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  • 1
    Online Resource
    Online Resource
    Prevalence of visceral artery involvement in patients with peripheral artery disease found on run-off MRA
    Springer Science and Business Media LLC ; 2021
    In:  BMC Medical Imaging Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Medical Imaging, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: In patients with peripheral artery disease (PAD), run-off MR-angiography (MRA) is a commonly performed diagnostic test to obtain high-resolution images for evaluation of the arterial system from the aorta through the distal run-off vessels. The aim of this study was to investigate the prevalence of visceral artery involvement (VAI) in patients with PAD and leg symptoms examined with run-off MRA. Methods We retrospectively analyzed 145 patients (median age 68 years, range 27–91) who underwent MRA due to known or suspected PAD at our institution between 2012 and 2018. MRA examinations were re-evaluated for visceral artery stenosis. Patient dossiers were reviewed to determine cardiovascular risk factors, kidney function and Fontaine stage of PAD. Results Involvement of at least one visceral artery with ≥ 50% diameter stenosis was found in 72 (50%) patients. There were no differences in age, gender, MRA indication, Fontaine stage, levels of C-reactive protein (CRP), cardiovascular risk factors or vascular comorbidities between patients with and without VAI. Renal artery (RA) involvement with ≥ 50% diameter stenosis was observed in 28 (20%) of patients. Patients with involvement of the RA were more likely to suffer from hypertension (79 vs. 54%, p  = 0.019) and reduced renal function (glomerular filtration rate 70 vs. 88 mL/min/1.73m 2 , p  = 0.014). Conclusion Visceral artery stenosis can be seen in half of patients with known or suspected PAD and leg symptoms on run-off MRA. Investigating for RA stenosis in patients with PAD and hypertension and/or impaired renal function may have high diagnostic yield.
    Type of Medium: Online Resource
    ISSN: 1471-2342
    URL: Article
    DOI: 10.1186/s12880-021-00615-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2061975-3
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  • 2
    Online Resource
    Online Resource
    Isolated calf deep venous thrombosis: frequency on venous ultrasound and clinical characteristics
    Springer Science and Business Media LLC ; 2021
    In:  BMC Emergency Medicine Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Emergency Medicine, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: It remains controversial whether to include calf veins in the initial ultrasound evaluation of suspected deep venous thrombosis (DVT). We sought to investigate the frequency and clinical characteristics of isolated calf DVT. Materials and methods In this retrospective analysis, we investigated a cohort of 596 patients (median age 69 years, 52.3% women) who had been imaged with complete lower extremity venous duplex ultrasound for suspected acute DVT. Radiology reports were analyzed for the presence and localization of DVT. Clinical information was collected from patients’ electronic charts. Results DVT was found in 157 patients (26.3%), of which 74 patients (47.1%) had isolated calf DVT. Isolated calf DVTs were located in the posterior tibial veins (22 patients, 29.7%), peroneal veins (41 patients, 55.4%) and muscle veins (19 patients, 25.7%). There were no differences in age or sex between patients with isolated calf DVT and patients with proximal DVT. Isolated calf DVT was more commonly associated with leg pain (52.7% vs. 33.7%, p  = 0.0234) and less commonly associated with subjective leg swelling (35.1% vs. 55.4%, p  = 0.0158) and objectively measured difference in leg circumference (23% vs. 39.8%, p  = 0.0268). D-Dimers were significantly lower in patients with isolated lower leg DVT (median 2.3 vs. 6.8 mg/L, p   〈  0.0001) compared to patients with proximal DVT. Conclusions Isolated calf DVT represents approximately half of DVT cases and has different clinical characteristics than proximal DVT.
    Type of Medium: Online Resource
    ISSN: 1471-227X
    URL: Article
    DOI: 10.1186/s12873-021-00516-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050431-7
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  • 3
    Online Resource
    Online Resource
    Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis
    Springer Science and Business Media LLC ; 2020
    In:  BMC Medical Imaging Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Medical Imaging, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: To investigate the prevalence, spectrum, and predictors of alternative diagnoses explaining leg symptoms in patients negative for suspected acute deep venous thrombosis (DVT), which can be detected with whole-leg ultrasound. Methods We retrospectively analyzed a cohort of 789 patients (median age 70 years, 50.6% women) evaluated with a whole-leg ultrasound examination for suspected acute DVT within one year. All findings in the radiology report were analyzed and electronic chart review was performed to collect clinical information. Results Ultrasound was negative for acute DVT in 531 patients (67.3%). Among these, alternative diagnoses explaining leg symptoms were seen in 349 patients (65.7%). The most frequent alternative diagnoses were chronic venous insufficiency (147 patients, 27.7%), followed by lymphedema (48 patients, 9.0%) and chronic post-thrombotic changes (41 patients, 7.7%). Patients with alternative diagnoses were older (median 71 vs. 66 years, p = 0.0226), as well as more likely to present with leg swelling (39.5% vs. 23.1%, p = 0.0002), difference in leg circumference (25.5% vs. 14.8%, p = 0.0055) and redness (7.7% vs. 2.7%, p = 0.0213) than patients without alternative diagnosis. Independent predictors of finding alternative diagnoses on whole-leg ultrasound were older age (odds ratio 1.014 per year, p = 0.0119), leg swelling (OR 1.949, p = 0.0020) and history of previous DVT (OR 2.235, p = 0.0154). Conclusions Alternative diagnoses explaining leg symptoms can be detected on whole-leg ultrasound in two thirds of patients with no evidence of acute DVT. Our data supports performing a comprehensive ultrasound evaluation beyond the venous system, particularly, in older patients, who present with leg swelling and a past history of DVT.
    Type of Medium: Online Resource
    ISSN: 1471-2342
    URL: Article
    DOI: 10.1186/s12880-020-00527-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2061975-3
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  • 4
    Online Resource
    Online Resource
    Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography
    Springer Science and Business Media LLC ; 2020
    In:  European Radiology Vol. 30, No. 7 ( 2020-07), p. 3908-3914
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 30, No. 7 ( 2020-07), p. 3908-3914
    Abstract: The clinical presentation of peripheral artery disease (PAD) and chronic venous insufficiency (CVI) can overlap and the conditions may co-exist. The purpose of our study was to investigate the prevalence and clinical significance of concomitant CVI in patients with PAD examined with run-off MR angiography (MRA). Methods We analysed 180 patients (median age 69 years, range 27 to 91) with known or suspected PAD who underwent MRA at our institution between 2012 and 2018. MRA datasets were re-evaluated for manifestations of CVI. Electronic charts were reviewed to analyse whether diagnosis of CVI was documented and to determine Fontaine stage of PAD. Results Evidence of possible CVI on MRA was found in 38 (21%) patients. Only seven (18%) of these patients had a documented diagnosis of CVI. Patients with co-existing PAD and CVI were more likely obese (median BMI 29.7 vs. 26.3 kg/m 2 , p  = 0.001) and diabetic (55 vs. 35%, p  = 0.039) than patients without CVI. The frequency of concomitant CVI manifestations decreased from distal to proximal with the lower leg affected in all 38 patients and the thigh in 17 patients (45%). Patients with co-existing PAD and CVI were more likely to have a clinical diagnosis of stage IV PAD than patients without co-existing CVI (57% vs. 34%, relative risk 1.68, p  = 0.018). Conclusions Signs of possible concomitant CVI can be seen in approximately one-fifth of patients with known or suspected PAD examined with run-off MRA. If present, these findings should be reported since CVI may mimic or contribute to symptoms attributed to PAD. Key Points • In total, 21% of patients with PAD patients examined with MR angiography show signs of possible co-existing CVI. • Patients with co-existing CVI were 1.7-fold more likely to have a clinical diagnosis of stage IV PAD. • Our data also showed that co-existing chronic venous insufficiency is under-diagnosed in patients with PAD.
    Type of Medium: Online Resource
    ISSN: 0938-7994 , 1432-1084
    URL: Article
    DOI: 10.1007/s00330-020-06696-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1472718-3
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  • 5
    Online Resource
    Online Resource
    Extravascular findings on run-off MR angiography: frequency, location and clinical significance
    Elsevier BV ; 2021
    In:  Clinical Imaging Vol. 69 ( 2021-01), p. 172-178
    Details
    In: Clinical Imaging, Elsevier BV, Vol. 69 ( 2021-01), p. 172-178
    Type of Medium: Online Resource
    ISSN: 0899-7071
    URL: Article
    DOI: 10.1016/j.clinimag.2020.07.010
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2004578-5
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