Arteriovenous Circulation Time Research Articles

Observation of the retinal arteriovenous circulation time of patients with different stages of diabetic retinopathy

Observation of the retinal arteriovenous circulation time of patients with different stages of diabetic retinopathy

Changes in Ocular Hemodynamics after Carotid Artery Angioplasty and Stenting (CAAS) in Patients with Different Severity of Ocular Ischemic Syndrome

ABSTRACTPurpose: To evaluate the effects of carotid artery angioplasty and stenting (CAAS) on patients who were diagnosed with ocular ischemic syndrome (OIS).Methods: Sixty-four eyes of 64 OIS patients with ipsilateral internal carotid artery stenosis ≥70% were included in the study. The study eyes were divided into two groups according to the presence of iris neovascularization: NVI-absent group and NVI-present group, with 32 eyes, respectively. All patients received ocular treatment modality according to the presence of non-perfusion area (pan-retinal photocoagulation) and intraocular pressure (medical treatment included timolol maleate eye drops combined with brinzolamide eye drop; trabeculectomy and cyclophotocoagulation). All patients went through CAAS surgery for treatment of internal carotid artery stenosis. Best-corrected visual acuity (BCVA); intraocular pressure (IOP), slit lamp examination, iris fluorescence angiography, fundus fluorescein angiography and color Doppler ultrasound of the internal carotid artery (ICA), ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCA) were performed pre-operatively and 1 month, 3 months, 6 months, and 12 months post-operatively.Results: There was no significant BCVA change postoperatively in the NVI-absent group, while postoperative BCVA in the INV-present group decreased significantly. There was no significant BCVA difference at pre-operative and 1month post-operative follow-up between the two groups. However, post-operative BCVA of NVI-present group starting from 3-months follow-up was significantly worse than NVI-absent group. Arm-retinal artery circulation time and arteriovenous circulation time decreased significantly in NVI-absent group, while showed no statistical difference in NVI-present group during the 12-months follow-up. Postoperative peak systolic velocity (PSV) of the ophthalmic artery, the central retinal artery, and short posterior ciliary artery showed significant increases at 1 month, 3 months, 6 months and 12 months follow-up in both groups.Conclusion: CAAS can greatly improve ocular blood in OIS patients with and without iris neovascularization. However, CAAS improved BCVA only in patients without iris neovascularization.

Evaluation of Circulation Disorder in Coronary Slow Flow by Fundus Fluorescein Angiography

Coronary slow flow (CSF) may be a reflection of a systemic slow-flow phenomenon in the coronary arterial tree. In this study, the CSF group consisted of 24 men (77.4%) and 7 women (22.5%). An age- and gender-matched normal coronary artery (control) group was composed of 21 men (72.4%) and 8 women (27.5%). Retinal arteriovenous circulation time was measured using fundus fluorescein angiography as a part of the microcirculation and the circulation time between the antecubital vein and the retina as a part of the systemic circulation in patients with CSF and controls with normal coronary arteries. The mean arm-retina circulation time was 19.0 ± 5.7 seconds in the CSF group and 14.1 ± 3.1 seconds in the control group (p <0.001). The mean retinal arteriovenous passage time was 2.6 ± 0.9 seconds in the CSF group and 2.1 ± 0.7 seconds in the control group (p= 0.001). Strikingly, retinal findings of chronic central serous retinopathy were observed in 3 patients in the CSF group. In conclusion, CSF may indeed be a part of a systemic slow-flow phenomenon. The association of central serous retinopathy with this condition suggests that corticosteroids and the sympathetic system may play important roles in the pathogenesis of the disease by causing or contributing to increases in microvascular resistance and tonus.

Reappraisal of birdshot retinochoroiditis (BRC): a global approach

This study aimed to readjust the appraisal of birdshot retinochoroiditis (BRC) in light of a global approach, including the full array of investigational procedures. This retrospective study reviewed charts of BRC cases treated in the uveitis clinic of our center between 1995 and 2011. We identified 25 patients with BRC; of these, 19 had sufficient data for inclusion in the study. Patients were examined with a standard clinical approach for inflammatory disorders, including dual fluorescence angiography with fluorescein and indocyanine green, perimetry, and laser flare photometry, both at presentation and during follow-up. Spectral optical coherence tomography (OCT) was performed when available. Disease characteristics and evolutionary patterns were reported. Human leucocyte antigen was positive for the A29 allele in all patients. The mean age at presentation was 49.6 ± 10.0 years, the mean diagnostic delay was 21.5 ± 18 months, and the mean follow-up was 85 ± 60 months. Out of 19 patients, three presented with mutton-fat keratic precipitates (KPs), three had no depigmented lesions at presentation, and eight did not fulfill the recommended criterion of three depigmented peripapillar lesions. Cystoid macular edema (CMO) at entry was present in 8/19 cases. Perimetric anomalies were noted in all patients at presentation. In 92 % of cases, fluorescein findings included disc hyperfluorescence, retinal vasculitis of large vessels, and leakage from medium-sized and small vessels. In all patients, a (pseudo)-delay was noted in the arterio-venous circulation time (mean venous dye appearance = 42.1 ± 13.1 s), which reflected massive capillary leakage. At presentation, all patients exhibited indocyanine green angiographic signs, including hypofluorescent dark dots, vessel fuzziness, and areas of diffuse late hyperfluorescence. This allowed early diagnosis in 3/19 patients (16 %) without birdshot fundus lesions at presentation. BRC is a granulomatous uveitis, and mutton-fat KPs do not exclude the disease. When BRC is suspected, indocyanine green angiography is crucial to allow early diagnosis and to monitor the evolution of choroiditis. Perimetry is an obligate investigation for diagnosis and follow-up. CMO is less frequent than stated earlier. Scores of fluorescein and indocyanine green angiographic signs indicated that choroiditis responded readily to therapy, but retinitis was relatively resistant to therapy.

Individualized endovascular treatment of intracranial venous sinus thrombosis

Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis based on individual condition. Methods Twelve patients with intracranial venous sinus thrombosis were treated with endovascular management according to the severity and course of disease after they failed to respond to anticoagulant therapy. The clinical signs and symptoms,cerebrospinal fluid pressure and arteriovenous circulation time were observed and followed up (including MRV). Intravenous thrombolysis and mechanical thrombus maceration were carried out in all 12 patients,while intravenous thrombolysis, mechanical thrombus maceration in combination with intra-arterial thrombolysis were employed in 3. After the treatment, anticoagulant therapy was carried out for 6 months.The patients were followed up for 12 to 24 months. Results Of the twelve patients, clinical signs and symptoms included slight headache (2 cases), mild hemiplegia (1 case), ambiopia or blurred vision (3 cases). The cerebrospinal fluid pressure returned to under 26 cm H2O (1 cm H2O =0.098 kPa)following treatment from 28 to 38 cm H2O [ mean (32. 4 ±3.0) cm H2O] in preoperative measurement and the arteriovenous circulation time returned to below 10 s in all patients following treatment. Neither recurrence of thrombosis nor new symptoms of neurologic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation with the exception of a subcutaneous bleeding at the venopuncture site. Conclusion Endovascular treatment is effective and safe for patients with intracranial venous sinus thrombosis. Key words: Sinus thrombosis, intracranial; Radiology, interventional; Clinical protocols; Individualized endovascular treatment

Effect of Qiming Granule (芪明颗粒) on retinal blood circulation of diabetic retinopathy: A multicenter clinical trial

To objectively assess the effect of Qiming Granule in the treatment of diabetic retinopathy (DR) by fluorescence fundus angiography (FFA). In a multi-center, randomized, parallel controlled clinical trial, patients with DR were randomly assigned to the control group (calcium dobesilate capsule) and the test group (Qiming Granule). Changes in the retinal blood circulation time were recorded by FFA after 3 months of medication. Significant reduction was observed in the retinal arterio-venous circulation time (AVCT) in both groups (P<0.01), the value was 7.635+/-3.149 s before treatment and 5.165 +/-3.382 s after treatment in the treated group, and 7.737+/-3.413 s and 5.313+/-3.472 s in the control group respectively. Qiming Granule also reduced the arm-to-retinal circulation time (ARCT, P<0.05). The value was 17.867+/-3.872 s before treatment and 15.643+/-4.648 s after treatment in the treated group, and 17.217+/-3.833 s and 16.312+/-3.613 s in the control group (P>0.05) respectively. The ARCT in the tested group was reduced, with a statistically significant difference post-medication (P<0.01). As a Chinese medicine complex prescription, Qiming Granule may alleviate retinal hypoxia and ischemia by increasing retinal blood flow and improving the blood circulation.

Contrast-enhanced magnetic resonance angiography: dose the test dose bolus represent the main dose bolus accurately?

ObjectiveTo determine whether the time-intensity curves acquired by test and main dose contrast injections for MR angiography are similar.Materials and MethodsIn 11 patients, repeated contrast-enhanced 2D-turbo-FLASH scans with 1-sec interval were obtained. Both test and main dose time-intensity curves were acquired from the abdominal aorta, and the parameters of time-intensity curves for the test and main boluses were compared. The parameters used were arterial and venous enhancement times, arterial peak enhancement time, arteriovenous circulation time, enhancement duration and enhancement expansion ratio.ResultsBetween the main and test boluses, arterial and venous enhancement times and arteriovenous circulation time showed statistically significant correlation (p < 0.01), with correlation coefficients of 0.95, 0.92 and 0.98 respectively. Although the enhancement duration was definitely greater than infusion time, reasonable measurement of the end enhancement point in the main bolus was impossible.ConclusionOnly arterial and venous enhancement times and arteriovenous circulation time of the main bolus could be predicted from the test-bolus results. The use of these reliable parameters would lead to improvements in the scan timing method for MR angiography.

The optimization of scan timing for contrast-enhanced magnetic resonance angiography.

ObjectiveTo determine the optimal scan timing for contrast-enhanced magnetic resonance angiography and to evaluate a new timing method based on the arteriovenous circulation time.Materials and MethodsEighty-nine contrast-enhanced magnetic resonance angiographic examinations were performed mainly in the extremities. A 1.5T scanner with a 3-D turbo-FLASH sequence was used, and during each study, two consecutive arterial phases and one venous phase were acquired. Scan delay time was calculated from the time-intensity curve by the traditional (n = 48) and/or the new (n = 41) method. This latter was based on arteriovenous circulation time rather than peak arterial enhancement time, as used in the traditional method. The numbers of first-phase images showing a properly enhanced arterial phase were compared between the two methods.ResultsMean scan delay time was 5.4 sec longer with the new method than with the traditional. Properly enhanced first-phase images were found in 65% of cases (31/48) using the traditional timing method, and 95% (39/41) using the new method. When cases in which there was mismatch between the target vessel and the time-intensity curve acquisition site are excluded, erroneous acquisition occurred in seven cases with the traditional method, but in none with the new method.ConclusionThe calculation of scan delay time on the basis of arteriovenous circulation time provides better timing for arterial phase acquisition than the traditional method.

Prolonged retinal arterio-venous circulation time by fluorescein but not by indocyanine green angiography in birdshot chorioretinopathy

Purpose: To compare retinal arterio-venous circulation time by fluorescein (FA) and indocyanine green angiography (ICGA) in birdshot chorioretinopathy. Methods: We analyzed prolonged retinal arterio-venous fluorescein transit time, a known feature in birdshot chorioretinopathy and correlated it with ICGA findings in four consecutive patients. Results: Mean retinal arterio-venous fluorescein circulation time was 31.1 ± 5.2 seconds, a transit time significantly longer than in a group of ten patients with sarcoid-osis (9.45 ± 3.36 sec., p<0.0001) and in a group of three cases with Vogt-Koyanagi-Harada disease (7.0 ± 1,i sec., p<0.0001). Conclusion: Prolonged fluorescein arterio-venous transit time seems to be a characteristic feature of birdshot chorioretinopathy that does however not reflect the actual intravas-cular hemodynamic situation but diffuse blood-retinal barrier damage allow-ing exudation, slow gradual tissue impregnation and delayed venous reab-sorption of small molecules like fluorescein.

Iris atrophy with hypoperfusion and microneovascularisation.

A series of 17 patients with stromal atrophy, hypoperfusion, and microneovascularisation of the iris investigated in the Glaucoma Investigation and Research Unit are described, and their iris angiograms were compared with those of normal irides of patients in the same age group seen in general clinics. In all but one of the 17 cases this iris atrophy was associated with glaucoma or ocular hypertension, which appeared to be secondary to the iris changes. The condition was bilateral and presented a typical slit-lamp appearance, with subtle evidence of microneovascularisation. There was neither history nor clinical evidence of previous trauma, heterochromia, or intraocular inflammation. The commonest form of iris atrophy affected the inner third of the iris stroma in a patchy manner, often with sparing above. However, diffuse atrophy occurred in two cases, and there were two cases of 'senile tears' of the iris. Some accompanying atrophy of the pigment epithelium was usual but less prominent. The changes on fluorescein angiography of the iris included the late appearance of dye with a long arteriovenous circulation time, fewer arteries than normal with sectorial hypoperfusion, leakage of dye from the pupil margin and peripupillary neovascularisation, stromal tufts, and sometimes more complex stromal microneovascularisation. An expanded prominent lesser vascular circle was a common feature of the condition. The condition is bilateral and distinct from other forms of iris atrophy. In all cases the iris changes appeared to be secondary to the vascular hypoperfusion and were not consistently associated with evidence of gross vascular disease. All patients had grey (blue) irides, and this may be an aetiological factor. The condition appears common enough to form a significant group of glaucoma patients and to be a separate clinical entity.

The effects of calcium antagonism on the epicerebral circulation in early vasospasm.

We have studied the effects of the calcium antagonist verapamil on the epicerebral arteriovenous transit time and regional epicerebral circulation of dogs by direct measurement of arterial diameters, fluorescein angiography, and krypton-85 regional epicerebral blood flow analysis. A large craniectomy was performed and vasoconstriction was induced by the subarachnoid injection of human platelet-rich plasma (PRP) pretreated with 25 mu M of ADP to cause maximum aggregation. Once vasoconstriction was established, verapamil (0.1 mg/kg) was topically applied to the perforated arachnoid. The PRP-ADP produced a mean decrease in the arterial diameters of 38.2 +/- 1.6% (p less than 0.01) at 10 minutes after its injection and verapamil produced a mean dilatation of 19.5 +/- 2.5% (p less than 0.01), compared to control values. Regional epicerebral blood flow was 54.9 +/- 3.4 ml/100 g/min in the control state, 34.8 +/- 3.2 ml/100 g/min (p less than 0.01) during vasospasm, and 78.2 +/- 4.5 ml/100 g/min (p less than 0.01) after verapamil. Fluorescein angiography, after verapamil, demonstrated a mean acceleration of the arteriovenous circulation time of 4.5 +/- 0.8 seconds (p less than 0.01) compared to the spasm value. We concluded that the topical application of verapamil can dilate previously constricted cortical arteries and that this dilatation is associated with acceleration of the epicerebral transit time and increased cerebral blood flow.

Clinical-radiological correlation in cerebral venous occlusive disease.

HomeRadiologyVol. 98, No. 1 PreviousNext ArticlesClinical-Radiological Correlation in Cerebral Venous Occlusive DiseaseFrederick S. Vines22, David O. DavisFrederick S. Vines22, David O. DavisAuthor Affiliations Department of Radiology Medical College of VirginiaRichmond, Va. 23219Frederick S. Vines22David O. DavisPublished Online:Jan 1 1971https://doi.org/10.1148/98.1.9MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe clinical and radiological findings in 10 patients with cerebral venous occlusive disease are reported. Headache, confusion, and signs of increased intracranial pressure were the primary findings. Angiographic observations included nonvisualization of the dural sinuses, prolonged arteriovenous circulation time, dilated dural and venous collateral channels, and reversal of collateral flow. In such cases, retrograde jugular venography may show obstruction of the sinuses and intraluminal thrombus formation, confirming the diagnosis. The demonstration of angiographically nonvisualized unusual venous collaterals is also possible by this technique.Article HistoryAccepted: Sept 1970Published in print: Jan 1971 FiguresReferencesRelatedDetailsCited ByThe Neuroradiology Journal, Vol. 35, No. 1Journal of NeuroInterventional Surgery, Vol. 10, No. 8Journal of Thrombosis and Thrombolysis, Vol. 40, No. 3Cerebral Venous and Sinus ThrombosisJournal of Neurosurgery, Vol. 114, No. 1Stroke Research and Treatment, Vol. 2010Journal of Neurosurgery, Vol. 111, No. 1Neurosurgical Focus, Vol. 27, No. 5Neurosurgical Focus, Vol. 27, No. 5Journal of Neurosurgery, Vol. 110, No. 3Journal of Stroke and Cerebrovascular Diseases, Vol. 17, No. 2Journal of Stroke and Cerebrovascular Diseases, Vol. 17, No. 6The Neurologist, Vol. 12, No. 1Arquivos de Neuro-Psiquiatria, Vol. 64, No. 2aDer Radiologe, Vol. 45, No. 5Journal of Neuro-Ophthalmology, Vol. 24, No. 2Journal of Neurosurgery, Vol. 101, No. 2Neuroimaging Clinics of North America, Vol. 13, No. 1Neurosurgery, Vol. 52, No. 3Current Treatment Options in Neurology, Vol. 4, No. 4Clínica e Investigación en Ginecología y Obstetricia, Vol. 29, No. 7Interventional Neuroradiology, Vol. 8, No. 1Current Treatment Options in Cardiovascular Medicine, Vol. 3, No. 5Archives of Physical Medicine and Rehabilitation, Vol. 82, No. 5, Vol. 26Journal of the Royal Society of Medicine, Vol. 93, No. 5Journal of the Royal Society of Medicine, Vol. 93, No. 5CNS Drugs, Vol. 14, No. 6Stroke, Vol. 31, No. 6Stroke, Vol. 30, No. 3Stroke, Vol. 30, No. 3Surgical Neurology, Vol. 49, No. 4Rivista di Neuroradiologia, Vol. 11, No. 4Clinical Neurology and Neurosurgery, Vol. 98, No. 2Journal of Clinical Neuroscience, Vol. 3, No. 2Annals of Neurology, Vol. 38, No. 1The Journal of Pediatrics, Vol. 126, No. 5, Vol. 22European Journal of Neurology, Vol. 1, No. 2Journal of Endovascular Therapy, Vol. 1, No. 1Journal of Endovascular Surgery, Vol. 1, No. 1Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, Vol. 20, No. 2Vascular Medicine Review, Vol. vmr-4, No. 2Stroke, Vol. 24, No. 12Progress in Cardiovascular Diseases, Vol. 34, No. 4Neurologic Clinics, Vol. 10, No. 1Journal of Stroke and Cerebrovascular Diseases, Vol. 2, No. 1Neurosurgery, Vol. 31, No. 5Acta Neurologica Scandinavica, Vol. 86, No. 4Journal of Neurology, Neurosurgery & Psychiatry, Vol. 55, No. 4Neurosurgery, Vol. 31, No. 5Neurosurgical Review, Vol. 14, No. 2Journal of Neurology, Neurosurgery & Psychiatry, Vol. 53, No. 9Journal of Neurology, Neurosurgery & Psychiatry, Vol. 53, No. 9Journal of Neurology, Neurosurgery & Psychiatry, Vol. 53, No. 9Journal of Neurology, Neurosurgery & Psychiatry, Vol. 53, No. 9Stroke, Vol. 21, No. 3Annals of Neurology, Vol. 24, No. 6Journal of Neurosurgery, Vol. 68, No. 2Pediatric Radiology, Vol. 17, No. 3Stroke, Vol. 16, No. 2, Vol. 11The complementary role of angiography and CT in the diagnosis of cerebral sinovenous occlusionThe Italian Journal of Neurological Sciences, Vol. 3, No. 3The American Journal of Medicine, Vol. 73, No. 5Surgical Neurology, Vol. 18, No. 3, Vol. 14 / 1 / 1BAnnals of Neurology, Vol. 3, No. 1Angiology, Vol. 27, No. 12Stroke, Vol. 4, No. 3Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 98, No. 1 Metrics Altmetric Score PDF download