Absolute Diameter Research Articles

Correlation Between Intracranial Calcification and Extracranial Stenosis of the Internal Carotid Artery.

Intracranial artery calcification is a marker of vascular atherosclerosis and has a high prevalence worldwide. Both atherosclerosis of the internal carotid artery at the carotid sinus in the neck and intracranial calcification have been associated with ischemic stroke. The relationship between the two has not been well studied. The present study investigated how carotid sinus narrowing could relate to calcification located in the distal intracranial artery at the cavernous carotid. We examined a population not selected for cerebral disease. This retrospective study contained 179 subjects aged 18 years and older from the Hawaii Diagnostic Radiology database. Extracranial internal carotid artery stenosis was determined using the absolute diameter, North American Symptomatic Carotid Endarterectomy Trial, and common carotid artery methods. Calcification was scored using the modified Woodcock method. A positive correlation between intracranial calcification and extracranial carotid stenosis was found using all three methods. Individuals with intracranial calcification were more likely to be older, have a smaller internal carotid artery diameter, and have a greater percent stenosis at the internal carotid artery than those without intracranial artery calcification (p<0.001 for all). These results may help refocus interest in calcification in studies of cerebral vasculature and its correlation with extracranial carotid stenosis.

Aortic root and left ventricular diameters ratio: a new tool to differentiate the athlete's heart from pathological aortic dilatation

Abstract Funding Acknowledgements Type of funding sources: None. Background Training-induced cardiac remodelling is usually accompanied by a harmonic and symmetric adaptation of cardiac chambers. Mild aortic enlargement may be a consequence of intense training, although even the definition of aortic dilatation, particularly in athletes and tall athletes, is sometimes challenging. It is therefore essential to early identify competitive athletes with aortic dilatation to manage this condition appropriately. Purpose This study aimed to test a new parameter for the definition of aortic dilatation in competitive athletes, assessing the balancing cardiac remodelling in athletes through the ratio between the aortic diameter and left ventricular (LV) diameter. Methods Competitive athletes were compared with sedentary subjects and with patients with known aortic dilatation. 1901 subjects who underwent echocardiography from 2019 to 2022 were retrospectively enrolled: 993 athletes (74% males, mean age 26±7 years), 410 sedentary (74.1% males, mean age 29±11 years) and 498 patients with aortic dilatation (74.3% males, mean age 56±7 years). Results Patients with aortic dilatation had both an absolute (39.2±2.4 mm) and indexed (19.4±2.2 mm/m2) aortic diameter larger than athletes (30.6±3.2 mm; 16.1±1.5 mm/m2) and sedentary subjects ( 30.5±3.1 mm; 16.5±1.6 mm/m2), with no statistically significant differences between athletes and sedentary subjects. The ratio between the aortic diameter and LV end-diastolic diameter was lower in athletes (0.59 ± 0.06), compared to sedentary subjects (0.65 ± 0.05) and to patients with aortic dilatation (0.81 ± 0.06). The latter had a significantly higher value than the remaining groups (p &amp;lt;0.05). The analysis of the ROC curves highlighted that the cut-off of the ratio between the aortic root diameter and LV diastolic diameter was 0.71, with a 96% sensitivity and 99% specificity of detecting a pathological aortic dilatation. Conclusions This study tested a new echocardiographic parameter for the definition of an aortic dilatation in competitive athletes. The ratio between aortic diameter and LV end-diastolic diameter, with a cut off of 0.71, demonstrated a good sensitivity and specificity to differentiate between physiological and pathological remodelling of the aorta.

Risk factors for atrial fibrillation in dogs with dilated cardiomyopathy.

Atrial fibrillation secondary to dilated cardiomyopathy (DCM) frequently affects large-breed dogs. The aim of the present study was to identify risk factors for the development of atrial fibrillation in dogs of different breeds with an echocardiographic diagnosis of DCM. In this multicenter retrospective study, we searched the electronic databases of five cardiology referral centers for dogs with an echocardiographic diagnosis of DCM. A comparison of clinical and echocardiographic variables was performed between dogs developing atrial fibrillation and those not developing atrial fibrillation and the ability to distinguish between these two groups of dogs was evaluated by receiver operating characteristic curve analysis. Univariate and multivariable logistic regression analysis estimated the odds ratio (OR) with 95% confidence interval (CI) of developing atrial fibrillation. We included 89 client-owned dogs with occult and overt echocardiographic DCM. Of these, 39 dogs (43.8%) had atrial fibrillation, 29 dogs (32.6%) maintained a sinus rhythm, and 21 dogs (23.6%) showed other cardiac arrhythmias. Left atrial diameter had high accuracy (area under the curve = 0.816, 95% CI = 0.719-0.890) to predict the development of atrial fibrillation at the cut-off of >4.66 cm. After multivariable stepwise logistic regression analysis, only increased left atrial diameter (OR = 3.58, 95% CI = 1.87-6.87; p < 0.001) and presence of right atrial enlargement (OR = 4.02, 95% CI = 1.35-11.97; p = 0.013) were significant predictors of atrial fibrillation development. Atrial fibrillation is a common complication of DCM in the dog and is significantly associated with increased absolute left atrial diameter and right atrial enlargement.

Constructing an In Vitro and In Vivo Flow Cytometry by Fast Line Scanning of Confocal Microscopy.

Composed of a fluidic and an optical system, flow cytometry has been widely used for biosensing. The fluidic flow enables its automatic high-throughput sample loading and sorting while the optical system works for molecular detection by fluorescence for micron-level cells and particles. This technology is quite powerful and highly developed; however, it requires a sample in the form of a suspension and thus only works in vitro. In this study, we report a simple scheme to construct a flow cytometry based on a confocal microscope without any modifications. We demonstrate that line scanning of microscopy can effectively excite fluorescence of flowing microbeads or cells in a capillary tube in vitro and in blood vessels of live mice in vivo. This method can resolve microbeads at several microns and the results are comparable to a classic flow cytometer. The absolute diameter of flowing samples can be indicated directly. The sampling limitations and variations of this method is carefully analyzed. This scheme can be easily accomplished by any commercial confocal microscope systems, expands the function of them, and is of promising potential for simultaneous confocal microscopy and in vivo detection of cells in blood vessels of live animals by a single system.

Biorock® Technology Application To The Growth And Acropora Corals Growth Rate

Karang Jeruk is one of the destinations for coral reef ecosystems in Tegal Regency. This study aimed to determine the growth and growth rate of branched coral Acropora transplanted using the biorock® method in Karang Jeruk Waters, Tegal Regency. The method used in this research is the method of experimentation and observation. It is then analyzed through the t-Students test using SPSS version 16. Based on the research results, the absolute growth of Acropora coral at the biorock® station was more significant than the absolute growth at the control station, both for height and diameter or significantly difference. It can be seen that the absolute height growth at the biorock® station is 44.9750 ± 15.3901 mm, while at the control station, 2.1675 ± 0.6726 mm, and the absolute diameter growth at the biorock® station is 0.8350 ± 0.2177 mm while at the control station 0 .2025 ± 0.0835 mm. The growth rate of Acropora coral at the biorock® station was faster than the growth rate at the control station, both for height and diameter. It can be seen that the high growth rate at the biorock® station is 11.2438 ± 3.8475 mm month-1, while at the control station, 0.5419 ± 0.1682 mm month-1, and the diameter growth rate at the biorock® station is 0.2088 ± 0.0544 mm month-1 while at the control station 0.0506 ± 0.0209 mm month-1.

Novel biomarkers associated with thoracic aortic disease

BackgroundBiomarkers might help to improve diagnosis, surveillance and risk stratification of thoracic aortic disease (TAD). We explored the association between a broad spectrum of cardiovascular biomarkers with clinical characteristics and thoracic aortic diameter in TAD patients. MethodsVenous blood-samples were obtained in 158 clinically stable TAD patients visiting our outpatient clinic (2017–2020). TAD was defined as a thoracic aortic diameter ≥ 40 mm, or genetic confirmation (hereditary TAD). The cardiovascular panel III of the Olink multiplex platform was used for batch analysis of 92 proteins. A comparison was made between biomarker levels in patients with and without previous aortic dissection and/or surgery, and with and without hereditary TAD. Linear regression analyses were applied to identify (relative, normalized) biomarker concentrations associated with the absolute thoracic aortic diameter (ADmax), and thoracic aortic diameter indexed for body surface area (IDmax). ResultsMedian age of study patients was 61.0 (IQR 50.3–68.8) years, 37.3% females. Mean ADmax and IDmax were 43.3 ± 5.4 mm and 21.3 ± 3.3 mm/m2. After multivariable adjustment, Matrix Metalloproteinase-3 (MMP-3) and Insulin-like growth factor binding protein 2 (IGFBP-2) showed a significant positive association with ADmax and IDmax, respectively. Patients with previous aortic surgery/dissection had higher N-terminal-pro hormone BNP (NTproBNP) (median 3.67 [IQR 3.01–3.99] vs 2.84 [2.32–3.26], p ≤0.001). Patients with hereditary TAD had higher Trem-like transcript protein 2 (TLT-2) (median 4.64 [IQR 4.45–4.84]) than those with non-heriditary TAD (4.40 [4.17–4.64]; p = 0.00042). ConclusionsAmong a broad range of biomarkers, MMP-3 and IGFBP-2 were associated with disease severity in TAD patients. The pathophysiological pathways uncovered by these biomarkers, and their potential clinical use warrants further research.

Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study

Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown sustained microvascular dysfunction, systemic inflammation, and coagulation activation at 3 months after acute COVID-19. The long-term effects of COVID-19 on vascular function remain unknown. This cohort study involved 167 patients who participated in the COVAS trial. At 3 months and 18 months after acute COVID-19, macrovascular dysfunction was evaluated by measuring the carotid artery diameter in response to cold pressor testing. Additionally, plasma endothelin-1, von Willebrand factor, Interleukin(IL)-1ra, IL-6, IL-18, and coagulation factor complexes were measured using ELISA techniques. The prevalence of macrovascular dysfunction did not differ between 3 months (14.5%) and 18 months (11.7%) after COVID-19 infection (p = 0.585). However, there was a significant decrease in absolute carotid artery diameter change, 3.5% ± 4.7 vs. 2.7% ± 2.5, p-0.001, respectively. Additionally, levels of vWF:Ag were persistently high in 80% of COVID-19 survivors, reflecting endothelial cell damage and possibly attenuated endothelial function. Furthermore, while levels of the inflammatory cytokines interleukin(IL)-1RA and IL-18 were normalized and evidence of contact pathway activation was no longer present, the concentrations of IL-6 and thrombin:antithrombin complexes were further increased at 18 months versus 3 months (2.5 pg/mL ± 2.6 vs. 4.0 pg/mL ± 4.6, p = 0.006 and 4.9 μg/L ± 4.4 vs. 18.2 μg/L ± 11.4, p < 0.001, respectively). This study shows that 18 months after COVID-19 infection, the incidence of macrovascular dysfunction as defined by a constrictive response during carotid artery reactivity testing is not increased. Nonetheless, plasma biomarkers indicate sustained endothelial cell activation (vWF), systemic inflammation (IL-6), and extrinsic/common pathway coagulation activation (FVII:AT, TAT) 18 months after COVID-19 infection.

NEOROCKS project: surface properties of small near-Earth asteroids

ABSTRACT We present new results of the observing program which is a part of the NEOROCKS project aimed to improve knowledge on physical properties of near-Earth Objects (NEOs) for planetary defense. Photometric observations were performed using the 1.2-m telescope at the Haute-Provence observatory (France) in the BVRI filters of the Johnson–Cousins photometric systems between June 2021 and April 2022. We obtained new surface colours for 42 NEOs. Based on the measured colours, we classified 20 objects as S-complex, nine as C-complex, nine as X-complex, two as D-type, one object as V-type, and one object remained unclassified. For all the observed objects, we estimated their absolute magnitudes and diameters. Combining these new observations with the previously acquired data within the NEOROCKS project extended our data set to 93 objects. The majority of objects in the data set with diameters D &amp;lt; 500 m belongs to a group of silicate bodies, which could be related to observational bias. Based on MOID and ΔV values we selected 14 objects that could be accessible by a spacecraft. Notably, we find D-type asteroid (163014) 2001 UA5 and A-type asteroid 2017 SE19 to be of particular interest as possible space mission targets.

Diameter Distribution of Vouacapoua americana Aublet in the Brazilian Amazon

Vouacapoua americana Aublet was classified as endangered in 2013 and its extraction banned in 2014. Forest management allows conservation and sustainable production, but, for this, knowledge of diameter distribution is fundamental. This study aimed to characterize and analyze diameter distribution patterns of the species at different sites in the Brazilian Amazon. Data on trees with diameter &amp;ge; 10 cm were acquired from continuous forest in permanent sample plots and preharvest forest inventories (PHFIs) of nine forest management areas. Absolute density, diameter distribution, and De Liocourt quotient (q) were calculated. Diameter distributions were fitted by a linearized Meyer type I distribution function, and the similarity between distributions was analyzed by the nonparametric Kruskal-Wallis test (H-test). The species showed high density (6.31 to 25.55 trees/ha). Mensrured diameters ranged from 10.00 to 127.32 cm. A decreasing behavior was observed in all diameter distributions, with few discontinuous distributions and mostly truncated distributions. The De Liocourt quotient (q) did not show constancy or proximity, with values ranging from 0.4 to 23.48. Diameter distributions did not differ by the Kruskal-Wallis test (H = 15.45, p = 0.3479). Diameter distributions fitted by the Meyer model resulted in an inverted &amp;ldquo;J&amp;rdquo;-like curve. The diameter structure showed a high density of individuals, a decreasing distribution from smaller to larger diameter classes, a characteristic inverted &amp;ldquo;J&amp;rdquo; pattern, and unbalanced diameter distributions.

Numerical Study of Heat Transfer in a Two-Dimensional Rarefied Hydrogen Gas Moved Jet Impingement Using Direct Simulation Monte Carlo-Finite Difference Coupled Method

Temperature control is an important indicator for the lithography. However, the factors causing temperature fluctuation in lithography remain unclear under a low-pressure environment. In this work, in order to study the jet impingement heat transfer of hydrogen under rarefied conditions, the direct simulation Monte Carlo (DSMC) method and the finite difference method (FDM) are coupled. The heat exchange capacity in the jet impingement obtained using DSMC method is treated as a boundary condition for substrate. The difference of impingement heat transfer of rarefied hydrogen jet under different conditions of inlet absolute pressure, impingement distance and jet aperture are studied. The temperature of substrate is calculated by FDM. Results show that heat exchange capacity of the jet impingement rises with an increasing the inlet absolute pressure and pipe diameter, drops with reducing impact distance. The temperature control requirements can be met when the heat exchange capacity exceeds 380 W/(m2·K), the structural parameters satisfying the temperature control requirement are demarcated. The aforementioned findings can provide design ideas for high-precision temperature control devices.

Echocardiographic values in healthy Pugs: Effect of body weight, age, and sex.

Transthoracic echocardiography represents the main noninvasive technique for evaluating cardiac morphology and function in dogs. In dogs with particular somatotypes, such as brachymorphic dogs, breed-specific echocardiographic values are needed for a proper echocardiographic interpretation. Nowadays, the Pug represents one of the most popular brachymorphic canine breeds worldwide. However, data on echocardiographic measurements in this breed are currently limited. We aimed to determine echocardiographic values in a population of apparently healthy Pugs, and to assess the possible effects of body weight (BW), age, and sex on selected echocardiographic variables, with particular emphasis on those related to the left-sided cardiac chambers. Apparently healthy Pugs underwent a full physical examination, a 1-minute six-lead electrocardiogram, and a complete transthoracic echocardiography. Twenty-four echocardiographic variables were measured by combining M-mode, two-dimensional and Doppler modalities, and relative values were determined by applying the statistical procedures recommended by the Clinical and Laboratory Standards Institute. Moreover, the effect of selected demographic variables on echocardiographic measurements was tested using a linear mixed model. The investigation included 86 Pugs. Echocardiographic values were provided for each variable and compared with previous veterinary literature. A statistically significant effect of BW, age, and sex was documented for several of the tested variables. Doppler examination demonstrated a trivial pulmonary regurgitation in 24/86 (27.9%) Pugs. Moreover, a persistent left cranial vena cava was suspected in 4/86 (4.7%) dogs. Echocardiographic features of the Pug were addressed and echocardiographic values were made available for clinical use. Because our findings were obtained using a standardized echocardiographic analysis in a population of 86 healthy Pugs, they may act as a reliable guide for an accurate echocardiographic interpretation in this breed.

Gender-specific Predicted Normal Aortic Size and Its Consequences of the Population-Based Prevalence of Abdominal Aortic Aneurysms

To investigate if a relative-size-index of the abdominal aortic diameter influences the prevalence estimates of abdominal aortic dilatations compared to absolute diameters. Cross-sectional study. Participants from the Viborg Vascular Screening Trial, Viborg Women Cohort, and the Viborg Screening Program. Through multivariate linear regression analyses, two gender-specific prediction-equations were developed based upon body-surface area and age. The definitions of absolute and relative size of aortic ectasies were 25-29 mm and 1.25-1.49 x individual-predicted size (IPS), abdominal aortic aneurysm (AAA) 30 mm and 1.5 x IPS, and large repair-recommendable AAA ≥55mm or ≥ 2.75 x IPS, respectively. 19 269 males (69.6 years) and 2 426 females (67.1 years) attended the population- and ultrasound-based screening studies for AAA. The mean peak systolic abdominal anterior-posterior inner to inner diameter was 19.1mm (±5.3mm) and 16.6mm (±2.8mm) (P< .001) in males and females, respectively. Body surface area showed the strongest correlation with aortic diameters in both males (r=0.19, p< .001) and females (r=0.17, p< .001). Age correlated significantly with size, but only in males (r=0.03, p< .001). The prevalence in men of absolute-size-defined and relative-size-index-defined screening-detected aortic ectasies, AAAs and repair-recommendable AAAs were: 5.9% and 9.5% (p< .001), 3.3% and 4.2% (p< .001) and 9.9% and 15.2% (p= .004), respectively. Prevalence in females of absolute-size-defined and relative-size-index-defined screening-detected aortic ectasies, AAAs and repair-recommendable AAAs were 1.2% and 5.8% (p< .001), 0.5% and 1.3% (p= .003) and 0.0% and 23.1% (p= .553), respectively. Despite statistical differences, ultrasound-based absolute diameters to detect AAA seem acceptable in men. In females, poor agreements were noticed concerning all three categories of aneurysms, indicating that the current absolute diagnostic cut-points do not reflect female anatomy.

Incidence of atrial functional tricuspid regurgitation and its correlation with tricuspid valvular deformation in patients with persistent atrial fibrillation.

With the growing prevalence of atrial fibrillation (AF), concomitant atrial functional tricuspid regurgitation (FTR) is increasing. In this study, we aimed to elucidate the incidence of significant atrial FTR and its association with tricuspid valvular (TV) deformation in patients with persistent AF. We retrospectively enrolled 344 patients (73.0 ± 9.3 years, 95 female) with persistent AF who underwent 2-dimensional echocardiography. We excluded patients with left-sided heart disease, pulmonary hypertension treated with pulmonary vasodilators, and congenital heart disease. We defined significant TR as having TR ≥ moderate; and tricuspid annulus (TA) diameter, tethering height, and area were measured in all patients. Among the study population, 80 (23.3%) patients had significant TR. TA diameter, tethering height, and area were significantly greater in the significant TR group (all p < 0.001). In multivariable analysis, TA diameter was independently associated with significant TR (odds ratio 1.1 per mm, p = 0.03), whereas TV tethering height was not. Receiver operating characteristic curve for significant TR exhibited the best predictive value of TA diameter indexed for body surface area [23 mm/m2; area under the curve (AUC) = 0.87] compared with absolute TA diameter (39 mm; AUC = 0.74) and TA diameter indexed for height (0.22 mm/cm; AUC = 0.80). Approximately 25% of patients with persistent AF had significant TR. The BSA-corrected TA diameter was strongly associated with significant TR, which might be helpful for predicting the development of significant TR and considering its therapeutic strategy in patients with persistent AF.

The impact of stent-graft sizing on venous stenosis re-intervention and arteriovenous graft patency: Free-floating stent outflow is associated with improved outcomes.

Early cannulation arteriovenous grafts (ecAVG) for dialysis access are limited by reintervention for venous stenosis (VS) despite their good initial patency. Whilst stent-grafts (SG) have shown promise, the optimal sizing is unclear. Therefore, this study aims to determine if outflow vein diameter, SG diameter or these relative to each other (V:Sr) alters outcomes, and if so, which is more important. Retrospective analysis was performed of Gore® Acuseal® ecAVGs with VS treated with Gore® Viabahn® SG over a 7-year period. Primary patency (PP), time to thrombosis and functional patency were analysed by SG length/diameter, vein diameter and V:Sr. We identified 114 ecAVGs with median follow-up 492 days (IQR 189-770). SG length and diameter did not correlate with PP, however, there was a significant relationship between vein diameter and PP (RR = 0.901 (0.832-0.975), p = 0.01) and between V:Sr and PP (RR = 0.462 (0.255-0.838), x2 = 5.866, p = 0.0015). The optimal V:Sr was ⩾1.4 (i.e. vein diameter at least 40% greater than the stent-graft; or 'free-floating' stent outflow) (RR = 2.759 (1.670-4.558), p < 0.001), translating to a difference in median PP of 252 versus 496 days (IQR: 188-316; 322-670). On multivariate analysis, absolute vein diameter lost significance, whilst V:Sr remained an independently significant predictor of PP (RR = 3.247 (1.560-6.759), p = 0.02). Placement of the SG outflow into a relatively larger segment of vein was associated with a significant increase in PP independent of the absolute vein diameter. This suggests that larger calibre SG which are apposed to the vein wall are not required for optimal primary patency, and indeed should be actively avoided. Instead, a 'free-floating' stent outflow which is undersized relative to the recipient vein (whilst maintaining a minimum anchoring calibre) is recommended where possible. This should be considered during intervention and may require selection of longer devices, where practical, to bring the stent outflow into a larger vein segment. Level 3a, Non-randomised controlled cohort/follow-up study.

Incidence and timing of coronary thrombosis in Kawasaki disease patients with giant coronary artery aneurysm

ObjectiveCoronary thrombosis is a common cardiovascular complication of Kawasaki disease (KD), which seriously affects the long-term therapeutic effect of KD. The purpose was to determine the incidence and timing of coronary thrombosis and to identify risk factors for coronary thrombosis in KD with giant coronary artery aneurysm (GCAA). Methods and resultsA total of 94 consecutive KD patients with GCAA from Children's Hospital Affiliated to Chongqing Medical University were enrolled retrospectively. The cumulative incidence of coronary thrombosis in KD patients with GCAA was 59 % (n = 54). Coronary thrombosis mainly occurred in the acute phase (n = 41/54, 76 %), with a median time of 16 days after onset. Cox regression analysis was used to identify risk factors for coronary thrombosis. Cox regression analysis indicated that male (hazard ratios, 1.87; 95 % CI, 1.01–3.44; P = 0.43), left anterior descending artery (LAD) involvement (hazard ratios, 3.75; 95 % CI, 1.85–7.39; P < 0.001), coronary absolute diameter ≥ 8 mm (hazard ratios, 2.93; 95 % CI, 1.36–6.29; P = 0.006) constituted a higher risk of coronary thrombosis after adjusting for confounders. Kaplan-Meier method showed the cumulative incidence for coronary thrombosis in KD patients with GCAA was 79 %, 92 %, and 88 % in male, LAD involvement, coronary absolute diameter > 8 mm, respectively. ConclusionsMale, LAD involvement, and coronary absolute diameter ≥ 8 mm were associated with a high incidence of coronary thrombosis. Based on the analysis of the incidence, time and risk factors of coronary thrombosis in different periods, this study may provide an essential reference for thromboprophylaxis management of KD with GCAA.

NCOG-04. RANO-BM RESPONSE CRITERIA VERIFICATION STUDY IN A SRS-TREATED COHORT

Abstract Brain metastases are frequently seen in neurosurgical practice. Standardised criteria are created to better classify these common pathologies in research studies. This study’s goal was to evaluate RANO-BM (Response Assessment in Neuro-Oncology - Brain Metastases) criteria’s current thresholds in a cohort of patients with brain metastases managed by stereotactic radiosurgery (SRS). We performed a retrospective metastasis-level analysis of patients treated with SRS for brain metastases. The data collected included cohort demographics, metastases characteristics, outcomes, and the rate of true positives, false negatives, true negatives and false positives as defined by RANO-BM criteria at last follow-up before second SRS. 251 metastases in 50 patients were included in the analysis. RANO-BM criteria using current thresholds yielded a sensitivity of 38%, a specificity of 95%, a positive predictive value of 71% and a negative predictive value of 84%. Modified RANO-BM criteria using absolute diameter differences of 2.5 mm yielded a sensitivity of 83%, a specificity of 87%, a positive predictive value of 67% and a negative predictive value of 94%. Pseudoprogression occurred significantly earlier than tumor progression, with a median time of onset of 6.9 months and 12.1 months respectively. Current RANO-BM criteria unreliably identifies clinically relevant tumor progression, but are useful in assessing diameter increases caused by tumor progression and pseudoprogression.

Abstract 15193: Coronary Ectasia in Patients With Thoracic Aortic Aneurysm

Introduction: Coronary ectasia is identified on coronary angiography in 1-5% of cases; however, its etiology, associations, and prognostic significance are poorly characterized Methods: In a large retrospective cohort of thoracic aortic aneurysm (TAA) patients, we identified rates of coronary ectasia and the presence of aortic aneurysm and bicuspid aortic valve. Two reviewers independently assessed coronary angiograms for the presence of coronary ectasia, defined as a diameter 1.5 times larger than the adjacent healthy reference segment or an absolute diameter &gt; 4.5 mm. Results: Of the 474 TAA patients assessed, coronary ectasia was identified in 87 (18.4%). Amongst patients with coronary ectasia, 59 (67.8%) had isolated thoracic aortic aneurysms [11 (18.6%) had aortic root involvement, 46 (78.0%) had ascending aortic involvement, and 2 (3.4%) had descending aortic involvement]. Further, 28 patients had aneurysms across vascular beds [5 (17.9%) had root and ascending aortic involvement; 11 (39.3%) had combined ascending and descending aortic involvement; 9 (32.1%) had both thoracic and abdominal aortic aneurysms and 3 (10.8%) had diffuse aneurysmal disease involving other beds including intracranial, iliac and distal aortic aneurysms]. Additionally, 16 (18.39%) patients with coronary ectasia were found to have a bicuspid aortic valve where fused right and left coronary cusps were the most common anatomic variant [7 (43.75%) patients]. Of the 87 ectasia patients, there were no major adverse cardiac events including rupture of the ectatic coronary segments or related thrombosis or myocardial infarction during the mean follow-up period of 5 years. Conclusion: This study identifies that coronary ectasia occurs in TAA patients at a rate higher than expected for the general population, demonstrating a potential association between these conditions. At 5-year follow up, the presence of coronary ectasia is not associated with any major adverse cardiac events.

Balloon angioplasty and stent implantation within 30 days postcongenital heart surgery (CHS) in children.

This study aims to assess balloon angioplasty (BAP) and stent implantation (SI) procedures early after congenital heart surgery (CHS) in children. These interventions are considered potential high-risk procedures and often avoided or postponed. This is a retrospective, single centre study of all BAP and SI procedures within 30 days after CHS (01/2001 until 01/2021). A total of 127 (96 SI, 31 BAP) procedures were performed in 104 patients at median 6.5 days (interquartile range: 1-15) after CHS. Balloon-to-stenosis ratio and balloon-to-reference vessel ratio were significantly smaller compared to stent-to-stenosis ratio and stent-to-reference vessel ratio (p < .001 and p = .005). There was a greater rise in absolute vessel diameter, greater rise in vessel diameter in relation to the stenosis and vessel diameter in relation to the reference vessel with SI (p < .001, p = .01, and p < .001). Up to 94% SIs fulfilled both success criteria (increase of vessel diameter ≥50% of minimal vessel diameter or achievement ≥75% of the reference vessel diameter). Major adverse events were more frequent in the BAP group (p = .05). Intraprocedural complications were 5/31 (16%) in the BAP group and 13/96 (13%) in the SI group (p = .77). BAP and SI procedures within 30 days post-CHS can be performed safely, with a greater stent-to-stenosis ratio and a greater rise in vessel diameter with stent implantation.

Male-female differences in acute type B aortic dissection: the DisSEXion study

Abstract Background/Introduction Acute type B aortic dissection (ATBAD) is a cardiovascular emergency with high risk of morbidity and mortality. Elucidating male-female differences in ATBAD might help optimize patient-specific care, while data is scarce on this topic. Purpose The aim of this study was to identify differences between male and female ATBAD patients in presentation, management and outcomes. Methods A retrospective cohort study was conducted including all consecutive patients who presented with ATBAD between 2007–2017 in four tertiary centers. Non-acute, traumatic, and iatrogenic dissections were excluded. We included patients presenting with an intramural hematoma or penetrating aortic ulcer in acute setting. Results The study population consisted of 384 patients, of which 41% (n=156) was female. In comparison to males, females presented at an older age (67 [IQR: 57–73] vs. 62 [IQR: 52–71], p=0.015) and fewer female patients had a history of abdominal aortic aneurysm (6% vs. 15%, p=0.009). Imaging diagnostics revealed a smaller proportion of patients with distally extended dissections in females. DeBakey type IIIb was diagnosed less frequently in females (73% vs. 85%, p=0.008) as was renal artery involvement (48% vs. 66%, p=0.009). Furthermore, classical type B dissection was less often observed in female patients compared to male patients (56% vs. 78%, p&amp;lt;0.001). Absolute maximum thoracic aortic diameters were not significantly different in females and males (44.0 [38.0–50.0] mm vs. 42.0 [39.0–49.0], p=0.870). No male-female differences were found in treatment strategy (p=0.561, Figure 1). In-hospital/30-day mortality was 9.6% in female patients and 11.8% in male patients (p=0.603). Long-term mortality did not show a significant male-female difference (p=0.90) during a median follow-up duration of 6.1 [IQR: 4.1–9.1] years (Figure 2). Conclusion This study showed that female patients were older at presentation, while male patients more often had distally extended dissections. Although mortality was not significantly different, we encourage male-female specific risk factor studies on late mortality. In this way ATBAD male and female patients at high risk of mortality can be identified and patient-specific care can be implemented. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ZonMw

Determination of the optimum definition of growth evaluation for indeterminate pulmonary nodules detected in lung cancer screening

ObjectiveTo determine the optimum definition of growth for indeterminate pulmonary nodules detected in lung cancer screening.Materials and methodsIndividuals with indeterminate nodules as defined by volume of 50–500 mm3 (solid nodules) and solid component volume of 50–500 mm3 or average diameter of non-solid component ≥8 mm (part-solid nodules) on baseline lung cancer screening low-dose chest CT (LDCT) were included. The average diameters and volumes of the nodules were measured on baseline and follow-up LDCTs with semi-automated segmentation. Sensitivities and specificities for lung cancer diagnosis of nodule growth defined by a) percentage volume growth ≥25% (defined in the NELSON study); b) absolute diameter growth >1.5 mm (defined in the Lung-RADS version 1.1); and c) subjective decision by a radiologist were evaluated. Sensitivities and specificities of diagnostic referral based on various thresholds of volume doubling time (VDT) were also evaluated.ResultsAltogether, 115 nodules (one nodule per individual; 93 solid and 22 part-solid nodules; 105 men; median age, 68 years) were evaluated (median follow-up interval: 201 days; interquartile range: 127–371 days). Percentage volume growth ≥25% exhibited higher sensitivity but lower specificity than those of diametrical measurement compared to absolute diameter growth >1.5 mm (sensitivity, 69.2% vs. 42.3%, p = 0.023; specificity, 82.0% vs. 96.6%, p = 0.002). The radiologist had an equivalent sensitivity (53.9%; p = 0.289) but higher specificity (98.9%; p = 0.002) compared to those of volume growth, but did not differ from those of diameter growth (p>0.05 both in sensitivity and specificity). Compared to the VDT threshold of 600 days (sensitivity, 61.5%; specificity, 87.6%), VDT thresholds ≤200 and ≤300 days exhibited significantly lower sensitivity (30.8%, p = 0.013) and higher specificity (94.4%, p = 0.041), respectively.ConclusionGrowth evaluation of screening-detected indeterminate nodules with volumetric measurement exhibited higher sensitivity but lower specificity compared to diametric measurements.