Hicham T. Abada

MDCT of the coronary arteries : Feasibility of low-dose CT with ECG-pulsed tube current modulation to reduce radiation dose

OBJECTIVE The objective of our study was to show the feasibility of coronary CT using low kilovoltage (80 kV) combined with ECG-pulsed tube current modulation in selected patients. CONCLUSION This study showed the combined effect of lowering the kilovoltage setting (80 kV) and using an automatic modulation technique (ECG-pulsed tube current modulation) for coronary CT. Radiation dose exposure can be reduced by up to 88% for slim patients without impairing image quality.

Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft

Purpose: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal stent-graft.Methods: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT).Results: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment, one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after a 6-month follow-up period.Conclusion: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible complications of the disease.

Embolization of Large Aneurysms with Long Wire Coils

The authors report the experience of using long coils of 2 m length in the management of large anuerysms. Knowledge of the characteristics of these coils is of value for correct placement. These coils are safe and cost-effective for excluding large aneurysms.

Interventional Management of Postpartum Hemorrhage

The selective transcatheter technique for embolization of uterine and/or internal iliac arteries in the management of intractable bleeding after delivery is safe and effective. In order to create the best hemodynamic and clinical conditions for this therapy, a strong multidisciplinary collaboration is essential to optimize clinical outcomes.