Ketha, Siva S.

Methods Patient exams were performed under an IRB-approved protocol. Two 3D SWIRLS [3] single phase contrast-enhanced angiographies with 1mm3 spatial resolution were used for this work. Clinical exams were acquired on 3.0 T scanners (GE, DVMR 20.1IB, Milwaukee, WI). Data analysis The angiogram was post-processed using tree analysis and virtual endoscopy modules of Analyze 11.0 software (Analyze 11.0; Biomedical Imaging Resource, Mayo Clinic, Rochester, MN) to fly through the artery. A statistical parameter called Brightness Area Product (BAP) was defined as the sum of the intensities above the sample minimum intensity/threshold set by the user. Results and Discussions Figures (I-IV) show the methodology to fly through the part of anterior carotid artery (ACA) and all statistics of part of the artery (Fig. IV) with angles from the “Root” to its different branches of A1 to G2 (Fig. III). Figure II shows the snap shot of the fly through/internal cross sectional structure of ACA of branch “E2”, at the location marked as “red dot”. Table (IV) represents different statistics including length, angle from the root, area of cross section and the BAP of the branches mentioned in Fig. III. The computation time for this method is < 5 minutes compared to the other reconstruction techniques (>~30 minutes). We proposed a simple and fast automated post-processing method to fly through the artery using Analyze 11.0 software. This technique can be extended to any arteries to monitor internal vasculature and to estimate the stenosis using the statistical parameter BAP, which generates a master profile/database of arteries. References 1 Shu Y, Bernstein MA, ISMRM 2009 p764.

Over 20 years of research has led to the now widely accepted role of cardiac resynchronization therapy (CRT) in medically refractory, mild to severe systolic heart failure (HF) with increased QRS duration. In addition to conferring a mortality benefit, CRT has been shown to reduce HF hospitalization rates and improve functional status in this population. However, not all patients consistently demonstrate a positive response to CRT. Efforts to improve response to CRT have focused on improving patient selection and optimizing device implantation and follow-up, thereby correcting electrical and mechanical dyssynchrony. In this article we review the pathobiology of cardiac dyssynchrony, the rationale for the use of CRT, the history and the state of the art of CRT, and guidelines and recommendations for CRT, while also focusing on the areas of controversy and potential future applications.

We report a case of an abdominal aortic aneurysm (AAA) that underwent inflammatory transformation which we treated medically with corticosteroids. Medical therapy resulted in resolution of presenting symptoms and observed inflammatory changes. We review the clinical features, associated pathology, diagnostic, and therapeutic options in the management of inflammatory AAA.

Thromboangiitis obliterans (TAO), or Buerger's disease, is a nonatherosclerotic segmental vasculitis that affects the small‐ and medium‐sized arteries and veins of the extremities and is strongly associated with tobacco exposure. The immunopathogenesis of TAO remains largely unknown. In the acute phase of the disease, macrophages and occasional giant cells are observed in the characteristic intraluminal thrombus with a relatively mild infiltration of CD4+ and CD8+ T cells and macrophages in the internal lamina. VCAM‐1, ICAM‐1, and E‐selectin expression on the surface of vascular endothelial cells is increased. A variety of circulating autoreactive antibodies targeting endothelial cells and vessel wall components are associated with active disease. One recent report suggests that removal of circulating antibodies by immunoadsorption may decrease disease severity. TAO has been associated positively and negatively with various MHC class 1 and 2 genes; however, genetic testing is not currently used for clinical diagnosis or management. The possible links between tobacco exposure and loss of tolerance for vascular tissues, current management strategy for patients with TAO, and opportunities for translational science are discussed.