient for the evaluation of aneurysm patency and parent artery integrity in this experimental setting. Fluorescein is nontoxic, can be re-administered if needed, and, in this technique, can expand the armamentarium for the preclinical evaluation of dynamic perfusion status.

Pediatric Nonvariceal Gastrointestinal Hemorrhage

Gastrointestinal bleeding (GIB) is a relatively rare yet potentially life-threatening event in children. While mesenteric angiography for GIB has grown into a ubiquitous component of adult interventional radiology practice, the pediatric experience is comparatively limited. We herein review the common etiologies and management of GIB in children, with special attention to angiographic technique relevant to pediatric anatomy.

P.099 Characteristics of the SOFIA distal access catheter in suction-stentriever acute stroke intervention

Background: Tri-axial systems are frequently employed in stroke interventions. In addition to more support, the distal access catheter can provide suction aspiration during a stent retrieval. We have recently adopted the 5F SOFIA as part of a tri-axial system for acute stroke interventions, and believe it has improved efficient recanalization. Methods: This is a retrospective case series of acute stroke interventions utilizing the 5 F SOFIA 125 cm distal access catheter. Cases were evaluated for distal location of the catheter, number of stent-triever passes, and final TICI score. We describe our angiographic technique. Results: Nine acute stroke cases were performed using the SOFIA catheter. LVOs were in the M1(6), M2 (2), distal basilar (1). The 5F SOFIA catheter was advanced into the M1 or Basilar artery in all cases. No dissections or spasm was seen in the catheterized intracranial artery. Mean stent-triever passes was 2 (1-4). Final angiographic results were TICI 3 (6), TICI 2b (2), and TICI 0 (1). Conclusions: Efficient thrombectomy is a key part of successful stroke recanalization. We report on our experience with a specific distal access catheter which has reduced the number of stent passes required to restore flow.

Can adding contrast-enhanced digital mammography (CEDM) as an adjunct to diagnostic mammography/US help decrease biopsy rates in women with suspicious (BIRADS 4) breast lesions?

6 Background: Traditional screening mammography (MG) enables early detection of breast cancer and therefore results in decreased mortality. Mammography, however, is an imperfect tool and limited by an overall sensitivity of 75-85%. Specificity is limited as well resulting in many false-positive examinations and unnecessary follow-up examinations. The recent development of contrast-enhanced digital mammography (CEDM) has made the usage of IV contrast enhancement with mammography a possibility. CEDM is an angiographic technique that uses digital subtraction, which removes the normal mammary gland on images in order to detect breast tumors and visualize their vascularity. The literature is promising with regard to CEDM as studies have found that CEDM achieves increased sensitivity without reductions in specificity in comparison to MG, US and/or MRI. Methods: In this multi-reader study we compared the diagnostic accuracy of CEDM as an adjunct to MG/US in patients with suspicious findings (BI-RADS 4). The study population included 31 patients who were imaged with CEDM prior to their scheduled US or stereotactic-guided biopsy. We compared the relative performance of MG/US alone versus MG/US/CEDM in determining the probability of malignancy. Histology served as the gold standard. Results: See table below. Conclusions: The addition of CEDM to the workup of suspected lesions on MG and/or US preliminarily decreases the number of false-positive MG thereby with potential to reduce cost and unnecessary patient harm. [Table: see text]