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Publications (47)
Background
Asymptomatic carotid artery stenosis (ACS) has a low risk of stroke. To achieve an advantage over noninterventional best medical treatment (BMT), carotid endarterectomy (CEA) or carotid artery stenting (CAS) must be performed with the lowest possible risk of stroke. Therefore, an analysis of risk-elevating factors is essential. Grade of...
Background
Prospective, randomized, multicenter trials show no beneficial impact of drug-coated balloon (DCB) therapy alone on the technical and clinical outcomes of infrapopliteal artery lesions in comparison to plain old balloon angioplasty. The aim of this study was to evaluate the performance of directional atherectomy (DA) plus DCB angioplasty...
Aims
Identifying factors associated with worse outcome following carotid endarterectomy (CEA) is important to improve prevention of major adverse cardiovascular and cerebrovascular events (MACCE), yet rarely used for registries. We intended to identify predictors of MACCE following CEA as recently analysed for stenting.
Methods and results
Patient...
Assessment of the severity of internal carotid artery stenosis is relevant to therapeutic decisions. Direct measurement of stenosis in static three-dimensionally rendered ultrasonographic color-Doppler images after an orientation with 4-D gray-scale views (4D/3D-C-US) was recently observed to be metrically non-inferior to angiography. In the study...
Purpose The accuracy of internal carotid artery stenosis (ICAS) quantification depends on the method of stenosis measurement, impacting therapeutic decisions and outcomes. The NASCET method references the stenotic to the distal ICAS lumen, the ECST method to the local outer and the common carotid artery (CC) method to the CC diameter. Direct morpho...
Die Methodik und Zielsetzung einer Duplexsonographie im Rahmen klinischer Studien ist grundsätzlich von der Anwendung in der klinischen Praxis zu unterscheiden. Im folgenden Beitrag werden die Unterschiede zwischen klinischer und studienbedingter Diagnostik anwendungsorientiert erörtert. Wichtige duplexsonographische Endpunkte werden dargestellt un...
Objectives:
The purpose was to analyze the agreement and binary accuracy of the degree of internal carotid artery stenosis (ICAS) as determined by 4-dimensionally (4D) real-time gray-scale guided 3-dimensional (3D) color-Doppler ultrasonography (3DC-US) (4D/3DC-US) compared with catheter angiography (CA) and duplex ultrasonography (DUS). This stud...
Background:
The purpose of this study was to assess the correlation between the transstenotic pressure gradient as determined by a pressure wire and the decrease in the intrarenal resistance index (RI) > 0.05 measured by duplex ultrasound in significant unilateral renal artery stenosis (RAS). Intravascular ultrasound (IVUS) was correlated to the a...
Introduction: Identifying factors associated with short term outcome following carotid endarterectomy (CEA) is important to improve patient selection. There are limited data assessing 30-day major adverse cardiac and cerebrovascular events (MACCE: stroke, myocardial infarction (MI) and death) in clinical practice.
Hypothesis: We hypothesized that p...
Introduction: Clinical stratification in patients with ICAS largely depends on symptomatic status and stenosis grading. The purpose was to analyze the agreement and binary accuracy for the degree of internal carotid artery stenoses (ICAS) as determined by four-dimensional (4D) real-time guided three-dimensional color-Doppler (3DC) ultrasonography (...
Aims: This prospective registry study was intended to evaluate outcomes and predictors of adverse events following carotid artery stenting (CAS). Methods and results: Patients received neurological and duplex exams before CAS, prior to discharge and at 30- and 180-day follow-up. Multiple regression analysis included patient- and procedure-related c...
Introducing anti-restenotic drug-based treatment modalities in femoropopliteal interventions is the potential revolutionizing reperfusion treatment of peripheral artery disease. Durability of recanalization procedures using drug-coated balloons (DCB) and drug-eluting stents (DES) yields in excellent mid-term and long-term technical and clinical out...
Opinion statement:
Drug-coated balloons (DCBs) provide a novel method to locally deliver paclitaxel into the arterial wall without the need of a chronically implanted delivery system. Following the first positive pilot studies, two large pivotal trials have confirmed superiority of DCBs over plain old balloon angioplasty (POBA) in the treatment of...
To evaluate duplex ultrasonography (DUS) in the assessment of femoropopliteal stenoses comparing a single native stenosis (SNS) to multisegmental native stenoses (MNS).
Among the 1284 patients treated for atherosclerotic occlusive disease involving the femoropopliteal segment between November 2002 and November 2012, 139 patients (97 men; mean age 6...
Objectives: Outcomes from carotid artery stenting (CAS) in a real world scenario is of interest to confirm clinical trial findings and to improve selection criteria. This prospective registry study intended to evaluate outcomes and predictors for adverse events of CAS.
Methods: Patients received neurological and duplex exams before CAS, prior to di...
BACKGROUND/PURPOSE: Patients with near-occlusion (NO) of the internal carotid artery (ICA) are suggested to benefit from an exclusive therapeutic stratification. We intended to verify computertomography angiography (CTA) criteria for NO-detection by the catheter angiography (CA) reference and to investigate the impact of NO upon diagnosis of 70%-NA...
Purpose:
To compare the performance of drug-coated balloons (DCB) and drug-eluting stents (DES) in long femoropopliteal lesions.
Methods:
A retrospective dual center study included 228 patients (139 men; median age 69 years) with femoropopliteal lesions ≥10 cm suffering from peripheral artery disease (Rutherford categories 1-5) treated either wi...
Significant renal artery stenosis (RAS) can cause or result in deterioration of arterial hypertension and may promote the development of renal insufficiency. The activation of the renin-angiotensin-aldosterone system results in structural heart disease and may impact patient survival. Technical improvements of diagnostic and interventional endovasc...
Background:
Restenosis remains an unresolved problem despite different treatment modalities and new stent technology in femoropopliteal arteries. No standard therapy has proven to provide acceptable outcome data for this entity. Directional atherectomy alone did not result in satisfactory long-term patency rates. The outcome might be improved in c...
Several position statements provided recommendations regarding the anatomical conditions qualifying for renal denervation catheter application based on the HTN-1 and HTN-2 trials. This manuscript summarises anatomical access artery and renal artery conditions which qualify for catheter-based renal denervation according to the instructions for use a...
Background:
To report feasibility and safety of the Pathway PV™ Atherectomy System during percutaneous peripheral vascular interventions of in-stent restenosis.
Patients and methods:
33 patients (66.7 % men; mean age 68.7 years; 39.4 % diabetics) with symptomatic infrainguinal in-stent restenosis were enrolled at 5 study sites. Primary study end...
Purpose:
Isolated atherosclerotic common femoral artery (CFA) disease is a rare cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice, little is known about outcomes of percutaneous treatment.
Materials and methods:
A prospectively maintained single-center database was retrospectiv...
Purpose:
To determine the clinical and technical outcomes following endovascular therapy for aortoiliac occlusive disease, including complex reconstruction of the aortic bifurcation.
Methods:
A retrospective database search identified 1184 consecutive patients (864 men; mean age 64±10 years) who underwent 1712 procedures to treat target lesions...
Background: Gray-Scale Median (GSM) analysis of carotid artery stenosis allows quantification of plaque echogenicity, correlates with histology and showed an association with symptoms and cerebral embolic findings. The aim of the study is to demonstrate whether several systematically aquired sections of 3-dimensional Power-Doppler ultrasound (3D-PD...
The study investigated the long-term clinical impact of sirolimus-eluting stents (SES) in comparison with bare-metal stents (BMS) in treatment of focal infrapopliteal lesions.
There is evidence that SES reduce the risk of restenosis after percutaneous infrapopliteal artery revascularization. No data from randomized trials are available concerning t...
macharzina@gmail.com
Aim:
Whole plaque analysis of carotid artery stenosis with Gray-Scale Median (GSM) allows quantification of plaque echogenicity, correlates with histology and was shown to be associated with symptoms and embolic cerebral findings. The aim of the study is to find out whether 3-dimensional Power-Doppler ultrasound (3D-PDUS) dat...
The purpose of this study was to evaluate the technical feasability, safety, and 1-year efficacy of the endovascular treatment of atherosclerotic common femoral artery (CFA) obstructions.
Atherosclerotic CFA obstruction is a known cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice...
Technical and clinical outcomes of femoro-popliteal artery stenting are highly dependent on stent design properties. First-generation slotted-tube nitinol stents did not sufficiently address the unique mechanical stress applied to this vessel segment resulting in high stent fracture rates that have been linked to restenosis. The main advantage of s...
Chronic mesenteric ischemia (CMI) is most likely caused by atherosclerosis and less frequently by external compression, fibromuscular dysplasia and vasculitis. Symptomatic CMI is an uncommon, potentially under-diagnosed condition caused by fixed stenoses or occlusion of in most conditions at least two visceral arteries. If only one of the three maj...
Purpose: Detection of restenosis by morphologic differentiation of perfused lumen from plaque is an unresolved issue for ultrasonography (US). We intended to quantitatively assess target lumen reduction (TLR) as a marker of sonografic morphometry by intensity-coded power doppler (ICPD) as compared to conventional Color-Doppler (CCD), hemodynamic ch...
Purpose: Comparison of Stenosis-Grades (CS) of angiography (A), multi-slice CTA (MSCTA) and Ultrasound (US) is mostly performed by measuring percentage carotid artery stenosis (CAS). Purpose: to evaluate the accuracy of MSCTA by using multiplanar reformation (MPR) for measuring CAS compared with that of A and accuracy of BF-US compared with MSCTA a...
In-stent restenosis (ISR) after non-coronary interventions is becoming an increasing clinical and technical problem in daily practice due to the more liberal use of stents particularly in femoro-popliteal and infra-popliteal interventions. Whereas in the coronaries the role of drug eluting stents (DES) in the treatment of ISR is already well define...
Directional atherectomy (DA) has become popular in some centers to remove atherosclerotic plaques in femoro-popliteal lesions. Although immediate and also short - term outcome data are promising, solid long-term data are warranted to justify the widespread use in daily practice.
In this prospective study de novo and restenotic lesions of the femoro...
To report our experience with a catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry after subintimal guide wire passage during recanalization of chronically occluded femoro-popliteal arteries.
Between March 2007 and August 2008, 65 legs in 61 patients (60% male, mean age 73 (49-98 years) with chronic occlus...
Long QT syndrome (LQTS) is a heritable disease associated with ECG QT interval prolongation, ventricular tachycardia, and sudden cardiac death in young patients. Among genotyped individuals, mutations in genes encoding repolarizing K+ channels (LQT1:KCNQ1; LQT2:KCNH2) are present in approximately 90% of affected individuals. Expression of pore muta...
Pseudoaneurysm is a common complication of cardiac catheterization and coronary intervention with an incidence of 2% even in experienced centers.
In a feasibility study conducted between December 2004 and February 2006 we enrolled 76 patients consecutively to receive local thrombin injection (mean 329 IU; range 100-800 IU) into the aneurysma sac.
U...
We assessed whether pharmacological inhibition of CuZn‐superoxide dismutase (SOD) mimics the molecular mechanism of either in vitro or in vivo nitrovasodilator tolerance.
In endothelium‐intact aortic rings from in vivo tolerant rabbits the GTN‐ and acetylcholine (ACh)‐induced maximal relaxation was attenuated by 36 and 23%, respectively. In vitro t...
Angiotensin II activates NAD(P)H-dependent oxidases via AT1-receptor stimulation, the most important vascular source of superoxide (O2*-). The AT1 receptor is upregulated in vitro by low-density lipoprotein. The present study was designed to test whether hypercholesterolemia is associated with increased NAD(P)H-dependent vascular O2*- production an...
Angiotensin II infusion has been shown to cause hypertension and endothelial dysfunction and to increase superoxide (O-.2) production in vascular tissue, mainly via an activation of nicotinamide adenine dinucleotide (phosphate) [NAD(P)H]-dependent oxidase, the most significant O-.2 source in endothelial and/or smooth muscle cells. With these studie...
